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HomeMy WebLinkAbout2021-031-E CJRD-Dispute Settlement Center outside agency agreement DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD OUTSIDE AGENCY 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, 200 South Cameron Street, Hillsborough, North Carolina, 27278, ("County") and Dispute Settlement Center, Inc., a not-for-profit corporation located at 302 Weaver Street, Carrboro,NC 27510 ("Provider"). WITNESSETH: WHEREAS, it is in the interests of the County that said program be assisted by the County and thereby enhance its availability to residents of the County, and said program addresses an important community human services need, as identified by the Board of Commissioners. NOW, THEREFORE, in consideration of the above and the mutual covenants and conditions hereafter set forth,the County and Dispute Settlement Center, 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, as outlined in the attached Outside Agency Funding Application and any amendments or revision thereto which is attached as Exhibit "A" and incorporated by reference, to the residents of Orange County. The Scope of Services and the Program Budget may be different from the original application based on County appropriation; however, any revisions or amendments to this Agreement must be approved in writing by the County and attached to this Agreement as Exhibit"B". b. The Provider shall be solely responsible for the means, methods, techniques, sequence, safety program and procedures necessary to properly and fully complete the work set forth in the Scope of Services. 3. Funding. a. The County agrees to appropriate for the provision of services described in Exhibit B, Scope of Services,the maximum sum of$82,358.00. b. All funds appropriated shall be used for purposes described in Exhibit B. Any funds not used for the purposes stated shall be returned to the County. Any changes in the use of funds must be authorized in writing by the County prior to any expenditure of the funds by the Provider. If the funds are expended not in accordance with the Scope of Services, at the discretion of the County the Provider may be required to repay the funds to the County. c. The Provider shall be paid in four equal installments in the amount of$20,589.50. The first payment is contingent upon receipt of the agency's performance agreement; the remaining payments are contingent upon receipt of the request for reimbursement and related supporting documentation. d. The County's obligation to make the quarterly payments is contingent upon receipt of Progress Reports, which show satisfactory progress toward completion of performance measures and an accounting of expenditures as detailed in the attached Scope of Services. DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD e. Once Provider has satisfied its obligations as provided in (d) payment will be made 21 days after receipt of the Progress Report and Request for Reimbursement or 21 days after due date of Progress Report whichever is later. f. The County is not obligated to provide any other support to Provider in this or in succeeding fiscal years. 4. Agency Reporting. a. Provider will provide Orange County a Progress Report that includes a fiscal report and updates on performance measures as outlined in the Scope of Services. Progress Report dates are: July 1 —December 31; January 1 —March 31 and April 1 -June 30. Reports are due on January 11,April 12, and July 12 of the program fiscal year. b. Provider agrees to allow the County to inspect its financial books and records, which document costs of those services,upon reasonable notice during normal working hours. 5. Termination. a. In the event of any of the circumstances set forth below (hereinafter referred to as "default"), the County may immediately terminate this Agreement, in whole or in part, and from time to time. Notice of termination must be in writing, state the reason or reasons for the termination, and specify the effective date of the termination: i. In the event that Provider shall cease to exist as an organization or shall enter bankruptcy proceedings, be declared insolvent, or liquidate all or substantially all of its assets, or significantly reduce its services or accessibility to Orange County residents during the term of this Agreement; or ii. In the event that Provider shall fail to render a satisfactory accounting as provided section 4 above, the County may terminate this Agreement and Provider shall return all payments already made to it by the County for services which have not been provided or for which no satisfactory accounting has been rendered; or iii. In the event of any fraudulent representation by the Provider in an invoice or other verification required to obtain payment under this Agreement or other dishonesty on a material matter relating to the performance of services under this Agreement. iv. Nonperformance,incomplete service or performance,or failure to satisfactorily perform any part of the work identified in the Scope of Services or to comply with any provision of this Agreement, as determined by the County in its sole discretion. v. Failure to adhere to the terms of applicable county, state or federal laws, regulations, or stated public policy. b. In the event of default by the Provider,the county may elect to terminate this Agreement, in whole or in part and/or require the Provider to repay the funds within ten(10)business days from written notice of default. The County may (but shall not be required to) grant the Provider an opportunity to cure the default without termination of this Agreement. This clause shall not be interpreted to limit the County's remedies in law or in equity. DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD c. Notwithstanding the foregoing, either party may terminate the agreement at any time without penalty; provided that written notice of such termination is furnished to the other party at least 30 days prior to termination. In the event of such termination, any payment due shall be prorated to the date of termination and any unused funds shall be returned to the County within 10 days of termination. d. Any termination of this Agreement for default under this section that is later deemed to be unjustified shall be deemed a termination for convenience. 6. Insurance. a. General Requirements. The Provider shall purchase and maintain, during the period of performance of this Agreement, insurance: i. Worker's Compensation. For protection from claims under workers'or workmen's compensation acts; ii. Comprehensive General Liability Insurance covering claims arising out of or relating to bodily injury, including bodily injury, sickness, disease or death of any of the Consultant's employees or any other person and to real and personal property including loss of use resulting thereof, iii. Comprehensive Automobile Liability Insurance, including hired and non-owned vehicles, if any, covering personal injury or death, and property damage; and iv. Professional Liability Insurance,covering personal injury,bodily injury and property damage and claims arising out of or related to the performance under this Agreement by the Consultant or his agents, consultants and employees. b. Limits of Coverage: Minimum limits of insurance coverage shall be as follows: INSURANCE DESCRIPTION MINIMUM REQUIRED COVERAGE • Worker's Compensation Limits for Coverage A-Statutory State NC&Coverage B -Employers Liability $500,000 each accident, disease policy limit and disease each employee • Commercial General $1,000,000 Each Occurrence Liability $2,000,000 Aggregate • Automobile Liability $500,000 Combined Single Limit • Professional Liability $1,000,000 Each Occurrence $2,000,000 Aggregate c. All insurance policies(with the exception of Worker's Compensation and Professional Liability)required under this Agreement shall name the County as an additional insured party and as a certificate holder. Evidence of such insurance and all correspondence shall be sent to: Orange County Risk Manager Post Office Box 8181 Hillsborough,NC 27278 d. Nothing in this section is intended to affect or abrogate the County's sovereign immunity defenses. DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD 7. Relationship of the Parties. Provider is an independent contractor of the County. Provider represents that they have or will secure, at his own expense, all personnel required in performing the services under this Agreement. Such personnel shall not be employees or have any contractual relationship with the County. All personnel engaged in work under this Agreement shall be fully qualified and shall be authorized and permitted under federal, state and local law to perform such services. 8. Compliance with all Laws. The Provider, at its sole expense, shall comply with all laws, ordinances, orders and regulations of the federal, state or local governments, as well as their respective departments, commissions, boards, and officers, which are in effect at the time of execution of this Agreement or are adopted at any time following execution of this agreement. 9. Subcontract. The County and Provider deem the services provided under this Agreement to be personal in nature and Provider may not subcontract any rights or duties under this Agreement to any other party without prior written consent from the County. 10. Assignment. The Provider shall not assign this Agreement, including the rights to payment, to any other party without the prior written consent of the County. 11. Indemnification. Provider agrees to defend, indemnify, and hold harmless the County, for all loss, liability, claims or expense (including reasonable attorney's fees) arising from bodily injury, including death or property damage, to any person or persons caused in whole or in part by the negligence or willful misconduct of the Provider, except to the extent same are caused by the negligence or willful misconduct of the County. It is the intent of this section to require Provider to indemnify the County to the extent permitted under North Carolina law. Nothing in this section is intended to affect or abrogate the County's sovereign immunity defenses. 12. Non-Appropriation. This Agreement is subject to the availability of funds to purchase the specified services and may be terminated at any time if such funds become unavailable. 13. Non-Discrimination. Provider agrees as part of consideration of the granting of funds by Orange County the parties hereto for themselves,their agents, officials, employees and servants agree not to discriminate in any manner of these basis of race, color, gender,national origin, age, handicap, religion, sexual orientation, familial status or veterans status with reference to any activities carried out by the grantee, no matter how remote. The parties hereto further agree in all respects to conform to the provision and intent of Orange County Civil Rights Ordinance, as amended and the Orange County Non-discrimination Policy. This provision is enforced by action for specific performance, injunctive relief, or other remedy as by law provided; this provision shall be binding on the grantees, the successors and assigns of the parties hereto with reference to the above subject manner. 14. Living Wage. Orange County is committed to providing its employees with a living wage and encourages agencies if funds to pursue the same goal. The County's living wage is $ 14.25 per hour. To the extent possible, Orange County recommends that Dispute Settlement Center, Inc. provide a living wage to its employees. 15. Notice. The Parties hereto agree and understand that written notice, mailed or delivered, to the last known address shall constitute sufficient notice to the County and the Provider. All notices required and/or made pursuant to this Agreement to be given to the County and the Provides shall be in writing and mailed to the party addressed as follows: DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD County: Finance&Administrative Services Provider: Boomerang Youth,Inc. Orange County 825A N. Estes Drive Post Office Box 8181 Chapel Hill,NC 27514 Hillsborough,NC 27278 16. Entire Agreement. This Agreement, including any referenced attachments, constitutes the entire Agreement between the parties and shall supersede, replace or nullify any and all prior Agreements of understandings; written or oral, relating to the matters set forth herein, and any such prior Agreements or understandings shall have no force or affect whatsoever on this Agreement. The County and Provider have read this Agreement and agree to be bound by all of its terms, and further agree that this Agreement constitutes the complete and exclusive statement of the Agreement between the County and Provider. 17. Severability. All clauses found herein shall act independently of each other. If a clause is found to be illegal or unenforceable, it shall have no effect on the other provisions of this Agreement. It is understood by the parties hereto that if any part, term or provision of this Agreement is by the Courts held to be illegal or in conflict with any laws of the State of North Carolina or the United States, the validity of the remaining portions or provisions shall not be affected, and the rights and obligations of the parties shall be construed and enforced as if the Agreement did not contain the particular part,term or provision held to be invalid. a. Governing Law. This Agreement and the duties, responsibilities, obligations and rights of respective parties hereunder shall be governed by the laws of the State of North Carolina. By executing this Agreement Provider affirms that Provider and any subcontractors of Provider are and shall remain in compliance with Article 2 of Chapter 64 of the North Carolina General Statutes. By executing this Agreement Provider certifies that Provider has not been identified, and has not utilized the services of any agent or subcontractor, on the list created by the State Treasurer pursuant to G.S. 147-86.58. 18. Signatures. This Agreement together with any amendments or modifications may be executed electronically. All electronic signatures affixed hereto evidence the intent of the Parties to comply with Article 11A and Article 40 of North Carolina General Statute Chapter 66. IN WITNESS WHEREOF,the Orange County and the Provider have signed this Agreement, effective on the last date this Agreement is signed by both parties as indicated by the dates set forth under signatures below. For �� 9#�4p1f of the Provider f4u411611 . 112 212 021 FrancessfenNe son;Executive Director Date For and 4f.'ofOrange County Government �jbl�t lndt �AaMtMt VS�t t� 1/2 5/2021 Bonnie Hammersley, County Manager Date DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD ORANGE COUNTY—DEPARTMENT USE ONLY Department Party/Vendor Name: Dispute Settlement Center, Inc. Party/Vendor Contact Person: Frances Henderson Contact Phone: 919-929-8800 Party/Vendor Address: 302 Weaver Street City: Carrboro State: NC Zip: 27510 Department: Finance & Administrative Services Amount: $82,358 Purpose: FY 2020-21 Outside Agency/Human Services Performance Agreeement Budget Code(s): 10495050-710015 Vendor# 800060 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract Type: (Check one)New® Renewal ❑ Amendment ❑ Effective Date 7/l/2020 Approved by Board Yes®Nor-1 Agenda Date: 6/16/2020 This agreement is approved as to technical form and cont Do1cluSigned by: Department Director's Signature r,AAbL � Date: 1/22/2021 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 sufficiency of insuran RPAffldSd Vecci�ifications,and requirements: Q�tSa rbvvulTb 1/23/2021 Office of the Risk Management Officer 7FncFanaann4oa Date: Financial Services This instrument has been pre-audited in the marine rlq �e Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officer Date:1/23/2021 Legal Services This agreement is approved as to legal form io : Office of the County Attorney hw— Date: 112512021 Clerk to the Board Received for record retention: All Docusign contracts must be copied to Allen Coleman upon completion @ acolemankorangecountync.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: DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD Exhibit A Provider's Outside Agency Application DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD Exhibit B Provider's Revised Scope of Services and Program Budget DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD ATTACHMENT "A" Orange County Certifications—FY 2020-21 Outside Agency Performance Agreement Chief Contact,Administrators,Chief Executive Officer and Chief Financial Officer I certify that I have provided a list of the chief contact, administrators, chief executive officer and chief financial officer for my agency with this Agreement and that I will keep it current to the County of Orange. The list should be in writing with the name,title,residential address;phone and email address and if possible, fax number. Officers and Board of Directors I certify that I have provided a current list of the Officers and Board of Directors with this Agreement and that we will continue to update the list as changes occur. The list should be in writing,with the name, physical address,mailing address and if possible,phone, fax and email address. Budget Submission I certify that I have provided a budget for the period to be covered by funding Orange County, and that any substantive changes made to this budget have been in advance authorized in writing by Orange County. Annual Financial Review I certify that I have provided a copy of the latest annual Financial Review for our agency and the budget adopted by the agency for the fiscal years encompassing this Agreement. If not,please explain on a separate sheet of paper. Alignment with Organization's Mission I certify that the programs and services for which this funding is requested align with the mission of the organization. Intended Purpose I certify that the funds provided to the agency under the terms of this Agreement will be used for a public purpose and shall only be used for the purposes intended and any money not used for those purposes will be promptly returned to Orange County. DocuSigned by: EF •u� fit"C"ay 1/22/2021 Certified by: a5cosaaeW124ca... Title: Executive Di rbsffr. (Provider's Signature) DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD COVER PAGE Applicant Contact Information Applicant Organization's Legal Name: Dispute Settlement Center Inc. Applicant Organization's Physical Address: 302 Weaver Street Carrboro NC 27510 Applicant Organization's Mailing Address: same Applicant Organization's Web Address: www.disputesettlement.org Executive Director: Frances Henderson Telephone Number: (919) 929-8800 E-Mail:fhenderson dis utesettlement.or Tax ID Number: F56-1216584 Funding Request Please list all Fiscal Year 2021 Human Services (HS)funding requested for all programs and the proposed use of funds (please list program name only) Program Carrboro- HS Chapel Hill- Orange Total HS County-HS Mediation, Conciliation, and referral $10,000 $16,000 $92,000 $118,000 of Interpersonal Disputes Operations Personnel Personnel Totals Briefly explain your proposed use of funds: For provision of mediation, conciliation and referral services for a wide variety of interpersonal disputes referred from Criminal District Court, and divorce, Medicaid, neighborhood, business or workplace disputes. Court-referred cases are provided without charge. Family/divorces cases have a sliding scale fee. Services include conflict coaching and referral as well as mediation. To the best of my knowledge and belief all information and data in this application is true and current. The document has been duly authorized by the governing board of the applicant. Signature: /- I- , (� J Executive Director Date F Signature: Boar Chairperson Date �' 6 of 23 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD DISCLOSURE OF POTENTIAL CONFLICTS OF INTEREST AND NON DISCRIMINATION CLAUSE Are any of the Board Members or employees of the agency which will be carrying out this program or members of their immediate families, or their business associates. YES NO ❑ �. a) Employees of or closely related to employees of the Town of Carrboro, the Town of Chapel Hill, or Orange County? ❑ b) Members of or closely related to members of the governing bodies of the Town of Carrboro, the Town of Chapel Hill, or Orange County? ❑ c) Current beneficiaries of the program for which funds are being requested? ❑ 5q d) Paid providers of goods or services to the program or having other financial interest in the program? If you have answered YES to any question, please provide a full explanation below. NON-DISCRIMINATION Provider agrees as part of consideration of the granting of funds by funding agencies to the parties hereto for themselves, their agents, officials, employees and servants agree not to discriminate in any manner of these basis of race, color,gender, national origin, age, handicap, religion, sexual orientation, gender identity/expression,familial status orveterans status with reference to any activities carried out by the grantee, no matter how remote. The parties hereto further agree in all respects to conform to the provision and intent of Orange County Civil Rights Ordinance, as amended and the Orange County Anti-discrimination Policy. This provision is enforced by action for specific performance, injunctive relief,or other remedy as by law provided;this provision shall be binding on the grantees,the successors and assigns of the parties hereto with reference to the above subject manner. To the best of my knowledge and belief all of the above information is true and current. I acknowledge and understand that the existence of a potential conflict of interest does not necessarily make the program ineligible for funding, but the existence of an undisclosed conflict may result in the termination of any grant awarded. Signature: ecutive Dire Date Signature: /V) 9 k Board,Chairpers Date DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD AG�NCY'INF©RMATIt)N Please provide the following information about your agency: 1. Date of Incorporation (Month/Year):September-1978 2. Agency's Purpose/Mission (no more than a few sentences): "To promote and bring about the peaceful settlement of disputes and prevent the escalation of conflict through mediation, conciliation, facilitation, and training." Programs include Mediation, Training, Facilitation, and Restorative Practices. Program Service Requested Here; Mediation, conciliation and referral: We provide relief for community members struggling with interpersonal conflict, through conflict coaching, encouragement to reconciliation, appropriate referrals, and when screened and voluntarily agreed upon, mediation. People call, email, and come by with a wide variety of issues. Working with them takes time and skill, and this is not reflected in just the mediation numbers. With this application we are seeking support of the full program effort to encourage interpersonal resolutions, and getting people referred to the right service. This "calming effect" is behind the scenes but essential to a healthy community. Pre-Arrest Diversion Pilot Program (OC-PAD) was initiated in February 2019 for certain low-level misdemeanor adult first offenders. OC-PAD provides law enforcement officers the discretion to divert individuals who commit eligible low-level misdemeanor offenses from the criminal justice system and to provide them with accountability processes. The goal is to increase community safety and well-being by offering earlier and direct access to interventions, programming and education. Dispute Settlement Center is a partner in this Program and stands ready to assist with referrals to our Restorative Processes Program. (Possible) Restorative Justice for appropriate felony cases. We also stand ready to assist the Orange County justice system by providing Restorative Justice support for appropriate felony cases, as screened and referred by the DA and defense bar. As of this writing, we have had an initial meeting with DA Woodall to explore a possible case. This has been done in Durham and Asheville, and we are equipped to do it here, with the right cases. We would assign Val Hanson, JD, Restorative Practices Director to handle such cases. Please provide a brief description of your organization's past achievements in carrying out similar projects and evidence of successful record of meeting proposed budgets and timetables (no more than 100 words). For 40+ years we've provided mediation for court and community-referred disputes. Founded with the assistance of the Orange County BOCC, DSC provides mediation and conciliation services in Criminal District Court, sliding scale family mediations and provision of Medicaid Appeals mediations as well as consultation, conciliation coaching, and referral in addition to mediations held for neighborhood, business, workplace, eldercare, and Special Education. DSC has an over 80% mediation success rate. Until FY20, we requested support Program information Page 9 oil 22 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD from the Towns for youth programming. We request support for consultation, conciliation, referral and mediation and partnering with OC-PAD and potentially offering Restorative Justice for felonies. 3. Living Wage: Does this agency pay permanent employees a minimum living wage?YES if yes,is this agency an Orange County Living Wage Certified Employer?YES.,.,,,,..... If no, please briefly explain. Schedule of Positions: #of FTE—Full-Time Paid Positons: 6 #of FTE--Part-Time Paid Positions: 1 hRO ItANt INFOR1llIAT1©fit Please subrnror each prrgrrrrr� crpplY�ng for�unrimg for more than one pragr�rm. S. Program Name: Mediation, Conciliation and Referral of Interpersonal Disputes Program Primary Contact and Title: Frances Henderson, Executive Director Telephone Number: 919 929-8800 ext 11 E-Mail:fhenderson@disputesettlement.org 6. Please briefly describe the proposed program, including an explanation of how it aligns with the Town of Chapel Hill and Carrboro s Results Framework and Orange County BOCC Goals and Priorities, and the target ,. , , ,,...,,.,.,, population to benefit from the program. (100 words or less) Target population: Those experiencing conflicts in family, work and community. Unresolved or poorly handled conflicts have public health consequences from stress to interpersonal violence. We offer conflict coaching, conciliation, mediation, and appropriate referrals through phone or in-person consultation, Medicaid referrals, and in Criminal District Court. Chapel Hill and Carrboro: Strategic Objective 2: Residents Increase their livelihoods security, through knowledge of appropriate social services, completed referrals, and receipt of legal information, services, or referral. Orange County: Supports "Ensure a community network of basic human services and infrastructure that maintains, protects, and promotes the well-being of all county residents." In addition to regular service in Criminal District Court, we partner with Orange County Pre- Arrest Diversion Program and are working with the DA to consider Restorative Justice diversion for appropriate felonies. Frogn@ 1 inforniat10)i P « g e 10 o f 23 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD 7.Target Population: Please complete the table below with numbers(not percentages) of individuals served and projected to be served. Program;Far et;Population Gemographi.cs...> - Projected Actual Projected Projected 2018-19 2018-19 2019-20 2020-21 Gender Men 450 460 Women 390 400 Nonbinary/Genderqueer 10 15 Self-Describe Total 624 609 850 875 nc._itRaandEth . ..._ .. _.._. _ ..a_ ..,.. ...... Black or African-American 245 260 American Indian or Alaska Native Asian 30 35 White 555 550 Native Hawaiian or other Pacific Islander Two or more races Some other race 20 30 Total 624 609 850 875 Of the above, how many Hispanic/Latino 20 30 Of the above, how many non-Hispanic/Latino 830 845 Total 624 609 850 875 �e 0-5 years 6-18 years 19-50 years 51+years Total 624 609 850 875 Geographic Location .�____ . _..__. . .....,...� • - Town of Chapel Hill 240 260 Town of Carrboro 130 155 Orange County(Outside of Chapel Hill/Carrboro) 180 190 Outside of Orange County 300 270 Total 0 0 850 875 Income Low-income(80%of the Area Median Income and Below) Please see income table in the attachments Total 0 0 0 0 Program information P a g e 1 1 o f 2 3 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD 8. Cost Per Individual This cost per individual must reflect the total program budget divided by the total number of program individuals in this application. _.; xtualt?18"-1 Rl�oecied0't9 2�3, Prjrcted 2020 Z'l Total Cost of Program 125,947 142,200 146,000 Total f# of Individuals 609 850 875 Cost Per Individual 207 167 167 9. Performance Indicators For Chapel Hill and Carrboro applicants: Please complete the following chart with information about the 5trategic Objective, Intermediate Result, and the Agency Performance Indicator for each program for which you are applying for funding. Please see the Results Framework in the Attachments section as a reference. Program Name: Strategic ❑ Children improve their educational outcomes Objective (please choose one from X Residents Increase their livelihood security the Results Framework) ❑ Residents improve their health outcomes Intermediate Insert Intermediate Result here. Result (please choose onefrom Residents access the most a the Results Framework) ppropriate social safety net services. RFSU�TS Actual Projected Protected f znt.s �.� zaxg zo 2n7az�. Performance Insert Performance Indicator here. Services:609 Services:650 Services:700 Referrals:unk. Referrals: 180 Referrals:150 Indicators Number of individuals who receive OC-PAD:n/a OC-PAD:20 OC-PAD (Please choose at least legal information,mediation or and RJ: 25 one performance Restorative Justice/Accountability 609 850 indicator to report on services,or referral. from the Results 875 Framework,and aeld additional performance indicators that you would like to report to the Towns. Please Program informatinr page 12 of 23 ........ ................ . . . ........................................................ DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD ORANGE COUNTY NOR "* .e A I Outside Agencies/Human Services Please use the drop down menu below to select which function area best aligns with your agency and program(s) in which you are requesting funding. Please select only one from the drop down menu below. Juvenile and Adult Justice Services If you selected other, please tell us what function area best aligns with your organization: Please indicate three program goals/performance measures below. A few notes: • If you use percentages, please put the actual number equivalence. • Please ensure your performance measures are outcome based and not outputs. Citiizens"will receive iinfarmation A out`comm inity. Program foal`# 1 resources for dispute resolution andlor new strategies for solving mteirpersvnal co,"nflicts on their own and be better able to meet theirneeds reduen fii` h#in anti distress, We will MaintaiiGi trained staff id`oiir office wil Performance Measure', answer phone,eml, and walk4n requests for assistance, Haw will you accantplrsh yaurgaal?) and as requested,suggest strategies for c©ticiLation, and `' � ;= : will xecord.demo ra'`hies,. Actual;Results tOutcome) Endi7k.TP, :.19 . . . . Pralected Results 1$0 people wail receive information,referral, or {Outcome) conciliation ideas firam trained mediation staff. n`d' ,FY2020 Pro�ectd Results AMpe©plc will receive information,referral; air (Outcome) conciliation ideas from trained mediattion staff. Citizens with neighborhood,famil ,business,school er y ! Pre rain Coo Mecl><caid rtisputes and#hose'referred from Criminal; g l#2 ; nistrict Court receive an o ortiini " for mediation with roT pp arain�ed mediator_or inediatois 'erformance Measure ?Ve will maintain a team of staff and volunteer me in ors (�`afv1��vFll you accumplrsh,yortr gaQlP) trained in the particular areas and will make them available for <ntake aiitd caiiit` letiian of cases.Pram tlAe Program information P a g e 14 of 23 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD ORANGE COUNTY NUIX 1-1 CAROLINA Outside Agencies/Human Services communiy and from coin,with pra�eted iresolutxon , rate of aver 8U"/o £or cases mediated and will reor� . resits,and dcatac� ra h><cs := .. . . ,. Actual"Results _ (Uutcome)' Eridt`ng' YI&I9 PxUJeEteEl Results 6S0 {Outcome} Parolected Results 704 �Q1itC8�e� End�i" ;FY2021 .. ` 4rauge C�urity 're t rres �venn andadul> Felony is Pr+r�gram G��I�3 � �e�to tt�e rushee�C�hzens rel'er��d by law enorccmen#for acevuntabll�ty se ><ces u�lcludutg 'v fx".�-.h'sa`� -"�r`y 3 "" rx-�": s ✓-. .s : �„: `^ r� 4. r"'✓ f 6 rr tFy .°.�"h'9F �"".Y`-'? ,,,'r.l`=z�- LV�'iJ�L.lR�47 �k�T�4RV'�►iR..i�A�L{4�.�1�t� r�f✓��/.iw7 R...i� YCU3'i1CiT4�4 .� lC" 'flCeS 111,e3 CitB S. ., a a. & '"s. � a.,F � �- _ ,yb i",.s `r• vT> xF ''s` dr � -- �a Y r -. 9 � j 4 �-n�a xo ms not�y+et estal�� `� j Prflectetl Results 20 (d+ependent on ar9Px><ate xeferrals fr©fin court _: s ✓is 'P�'c�jecferl Res{ults �5��epend�nt�gn,�ap�rc�pr�ate ret'�rra7s�ri>rzn court] 'Y (Outcome) ,f ry , Program information P a g e 1 5 o f 2 3 ................ .... ....................... ... .......... .. DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD Agency Budget Operating Budget for Program PROGRAM NAME Dispute Settlement Center FY21 Actual Estimated Projected PROGRAM REVENUE 2018-19 2019-20 2020-21 Private Donations $ 35,082 $ 85,000 $ 56,000 Program Generated Revenue $ 239,001 $ 265,000 $ 292,000 Local Government Grants: Human Services -Town of Carrboro $ 8,000 $ 7,200 $ 10,000 Other-Town of Carrboro $ - $ - Human Services -Town of Chapel Hill $ 14,000 $ 14,000 $ 16,000 Other-Town of Chapel Hill $ - $ - $ - Human Services - Orange County $ 81,850 $ 82,358 $ 92,000 Other- Orange County $ 12,144 $ 13,718 $ 16,500 Other- Town of Hillsborough $ - $ - $ - Other Government Grants Oln Triangle United Way $ 959.00 $ 950.00 $ 900.00 State Government $ 42,087.00 $ 45,727.00 $ 55,000.00 Federal Government (CDBG/HOME/etc.) $ - $ - $ - Private Foundation Grants $ 78,930.00 $ 80,000.00 $ 80,000.00 Other Revenue $ 840 $ 800 $ 1,600 Total Program Revenue $ 512,893 $ 595,653 $ 620,000 PROGRAM EXPENSES Compensation $ 415,371 $ 518,903 $ 547,500 Rent& Utilities $ 13,194 $ 11,000 $ 12,000 Supplies & Equipment $ 18,935 $ 22,500 $ 18,000 Travel &Training $ 8,841 $ 10,900 $ 11,500 Other Expenses: $ 20,677 1 $ 29,550 1 $ 31,000 Total Program Expenses $ 477,018 $ 592,853 $ 620,000 SURPLUS/(DEFICIT) FOR PERIOD: $ 35,875 $ 2,800 $ - Please explain Other Grants Orange County provides a 30% (required) match to DPS-JI We raised additonal private funds during FY20 which was Does your program budget show a surplus or deficit? Please provide a brief explanation for the surplus or FY19 showed a surplus which we needed for maintaining our reserve funds as we grew. FY19 and equipment upgrades. This is part of our Four-Year Plan. DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD Program Budget Operating Budget for Program PROGRAM NAME Mediation, Conciliation, and Referral of Interpersonal Disputes Actual Estimated Projected Percent PROGRAM REVENUE 2018-19 2019-20 2020-21 Change Private Donations $ 13,000 $ 10,000 $ 5,000 -50% Program Generated Revenue $ 21,777 $ 23,000 $ 23,000 0% Local Government Grants: Human Services -Town of Carrboro $ 7,200 $ 10,000 39% Other-Town of Carrboro $ - $ - $ - 0 Human Services -Town of Chapel Hill $ 14,000 $ 16,000 14% Other- Town of Chapel Hill $ - $ - $ - 0 Human Services - Orange County $ 81,500 $ 82,358 $ 92,000 12% Other- Orange County 0 Other-Town of Hillsborough $ - $ - $ - 0 Other Government Grants Triangle United Way $ - $ - $ - 0 State Government 0 Federal Government (CDBG/HOME/etc.) $ - $ - $ - 0 Private Foundation Grants $ 5,000.00 $ 5,000.00 $ (1.00) Other Revenue $ - $ - 0 Total Program Revenue $ 121,277 $ 141,738 $ 146,000 3% PROGRAM EXPENSES Compensation $ 109,510 $ 116,500 $ 123,600 6% Rent& Utilities $ 3,298 $ 4,000 $ 4,000 0% Supplies & Equipment $ 4,733 $ 8,800 $ 5,000 -43% Travel &Training $ 3,237 $ 4,000 $ 4,400 10% Other Expenses: $ 5,169 1 $ 8,900 1 $ 9,000 1 1% Total Program Expenses $ 125,947 1 $ 142,200 1 $ 146,000 1 3% SURPLUS/(DEFICIT) FOR PERIOD: 1 $ (4,670) $ (462) 100% Please explain Other Grants Private Foundation grant supporting mediation. During FY20, we were able to raise additional funds as it was our 40th Anniversary. Does your program budget show a surplus or deficit? Please provide a brief explanation for the surplus or deficit. The program has had slight deficits. We have made modest requests for increases for this reason, as well as growth in the program, and increased costs. FY 2018-19 Program Budget DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD Chubb CSI 82 Hopmeadow Street P.O. Box 2002 Simsbury, CT 06070-7683 Phone: (860) 408-2000 Fax: (860) 408-2002 Lisa R Downey MARSHALL & STERLING UPSTATE, INC. 300 RT. 23 B LEEDS, NY 12451-0909 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD CHUBBm August 20, 2020 Quotation Worksheet To: Account Number: 435072 Account: Dispute Settlement Center 302 Weaver Street Carrboro, NC 27510 In care of: Producer Contact: Lisa R Downey Producer: MARSHALL&STERLING UPSTATE, INC. 300 RT. 23 B LEEDS, NY 12451-0909 Licensed Producer: Frank S. Maranto, Jr Chubb Contact: Kelly Merce 860 408-2594 Kelly.Merce Chubb.com Product: Forefront Portfolio for Not-For-Profit Organizations Writing Company: Federal Insurance Company Policy Form: 14-02-10190 (Ed. 11/2004) Expiring Policy: 8179-7950 Policy Period: From: October 30,2020 To: October 30, 2021 At 12:01 A.M. local time at the address in Item 1. Chubb Group Of Insurance Companies 82 Hopmeadow Street 860.408.2000 P.O. Box 2002 Fax 860.408.2002 Simsbury, CT 06070-7683 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD Coverage is only available for the following if indicated by an "X" _x_ Directors&Officers Liability and Entity Liability _x_ Employment Practices Liability Fiduciary Liability Crime Special Coverage LIABILITY COVERAGE SECTIONS Option 1 Combined Maximum Aggregate Limit of Liability for Claims each Policy Year: X Yes No Combined Maximum Aggregate Limit:$1,000,000 Applicable to: X Directors&Officers Liability and Entity Liability X Employment Practices Liability Fiduciary Liability Extended Reporting Period: Additional Period: 1 year Additional Premium: 100%of Annual Premium Chubb Group Of Insurance Companies 82 Hopmeadow Street 860.408.2000 P.O. Box 2002 Fax 860.408.2002 Simsbury, CT 06070-7683 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD Directors&Officers Liability and Entity Liability Coverage Section Option 1 (A)Maximum Aggregate Limit of Liability for this Coverage Section for all Claims each Policy Year: $1,000,000 (B)Sublimit for all Excess Benefit Transaction Excise Tax: $100,000 Retention Amounts: D&O Insuring Clause 1 $0 D&O Insuring Clause 2 $1,000 D&O Insuring Clause 3 $1,000 Pending or Prior Litigation Date: October 30, 2000 Defense Outside the Limits of Liability _ Yes X No Endorsements applicable Only to Directors&Officers Liability and Entity Liability Coverage Section: 14-02-10357(10/04 ed.) North Carolina Amendatory Endorsement to the Directors and Officers Liability and Entity Liability Coverage Section 14-02-11271(6/05 ed.) Professional Services Exclusion Endorsement 14-02-11407(11/05 ed.) Absolute Breach of Contract Exclusion Endorsement 14-02-11469(11/07 ed.) Amend Definition of Loss Endorsement 14-02-11692(8/10 ed.) Amended Exclusion 5 c Endorsement 14-02-12609(11/06 ed.) Amend Definition of Loss to Include Coverage for Multiplied Damages Endorsement 14-02-13664(5/08 ed.) Whistleblower Endorsement (The titles and headings are for convenience only. Please refer to the policy and endorsements for a description of coverage.) Chubb Group Of Insurance Companies 82 Hopmeadow Street 860.408.2000 P.O. Box 2002 Fax 860.408.2002 Simsbury, CT 06070-7683 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD Employment Practices Liability Coverage Section Option 1 (A)Maximum Aggregate Limit of Liability for this Coverage Section for all Claims each Policy Year: $1,000,000 (B)Sublimit for all Third Party Claims each Policy Year under Insuring Clause 2- Third Party Liability: $1,000,000 Retention Amounts: EPL Insuring Clause 1 -Employment Practices Liability Coverage $5,000 EPL Insuring Clause 2-Third Party Liability Coverage $5,000 Pending or Prior Litigation Dates: EPL Insuring Clause 1 - Employment Practices Liability Coverage October 30,2000 EPL Insuring Clause 2-Third Party Liability Coverage October 30,2000 Defense Outside the Limits of Liability _ Yes X No Endorsements applicable Only to Employment Practices Liability Coverage Section: 14-02-10358(10/04 ed.) North Carolina Amendatory Endorsement to the Employment Practices Liability Coverage Section 14-02-12614(11/06 ed.) Amend Insured Person Definition Endorsement 99-10-0769(9/04 ed.) Notice to Purchasers of Employment Practices Liability Coverage or Fiduciary Liability Coverage (The titles and headings are for convenience only. Please refer to the policy and endorsements for a description of coverage.) Chubb Group Of Insurance Companies 82 Hopmeadow Street 860.408.2000 P.O. Box 2002 Fax 860.408.2002 Simsbury, CT 06070-7683 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD GENERAL TERMS AND CONDITIONS Endorsements applicable to all Coverage Sections: Applicable to Option#1 10-02-1295(6/07 ed.) Important Notice to Policyholders 14-02-10356(10/04 ed.) North Carolina Amendatory Endorsement to the General Terms and Conditions Section 14-02-11575(11/05 ed.) Amend Subsection 19 Representations and Severability Endorsement 14-02-12049(5/06 ed.) Amend Definition of Organization Endorsement 14-02-14230(5/08 ed.) North Carolina Amendatory Endorsement Regarding the Application 14-02-22814(12/17 ed.) CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM 14-02-23030(5/18 ed.) Notice of Loss Control Services (The titles and headings are for convenience only. Please refer to the policy and endorsements for a description of coverage.) ForeFront Portfolios""for Not-For-Profit Organizations General Terms and Conditions Section -Form# 14-02-10190 Liability Coverage Sections Directors&Officers Liability and Entity Liability Coverage Section -Form#14-02-10191 Employment Practices Liability Coverage Section - Form# 14-02-10192 Chubb Group Of Insurance Companies 82 Hopmeadow Street 860.408.2000 P.O. Box 2002 Fax 860.408.2002 Simsbury, CT 06070-7683 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD PREMIUM SUMMARY: Option 1: $813. Directors&Officers Liability and Entity Liability $892. Employment Practices Liability $1,705. POLICY TOTAL Option Information: POLICY COMMISSION: 20% BILLING TYPE: Direct Bill CONTINGENCIES: The above quote is expressly contingent upon receipt, review and acceptance of the subjectivities listed below. We must receive all of the items identified below on or before the Quotation Expiration date shown below. If all of these items are not received and approved by us on or before this date,this quote will automatically expire without further action or notice. Nothing is required at this time. IMPORTANT The foregoing quotation for coverage is subject to modification or withdrawal by the Company if, before the proposed inception date, any new, corrected or updated information becomes known which relates to any proposed Insured's claims history or risk exposure or which could otherwise change the underwriting evaluation of any proposed Insured, and the Company, in its sole discretion, determines that the terms of this quotation are no longer appropriate. This proposal does not apply to the extent that trade or economic sanctions or other laws or regulations prohibit us from offering or providing insurance. To the extent any such prohibitions apply,this proposal is void ab initio. Quotation Expiration: October 30,2020 Notes: If you have any questions, please call me at(860)408-2594 Kelly Mercey Underwriter Fax Number: (555)555-5555 Email Address: Kelly.Mercey@Chubb.com Chubb Group Of Insurance Companies 82 Hopmeadow Street 860.408.2000 P.O. Box 2002 Fax 860.408.2002 Simsbury, CT 06070-7683 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD CHUBB® OFFEREE DISCLOSURE NOTICE OF TERRORISM INSURANCE COVERAGE (new policies and renewals with no terrorism exclusion or sublimit and no premium charge) Insuring Company: Federal Insurance Company You are hereby notified that, under the Terrorism Risk Insurance Act (the "Act") effective December 26, 2007, we are making available to you insurance for losses arising out of certain acts of terrorism. The policy you are purchasing already includes insurance for such acts. Terrorism is defined as any act certified by the Secretary of the Treasury, in concurrence with the Secretary of State and the Attorney General of the United States, to be an act of terrorism; to be a violent act or an act that is dangerous to human life, property or infrastructure; to have resulted in damage within the United States, or outside the United States in the case of an air carrier or vessel or the premises of a United States Mission; and to have been committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. You should know that the insurance provided by your policy for losses caused by acts of terrorism is partially reimbursed by the United States under the formula set forth in the Act. Under this formula, the United States pays 85% of covered terrorism losses that exceed the statutorily established deductible to be paid by the insurance company providing the coverage. However, if aggregate insured losses attributable to terrorist acts certified under the Act exceed $100 billion in a Program Year (January 1 through December 31), the Treasury shall not make any payment for any portion of the amount of such losses that exceeds $100 billion. If aggregate insured losses attributable to terrorist acts certified under the Act exceed $100 billion in a Program Year (January 1 through December 31) and we have met our insurer deductible under the Act, we shall not be liable for the payment of any portion of the amount of such losses that exceeds $100 billion, and in such case insured losses up to that amount are subject to pro rata allocation in accordance with procedures established by the Secretary of the Treasury. The portion of the offered policy's annual premium that is attributable to insurance for acts of terrorism is: $ -0-. If you have any questions about this notice, please contact your agent or broker. DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD IMPORTANT NOTICE TO POLICYHOLDERS Insuring Company:<CARRNAME> All of the members of the Chubb Group of Insurance companies doing business in the United States(hereinafter "Chubb")distribute their products through licensed insurance brokers and agents("producers"). Detailed information regarding the types of compensation paid by Chubb to producers on US insurance transactions is available under the Producer Compensation link located at the bottom of the page at www.chubb.com,or by calling 1-866-588-9478. Additional information may be available from your producer. Thank you for choosing Chubb. 10-02-1295 (ed. 6/2007) DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD ENDORSEMENT <COVSECT> Effective date of this endorsement: <TRXEFFDATE> Company: <CARRNAME> Endorsement No. <EN> To be attached to and form a part of Policy No. <POLICYNO> Issued to: <ACCTNAME> NORTH CAROLINA AMENDATORY ENDORSEMENT TO THE GENERAL TERMS AND CONDITIONS SECTION In consideration of the premium charged, it is agreed that: 1. Subsection 4.Extended Reporting Period of the General Terms and Conditions Section is amended to read as follows: "(a) If any Liability Coverage Section is either terminated or not renewed for any reason other than nonpayment of premium,any Insured shall have the right to purchase an Extended Reporting Period for the period set forth in Item 5(A)of the Declarations of these General Terms and Conditions,which period shall be one(1)year or such other period of time as agreed upon by the Company and the Insured. The Insured shall have the option of purchasing the Extended Reporting Period: 0) with a limit of liability that is part of,and not in addition to,the Company's maximum aggregate limit of liability for all Loss on account of all Claims first made during the immediately preceding Policy Year;or (ii) with a limit of liability that is equal to,and in addition to,the Company's maximum aggregate limit of liability for all Loss on account of all Claims first made during the immediately preceding Policy Year(the"reinstated limit"). The right to purchase an Extended Reporting Period shall lapse unless written notice of the desired Extended Reporting Period, together with payment of the additional applicable premium due, is received by the Company within thirty(30) days after the end of the Policy Period. Such notice must state if a reinstated limit of liability is desired. If such notice does not state that a reinstated limit of liability is desired, the limit of liability for the Extended Reporting Period shall be part of, and not in addition to, the Company's maximum aggregate limit of liability for all Loss on account of all Claims first made during the immediately preceding Policy Year. (b) If the Extended Reporting Period is purchased, then coverage otherwise afforded by such Liability Coverage Section will be extended to apply to Loss from Claims first made during such Extended Reporting Period but only for Wrongful Acts committed 14-02-10356 (ed. 10/2004) Page 1 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD or allegedly committed before the end of the Policy Period or the date of any conversion of coverage described in Subsection 9, 10 or 11 of these General Terms and Conditions, whichever is earlier. The amount of the premium for the Extended Reporting Period is the amount set forth in Item 5(B) of the Declarations of these General Terms and Conditions, unless the Insured elects a reinstated limit, in which case the premium for the Extended Reporting Period shall be adjusted upward. The entire additional premium for the Extended Reporting Period shall be deemed fully earned at the inception of such Extended Reporting Period. No coverage will be available under this Policy for Loss from Claims made during an Extended Reporting Period based on, arising out of, directly or indirectly resulting from, in consequence of, or in any way involving any fact, circumstance, situation, transaction, event, Claim or Wrongful Act: (i)underlying or alleged in any prior and/or pending litigation as of the termination date of this Policy; or(ii)which has been the subject of any notice given before the termination date under any policy of insurance, including this Policy." 2. Subsection 17. Termination of Policy or Coverage Section(a) of the General Terms and Conditions Section is amended by adding the following at the end of such paragraph (a): "provided that,non-renewal by the Company is effective only if the Company mails or delivers at least forty- five(45)days advance written notice of non-renewal to the Organization at the address last known to the Company,stating the reason(s)for non-renewal,with a copy to the mortgagee or loss payee and the agent or broker of record,if any;" 3. Subsection 17. Termination of Policy or Coverage Section of the General Terms and Conditions Section is amended by adding the following at the end of such Subsection: "Notice of termination by the Company will state the effective date of,and the reason for,such termination and will be mailed or delivered to the Organization at the address shown on this Policy,with a copy to the agent or broker of record,if any,and to the mortgagee or loss payee,if any. Proof of mailing is sufficient proof of notice of any termination or non-renewal by the Company. Within forty-five (45) days after receipt of a written request from the Organization, the Company will mail to the Organization loss information respecting its account for the past three (3) years, which information shall include,but not be limited to, aggregate information on total open and closed Claims (which shall include the date, description of occurrence, and amount of payments) and information on any notice of occurrence." The Policy will be deemed to have been amended to the extent necessary to effect the purposes of this Amendatory Endorsement. 14-02-10356 (ed. 10/2004) Page 2 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD The regulatory requirements set forth in this Amendatory Endorsement shall supersede and take precedence over any provisions of the Policy or any endorsement to the Policy, whenever added, that are inconsistent with or contrary to the provisions of this Amendatory Endorsement,unless such Policy or endorsement provisions comply with the applicable insurance laws of the state of North Carolina. All other terms, conditions and limitations of this Policy shall remain unchanged. <ENDSIG> Authorized Representative 14-02-10356 (ed. 10/2004) Page 3 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD ENDORSEMENT <COVSECT> Effective date of this endorsement: <TRXEFFDATE> Company: <CARRNAME> Endorsement No. <EN> To be attached to and form a part of Policy No. <POLICYNO> Issued to: <ACCTNAME> NORTH CAROLINA AMENDATORY ENDORSEMENT TO THE DIRECTORS AND OFFICERS LIABILITY AND ENTITY LIABILITY COVERAGE SECTION In consideration of the premium charged, it is agreed that: 1. Subsection 8.Limit of Liability and Retention(f)of the Directors and Officers Liability and Entity Liability Coverage Section is amended to read as follows: "(f) The limit of liability available during the Extended Reporting Period(if exercised)shall be part of,and not in addition to,the Company's maximum aggregate limit of liability for all Loss on account of all Claims first made during the immediately preceding Policy Year,unless an Extended Reporting Period is purchased with a"reinstated limit" in accordance with Subsection 4. of the General Terms and Conditions Section." The Policy will be deemed to have been amended to the extent necessary to effect the purposes of this Amendatory Endorsement. The regulatory requirements set forth in this Amendatory Endorsement shall supersede and take precedence over any provisions of the Policy or any endorsement to the Policy, whenever added, that are inconsistent with or contrary to the provisions of this Amendatory Endorsement, unless such Policy or endorsement provisions comply with the applicable insurance laws of the state of North Carolina. 14-02-10357 (ed. 10/2004) Page 1 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD All other terms, conditions and limitations of this Policy shall remain unchanged. <ENDSIG> Authorized Representative 14-02-10357 (ed. 10/2004) Page 2 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD ENDORSEMENT <COVSECT> Effective date of this endorsement: <TRXEFFDATE> Company: <CARRNAME> Endorsement No. <EN> To be attached to and form a part of Policy No. <POLICYNO> Issued to: <ACCTNAME> NORTH CAROLINA AMENDATORY ENDORSEMENT TO THE EMPLOYMENT PRACTICES LIABILITY COVERAGE SECTION In consideration of the premium charged, it is agreed that: 1. Subsection 8.Limit of Liability and Retention(e)of the Employment Practices Liability Coverage Section is amended to read as follows: "(e) The limit of liability available during the Extended Reporting Period(if exercised)shall be part of,and not in addition to,the Company's maximum aggregate limit of liability for all Loss on account of all Claims first made during the immediately preceding Policy Year,unless an Extended Reporting Period is purchased with a"reinstated limit"in accordance with Subsection 4.of the General Terms and Conditions Section." The Policy will be deemed to have been amended to the extent necessary to effect the purposes of this Amendatory Endorsement. The regulatory requirements set forth in this Amendatory Endorsement shall supersede and take precedence over any provisions of the Policy or any endorsement to the Policy, whenever added, that are inconsistent with or contrary to the provisions of this Amendatory Endorsement, unless such Policy or endorsement provisions comply with the applicable insurance laws of the state of North Carolina. 14-02-10358 (ed. 10/2004) Page 1 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD All other terms, conditions and limitations of this Policy shall remain unchanged. <ENDSIG> Authorized Representative 14-02-10358 (ed. 10/2004) Page 2 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD ENDORSEMENT <COVSECT> Effective date of this endorsement: <TRXEFFDATE> Company: <CARRNAME> Endorsement No. <EN> To be attached to and form a part of Policy No. <POLICYNO> Issued to: <ACCTNAME> PROFESSIONAL SERVICES EXCLUSION ENDORSEMENT In consideration of the premium charged, it is agreed that no coverage will be available under this Coverage Section for Loss on account of any Claim based upon, arising from, or in consequence of any actual or alleged error, misstatement, misleading statement, act, omission, neglect, or breach of duty committed, attempted, or allegedly committed or attempted in connection with the rendering of, or actual or alleged failure to render, any professional services for others by any person or entity otherwise entitled to coverage under this Coverage Section. The title and any headings in this endorsement are solely for convenience and form no part of the terms and conditions of coverage. All other terms, conditions and limitations of this policy shall remain unchanged. <ENDSIG> Authorized Representative Xx-xx-xxxx (xx/xxxx) Page I DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD ENDORSEMENT/RIDER <COVSECT> Effective date of this endorsement/rider: <TRXEFFDATE> <CARRNAME> Endorsement/Rider No. <EN> To be attached to and form a part of Policy No. <POLICYNO> Issued to: <ACCTNAME> ABSOLUTE BREACH OF CONTRACT EXCLUSION ENDORSEMENT In consideration of the premium charged, it is agreed that Subsection 6(a) of this Coverage Section is amended in its entirety to read as follows: (a) The Company shall not be liable under Insuring Clause 3 for Loss on account of any Claim based upon, arising from, or in consequence of any actual or alleged liability of an Organization under any written or oral contract or agreement,provided that this Exclusion 6(a) shall not apply to the extent that the Organization would have been liable in the absence of such contract or agreement. The title and any headings in this endorsement/rider are solely for convenience and form no part of the terms and conditions of coverage. All other terms, conditions and limitations of this Policy shall remain unchanged. <ENDSIG> Authorized Representative Xx-xx-xxxx (xx/xxxx) Page I DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD ENDORSEMENT/RIDER <COVSECT> Effective date of this endorsement/rider: <TRXEFFDATE> <CARRNAME> Endorsement/Rider No. <EN> To be attached to and form a part of Policy No. <POLICYNO> Issued to: <ACCTNAME> AMEND DEFINITION OF LOSS ENDORSEMENT In consideration of the premium charged, it is agreed that: (1) Notwithstanding anything to the contrary contained in this Coverage Section, the term Loss, as defined in Subsection 4 Definitions of this Coverage Section, is amended to include Defense Costs incurred by any Insured in contesting a Claim for the assessment of taxes, initial taxes, additional taxes, tax deficiencies, or penalties pursuant to the following sections of the Internal Revenue Code, 26 U.S.C. §§ 4911, 4940(a), 4941(a), 4941(b), 4942(a), 4942(b), 4943(a), 4943(b), 4944(a), 4944(b), 4945(a), 4945(b), 4955(a), 4955(b), 6652(c)(1)(A), 6652(c)(1)(B), 6655(a)1, 6656(a) or 6656(b). (2) It is understood and agreed that no coverage will be available under this Coverage Section for: (a) Defense Costs incurred by any Insured in contesting a Claim for the assessment of any tax penalty pursuant to any section of the Internal Revenue Code other than those specified in paragraph(1) above; or (b) Loss which constitutes damages (including punitive or exemplary damages),judgments, settlements,pre judgment interest,post judgment interest on account of any Claim for the assessment of taxes, initial taxes, additional taxes, tax deficiencies, or penalties pursuant to any section of the Internal Revenue Code specified in paragraph(1) above, or the payment of any taxes, initial taxes, additional taxes, tax deficiencies, or penalties assessed pursuant to any such section of the Internal Revenue Code. 14-02-11469 (11/2007) rev. Page 1 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD The title and any headings in this endorsement/rider are solely for convenience and form no part of the terms and conditions of coverage. All other terms, conditions and limitations of this Policy shall remain unchanged. <ENDSIG> Authorized Representative 14-02-11469 (11/2007) rev. Page 2 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD ENDORSEMENT/RIDER <COVSECT> Effective date of this endorsement/rider: <TRXEFFDATE> <CARRNAME> Endorsement/Rider No. <EN> To be attached to and form a part of Policy No. <POLICYNO> Issued to: <ACCTNAME> AMEND SUBSECTION 19 REPRESENTATIONS AND SEVERABILITY ENDORSEMENT In consideration of the premium charged, it is agreed that Subsection 19 Representations and Severability of these General Terms and Conditions is amended to include the following: (d) The Company shall not be entitled under any circumstances to rescind Insuring Clause 1 of this Policy's Directors and Officers Liability and Entity Liability coverage section. The title and any headings in this endorsement/rider are solely for convenience and form no part of the terms and conditions of coverage. All other terms, conditions and limitations of this Policy shall remain unchanged. <ENDSIG> Authorized Representative Xx-xx-xxxx (xx/xxxx) Page 1 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD ENDORSEMENT/RIDER <COVSECT> Effective date of this endorsement/rider: <TRXEFFDATE> <CARRNAME> Endorsement/Rider No. <EN> To be attached to and form a part of Policy No. <POLICYNO> Issued to: <ACCTNAME> AMENDED EXCLUSION 5 (c) ENDORSEMENT In consideration of the premium charged, it is agreed that Exclusion 5(c) of Exclusions Applicable To All Insuring Clauses of this Coverage Section is amended as follows: (1) Exclusion 5(c) shall also not apply to a Claim brought against an Insured Person by a bankruptcy trustee, receiver, creditors' committee, liquidator, conservator, rehabilitator or similar official, who has been appointed to take control of, supervise, manage or liquidate the First Named Organization. (2) Subparagraph 5(c)(iii) is amended by deleting both iterations of the phrase "four(4) years" and replacing each with the phrase "three (3) years". (3) As used in this endorsement, the term"First Named Organization" shall mean the Organization first named in the Declarations of the General Terms and Conditions Section of this policy. The title and any headings in this endorsement/rider are solely for convenience and form no part of the terms and conditions of coverage. 14-02-11692 (08/2010) Page 1 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD All other terms, conditions and limitations of this Policy shall remain unchanged. <ENDSIG> Authorized Representative 14-02-11692 (08/2010) Page 2 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD ENDORSEMENT/RIDER <COVSECT> Effective date of this endorsement/rider: <TRXEFFDATE> <CARRNAME> Endorsement/Rider No. <EN> To be attached to and form a part of Policy No. <POLICYNO> Issued to: <ACCTNAME> AMEND DEFINITION OF ORGANIZATION ENDORSEMENT In consideration of the premium charged, it is agreed that the term Organization, as defined in Subsection 3 Definitions of these General Terms and Conditions, is amended to read in its entirety as follows: Organization means, collectively, those organizations (including their Subsidiaries) designated in Item 1 of the Declarations of these General Terms and Conditions, except as otherwise provided in any Coverage Section, including any such organization in its capacity as a debtor in possession under the United States bankruptcy law or in an equivalent status under the law of any other country The title and any headings in this endorsement/rider are solely for convenience and form no part of the terms and conditions of coverage. All other terms, conditions and limitations of this Policy shall remain unchanged. <ENDSIG> Authorized Representative Xx-xx-xxxx (xx/xxxx) Page 1 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD ENDORSEMENT/RIDER <COVSECT> Effective date of this endorsement/rider: <TRXEFFDATE> <CARRNAME> Endorsement/Rider No. <EN> To be attached to and form a part of Policy No. <POLICYNO> Issued to: <ACCTNAME> AMEND DEFINITION OF LOSS TO INCLUDE COVERAGE FOR MULTIPLIED DAMAGES ENDORSEMENT In consideration of the premium charged, it is agreed that: The definition of Loss set forth in Section 4., Definitions, of this Coverage Section is amended as follows: (a) subparagraph(i) is amended to read in its entirety as follows: (i) damages (including punitive damages, exemplary damages, or the multiple portion of any multiplied damage award, if and to the extent that such punitive damages, exemplary damages, or the multiple portion of any multiplied damage award, are insurable under the law of the jurisdiction most favorable to the insurability of such damages provided such jurisdiction has a substantial relationship to the relevant Insureds, to the Company, or to the Claim giving rise to the damages); (b) subparagraph (d) is amended to read in its entirety as follows: (d) taxes, fines or penalties, except as provided above with respect to punitive damages, exemplary damages, the multiple portion of any multiplied damage award and Excess Benefit Transaction Excise Taxes; (c) subparagraph (e) is amended to read in its entirety as follows: (e) any amount not insurable under the law pursuant to which this Coverage Section is construed, except as provided above with respect to punitive damages,exemplary damages or the multiple portion of any multiplied damage award; 14-02-12609 (11/2006) Page 1 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD The title and any headings in this endorsement/rider are solely for convenience and form no part of the terms and conditions of coverage. All other terms, conditions and limitations of this Policy shall remain unchanged. <ENDSIG> Authorized Representative 14-02-12609 (11/2006) Page 2 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD ENDORSEMENT/RIDER <COVSECT> Effective date of this endorsement/rider: <TRXEFFDATE> <CARRNAME> Endorsement/Rider No. <EN> To be attached to and form a part of Policy No. <POLICYNO> Issued to: <ACCTNAME> AMEND INSURED PERSON DEFINITION ENDORSEMENT In consideration of the premium charged, it is agreed that the term Insured Person, as defined in Subsection 3. Definitions, of this Coverage Section, is deleted and replaced with the following: Insured Person means: (a) any natural person who was, now is or shall become a full-time, part-time, temporary, leased or seasonal employee or volunteer of the Organization but only while acting in his or her capacity as such; (b) any natural person who was, now is or shall become: (i) a duly elected or appointed director, officer, trustee, Manager, in-house general counsel, or duly constituted committee member of any Organization chartered in the United States of America, but only while acting in his or her capacity as such; or (ii) a holder of a position equivalent to any position described in(b)(i) above in any Organization that is chartered in any jurisdiction other than the United States of America; or (c) an Independent Contractor working for the Organization, but only while acting in his or her capacity as such and only if the Organization agrees in writing, prior to or no later than thirty(30) days after the Claim is made, to indemnify the Independent Contractor for liability arising out of such Claim. 14-02-12614 (11/2006) Page 1 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD The title and any headings in this endorsement/rider are solely for convenience and form no part of the terms and conditions of coverage. All other terms, conditions and limitations of this Policy shall remain unchanged. <ENDSIG> Authorized Representative 14-02-12614 (11/2006) Page 2 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD ENDORSEMENT/RIDER <COVSECT> Effective date of this endorsement/rider: <TRXEFFDATE> <CARRNAME> Endorsement/Rider No. <EN> To be attached to and form a part of Policy No. <POLICYNO> Issued to: <ACCTNAME> WHISTLEBLOWER ENDORSEMENT In consideration of the premium charged, it is agreed that solely for the purposes of paragraph (i) of Exclusion 5(c) of this coverage section, the phrase "active assistance or participation of, or solicitation by any Executive" shall not include any activity protected under an applicable federal, state, local or foreign law that provides protection similar to 18 U.S.0 1514A(a) ("whistleblower"protection provided under Sarbanes-Oxley Act of 2002)). The title and any headings in this endorsement/rider are solely for convenience and form no part of the terms and conditions of coverage. All other terms, conditions and limitations of this Policy shall remain unchanged. <ENDSIG> Authorized Representative 14-02-13664 (05/2008) rev. Page 1 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD ENDORSEMENT/RIDER <COVSECT> Effective date of this endorsement/rider: <TRXEFFDATE> <CARRNAME> Endorsement/Rider No. <EN> To be attached to and form a part of Policy No. <POLICYNO> Issued to: <ACCTNAME> NORTH CAROLINA AMENDATORY ENDORSEMENT REGARDING THE APPLICATION In consideration of the premium charged, it is agreed that the section of the Application that deems the Application attached to and part of the policy is inapplicable unless the Application is physically attached to the policy. The Policy will be deemed to have been amended to the extent necessary to effect the purposes of this Amendatory Endorsement. The regulatory requirements set forth in this Amendatory Endorsement shall supersede and take precedence over any provisions of the Policy or any endorsement to the Policy,whenever added,that are inconsistent with or contrary to the provisions of this Amendatory Endorsement,unless such Policy or endorsement provisions comply with the applicable insurance laws of the state of North Carolina. The title and any headings in this endorsement/rider are solely for convenience and form no part of the terms and conditions of coverage. All other terms, conditions and limitations of this Policy shall remain unchanged. <ENDSIG> Authorized Representative 14-02-14230 (05/2008) Page 1 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD ENDORSEMENT/RIDER <COVSECT> Effective date of this endorsement/rider: <TRXEFFDATE> <CARRNAME> Endorsement/Rider No. <EN> To be attached to and form a part of Policy No. <POLICYNO> Issued to: <ACCTNAME> CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM In consideration of the premium charged, it is agreed that: A. If aggregate insured losses attributable to terrorist acts certified under the federal Terrorism Risk Insurance Act exceed $100 billion in a calendar year and we have met our insurer deductible under the Terrorism Risk Insurance Act, we shall not be liable for the payment of any portion of the amount of such losses that exceeds $100 billion, and in such case insured losses up to that amount are subject to pro rata allocation in accordance with procedures established by the Secretary of the Treasury. "Certified act of terrorism" means an act that is certified by the Secretary of the Treasury, in accordance with the provisions of the federal Terrorism Risk Insurance Act, to be an act of terrorism pursuant to such Act. The criteria contained in the Terrorism Risk Insurance Act for a "certified act of terrorism" include the following: 1. The act resulted in insured losses in excess of$5 million in the aggregate, attributable to all types of insurance subject to the Terrorism Risk Insurance Act; and 2. The act is a violent act or an act that is dangerous to human life, property or infrastructure and is committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. B. The terms and limitations of any terrorism exclusion, or the inapplicability or omission of a terrorism exclusion, do not serve to create coverage for any "loss" that is otherwise excluded under this Policy. 14-02-22814 (12/2017) Page 1 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD The title and any headings in this endorsement/rider are solely for convenience and form no part of the terms and conditions of coverage. All other terms, conditions and limitations of this Policy shall remain unchanged. <ENDSIG> Authorized Representative 14-02-22814 (12/2017) Page 2 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD Notice of Loss Control Services Insuring Company: <CARRNAME> As a Chubb policyholder, you have loss prevention information and/or services available to you, as listed in this Notice. You may order any brochure by email to formsorderingka,chubb.com and to view our full suite of loss prevention brochures/services go to www.chubb.com/us/fl-lossprevention Directors and Officers(D&O)Liability Loss Prevention Services • Directors and Officers Liability Loss Prevention Manuals: Directors and Officers Liability Loss Preventions—#14-01-0035 Directors and Officers Securities Litigation Loss Preventions—#14-01-0448 Director Liability Loss Prevention in Mergers and Acquisitions—#14-01-1099 Directors and Officers Liability Loss Prevention for Not-for-Profit-414-01-0036 Cyber Loss Mitigation for Directors 414-01-1199 Employment Practices Liability(EPL)Loss Prevention Services • Toll-free Hot Line Have a question on how to handle an employment situation? Simply call 1.888.249.8425 to access the nationally known employment law firm of Jackson Lewis P.C. We offer customers an unlimited number of calls to the hot line at no additional charge. • ChubbWorks.com ChubbWorks.com is a web-based platform that offers multiple services including overviews of employment laws, sample employment policies and procedures, and on-line training. To gain immediate access to ChubbWorks go to www.chubbworks.com and register using your policy number. • Employment Practices Loss Prevention Guidelines Manual Employment Practices Loss Prevention Guidelines-#14-01-0061 • Loss Prevention Consultant Services Chubb has developed a network of more than 120 law firms, human resources consulting firms, and labor economist/statistical firms that offer specialized services for employment issues. • Public Company EPL Customers Employment Practices Loss Prevention Guidelines — Written by Seyfarth Shaw exclusively for Chubb this manual provides an overview of key employment issues faced by for-profit companies and offers proactive idea for avoiding employment lawsuits. • Private Company EPL Customers Employment Practices Loss Prevention Guidelines — Written by Seyfarth Shaw exclusively for Chubb this manual provides an overview of key employment issues for —profit companies and offers proactive idea for avoiding employment lawsuits. Page 1 of 36 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD Page 2 of 36 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD Fiduciary Liability Loss Prevention Services • Fiduciary Liability Loss Prevention Manual Who May Sue You and Why: How to Reduce Your ERISA Risks and the Role of Fiduciary Liability Insurance#14-01-1019 Crime Loss Prevention Services • Crime/Kidnap, Ransom &Extortion Loss Prevention Manual Preventing Fraud: How Anonymous Hotlines Can Help#14-01-1090 Cyber Security Loss Prevention Services Visit: https://www2.chubb.com/us-en/business-insurance/cyber-securiiy.g x to learn more about Chubb's Cyber Services for our policyholders. Health Care Directors and Officers (D&O)Liability Loss Prevention Services • Readings in Health Care Governance Manual Readings in Health Care Governance 414-01-0788 • ChubbWorks.com ChubbWorks.com for Health Care Organizations — The Health Care Zone is a free online resource containing health care specific loss prevention information for employment practices liability, directors and officers(D&O) liability, and fiduciary liability exposures. To gain immediate access to ChubbWorks go to www.chubbworks.com and register using your policy number. • Health Care D&O Loss Prevention Consultant Services Health Care D&O Loss Prevention Consultant Services-#14-01-1164 -------------------- The services provided are advisory in nature.While this program is offered as a resource in developing or maintaining a loss prevention program, you should consult competent legal counsel to design and implement your own program. No liability is assumed by reason of the services, access or information provided. All services are subject to change without notice. 14-02-23030 (05/2018) Page 3 of 36 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD Notice to Purchasers of Employment Practices Liability Coverage or Fiduciary Liability Coverage Insuring Company: <CARRNAME> As a purchaser of an Employment Practices Liability Coverage Section and/or a Fiduciary Liability Coverage Section,please note that the Company has the right and duty to defend any Claim(as such term is defined in the Definitions section of each applicable Coverage Section) covered by each applicable Coverage Section,unless such Coverage Section has been amended by written endorsement. Defense counsel for any such Claim shall be selected by the Company from the Company's list of approved defense firms. Please also note that, as a condition precedent to any right to coverage under each applicable Coverage Section, all Claims must be reported to the Company in writing in the manner and within the time provided in the Reporting and Notice provisions of such Coverage Section. For a list of approved defense firms, please contact your insurance agent or broker, or access such list by using the following internet address: http://csi.chubb.com/panel—counsel.asp Please note that the Company reserves the right to modify such list at any time without notice. 14-02-23030 (05/2018) Page 1 of 36 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD EXHIBIT `B" Scope of Services—FY 2020-21 Outside Agency Performance Agreement Agency Name: Dispute Settlement Center, Inc. Program Name: Mediation, Conciliation, and Referral of Interpersonal Disputes Funding Award: $82,358 Outline how the agency will spend Orange County's funding award. Expense Description Amount Personnel including salaries,benefits,and taxes $82,358 Program Services Outline the critical services(activities)the agency will employ to attain the Anticipated Outcomes below,by June 30,2021. • Information about community resources for dispute resolution and strategies for conciliation. • Mediation services for referrals from Criminal District Court and Medicaid and Family mediation for Orange County residents, and referral to appropriate services if not right for mediation; • Restorative Justice/Practices services for youth referred from Juvenile Court, OCPAD, and the community. 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 percentases,you must also provide the total number of participants within that measure's description or for an earlier performance measure. Performance Measures Anticipated Results Trained mediation staff will be available for referral to appropriate services,providing strategies 133 people will for solving interpersonal conflicts through conciliation. receive information, referral,or conciliation ideas from trained mediation staff Staff and volunteer mediators will provide intake and mediation in Criminal District Court, for 623 people will Medicaid cases,for family/divorce,education,and community cases. be screened for mediation or participate in mediation DSC staff will work with law enforcement and court officials to provide accountability processes 22 people will and Restorative Justice practices in appropriate cases. be referred to the program for screening and services DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD Certified by: �� � Title: FXP.cutIVP norPctnr Date: 12-16-2020 (Provider's Electronic Signature) "You will sign this document electronically with your performance agreement. DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD Chubb CSI 82 Hopmeadow Street P.O. Box 2002 Simsbury, CT 06070-7683 Phone: (860) 408-2000 Fax: (860) 408-2002 Lisa R Downey MARSHALL & STERLING UPSTATE, INC. 300 RT. 23 B LEEDS, NY 12451-0909 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD CHUBBm August 20, 2020 Quotation Worksheet To: Account Number: 435072 Account: Dispute Settlement Center 302 Weaver Street Carrboro, NC 27510 In care of: Producer Contact: Lisa R Downey Producer: MARSHALL&STERLING UPSTATE, INC. 300 RT. 23 B LEEDS, NY 12451-0909 Licensed Producer: Frank S. Maranto, Jr Chubb Contact: Kelly Merce 860 408-2594 Kelly.Merce Chubb.com Product: Forefront Portfolio for Not-For-Profit Organizations Writing Company: Federal Insurance Company Policy Form: 14-02-10190 (Ed. 11/2004) Expiring Policy: 8179-7950 Policy Period: From: October 30,2020 To: October 30, 2021 At 12:01 A.M. local time at the address in Item 1. Chubb Group Of Insurance Companies 82 Hopmeadow Street 860.408.2000 P.O. Box 2002 Fax 860.408.2002 Simsbury, CT 06070-7683 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD Coverage is only available for the following if indicated by an "X" _x_ Directors&Officers Liability and Entity Liability _x_ Employment Practices Liability Fiduciary Liability Crime Special Coverage LIABILITY COVERAGE SECTIONS Option 1 Combined Maximum Aggregate Limit of Liability for Claims each Policy Year: X Yes No Combined Maximum Aggregate Limit:$1,000,000 Applicable to: X Directors&Officers Liability and Entity Liability X Employment Practices Liability Fiduciary Liability Extended Reporting Period: Additional Period: 1 year Additional Premium: 100%of Annual Premium Chubb Group Of Insurance Companies 82 Hopmeadow Street 860.408.2000 P.O. Box 2002 Fax 860.408.2002 Simsbury, CT 06070-7683 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD Directors&Officers Liability and Entity Liability Coverage Section Option 1 (A)Maximum Aggregate Limit of Liability for this Coverage Section for all Claims each Policy Year: $1,000,000 (B)Sublimit for all Excess Benefit Transaction Excise Tax: $100,000 Retention Amounts: D&O Insuring Clause 1 $0 D&O Insuring Clause 2 $1,000 D&O Insuring Clause 3 $1,000 Pending or Prior Litigation Date: October 30, 2000 Defense Outside the Limits of Liability _ Yes X No Endorsements applicable Only to Directors&Officers Liability and Entity Liability Coverage Section: 14-02-10357(10/04 ed.) North Carolina Amendatory Endorsement to the Directors and Officers Liability and Entity Liability Coverage Section 14-02-11271(6/05 ed.) Professional Services Exclusion Endorsement 14-02-11407(11/05 ed.) Absolute Breach of Contract Exclusion Endorsement 14-02-11469(11/07 ed.) Amend Definition of Loss Endorsement 14-02-11692(8/10 ed.) Amended Exclusion 5 c Endorsement 14-02-12609(11/06 ed.) Amend Definition of Loss to Include Coverage for Multiplied Damages Endorsement 14-02-13664(5/08 ed.) Whistleblower Endorsement (The titles and headings are for convenience only. Please refer to the policy and endorsements for a description of coverage.) Chubb Group Of Insurance Companies 82 Hopmeadow Street 860.408.2000 P.O. Box 2002 Fax 860.408.2002 Simsbury, CT 06070-7683 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD Employment Practices Liability Coverage Section Option 1 (A)Maximum Aggregate Limit of Liability for this Coverage Section for all Claims each Policy Year: $1,000,000 (B)Sublimit for all Third Party Claims each Policy Year under Insuring Clause 2- Third Party Liability: $1,000,000 Retention Amounts: EPL Insuring Clause 1 -Employment Practices Liability Coverage $5,000 EPL Insuring Clause 2-Third Party Liability Coverage $5,000 Pending or Prior Litigation Dates: EPL Insuring Clause 1 - Employment Practices Liability Coverage October 30,2000 EPL Insuring Clause 2-Third Party Liability Coverage October 30,2000 Defense Outside the Limits of Liability _ Yes X No Endorsements applicable Only to Employment Practices Liability Coverage Section: 14-02-10358(10/04 ed.) North Carolina Amendatory Endorsement to the Employment Practices Liability Coverage Section 14-02-12614(11/06 ed.) Amend Insured Person Definition Endorsement 99-10-0769(9/04 ed.) Notice to Purchasers of Employment Practices Liability Coverage or Fiduciary Liability Coverage (The titles and headings are for convenience only. Please refer to the policy and endorsements for a description of coverage.) Chubb Group Of Insurance Companies 82 Hopmeadow Street 860.408.2000 P.O. Box 2002 Fax 860.408.2002 Simsbury, CT 06070-7683 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD GENERAL TERMS AND CONDITIONS Endorsements applicable to all Coverage Sections: Applicable to Option#1 10-02-1295(6/07 ed.) Important Notice to Policyholders 14-02-10356(10/04 ed.) North Carolina Amendatory Endorsement to the General Terms and Conditions Section 14-02-11575(11/05 ed.) Amend Subsection 19 Representations and Severability Endorsement 14-02-12049(5/06 ed.) Amend Definition of Organization Endorsement 14-02-14230(5/08 ed.) North Carolina Amendatory Endorsement Regarding the Application 14-02-22814(12/17 ed.) CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM 14-02-23030(5/18 ed.) Notice of Loss Control Services (The titles and headings are for convenience only. Please refer to the policy and endorsements for a description of coverage.) ForeFront Portfolios""for Not-For-Profit Organizations General Terms and Conditions Section -Form# 14-02-10190 Liability Coverage Sections Directors&Officers Liability and Entity Liability Coverage Section -Form#14-02-10191 Employment Practices Liability Coverage Section - Form# 14-02-10192 Chubb Group Of Insurance Companies 82 Hopmeadow Street 860.408.2000 P.O. Box 2002 Fax 860.408.2002 Simsbury, CT 06070-7683 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD PREMIUM SUMMARY: Option 1: $813. Directors&Officers Liability and Entity Liability $892. Employment Practices Liability $1,705. POLICY TOTAL Option Information: POLICY COMMISSION: 20% BILLING TYPE: Direct Bill CONTINGENCIES: The above quote is expressly contingent upon receipt, review and acceptance of the subjectivities listed below. We must receive all of the items identified below on or before the Quotation Expiration date shown below. If all of these items are not received and approved by us on or before this date,this quote will automatically expire without further action or notice. Nothing is required at this time. IMPORTANT The foregoing quotation for coverage is subject to modification or withdrawal by the Company if, before the proposed inception date, any new, corrected or updated information becomes known which relates to any proposed Insured's claims history or risk exposure or which could otherwise change the underwriting evaluation of any proposed Insured, and the Company, in its sole discretion, determines that the terms of this quotation are no longer appropriate. This proposal does not apply to the extent that trade or economic sanctions or other laws or regulations prohibit us from offering or providing insurance. To the extent any such prohibitions apply,this proposal is void ab initio. Quotation Expiration: October 30,2020 Notes: If you have any questions, please call me at(860)408-2594 Kelly Mercey Underwriter Fax Number: (555)555-5555 Email Address: Kelly.Mercey@Chubb.com Chubb Group Of Insurance Companies 82 Hopmeadow Street 860.408.2000 P.O. Box 2002 Fax 860.408.2002 Simsbury, CT 06070-7683 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD CHUBB® OFFEREE DISCLOSURE NOTICE OF TERRORISM INSURANCE COVERAGE (new policies and renewals with no terrorism exclusion or sublimit and no premium charge) Insuring Company: Federal Insurance Company You are hereby notified that, under the Terrorism Risk Insurance Act (the "Act") effective December 26, 2007, we are making available to you insurance for losses arising out of certain acts of terrorism. The policy you are purchasing already includes insurance for such acts. Terrorism is defined as any act certified by the Secretary of the Treasury, in concurrence with the Secretary of State and the Attorney General of the United States, to be an act of terrorism; to be a violent act or an act that is dangerous to human life, property or infrastructure; to have resulted in damage within the United States, or outside the United States in the case of an air carrier or vessel or the premises of a United States Mission; and to have been committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. You should know that the insurance provided by your policy for losses caused by acts of terrorism is partially reimbursed by the United States under the formula set forth in the Act. Under this formula, the United States pays 85% of covered terrorism losses that exceed the statutorily established deductible to be paid by the insurance company providing the coverage. However, if aggregate insured losses attributable to terrorist acts certified under the Act exceed $100 billion in a Program Year (January 1 through December 31), the Treasury shall not make any payment for any portion of the amount of such losses that exceeds $100 billion. If aggregate insured losses attributable to terrorist acts certified under the Act exceed $100 billion in a Program Year (January 1 through December 31) and we have met our insurer deductible under the Act, we shall not be liable for the payment of any portion of the amount of such losses that exceeds $100 billion, and in such case insured losses up to that amount are subject to pro rata allocation in accordance with procedures established by the Secretary of the Treasury. The portion of the offered policy's annual premium that is attributable to insurance for acts of terrorism is: $ -0-. If you have any questions about this notice, please contact your agent or broker. DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD IMPORTANT NOTICE TO POLICYHOLDERS Insuring Company:<CARRNAME> All of the members of the Chubb Group of Insurance companies doing business in the United States(hereinafter "Chubb")distribute their products through licensed insurance brokers and agents("producers"). Detailed information regarding the types of compensation paid by Chubb to producers on US insurance transactions is available under the Producer Compensation link located at the bottom of the page at www.chubb.com,or by calling 1-866-588-9478. Additional information may be available from your producer. Thank you for choosing Chubb. 10-02-1295 (ed. 6/2007) DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD ENDORSEMENT <COVSECT> Effective date of this endorsement: <TRXEFFDATE> Company: <CARRNAME> Endorsement No. <EN> To be attached to and form a part of Policy No. <POLICYNO> Issued to: <ACCTNAME> NORTH CAROLINA AMENDATORY ENDORSEMENT TO THE GENERAL TERMS AND CONDITIONS SECTION In consideration of the premium charged, it is agreed that: 1. Subsection 4.Extended Reporting Period of the General Terms and Conditions Section is amended to read as follows: "(a) If any Liability Coverage Section is either terminated or not renewed for any reason other than nonpayment of premium,any Insured shall have the right to purchase an Extended Reporting Period for the period set forth in Item 5(A)of the Declarations of these General Terms and Conditions,which period shall be one(1)year or such other period of time as agreed upon by the Company and the Insured. The Insured shall have the option of purchasing the Extended Reporting Period: 0) with a limit of liability that is part of,and not in addition to,the Company's maximum aggregate limit of liability for all Loss on account of all Claims first made during the immediately preceding Policy Year;or (ii) with a limit of liability that is equal to,and in addition to,the Company's maximum aggregate limit of liability for all Loss on account of all Claims first made during the immediately preceding Policy Year(the"reinstated limit"). The right to purchase an Extended Reporting Period shall lapse unless written notice of the desired Extended Reporting Period, together with payment of the additional applicable premium due, is received by the Company within thirty(30) days after the end of the Policy Period. Such notice must state if a reinstated limit of liability is desired. If such notice does not state that a reinstated limit of liability is desired, the limit of liability for the Extended Reporting Period shall be part of, and not in addition to, the Company's maximum aggregate limit of liability for all Loss on account of all Claims first made during the immediately preceding Policy Year. (b) If the Extended Reporting Period is purchased, then coverage otherwise afforded by such Liability Coverage Section will be extended to apply to Loss from Claims first made during such Extended Reporting Period but only for Wrongful Acts committed 14-02-10356 (ed. 10/2004) Page 1 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD or allegedly committed before the end of the Policy Period or the date of any conversion of coverage described in Subsection 9, 10 or 11 of these General Terms and Conditions, whichever is earlier. The amount of the premium for the Extended Reporting Period is the amount set forth in Item 5(B) of the Declarations of these General Terms and Conditions, unless the Insured elects a reinstated limit, in which case the premium for the Extended Reporting Period shall be adjusted upward. The entire additional premium for the Extended Reporting Period shall be deemed fully earned at the inception of such Extended Reporting Period. No coverage will be available under this Policy for Loss from Claims made during an Extended Reporting Period based on, arising out of, directly or indirectly resulting from, in consequence of, or in any way involving any fact, circumstance, situation, transaction, event, Claim or Wrongful Act: (i)underlying or alleged in any prior and/or pending litigation as of the termination date of this Policy; or(ii)which has been the subject of any notice given before the termination date under any policy of insurance, including this Policy." 2. Subsection 17. Termination of Policy or Coverage Section(a) of the General Terms and Conditions Section is amended by adding the following at the end of such paragraph (a): "provided that,non-renewal by the Company is effective only if the Company mails or delivers at least forty- five(45)days advance written notice of non-renewal to the Organization at the address last known to the Company,stating the reason(s)for non-renewal,with a copy to the mortgagee or loss payee and the agent or broker of record,if any;" 3. Subsection 17. Termination of Policy or Coverage Section of the General Terms and Conditions Section is amended by adding the following at the end of such Subsection: "Notice of termination by the Company will state the effective date of,and the reason for,such termination and will be mailed or delivered to the Organization at the address shown on this Policy,with a copy to the agent or broker of record,if any,and to the mortgagee or loss payee,if any. Proof of mailing is sufficient proof of notice of any termination or non-renewal by the Company. Within forty-five (45) days after receipt of a written request from the Organization, the Company will mail to the Organization loss information respecting its account for the past three (3) years, which information shall include,but not be limited to, aggregate information on total open and closed Claims (which shall include the date, description of occurrence, and amount of payments) and information on any notice of occurrence." The Policy will be deemed to have been amended to the extent necessary to effect the purposes of this Amendatory Endorsement. 14-02-10356 (ed. 10/2004) Page 2 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD The regulatory requirements set forth in this Amendatory Endorsement shall supersede and take precedence over any provisions of the Policy or any endorsement to the Policy, whenever added, that are inconsistent with or contrary to the provisions of this Amendatory Endorsement,unless such Policy or endorsement provisions comply with the applicable insurance laws of the state of North Carolina. All other terms, conditions and limitations of this Policy shall remain unchanged. <ENDSIG> Authorized Representative 14-02-10356 (ed. 10/2004) Page 3 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD ENDORSEMENT <COVSECT> Effective date of this endorsement: <TRXEFFDATE> Company: <CARRNAME> Endorsement No. <EN> To be attached to and form a part of Policy No. <POLICYNO> Issued to: <ACCTNAME> NORTH CAROLINA AMENDATORY ENDORSEMENT TO THE DIRECTORS AND OFFICERS LIABILITY AND ENTITY LIABILITY COVERAGE SECTION In consideration of the premium charged, it is agreed that: 1. Subsection 8.Limit of Liability and Retention(f)of the Directors and Officers Liability and Entity Liability Coverage Section is amended to read as follows: "(f) The limit of liability available during the Extended Reporting Period(if exercised)shall be part of,and not in addition to,the Company's maximum aggregate limit of liability for all Loss on account of all Claims first made during the immediately preceding Policy Year,unless an Extended Reporting Period is purchased with a"reinstated limit" in accordance with Subsection 4. of the General Terms and Conditions Section." The Policy will be deemed to have been amended to the extent necessary to effect the purposes of this Amendatory Endorsement. The regulatory requirements set forth in this Amendatory Endorsement shall supersede and take precedence over any provisions of the Policy or any endorsement to the Policy, whenever added, that are inconsistent with or contrary to the provisions of this Amendatory Endorsement, unless such Policy or endorsement provisions comply with the applicable insurance laws of the state of North Carolina. 14-02-10357 (ed. 10/2004) Page 1 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD All other terms, conditions and limitations of this Policy shall remain unchanged. <ENDSIG> Authorized Representative 14-02-10357 (ed. 10/2004) Page 2 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD ENDORSEMENT <COVSECT> Effective date of this endorsement: <TRXEFFDATE> Company: <CARRNAME> Endorsement No. <EN> To be attached to and form a part of Policy No. <POLICYNO> Issued to: <ACCTNAME> NORTH CAROLINA AMENDATORY ENDORSEMENT TO THE EMPLOYMENT PRACTICES LIABILITY COVERAGE SECTION In consideration of the premium charged, it is agreed that: 1. Subsection 8.Limit of Liability and Retention(e)of the Employment Practices Liability Coverage Section is amended to read as follows: "(e) The limit of liability available during the Extended Reporting Period(if exercised)shall be part of,and not in addition to,the Company's maximum aggregate limit of liability for all Loss on account of all Claims first made during the immediately preceding Policy Year,unless an Extended Reporting Period is purchased with a"reinstated limit"in accordance with Subsection 4.of the General Terms and Conditions Section." The Policy will be deemed to have been amended to the extent necessary to effect the purposes of this Amendatory Endorsement. The regulatory requirements set forth in this Amendatory Endorsement shall supersede and take precedence over any provisions of the Policy or any endorsement to the Policy, whenever added, that are inconsistent with or contrary to the provisions of this Amendatory Endorsement, unless such Policy or endorsement provisions comply with the applicable insurance laws of the state of North Carolina. 14-02-10358 (ed. 10/2004) Page 1 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD All other terms, conditions and limitations of this Policy shall remain unchanged. <ENDSIG> Authorized Representative 14-02-10358 (ed. 10/2004) Page 2 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD ENDORSEMENT <COVSECT> Effective date of this endorsement: <TRXEFFDATE> Company: <CARRNAME> Endorsement No. <EN> To be attached to and form a part of Policy No. <POLICYNO> Issued to: <ACCTNAME> PROFESSIONAL SERVICES EXCLUSION ENDORSEMENT In consideration of the premium charged, it is agreed that no coverage will be available under this Coverage Section for Loss on account of any Claim based upon, arising from, or in consequence of any actual or alleged error, misstatement, misleading statement, act, omission, neglect, or breach of duty committed, attempted, or allegedly committed or attempted in connection with the rendering of, or actual or alleged failure to render, any professional services for others by any person or entity otherwise entitled to coverage under this Coverage Section. The title and any headings in this endorsement are solely for convenience and form no part of the terms and conditions of coverage. All other terms, conditions and limitations of this policy shall remain unchanged. <ENDSIG> Authorized Representative Xx-xx-xxxx (xx/xxxx) Page I DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD ENDORSEMENT/RIDER <COVSECT> Effective date of this endorsement/rider: <TRXEFFDATE> <CARRNAME> Endorsement/Rider No. <EN> To be attached to and form a part of Policy No. <POLICYNO> Issued to: <ACCTNAME> ABSOLUTE BREACH OF CONTRACT EXCLUSION ENDORSEMENT In consideration of the premium charged, it is agreed that Subsection 6(a) of this Coverage Section is amended in its entirety to read as follows: (a) The Company shall not be liable under Insuring Clause 3 for Loss on account of any Claim based upon, arising from, or in consequence of any actual or alleged liability of an Organization under any written or oral contract or agreement,provided that this Exclusion 6(a) shall not apply to the extent that the Organization would have been liable in the absence of such contract or agreement. The title and any headings in this endorsement/rider are solely for convenience and form no part of the terms and conditions of coverage. All other terms, conditions and limitations of this Policy shall remain unchanged. <ENDSIG> Authorized Representative Xx-xx-xxxx (xx/xxxx) Page I DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD ENDORSEMENT/RIDER <COVSECT> Effective date of this endorsement/rider: <TRXEFFDATE> <CARRNAME> Endorsement/Rider No. <EN> To be attached to and form a part of Policy No. <POLICYNO> Issued to: <ACCTNAME> AMEND DEFINITION OF LOSS ENDORSEMENT In consideration of the premium charged, it is agreed that: (1) Notwithstanding anything to the contrary contained in this Coverage Section, the term Loss, as defined in Subsection 4 Definitions of this Coverage Section, is amended to include Defense Costs incurred by any Insured in contesting a Claim for the assessment of taxes, initial taxes, additional taxes, tax deficiencies, or penalties pursuant to the following sections of the Internal Revenue Code, 26 U.S.C. §§ 4911, 4940(a), 4941(a), 4941(b), 4942(a), 4942(b), 4943(a), 4943(b), 4944(a), 4944(b), 4945(a), 4945(b), 4955(a), 4955(b), 6652(c)(1)(A), 6652(c)(1)(B), 6655(a)1, 6656(a) or 6656(b). (2) It is understood and agreed that no coverage will be available under this Coverage Section for: (a) Defense Costs incurred by any Insured in contesting a Claim for the assessment of any tax penalty pursuant to any section of the Internal Revenue Code other than those specified in paragraph(1) above; or (b) Loss which constitutes damages (including punitive or exemplary damages),judgments, settlements,pre judgment interest,post judgment interest on account of any Claim for the assessment of taxes, initial taxes, additional taxes, tax deficiencies, or penalties pursuant to any section of the Internal Revenue Code specified in paragraph(1) above, or the payment of any taxes, initial taxes, additional taxes, tax deficiencies, or penalties assessed pursuant to any such section of the Internal Revenue Code. 14-02-11469 (11/2007) rev. Page 1 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD The title and any headings in this endorsement/rider are solely for convenience and form no part of the terms and conditions of coverage. All other terms, conditions and limitations of this Policy shall remain unchanged. <ENDSIG> Authorized Representative 14-02-11469 (11/2007) rev. Page 2 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD ENDORSEMENT/RIDER <COVSECT> Effective date of this endorsement/rider: <TRXEFFDATE> <CARRNAME> Endorsement/Rider No. <EN> To be attached to and form a part of Policy No. <POLICYNO> Issued to: <ACCTNAME> AMEND SUBSECTION 19 REPRESENTATIONS AND SEVERABILITY ENDORSEMENT In consideration of the premium charged, it is agreed that Subsection 19 Representations and Severability of these General Terms and Conditions is amended to include the following: (d) The Company shall not be entitled under any circumstances to rescind Insuring Clause 1 of this Policy's Directors and Officers Liability and Entity Liability coverage section. The title and any headings in this endorsement/rider are solely for convenience and form no part of the terms and conditions of coverage. All other terms, conditions and limitations of this Policy shall remain unchanged. <ENDSIG> Authorized Representative Xx-xx-xxxx (xx/xxxx) Page 1 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD ENDORSEMENT/RIDER <COVSECT> Effective date of this endorsement/rider: <TRXEFFDATE> <CARRNAME> Endorsement/Rider No. <EN> To be attached to and form a part of Policy No. <POLICYNO> Issued to: <ACCTNAME> AMENDED EXCLUSION 5 (c) ENDORSEMENT In consideration of the premium charged, it is agreed that Exclusion 5(c) of Exclusions Applicable To All Insuring Clauses of this Coverage Section is amended as follows: (1) Exclusion 5(c) shall also not apply to a Claim brought against an Insured Person by a bankruptcy trustee, receiver, creditors' committee, liquidator, conservator, rehabilitator or similar official, who has been appointed to take control of, supervise, manage or liquidate the First Named Organization. (2) Subparagraph 5(c)(iii) is amended by deleting both iterations of the phrase "four(4) years" and replacing each with the phrase "three (3) years". (3) As used in this endorsement, the term"First Named Organization" shall mean the Organization first named in the Declarations of the General Terms and Conditions Section of this policy. The title and any headings in this endorsement/rider are solely for convenience and form no part of the terms and conditions of coverage. 14-02-11692 (08/2010) Page 1 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD All other terms, conditions and limitations of this Policy shall remain unchanged. <ENDSIG> Authorized Representative 14-02-11692 (08/2010) Page 2 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD ENDORSEMENT/RIDER <COVSECT> Effective date of this endorsement/rider: <TRXEFFDATE> <CARRNAME> Endorsement/Rider No. <EN> To be attached to and form a part of Policy No. <POLICYNO> Issued to: <ACCTNAME> AMEND DEFINITION OF ORGANIZATION ENDORSEMENT In consideration of the premium charged, it is agreed that the term Organization, as defined in Subsection 3 Definitions of these General Terms and Conditions, is amended to read in its entirety as follows: Organization means, collectively, those organizations (including their Subsidiaries) designated in Item 1 of the Declarations of these General Terms and Conditions, except as otherwise provided in any Coverage Section, including any such organization in its capacity as a debtor in possession under the United States bankruptcy law or in an equivalent status under the law of any other country The title and any headings in this endorsement/rider are solely for convenience and form no part of the terms and conditions of coverage. All other terms, conditions and limitations of this Policy shall remain unchanged. <ENDSIG> Authorized Representative Xx-xx-xxxx (xx/xxxx) Page 1 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD ENDORSEMENT/RIDER <COVSECT> Effective date of this endorsement/rider: <TRXEFFDATE> <CARRNAME> Endorsement/Rider No. <EN> To be attached to and form a part of Policy No. <POLICYNO> Issued to: <ACCTNAME> AMEND DEFINITION OF LOSS TO INCLUDE COVERAGE FOR MULTIPLIED DAMAGES ENDORSEMENT In consideration of the premium charged, it is agreed that: The definition of Loss set forth in Section 4., Definitions, of this Coverage Section is amended as follows: (a) subparagraph(i) is amended to read in its entirety as follows: (i) damages (including punitive damages, exemplary damages, or the multiple portion of any multiplied damage award, if and to the extent that such punitive damages, exemplary damages, or the multiple portion of any multiplied damage award, are insurable under the law of the jurisdiction most favorable to the insurability of such damages provided such jurisdiction has a substantial relationship to the relevant Insureds, to the Company, or to the Claim giving rise to the damages); (b) subparagraph (d) is amended to read in its entirety as follows: (d) taxes, fines or penalties, except as provided above with respect to punitive damages, exemplary damages, the multiple portion of any multiplied damage award and Excess Benefit Transaction Excise Taxes; (c) subparagraph (e) is amended to read in its entirety as follows: (e) any amount not insurable under the law pursuant to which this Coverage Section is construed, except as provided above with respect to punitive damages,exemplary damages or the multiple portion of any multiplied damage award; 14-02-12609 (11/2006) Page 1 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD The title and any headings in this endorsement/rider are solely for convenience and form no part of the terms and conditions of coverage. All other terms, conditions and limitations of this Policy shall remain unchanged. <ENDSIG> Authorized Representative 14-02-12609 (11/2006) Page 2 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD ENDORSEMENT/RIDER <COVSECT> Effective date of this endorsement/rider: <TRXEFFDATE> <CARRNAME> Endorsement/Rider No. <EN> To be attached to and form a part of Policy No. <POLICYNO> Issued to: <ACCTNAME> AMEND INSURED PERSON DEFINITION ENDORSEMENT In consideration of the premium charged, it is agreed that the term Insured Person, as defined in Subsection 3. Definitions, of this Coverage Section, is deleted and replaced with the following: Insured Person means: (a) any natural person who was, now is or shall become a full-time, part-time, temporary, leased or seasonal employee or volunteer of the Organization but only while acting in his or her capacity as such; (b) any natural person who was, now is or shall become: (i) a duly elected or appointed director, officer, trustee, Manager, in-house general counsel, or duly constituted committee member of any Organization chartered in the United States of America, but only while acting in his or her capacity as such; or (ii) a holder of a position equivalent to any position described in(b)(i) above in any Organization that is chartered in any jurisdiction other than the United States of America; or (c) an Independent Contractor working for the Organization, but only while acting in his or her capacity as such and only if the Organization agrees in writing, prior to or no later than thirty(30) days after the Claim is made, to indemnify the Independent Contractor for liability arising out of such Claim. 14-02-12614 (11/2006) Page 1 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD The title and any headings in this endorsement/rider are solely for convenience and form no part of the terms and conditions of coverage. All other terms, conditions and limitations of this Policy shall remain unchanged. <ENDSIG> Authorized Representative 14-02-12614 (11/2006) Page 2 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD ENDORSEMENT/RIDER <COVSECT> Effective date of this endorsement/rider: <TRXEFFDATE> <CARRNAME> Endorsement/Rider No. <EN> To be attached to and form a part of Policy No. <POLICYNO> Issued to: <ACCTNAME> WHISTLEBLOWER ENDORSEMENT In consideration of the premium charged, it is agreed that solely for the purposes of paragraph (i) of Exclusion 5(c) of this coverage section, the phrase "active assistance or participation of, or solicitation by any Executive" shall not include any activity protected under an applicable federal, state, local or foreign law that provides protection similar to 18 U.S.0 1514A(a) ("whistleblower"protection provided under Sarbanes-Oxley Act of 2002)). The title and any headings in this endorsement/rider are solely for convenience and form no part of the terms and conditions of coverage. All other terms, conditions and limitations of this Policy shall remain unchanged. <ENDSIG> Authorized Representative 14-02-13664 (05/2008) rev. Page 1 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD ENDORSEMENT/RIDER <COVSECT> Effective date of this endorsement/rider: <TRXEFFDATE> <CARRNAME> Endorsement/Rider No. <EN> To be attached to and form a part of Policy No. <POLICYNO> Issued to: <ACCTNAME> NORTH CAROLINA AMENDATORY ENDORSEMENT REGARDING THE APPLICATION In consideration of the premium charged, it is agreed that the section of the Application that deems the Application attached to and part of the policy is inapplicable unless the Application is physically attached to the policy. The Policy will be deemed to have been amended to the extent necessary to effect the purposes of this Amendatory Endorsement. The regulatory requirements set forth in this Amendatory Endorsement shall supersede and take precedence over any provisions of the Policy or any endorsement to the Policy,whenever added,that are inconsistent with or contrary to the provisions of this Amendatory Endorsement,unless such Policy or endorsement provisions comply with the applicable insurance laws of the state of North Carolina. The title and any headings in this endorsement/rider are solely for convenience and form no part of the terms and conditions of coverage. All other terms, conditions and limitations of this Policy shall remain unchanged. <ENDSIG> Authorized Representative 14-02-14230 (05/2008) Page 1 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD ENDORSEMENT/RIDER <COVSECT> Effective date of this endorsement/rider: <TRXEFFDATE> <CARRNAME> Endorsement/Rider No. <EN> To be attached to and form a part of Policy No. <POLICYNO> Issued to: <ACCTNAME> CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM In consideration of the premium charged, it is agreed that: A. If aggregate insured losses attributable to terrorist acts certified under the federal Terrorism Risk Insurance Act exceed $100 billion in a calendar year and we have met our insurer deductible under the Terrorism Risk Insurance Act, we shall not be liable for the payment of any portion of the amount of such losses that exceeds $100 billion, and in such case insured losses up to that amount are subject to pro rata allocation in accordance with procedures established by the Secretary of the Treasury. "Certified act of terrorism" means an act that is certified by the Secretary of the Treasury, in accordance with the provisions of the federal Terrorism Risk Insurance Act, to be an act of terrorism pursuant to such Act. The criteria contained in the Terrorism Risk Insurance Act for a "certified act of terrorism" include the following: 1. The act resulted in insured losses in excess of$5 million in the aggregate, attributable to all types of insurance subject to the Terrorism Risk Insurance Act; and 2. The act is a violent act or an act that is dangerous to human life, property or infrastructure and is committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. B. The terms and limitations of any terrorism exclusion, or the inapplicability or omission of a terrorism exclusion, do not serve to create coverage for any "loss" that is otherwise excluded under this Policy. 14-02-22814 (12/2017) Page 1 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD The title and any headings in this endorsement/rider are solely for convenience and form no part of the terms and conditions of coverage. All other terms, conditions and limitations of this Policy shall remain unchanged. <ENDSIG> Authorized Representative 14-02-22814 (12/2017) Page 2 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD Notice of Loss Control Services Insuring Company: <CARRNAME> As a Chubb policyholder, you have loss prevention information and/or services available to you, as listed in this Notice. You may order any brochure by email to formsorderingka,chubb.com and to view our full suite of loss prevention brochures/services go to www.chubb.com/us/fl-lossprevention Directors and Officers(D&O)Liability Loss Prevention Services • Directors and Officers Liability Loss Prevention Manuals: Directors and Officers Liability Loss Preventions—#14-01-0035 Directors and Officers Securities Litigation Loss Preventions—#14-01-0448 Director Liability Loss Prevention in Mergers and Acquisitions—#14-01-1099 Directors and Officers Liability Loss Prevention for Not-for-Profit-414-01-0036 Cyber Loss Mitigation for Directors 414-01-1199 Employment Practices Liability(EPL)Loss Prevention Services • Toll-free Hot Line Have a question on how to handle an employment situation? Simply call 1.888.249.8425 to access the nationally known employment law firm of Jackson Lewis P.C. We offer customers an unlimited number of calls to the hot line at no additional charge. • ChubbWorks.com ChubbWorks.com is a web-based platform that offers multiple services including overviews of employment laws, sample employment policies and procedures, and on-line training. To gain immediate access to ChubbWorks go to www.chubbworks.com and register using your policy number. • Employment Practices Loss Prevention Guidelines Manual Employment Practices Loss Prevention Guidelines-#14-01-0061 • Loss Prevention Consultant Services Chubb has developed a network of more than 120 law firms, human resources consulting firms, and labor economist/statistical firms that offer specialized services for employment issues. • Public Company EPL Customers Employment Practices Loss Prevention Guidelines — Written by Seyfarth Shaw exclusively for Chubb this manual provides an overview of key employment issues faced by for-profit companies and offers proactive idea for avoiding employment lawsuits. • Private Company EPL Customers Employment Practices Loss Prevention Guidelines — Written by Seyfarth Shaw exclusively for Chubb this manual provides an overview of key employment issues for —profit companies and offers proactive idea for avoiding employment lawsuits. Page 1 of 36 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD Page 2 of 36 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD Fiduciary Liability Loss Prevention Services • Fiduciary Liability Loss Prevention Manual Who May Sue You and Why: How to Reduce Your ERISA Risks and the Role of Fiduciary Liability Insurance#14-01-1019 Crime Loss Prevention Services • Crime/Kidnap, Ransom &Extortion Loss Prevention Manual Preventing Fraud: How Anonymous Hotlines Can Help#14-01-1090 Cyber Security Loss Prevention Services Visit: https://www2.chubb.com/us-en/business-insurance/cyber-securiiy.g x to learn more about Chubb's Cyber Services for our policyholders. Health Care Directors and Officers (D&O)Liability Loss Prevention Services • Readings in Health Care Governance Manual Readings in Health Care Governance 414-01-0788 • ChubbWorks.com ChubbWorks.com for Health Care Organizations — The Health Care Zone is a free online resource containing health care specific loss prevention information for employment practices liability, directors and officers(D&O) liability, and fiduciary liability exposures. To gain immediate access to ChubbWorks go to www.chubbworks.com and register using your policy number. • Health Care D&O Loss Prevention Consultant Services Health Care D&O Loss Prevention Consultant Services-#14-01-1164 -------------------- The services provided are advisory in nature.While this program is offered as a resource in developing or maintaining a loss prevention program, you should consult competent legal counsel to design and implement your own program. No liability is assumed by reason of the services, access or information provided. All services are subject to change without notice. 14-02-23030 (05/2018) Page 3 of 36 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD Notice to Purchasers of Employment Practices Liability Coverage or Fiduciary Liability Coverage Insuring Company: <CARRNAME> As a purchaser of an Employment Practices Liability Coverage Section and/or a Fiduciary Liability Coverage Section,please note that the Company has the right and duty to defend any Claim(as such term is defined in the Definitions section of each applicable Coverage Section) covered by each applicable Coverage Section,unless such Coverage Section has been amended by written endorsement. Defense counsel for any such Claim shall be selected by the Company from the Company's list of approved defense firms. Please also note that, as a condition precedent to any right to coverage under each applicable Coverage Section, all Claims must be reported to the Company in writing in the manner and within the time provided in the Reporting and Notice provisions of such Coverage Section. For a list of approved defense firms, please contact your insurance agent or broker, or access such list by using the following internet address: http://csi.chubb.com/panel—counsel.asp Please note that the Company reserves the right to modify such list at any time without notice. 14-02-23030 (05/2018) Page 1 of 36 DocuSign Envelope ID:A29AB125-209D-4CB9-854C-789BEC34FODD DATE(MM/DD/YYYY) A�" CERTIFICATE OF LIABILITY INSURANCE 06/05/2020 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). PRODUCER CONTACT Diane Nadeau NAME: Business Insurers of Carolinas aCC Ext: (919)968-4611 AIX No): (919)968-8991 501 Eastowne Drive,Suite 250 E-MAIL dnadeau@business-insurers.com ADDRESS: PO Box 2536 INSURER(S)AFFORDING COVERAGE NAIC# Chapel Hill NC 27515 INSURERA: American Liberty Insurance Co 25186 INSURED INSURER B: DISPUTE SETTLEMENT CENTER INC INSURER C: 302 W WEAVER ST STE A INSURER D: INSURER E: CARRBORO NC 27510-6004 INSURER F: COVERAGES CERTIFICATE NUMBER: 20-21 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 INSURANCEADDLSUBR POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR PRIM SES Ea oNcE ence $ 300,000 MED EXP(Any one person) $ 5,000 A 4W54487 06/17/2020 06/17/2021 PERSONAL&ADV INJURY $ GEN-LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 X JECT LOC PRODUCTS-COMP/OPAGG $POLICY ❑ PRO 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANYAUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LAB HCLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION xi STATUTE ERH AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ A oFFICIR MIMBIR EXCLUDED? NIA 4W54487 06/17/2020 06/17/2021 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Orange County Government ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 8181 AUTHORIZED REPRESENTATIVE Hillsborough NC 27278 Qtava% ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD