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2020-787-E Social Svc-Interfaith Council outside agency agreement
DocuSign Envelope ID:74211493-D876-4700-813D-OA9F75861508 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 Inter-Faith Council for Social Services, Inc., a not- for-profit corporation,located at 110 West Main 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 Provider agree as follows: 1. Term of the Agreement. The term of this Agreement shall be a program year beginning July 1,2020 to June 30,2021. 2. Scope of Services. a. Provider will provide services to the residents of Orange County, as outlined in the Outside Agency Funding Application and any amendments or revision thereto (Exhibit "A") and Emergency Assistance Scope of Work ("Exhibit B"), both of which are attached and hereby incorporated into this document as if set out herein. The Scope of Services in Exhibit A and the Program Budget may be different from the original application based on County appropriation; however, any revisions or amendments to this Agreement must be approved in writing by the County and attached to this Agreement as Exhibit C. b. The Provider shall be solely responsible for the means, methods, techniques, sequence, safety program and procedures necessary to properly and fully complete the work set forth in the Scope of Services.' 3. Funding. a. The County agrees to appropriate funds for the provision of services described in Exhibit A, Scope of Services, and more particularly described in the Program Budget or Revised Program Budget,the maximum sum of One Hundred and Twenty-Seven Thousand Dollars ($127,000). The County also agrees to appropriate funds for the provision of services described in Exhibit B, the maximum sum of Eighty Five Thousand Dolloars ($85,000). The total amounted appropriated by the County to Provider for these services shall be Two Hundred and Twelve Thousand Dollars($212,000). i b. All funds appropriated shall be used for purposes described in Exhibit A and Exhibit B. Any funds not used for the purposes stated shall be returned to the County. Any changes in the use of funds must be authorized in writing by the County prior to any expenditure of the funds by the Provider. If the funds are expended not in accordance with the Scope of Services provided in Exhibits A and B, at the discretion of the County the Provider may be required to repay the funds to the County. c. Funds Appropriated for Outside Agency Funding(Exhibit A) Services. Inter-Faith Council far Social Services, Inc. Orange County Outside Agency Performance Agreement Revised7712018 ------------ DocuSign Envelope ID:74211493-D876-4700-813D-OA9F75861508 i. For funds appropriated for Exhibit A services, the Provider shall be paid in four equal installments in the amount of$31,750. The first payment is contingent upon receipt of the agency's performance agreement; the remaining payments are contingent upon receipt of the request for reimbursement and related supporting documentation. ii. The County's obligation to make the quarterly payments is contingent upon receipt of Progress Reports, which show satisfactory progress toward completion of performance measures and an accounting of expenditures as detailed in the attached Scope of Services. iii. Once Provider has satisfied its obligations as provided in c.1. above payment will be made 21 days after receipt of the Progress Report and Request for Reimbursement or 21 days after due date of Progress Report whichever is later. d. Funds Appropriated for Emergency Assistance(Exhibit B) Services. i. For funds appropriated for Exhibit B services, the County will reimburse Provider for services described in Exhibit B up to the limits allocated by this Agreement. Provider shall only be reimbursed for actual expenditures for approved services. I For reimbursement, Provider must submit copies of bills, checks, receipts and/or other proof of expenditures to the person designated by the County. Reimbursement will be provided bimonthly. iii. For reimbursement of staff costs, Provider shall submit the payment records for staff cost. The County will reimburse the Provider monthly upon receipt of a complete and correctly filed report. e. The County is not obligated to provide any other support to Provider in this or in succeeding fiscal years. 4. Agency Reporting. a. Provider will provide Orange County a Progress Report that includes a fiscal report and updates on performance measures as outlined in the Scope of Services. Progress Report dates are: July 1 —December 31; January 1 —March 31 and April 1 - June 30. Reports are due on January 22,April 16,and July 16 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 2 DocuSign Envelope ID:74211493-D876-4700-813D-OA9F75861508 ii. In the event that Provider shall fail to render a satisfactory accounting as provided section 4 above, the County may terminate this Agreement and Provider shall return all payments already made to it by the County for services which have not been provided or for which no satisfactory accounting has been rendered; or iii. In the event of any fraudulent representation by the Provider in an invoice or other verification required to obtain payment under this Agreement or other dishonesty on a material matter relating to the performance of services under this Agreement. iv. Nonperformance,incomplete service or performance,or failure to satisfactorily perform any part of the work identified in the Scope of Services or to comply with any provision of this Agreement, as determined by the County in its sole discretion. v. Failure to adhere to the terms of applicable county, state or federal laws, regulations, or stated public policy. b. In the event of default by the Provider,the county may elect to terminate this Agreement, in Whole or in part and/or require the Provider to repay the funds within ten(10)business days from written notice of default. The County may (but shall not be required to) grant the Provider an opportunity to cure the default without termination of this Agreement. This clause shall not be interpreted to limit the County's remedies in law or in equity. c. Notwithstanding the foregoing, either party may terminate the agreement at any time without penalty; provided that written notice of such termination is furnished to the other party at least 30 days prior to termination. In the event of such termination, any payment due shall be prorated to the date of termination and any unused funds shall be returned to the County within 10 days of termination. d. Any termination of this Agreement for default under this section that is later deemed to be unjustified shall be deemed a termination for convenience. 6. Insurance. a. General Requirements. The Provider shall purchase and maintain, during the period of performance of this Agreement,insurance: i. Worker's Compensation. For protection from claims under workers' or workmen's compensation acts; ii. Comprehensive General Liability Insurance covering claims arising out of or relating to bodily injury, including bodily injury,sickness, disease or death of any of the Consultant's employees or any other person and to real and personal property including loss of use resulting thereof; iii. Comprehensive Automobile Liability Insurance, including hired and non-owned vehicles, if any, covering personal injury or death,and property damage; and 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: 3 DocuSign Envelope ID:74211493-D876-4700-813D-OA9F75861508 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 parry and as a certificate holder. Evidence of such insurance and all correspondence shall be sent to: Orange County Risk Manager Post Office Box 8181 Hillsborough,NC 27278 d. Nothing in this section is intended to affect or abrogate the County's sovereign immunity defenses. 7. Relationship of the Parties. Provider is an independent contractor of the County. Provider represents that they have or will secure, at his own expense, all personnel required in performing the services under this Agreement. Such personnel shall not be employees or have any contractual relationship with the County. All personnel engaged in work under this Agreement shall be fully qualified and shall be authorized and permitted under federal, state and local law to perform such services. 8. Compliance with all Laws. The Provider, at its sole expense, shall comply with all laws, ordinances, orders and regulations of the federal, state or local governments, as well as their respective departments, commissions, boards, and officers, which are in effect at the time of execution of this Agreement or are adopted at any time following execution of this agreement. 9. Subcontract. The County and Provider deem the services provided under this Agreement to be personal in nature and Provider may not subcontract any rights or duties under this Agreement to any other party without prior written consent from the County. 10. 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. 4 DocuSign Envelope ID:74211493-D876-4700-813D-OA9F75861508 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 $ 14.95 per hour. To the extent possible, Orange County recommends that Provider provide a living wage to its employees. 15. Notice. The Parties hereto agree and understand that written notice, mailed or delivered,to the last known address shall constitute sufficient notice to the County and the Provider. All notices required and/or made pursuant to this Agreement to be given to the County and the Provides shall be in writing and mailed to the party addressed as follows: County: Provider: Nancy Coston Executive Director Department of Social Services The Inter-Faith Council for Social Orange County Service,Inc. Post Office Box 8181 110 W.Main Street Hillsborough,North Carolina 27278 Carrboro,North Carolina 27510 16. Entire Agreement. This Agreement, including any referenced attachments, constitutes the entire Agreement between the parties and shall supersede, replace or nullify any and all prior Agreements of understandings; written or oral, relating to the matters set forth herein, and any such prior Agreements or understandings shall have no force or affect whatsoever on this Agreement. The County and Provider have read this Agreement and agree to be bound by all of its terms, and further agree that this Agreement constitutes the complete and exclusive statement of the Agreement between the County and Provider. 17. Severability. All clauses found herein shall act independently of each other. If a clause is found to be illegal or unenforceable, it shall have no effect on the other provisions of this Agreement. It is understood by the parties hereto that if any part, term or provision of this Agreement is by the Courts held to be illegal or in conflict with any laws of the State of North Carolina or the United States, the validity of the remaining portions or provisions shall not be affected, and the rights and obligations of the parties shall be construed and enforced as if the Agreement did not contain the particular part,term or provision held to be invalid. 18. Governing Law. This Agreement and the duties, responsibilities, obligations and rights of respective parties hereunder shall be governed by the laws of the State of North Carolina. Provider shall at all times remain in compliance with all applicable local, state, and federal laws, rules, and regulations including but not limited to all state and federal anti-discrimination laws, policies, rules, and regulations and the Orange County Non-Discrimination Policy and Orange County Living Wage Policy (each policy is incorporated herein by reference and may be viewed at http://www.orangecountyne.gov/departments/purchasing_division/contracts.php). Any violation of this requirement is a breach of the Agreement and County may immediately 5 —DocuSign Envelope ID:74211493-D876-4700-813D-OA9F75861508 terminate this Agreement without further obligation on part of the County. This paragraph is not intended to limit and does not limit the definition of breach to discrimination.By executing this Agreement Provider affirms that Provider and any subcontractors of Provider are and shall remain in compliance with Article 2 of Chapter 64 of the North Carolina General Statutes. By executing this Agreement Provider certifies that Provider has not been identified, and has not utilized the services of any agent or subcontractor, on the list created by the State Treasurer pursuant to G.S. 147-86.58. 19. Signatures. This Agreement together with any amendments or modifications may be executed electronically. All electronic signatures affixed hereto evidence the intent of the Parties to comply with Article 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. aad„ &,behatf of the Provider �a.&t, Jt,AS 10/27/2020 Jackie Jenks,Executive Director Date aW61aabpehalf of Orange County Government Li5I 6V,lAlt, C1aAMWtt,V'Sbt 10/27/2020 Bonnie Hammersley, County Manager Date 6 DocuSign Envelope ID:74211493-D876-4700-813D-OA9F75861508 _ ORANGE COUNTY—DEPARTMENT USE ONLY Department Party/Vendor Name: Inter-Faith Council Party/Vendor Contact Person: Jackie Jenks Contact Phone: 919-929-6380 Party/Vendor Address: 110 West Main Street City Carrboro State: NC Zip: 27510 Department: Social Services Amount: $212,000 Purpose: outside agency funding + emergency assistance program Budget Code(s): 10403020- 630000 Vendor# 1149 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract Type: (Check one) New ❑ Renewal ® Amendment ❑ Effective Date July 1, 2020 Approved by Board Yes® NOD Agenda Date: June 10,2020 This agreement is approved as to to Qad�iin1d content: Department Director's Signature �� o- Date: 10/27/2020 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 sufficienc specifications, and requirements: Q�ISA. C,bvvt,e.11b 10/13/2020 Office of the Risk Management Officer Date: Financial Services This instrument has been pre-audited' nttbffequired by the Local Government Budget and Fiscal Control Act: Office of the Chief Financial Office Date:10/27/2020 Legal Services This agreement is approved as t is�md sufficiency: 10/27/2020 Office of the County Attorney ` Date: Clerk to the Board Received for record retention: All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd@orangecountync.gov The following signature block is for hard copies only and is not required for Docusign contracts: Office of the Clerk to the Board Date: 7 --DocuSign Envelope ID:74211493-D876-4700-813D-OA9F75861508 Exhibit A Outside Agency Application and Scope of Services 8 DocuSign Envelope ID:74211493-D876-4700-813D-OA9F75861508 fc fIG!YG�FI TN Ckb`+eClt 6GR SOSfkf.iFgYi£^ January 14, 2020 Dear Outside Agencies Partners, As IFC respectfully submits our 2020-21 funding application, we felt it was important to share with you the context of our increased request. Later this year, IFC will move non-residential services and agency offices to our new building in Carrboro. The new site will provide a dignified space for IFC members to gather, eat together, shop for groceries for their families, and engage with volunteers and other community representatives in meaningful ways. When construction of the new building is complete, it will be the first time in 57 years that all of IFC's programs are operating out of spaces that are purpose-built for the services offered. It will also be the first time in a decade that IFC is not dedicating resources to plan or execute a capital project. As a result, staff and board leadership have proactively turned our focus to projecting the financial resources needed to sustain these vital community programs in permanent, IFC-owned buildings with appropriate staffing levels. As you might expect, IFC's annual operating costs have increased over the last five years due to several factors, including the addition of the new Community House building in 2015, increased requirements from funders (eg. more complex documentation, cyber liability insurance, compliance with best practices), and other expenses necessary to keep up with information technology advances, staffing and facility needs. Unexpected one-time gifts and bequests have covered additional expenses to date. Costs will immediately jump again when we move the Community Kitchen and Food Pantry out of the Old Town Hall, since the Town of Chapel Hill has enabled IFC to serve more low-income residents and workers with available resources by providing utilities and building maintenance at no charge for the past 30 years. Leaving Old Town Hall will be a divestment of$48,000 per year of in-kind, public support, a cost that IFC will now incur. To sustain current operations in fiscal year 2020-21 and beyond, IFC will require additional commitments of dependable, annual support from government and private funders. IFC's annual budget totals almost$2.4 million, of which 8 percent comes from local government. We work to raise more than 75 percent of funds from private donors, and IFC also leverages significant in-kind support to meet people's basic needs.Your neighbors volunteer almost 30,000 hours of staffing each year, and nearly all of the food distributed at the Food Pantry and served at the Community Kitchen is donated. While IFC has increased non-governmental funding, private funding cannot cover the increasing cost of operating 24-hour shelter services in two locations for 90+ people on a given day; serving nutritious, balanced meals every day of the year; and providing groceries and emergency financial assistance every weekday. Ultimately, this request asks you to consider increasing the allocation of public resources to build an equitable community by making sure people can meet their most basic needs for food and shelter. Orange County has one of the highest income disparities in the state.When adequately funded, IFC makes Orange County more affordable for low-income residents and workers,who make this a diverse and desirable place to live.We appreciate the task ahead of you. Thank you for your thoughtful consideration and dependable partnership confronting the causes and responding to the effects of poverty in our community. Sincerely, Jackie Jenks Executive Director 110 W.Main Street•Carrboro,NC 27510•Phone 919-929-&380•fax 9,1 g-929-3353•www.ifcweb.org DocuSign Envelope ID:74211493-D876-4700-813D-OA9F75861508 Applicant Contact Information. Applicant Organization's Legal Name: Inter+aith Council for Social Service Applicant Organizabon's Physical Address; 100 West Rosemary Street, Chapel Hill NC 27516 Applicant Organization's Mailing Address: 110 West:Main Street, Carrboro, NC 2751:.0 Applicant Organization's Web Address:www.ifcweb.ora. Executive Director:.Jackie Jenks Telephone Number:(91:9)929-6380 x14 E-Mail:ijenksaifcmailbox.org Tax ID Number:59-1224041 Funding,Recluest 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- Chapel Hill.. Oranae Total Hs Hs bounty-H5. Residential Services: $44,000 $40,000 $80,000 $155,000 HomeStart(shelter for women and families).& Personnel Personnel Personnel Community House (shelter for men) $1'000 $10,000. $20,00.0 Operations Operations Operations Food Security Programs: $17,000: $43,000 $21;000 $96,000 Food Pantry&Community Kitchen Personnel Personnel Personnel $3,000 $7,000 $44,000 Operations Operations Operations Totals $25,000 $100;000 $14000 $250,000 Briefly explain your proposed.use.of funds: IFC continues to.be the primary non-profit provider of food pantry services; daily hot meats, and emergency financial assistance in Chapel Hill'and Carrboro and is the only provider of shelter in Orange County for people experiencing homelessness. Funds will enablee us to continue providing these vitae services for people living and working in our community; To the best:of my knowledge and belief all information and data in this application.,is true and current. The document has been duly authorized by the governing board of the applicant, Signature: ''' Executive Director Date Signature: w -4� � /, -, Board Chairperson Date cover Page P a g.9 6 c f 2 9 .... _........._ .. ....... . _ DocuSign Envelope ID:74211493-D876-4700-813D-OA9F75861508 DISCLOSURE OF POTENTIAL CONFLICTS OF INTEREST AND NON DISCRIMINATION CLAUSE Are any of the Board Members or employees of the agency which will be carrying out this program or members of their immediate families,or their business associates, YES NO x[:] [] a) Employees of or closely related to employees of the Town of Carrboroj.the Town:of Chapel Hill, or-O.rb..hge County? EJ x0b) Members of or closely related to members of the governing-bodies of the town of Carr.boro,: the.ToW.n of Chapel Hill, or Orange:County? X❑ ❑c) Current beneficiaries of the program for which funds are being requested? ❑ xF_1 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. a) One of.our part-time residential staff members at HomeSiart is an employee of the Orange. County Health Department. c) Embracing a commitment to equity and representation of all stakeholder perspectives, :IFC prionfizes, including-current recipients of services and others with lived experience,on our Board of Directors.. Two members of our Board are current shelter residents, NON-DISCRIMINATIoN Provider agrees as part of consideration of the grant,ing.of funds by funding agencies to the parties hereto for-themselves, their agents, officials, employees and servants agree not to discriminate:in any manner of 'these basis of race; color, gender, national origin, age, handicap, religion) sexual orientation, gender- identity. /expression, familial status or veterans status with.reference to. any activities carried out by the grantee, no matter how remote. The parties hereto further agree in all respects to conform to the provision and intent of Orange County Civil Rights Ordinance, as amended and the Orange County Anti-digatmiriation 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 witK 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 Inell ible for funding) but the existence of an undisclosed conflict may,result in the I gi termination of anvgrant awarded. Signature: Executive Director Date Signaturv., Board Chairperson Date Cover Page Rage 1 of 29 ............. DocuSign Envelope ID:74211493-D876-4700-813D-OA9F75861508 AGENCY INFORMATION Please provide the following information about your agency: 1. Date of Incorporation (Month/Year): November 1970 IFC was founded in 1963 and was incorporated in November 1970. 2. Agency's Purpose/Mission (no more than a few sentences): IFC confronts the causes and responds to the effects of poverty in our community. We believe in a community that meets everyone's basic needs, including dignified and affordable housing, an abundance of healthy food, and meaningful social connection. 3. 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). In 1963, seven women united to address the conditions of poverty in Chapel Hill and Carrboro through the efforts of volunteers. Since then, IFC has become the primary non-profit provider of basic needs services for people living or working in our community. IFC has built capacity over decades to respond quickly and competently to residents' diverse needs in partnership with local congregations, foundations and individuals; Orange County's Department of Social Services; the Towns of Chapel Hill and Carrboro; the OC Partnership to End Homelessness; United Way of the Triangle; the Emergency Solutions Grant Program; and the Department of Housing and Urban Development. 4. Living Wage: Does this agency pay permanent employees a minimum living wage?(Yes/No) If yes,is this agency an Orange County Living Wage Certified Employer?Yes, proudly! If no, please briefly explain. Schedule of Positions: #of FTE—Full-Time Paid Positons: 28 #of FTE—Part-Time Paid Positions: 8 IFC leverages the time and energy of 750+ volunteers, who provide almost 30,000 hours of pro bono staff time each year. IFC could not operate without them. DocuSign Envelope ID:74211493-D876-4700-813D-OA9F75861508 PROGRAM INFORMATION * lease submi for each program, if applying for funding for more than one program, 5. Program Name: Residential Services Program Primary Contact and Title: Stel3hani Kilpatrick, Residential Services Director Telephone Number: 919,967.1086 ext. 12 E-Mail: ski 1patrick(@_ifcmailbox.oM 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) As Orange County's only provider of homeless shelter services, IFC works with numerous community partners to ensure a community network of basic human services and infrastructure that maintains, protects, and promotes the well-being of all county residents, including social safety net services such as safe shelter and meals, which are critical to well-being. IFC works with residents to identify their goals in increasing their livelihood security and access the most appropriate social safety net services, partly by participating in Orange County's Coordinated Entry system, which determines quickly, consistently and effectively which services or resources will best help people experiencing homelessness. 7.Target Population: Please complete the table below with numbers (not percentages)of individuals served and projected to be served. Program Target Population Demographics* Projected Actual Projected Projected 2018-19 2018-19 2019-20 2020-21 ' sw ' Men 220 164 164 164 Women 115 42 84 84 Nonbinary/Genderqueer 0 0 0 0 Self-Describe 0 0 0 0 Total 335 206 248 248 Race and Ethnicity Black or African-American 201 101 123 123 American Indian or Alaska Native 10 7 7 7 Asian 3 1 1 1 White 117 87 105 105 Native Hawaiian or other Pacific Islander 0 2 2 2 Two or more races 4 8 10 10 Some other race Program infori'nation a c. ', t:, f 2 DocuSign Envelope ID:74211493-D876-4700-813D-OA9F75861508 Total 1 3351 206 1 2481 248 Of the above,how many Hispanic/Latino 3 7 7 7 Of the above, how many non-Hispanic/Latino 332 199 241 241 Total 335 206 248 248 0-5 years 37 13 15 15 6-18 years 30 24 30 30 19-50 years 164 85 102 102 51+years 104 84 101 1 101 Total 335 206 248 24gg Geographic Location ¢ , Town of Chapel Hill 168 133 161 161 Town of Carrboro 13 4 5 5 Orange County(Outside of Chapel Hill/Carrboro) 17 12 15 15 Outside of Orange County 137 57 67 67 Total 335 206 248 248 Income Low-income(80%of the Area Median Income and Below) Please see income table in the attachments 335 206 248 248 Total 335 206 248 248 *Demographics above reflect residents residing in our regular shelter beds. In addition, IFC provided cot space to 286 unduplicated individuals during inclement weather in FY 2018-19 and projects to provide inclement weather cots to 213 individuals in FY 2019-20 and 2020- 21. 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. ra 1k$44 I'ri a 5-20,i Pro t-Mtt ' Total Cost of Program $934,736 $979,343 $1,061,106 Total #of Individuals 206 248 248 Cost Per Individual $4,538 $3,949 $4,279 9. Performance Indicators For Chapel Hill and Carrboro applicants: Please complete the following chart with information about the Strategic 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: Residential Services Progi,-mn information U a g _' In 0 t 2 5 DocuSign Envelope ID:74211493-D876-4700-813D-OA9F75861508 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 Result 2.1 Residents access the most appropriate social safety net services (please choose one from the Results Framework) RESULTS Actual Projected Projected 2018-19 2019-20 '20 -21 Performance % and # of unduplicated 100%, 206 100%, 248 100%, 248 Indicators community members who (Please choose at least receive emergency shelter oneperformance Services indicator to report on % and # of program 37%, 52* 37%, 92 37%, 92 from the Results Framework,and add participants who are of 142 additionalperformance homeless or experiencing move-outs; indicators thatyou unstable housing who obtain (not all206 would like to report to residents the Towns. Please housing served in insert additional rows as needed,listing one per 2018-19 row). moved out of the shelter in 2018-19 J�'t'ul"l{IIfiJYtY 31iCZI1 O a a 7 f 2 5 - DocuSign Envelope ID:74211493-D876-4700-813D-OA9F75861508 ORANGE COUNTY 01 1. 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. Housing If you selected other, please tell us what function area best aligns with your organization: n/a 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. Program Goal# 1 Residents access the most appropriate social safety net services Performance Measure % and # of unduplicated community members who (How will you accomplish your goal?) receive emergency shelter services g % -� { 2 W011... _... - Actual Results °' t (Outcome) ; Wyk Ending FY18-19 Projected Results y 100%, 248 (Outcome) Ending FY2020 Projected Res s . 100%, 24811611 IS �. # (Outcome) Endue Program Goal#2 Residents increase their livelihood security Performance Measure % and # of program participants who are homeless or (Flow will you accomplish your goal?) experiencing unstable housing who obtain housing 37%, 52* lri Actual Results (Outcomes ,_ of 942 rove otafs—no€all 2f36resldents served i EndingFY�B-19 2018-19 moved out of the shelter in 2418-99 ,, Projected Res ultsy 37%, 92 � a (Outcome) Atka � Ending FY202t Program inforrnation P a g, e 8 c f 2 5 DocuSign Envelope ID:74211493-D876-4700-813D-OA9F75861508 ORANGE CaUNITY Outside Agencies/Human Services Projected Results 37%, 92 �3 � ? WEIN = . (Outcome) s � . Ending FY2021 Offer Case Management services to homeless Program Goal#3 households to help them obtain shelter, address barriers to permanent housing, and secure permanent affordable housing Performance Measure # of times a Case Manager meets with shelter (How willyou accomplish your goal?) residents during the program year Actual Results 1,236 meetings (Outcome) Ending FY18-19 Projected Results 1,300 meetings (Outcome) Ending FY2020 Projected Results 1,300 meetings (Outcome) Ending FF2021 Prograrn information M a mi e 9 of 25 DocuSign Envelope ID:74211493-D876-4700-813D-OA9F75861508 PROGRAM INFORMATION *Please submit for each program,if applying forfunding for more than one program, 5. Program Name: Food SecuritV Programs Program Primary Contact and Title: Kristin Lavergne, Community Services Director Telephone Number: 919-929-6380 x41 E-Mail:.kiavergne@ifcmailbox.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) As the largest non-profit provider of food security in our community, IFC ensures a community network of basic human services and infrastructure that maintains, protects, and promotes the well-being of all County residents. IFC's Community Kitchen serves hot meals daily to anyone who is hungry, and the Food Pantry provides a full complement of groceries, personal care items and emergency financial assistance to prevent eviction and utility disruption. These programs advance the priorities of the Towns to increase residents' livelihood security and support residents in accessing the most appropriate social safety net services within and beyond IFC. 7.Target Population: Please complete the table below with numbers(not percentages)of individuals served and projected to be served. Program Target Population Demographics* Projected Actual Projected Projected 2018-19 2018-19 2019-20 2020-21 Gender Men 1,500 1,231 1,250 1,250 Women 2,100 1,958 1,950 1,950 Nonbinary/Genderqueer ---- ---- ---- Self-Describe ---- ---- Total 3,600 3,189 3,200 3,200 Race and Ethnrcity. Black or Africa n-American 2,000 1,809 1,824 1,824 American Indian or Alaska Native 50 63 60 60 Asian 50 62 60 60 White 1,050 880 896 896 Native Hawaiian or other Pacific Islander 50 62 60 60 Two or more races 400 46 32 32 Some other race 267 268 268 Total 3,600 3,189 3,200 3,200 Of the above,how many Hispanic/Latino 350 267 255 255 DocuSign Envelope ID:74211493-D876-4700-813D-OA9F75861508 of the above, how many non-Hispanic/Latino 3,250 2,913 2,945 2,945 Total 3,600 3,189 3,200 3,200 0-5 years 0 0 0 0 6-18 years 30 5 15 15 19-50 years 2,100 2,168 2,160 2,160 51+years 1,470 1,016 1,025 1,025 Total 3,600 3,189 3,200 3,200 R W .� d Geographic Location }` � . .. Town of Chapel Hill 2,450 2,137 2,145 2,145 Town of Carrboro 1,000 893 900 900 Orange County(Outside of Chapel Hill/Carrboro) 50 63 59 59 Outside of Orange County 100 46 96 96 Total 3,600 3,189 3,200 3,200 Low-income(80%of the Area Median Income and Below) Please see income table in the attachments 3,492 3,030 3,040 3,040 Total 3,6 0 1 3,189 3,200 3,200 *Demographics are only for Food Pantry Members. The Community Kitchen does not collect this data. 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. ctri 1 -1 i lFirof:c# tt2i1 Total Cost of Program $327,730 $347,051 $387,251 Total #of Individuals 3,189 3,200 3,200 Cost Per Individual $103 $108 $121 9. Performance Indicators For Chapel Hill and Carrboro applicants: Please complete the following chart with information about the Strategic 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: Food Security Programs Strategic ❑ Children improve their educational outcomes Obj ective (please choose one from x Residents Increase their livelihood security the Results Framework) ❑ Residents improve their health outcomes Program infurnnation P a g , :t 3 o 1 2 5 — DocuSign Envelope ID:74211493-D876-4700-813D-OA9F75861508 Intermediate Result 2.1 Residents access the most appropriate social safety net services. (please choose one from the Results Framework) RESULTS Actual Projected Proiected 2018-19 2019-20 202041 Performance % and # of households that 3,189 3,200 3,200 Indicators receive food assistance (Please choose at least (Pantry) one performance indicator to report on # meals provided/food from the Results 55,249 56,000 56,000 Framework,and add assistance (Kitchen) additional performance indicators thatyou % and # of individuals who would like to report to 646 650 650 the Towns. Please receive emergency financial insert additional rows as assistance for essential needed,listing one per needs. row). Program information Page 14 ©f 25 -DocuSign Envelope ID:74211493-D876-4700-813D-OA9F75861508 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. Food and Nutritional Services If you selected other, please tell us what function area best aligns with your organization: n/a 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. w " Food Pantry will collect and purchase enough food Program Goal#1 3 items to provide groceries as often as once a month to member households # of households that receive food assistance ` „ Performance Measure r (How will you accomplish your goal?) htp4a '. Actual Results } � k (Outcome) Ending FY18-19 " r :. . � l" mw� gag } a Projected Results 3,200 �1� , (Outcome) Ending FY2020 Projected Results O (Outcome) Ending FY202 • RV A balanced, nutritionally dense meal will be served to Program Goal#2 any hungry person who shows up at meal times at the . � NON- Community Kitchen and/or to residents at one of the shelters # meal provided/food assistance Performance Measure (How will you accomplish your goal?) T Program information P a g e 1 5 o f 2 5 DocuSign Envelope ID:74211493-D876-4700-813D-OA9F75861508 ry 55,249 Actual Results (Outcome) , � 3 ` Ending FYI 8-19 Projected Results 56,000 � � - (Outcome) - �� -��- IN Ending FY2020 Projected Results 56,000 (Outcome)- Ending FF202I Community Services program will provide emergency Program Goal#3 financial assistance and referral for essential needs, as applicable, to individuals by appointment Performance Measure # of individuals who receive emergency financial (How will you accomplish your goal?) assistance for essential needs Actual Results 646 (Outcome) Ending FYI8-19 Projected Results 650 (Outcome) Ending FY2020 Projected Results 650 (Outcome) Ending FY2021 Program information Page 16 0 f 2 s DocuSign Envelope ID:74211493-D876-4700-813D-OA9F75861508 Agency Budget Operating Budget for Entire Agency AGENCY NAME: Inter-Faith Council for Social Service Actual Estimated Projected Percent AGENCY REVENUE 2018-19 " 2019-20 2020-21 Change Private Donations* $ 1,173,223 $ 1,427,447 $ 1,365,896 4% Agency Generated Revenue(fees) $ - $ - $ - 0 Local Government Grants: Human Services-Town of Carrboro $ 12,000 $ 11,000 $ 25,000 127% Other-Town of Carrboro $ 1,500 $ 1,350 $ 1,500 11% Human Services-Town of Chapel Hill $ 29,000 $ 36,000 $ 100,000 178% Other-Town of Chapel Hill $ 1,500 $ 1,500 $ 1,500 0% Human Services-Orange County $ 53,650 $ 57,603 $ 125,000 117% Other-Orange County $ 94,944 $ 85,000 $ 85,000 0% Other-Town of Hillsborough $ - $ - $ - 0 Other Government Grants Triangle United Way $ 100,610 $ 68,000 $ 68,000 0% State Government $ 99,714 1 $ 36,000 $ 64,500 79% Federal Government(CDBG/HOME/etc.) $ 290,703 $ 355,379 $ 436,839 23% Private Foundation Grants $ 293,358 $ 266,823 $ 266,823 0% Other Revenue $ 51,267 $ 51,240 $ 49,440 4% Total Agency Revenue $ 2,201,469 $ 2,397,342 $ 2,589,498 8% AGENCY EXPENSES Compensation $ 1,424,010 $ 1,610,106 $ 1,741,195 8% Client Assistance $ 269,410 $ 336,772 $ 346,876 3% Admin/Program Exp $ 270,951 $ 222,947 $ 230,161 3% Rent&Utilities Exp $ 91,300 $ 94,556 $ 136,340 44% Supplies&Equipment Exp $ 50,978 $ 72,788 $ 75,349 4% Travel&Training $ 5,192 $ 18,395 $ 14,906 -19% Other Expenses: $ 89,628 $ 41,778 $ 44,671 7% 2,201,469 $ 2,397,342 $ 2,589,498 8% SURPLUS/(DEFICIT) FOR'.PERIQR. FY 2018-19 Agency Budget DocuSign Envelope ID:74211493-D876-4700-813D-OA9F75861508 ------------ Program Budget Operating Budget for Program PROGRAM NAME IFC-Residential Services Actual Estimated Projected Percent PROGRAM REVENUE 2018-19 2019-20 2020-21 Change Private Donations $ 752,723 $ 829,476 $ 652,900 -21% Program Generated Revenue $ - $ - $ - 0 Local Government Grants: Human Services-Town of Carrboro $ 6,000 $ 5,500 $ 12,500 127% Other-Town of Carrboro $ - $ - $ - 0 Human Services-Town of Chapel Hill $ 14,500 $ 18,000 $ 50,000 178% Other-Town of Chapel Hill $ - $ - $ - 0 Human Services-Orange County $ 26,825 $ 28,801 $ 62,500 117% Other-Orange County $ - $ - $ - 0 Other-Town of Hillsborough $ - $ - $ - 0 Other Government Grants Triangle United Way $ 1,700 $ - $ - 0 State Government $ 85,214 1 $ 36,000 1 $ 64,500 79% Federal Government(CDBG/HOME/etc.) $ 45,774 $ 59,166 1 $ 140,6263 1380%/6 Private Foundation Grants $ 2,000 $ 2,400 1 $ 78,080 1 3153% Other Revenue $ - $ - I $ - 1 0 Total Program Revenue $ 934,736 $ 979,343 1 $ 1,061,106 1 8% PROGRAM EXPENSES Compensation $ 677,995 $ 741,796 $ 816,482 10% Client Assistance $ 3,671 $ - $ - 0 Admin/Program Exp $ 96,036 $ 78,210 $ 81,107 4% Rent&Utilities Exp $ 84,176 $ 87,255 $ 89,872 3% Supplies &Equipment Exp $ 30,229 $ 50,320 $ 51,230 2% Travel &Training $ 351 $ 6,000 $ 6,180 3% Other Expenses: $ 42,278 $ 15,762 $ 16,235 3% Total Program Expenses $ 934,736 $ 979,343 1 $ 1,061,106 1 8% SU 11 RPLUS/{DEFICIT) FOR PERIOD: $ - $ - $ - 0 FY 2018-19 Program Budget DocuSign Envelope ID:74211493-D876-4700-813D-OA9F75861508 Program Budget Operating Budget for Program PROGRAM NAME IFC -Food Security Programs Actual Estimated Projected Percent PROGRAM REVENUE 2018-19 2019-20 2020-21 Change Private Donations $ 266,736 $ 282,749 $ 250,251 -11% Program Generated Revenue $ - $ - $ - 0 Local Government Grants: Human Services-Town of Carrboro $ 6,000 $ 5,500 $ 12,500 12706 Other-Town of Carrboro $ - $ - $ - 0 Human Services-Town of Chapel Hill $ 14,500 $ 18,000 $ 50,000 178% Other-Town of Chapel Hill $ - $ - $ - 0 Human Services-Orange County $ 26,825 $ 28,802 $ 62,500 117% 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 $ 1,000 $ - $ - 0 Other Revenue I I 12,669 $ 12,000 $ 12,000 $ - Total Program Revenue $ 327,730 $ 347,051 $ 387,251 12% PROGRAM EXPENSES Compensation $ 265,006 $ 298,719 $ 312,468 5% Client Assistance $ 21,583 $ 21,300 $ 21,939 3% Admin/Program Exp $ 22,470 $ 11,572 $ 11,920 3% Rent&Utilities Exp $ 1,931 $ 6,280 $ 31,468 401% Supplies&Equipment Exp $ 15,782 $ 9,180 $ 9,456 3% Travel &Training $ 19 $ - $ - 0 Other Expenses: $ 939 $ - $ - 0 Total Program Expenses $ 327,730 $ 347,051 $ 387,251 12% SURPLUS/(DEFICIT) FOR PERIOD: $ $ - $ - 0 FY 2018-19 Program Budget DocuSign Envelope ID:74211493-D876-4700-813D-OA9F75861508 COVER PAGE Applicant Contact Information Applicant Organization's Legal Name: Inter-Faith Council for Social Service Applicant Organization's Physical Address: 100 W Rosemary,St,Chapel Hill NC 27516 Applicant Organization's Mailing Address: 110 W Main St,Carrboro,NC 27510 Applicant Organization's Web Address:www.ifcweb.org Executive Director:Jackie Jenks Telephone Number:919-929-6380,x14 E-Mail:Henks@)ifcmailbox.org Tax ID Number:59-1224041 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- Chapel Orange Total HS Hill-HS County-HS Food for the Summer $2,000 $2,000 $2,000 $6,000 Personnel Personnel Personnel Totals $2,000 $2,000 $2,000 $6,000 Briefly explain your proposed use of funds: The funds will be used to provide compensation to 2 part-time Program Co-Directors. 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: c L,,y_m� i; 2,1 Z.�, Executive Director Date Signature; Board Chairperson �- Date Cover Page Page 5 of 2,0 DocuSign Envelope ID:74211493-D876-4700-813D-OA9F75861508 DISCLOSURE OF POTENTIAL CONFLICTS OF INTEREST AND NON DISCRIMINATION CLAUSE Are any of the Board Members or employees of the agency which will be carrying out this program or members of their immediate families,or their business associates. YES NO x❑ ❑ a) Employees of or closely related to employees of the Town of Carrboro,the Town of Chapel Hill, or Orange County? ❑ x❑ b) Members of or closely related to members of the governing bodies of the Town of Carrboro, the Town of Chapel Hill, or Orange County? x❑ ❑ c) Current beneficiaries of the program for which funds are being requested? ❑ x❑ d) Paid providers of goods or services to the program or having other financial interest in the - program? If you have answered YES to any question,please provide a full explanation below. a) One of our part-time residential staff members at HomeStart is an employee of the Orange County Health Department. c) Embracing a commitment to equity and representation of all stakeholder perspectives, IFC prioritizes including current recipients of services and others with lived experience on our Board of Directors, Two members of our Board are current shelter residents. NON-DISCRIMINATION Provider agrees as part of consideration of the granting of funds by funding agencies to the parties hereto for themselves, their agents, officials, employees and servants agree not to discriminate in any manner of these basis of race, color, gender, national origin, age, handicap, religion, sexual orientation, gender identity/expression, familial status or veterans status with reference to any activities carried out by the grantee, no matter how remote. The parties hereto further agree in all respects to conform to the provision and intent of Orange County Civil Rights Ordinance, as amended and the Orange County Anti-discrimination Policy. This provision is enforced by action for specific performance, injunctive relief, or other remedy as by law provided, this provision shall be binding on the grantees, the successors and assigns of the parties hereto with reference to the above subject manner. To the best of my knowledge and belief all of the above information is true and current. I acknowledge and understand that the existence of a potential conflict of interest does not necessarily make the program ineligible for funding,but the existence of an undisclosed conflict may result in the termination of any grant awarded. Signature �..j.: ,:i. L.---- I J i 3 (2 ZZ Executive Director Date Signature: Board Chairperson Date Cover Page P a g o f 29 DocuSign Envelope ID:74211493-D876-4700-813D-OA9F75861508 Outside Agencies/Human Services Children and youth under 18 years of age qualify for the program. Most of the children currently served are elementary school aged. We serve children from all three communities and are unable to break out totals by town/county. The estimates included below are based on observations/information counts provided by AmeriCorps volunteers who worked with us in 2018/19. We were unable to obtain similar information this year. Program Target Population Demographics Projected Actual Projected Projected 2018-19 2018-19 2019-20 2020-21 Gender Men Women Nonbinary/Genderqueer Self-Describe Total 0 0 0 0 Race and Ethnicity Black or Africa n-Am erican 142 American Indian or Alaska Native 21 Asian 79 White 80 Native Hawaiian or other Pacific Islander 11 Two or more races 141 Some other race Total 1 474 0 0 0 Of the above, how many Hispanic/Latino Of the above,how many non-Hispanic/Latina Total 0 0 0 0 Age 0-5 years 6-18 years 19-50 years 51+years Total 0 0 0 0 Geographic Location Town of Chapel Hill COVC- P3Fe r a „ C f _ DocuSign Envelope ID:74211493-D876-4700-813D-OA9F75861508 Outside Agencies/Human Services Town of Carrboro Orange County(Outside of Chapel Hill/Carrboro) Outside of Orange County Total 0 0 0 0 Income Low-income(90%of the Area Median Income and Below) Please see income table in the attachments Total 0 0 0 0 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. PLEASE NOTE; Because we are not allowed to roster children for the open sites (to encourage access), it is difficult to enter exact numbers here. However if one assumes 474 children receiving meals on any given day and that there were 54 days of service, the estimated costs are entered below. _ ActuaF:201:8-`T9 Pirojected 2019 20 - Plrojected 2020 21; Total Cost of Program $18,957 $17,987 $18,506* Total # of Individuals 474 500 550 Cost Per Individual $0.74 $0.67 $0.72 *For Summer 2020, the program anticipates the need for additional monies to cover the cost of lunches at specific locations where the lack of facilities or other circumstances prevent us from meeting USDA rules regarding children eating the meal at the site. In these cases, we will be providing the same hot lunches in "to go" bags but will be unable to recoup those costs through the federal program. Cover P2ge c e , o DocuSign Envelope ID:74211493-D876-4700-813D-OA9F75861508 Outside Agencies/Human Services 9. Performance Indicators For Chapel Hill and Carrboro applicants: Please complete the following chart with information about the Strategic 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 onefrom X Residents Increase their livelihood security the Results Framework) ❑ Residents improve their health outcomes Intermiediate 2.1 Residents access the most appropriate safety net services. Result (please choose one from the Results Framework) RESULTS ole a 'Projected ' - 2018 19 :2019-20. : : . .. 202021: i. ; Performance Number of program 22.084 29,720 30,000 — Indicators participants that receive meals meals 35,000 (Please choose at least food assistance (duplicated delivered by delivered by meals oneperformance #of people based on FFTS FFTS delivered by indicator to report on #of meals served) volunteers volunteers FFTS from the Results volunteers Framework,and add addition al p erformance Help reduce the summer indicators thatyou slide by providing daily 54 days of 54 days of 54 days of would like to report to the Towns. Please opportunities for outdoor service service service insert additional rows as recreation, interaction and needed,listing oneper frequent enrichment Fun Buckets Fun Buckets Fun Buckets raw). activities. — daily —daily —daily Free Book Free Book Free Book Wednesdays Wednesdays Wednesdays —weekly —weekly —weekly Enrichment Enrichment Enrichment activities: 2 — activities: 2 — activities: 2 — 3 times per 3 times per 3 times per week week week Special Special Special Visitors Visitors Visitors Cover PeFe 2 DocuSign Envelope ID:74211493-D876-4700-813D-OA9F75861508 ,�.q� tg§ p, j@{ p•• ice`C`.",� Outside Agencies/Human Services (police, (police, fire, (police, fire, fire...) at all local local sites farmers, bike farmers, bike repair...) at repair...) at all sites all sites 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. Food and Nutritional Services If you selected other, please tell us what function area best aligns with your organization: h 1a 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. Number of breakfast,lunches and/or snacks delivered at meal Program Goal A I sites or to camps(30,000—35,000 total) The program employs 2 Directors and 2 Site Coordinators for the summer. These employees will coordinate the efforts of our volunteer network to Performance Measure deliver meals from the school cafeterias to local camps (How vaiyouaccomplish your goam and open meal sites. Anticipated growth is tied to creation of new camp slots being considered by CHCCS and Chapel Hill's Parks & Recreation department. Actual Results 22,084 meals (Outcome) EnStW FY78-19 Projected Results 29,720 meals (Outcome) Ending FDO20 Projected Results 30,000—35,000 Cover Oagl _ Q 9 0-1 12 -DocuSign Envelope ID:74211493-D876-4700-813D-OA9F75861508 Outside Agencies/Human Services (Outcome) Ending M021 Program Goal#2 Provide food throughout the entire summer break Meal service begins on the first Monday of summer ..-.*. Performance Measure(How will you accomplish yourgoal?) break and runs.through the final Friday of summer b reak. Actual Results 54 days (Outcome) Ending Fng-19 Projected Results 54 days (Outcome) Ending FX2020 Projected Results 54 days (Outcome) Ending FY2021 Engage children/youth and offer opportulli es for Pirogxa>oa Goal<#3 recrea#ion and;enrichment free book:lNednesdays; Fpn Buckets (daily);;.Plahhbd:::::: Performance Measure; activlties (2 3 tiines/week);.Community visitors (2 (I3bw fvill yorcacromplish yoargokl�) tlrlleS/1Ne2k) . . Free. ..- .. book Wednesdays;.Fun Buckets(daily) <Planned : i, Actual Results ' aictivities.(2-3 times/weak};:CommILI visitors (2 (Outcome)' times/week) Ending'FY18-19 For our open sites: On a daily basis, we send out"Fun Buckets"` hi6>1 are filled with games and activities ranging such as coloring supplies, sidewalk chalk, Frisbees, balls;jump ropes and card games. Projected Results On a weekly basis: (Outcome) We sent out enrichment activities 2—3 times a week: Ending M020 Examples from last year included: giant word search puzzles, paper cup ping pong ball launchers, tabletop catapult kits and homemade slime ingredients. Site volunteers helped the children with these activities. On Wednesdays, crates of books from Book Harvest were sent to each site. The children were encouraged DocuSign Envelope ID:74211493-D876-4700-813D-OA9F75861508 I Outside Agencies/Human Services b .;h to��t;�ke:.,on,e-,..-,or,,More::* ooks�.' omo-...,with-.,,them-:.-.--.:Th'is'.-:year.-::-::., -We,.*crea 0, ib; ea 46 raine 'R'' din' 'g-" a n.,*.*.?.:,.program V 't' : 1bbal*!*:.eens-.*.,on-.,:how--o,--*h e plit h 6;dhild eh: 66bt'bdoks ::engaged them 'e .literature related:activi ies-,,! 'S'"** "e W� imes:. u-rin-g:�thL=iU�h-"'mer-ispecia .P'op% n 'Giaver 6t 9 :.Viltit6d b8d .:inoludet ito*:,ol Icer'- :units',',o*c**"a'I prod uce, Ot6vid6Ts-.',boek6e"p'"e-'rs-.a'n- bicycle.repair.,.--: :.assistance::: ' t we engaged Attwo Of bur-sit'e who-lived i" mimUnity","Th"Youth Ambassadors".: :.higb-.sdh'o`61:students n the Ambassadbts-.heIped..voIu hteers-distribute meal --yen gagedwith:the students,-.-holping with-:dail� e'nrichment,-.:-- Tree book-W6dnesdays;Fun Buckets'*(daily);.:Pl'a'hnigd':'- activities (2 —3 times/week); Community visit6rs-(2,. ..:.:(Outcome) times/week) - Cover page a a-2 C 12 DocuSign Envelope ID:74211493-D876-4700-813D-OA9F75861508 Exhibit B Emergency Assistance Scope of Services Federal Tax Id. or SSN 59-1224041 Contract# A. CONTRACTOR INFORMATION 1. Contractor Agency Name: Inter-Faith Council for Social Service,Inc. 2. If different from Contract Administrator Information in General Contract: Address Telephone Number: Fax Number: Email: 3. Name of Program(s): Emergency Assistance 4. Status: ( )Public (X)Private,Not for Profit ( )Private,For Profit 5. Contractor's Financial Reporting Year July 1,2020 through June 30,2021 B. Explanation of Services to be provided and to whom: Through the Emergency Assistance Program,the Contractor will assist eligible individuals with rent and related costs as well as Orange Water and Sewer Authority(OWASA)bills and related costs The Countywill reimburse the Contractor up to $5 000/month unless prior approval by County,for a total of$60 000 for the contract period for rent/related costs and/or Orange Water and Sewer Authority(OWASA)bills/related costs.To be eligible clients must: be residents of Orange County have income at or below 200% of the Federal Poverty Level, and have a household experiencing a financial crisis Payments are limited to$200 within a 12-month period The County will also reimburse the Contractor for staff costs(including salary,FICA, and fringe) for administering the Emergency Assistance Program up to$25 000 for the contract period. The Contractor will submit program paperwork provided by County at time and dates desi a ted by County. C. Funding reimbursement limits by category: Rent/related costs and OWASA bills/related costs $60,000 ($5,000 per month) Staff costs: salary FICA fringe $25,000 D.Number of units to be provided:NA E.Area to be served/Delivery site(s): _Orange County DocuSigned by: DocuSigned by: Naunl,� cesfew ,�al,�it, ,�C,�.�S Nancy Coston,Social Services Director (Signature of Contractor) 10/27/2020 10/27/2020 (Date Submitted) (Date Submitted) 9 - DocuSign Envelope ID:74211493-D876-4700-813D-OA9F75861508 EDIT"C" Scope of Services—FY 2020-2021 Outside Agency Performance Agreement Agency Name: Inter-Faith Council for Social Service Program Name: Residential Funding Award: $1003000 Outline how the agency will spend Orange County's funding award. Expense Description Amount Personnel $80,000 Operations $20,000 Program Services Outline the critical services(activities)the agency will employ to attain the Anticipated Outcomes below,by June 30,2020. • Provide safe shelter and offer Case Management services to homeless households to help them obtain shelter, address barriers to permanent housing, and secure permanent affordable housing so that Residents access the most appropriate social safety net services and increase their livelihood security Anticipated Outcomes The Anticipated Results column must include quantifiable results in the form of number of persons/units served within Orange County,only(all Towns and municipalities).If you use percentages,you must also provide the total number of participants within that measure's description or for an earlier performance measure. Performance Measures Anticipated Results %and#of unduplicated community members who receive emergency shelter service 100%/248 %and#of program participants who are homeless or experiencing unstable housing who obtain 37%/92 housing #of times a Case Manager meets with shelter residents during the program year 1,300 DocuSigne^^d..b''y::II� J 1L )�& President/CEO 10/27/2020 Certified by: Title: Date: (Provider's Signature) Orange County Outside Agency Performance Agreement Revised 6/2018 — DocuSign Envelope ID:74211493-D876-4700-813D-OA9F75861508 -- — EXHMIT"C" Scope of Services—FY 2020-2021 Outside Agency Performance Agreement Agency Name: Inter-Faith Council for Social Service Program Name: Food Security Programs Funding Award: $27,000 Outline how the agency will spend Orange County's funding award. Expense Description Amount Personnel $21,000 Operations $4,000 Food for Students $2,000 Program Services Outline the critical services(activities)the agency will employ to attain the Anticipated Outcomes below,by June 30,2020. • Collect or purchase enough food items to provide groceries as often as once per month to member households. • Serve a hot,nutritious meal to any hungry person who shows up at mealtimes at the Community Kitchen. • Provide emergency financial assistance and referral for essential needs, as applicable, to individuals by appointment. Anticipated Outcomes The Anticipated Results column must include quantifiable results in the form of number of persons/units served within Orange County,only(all Towns and municipalities).If you use percentages,you must also provide the total number of participants within that measure's description or for an earlier performance measure. Performance Measures Anticipated Results Number of households that receive food assistance 3,200 Number of meals provided 56,000 Number of individuals who receive emergency financial assistance for essential needs 650 DocuSigned by: J 1L YJAS President/CEO 10/27/2020 Certified by: Title: Date: (Provider's Signature) 2 DocuSign Envelope ID:74211493-D876-4700-813D-OA9F75861508 INTECOU-01 MSUMMERS CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 7/1/2020 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). CONTACT PRODUCER NAME: Summers Thompson Lowry,Inc. PHONE FAX 919 942-4221 2113 Cameron Street (A/c,No,Ext):(919)968-4472 (A/C,No):( ) Suite 219 E-MAIL info@STLinsure.com Raleigh,NC 27605-1370 INSURER )AFFORDING COVERAGE NAIC# INSURER A:Alliance for Non-Profits for Insurance Risk Retention Group 10023 INSURED INSURER B:Eastern Alliance Insurance Co Inter-Faith Council for Social Service Inc. INSURER C:Hartford Fire Insurance Company 19682 110 W.Main Street INSURER D,The Hanover Ins Co 22292 Carrboro,NC 27510 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDLI WVD POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD MMIDD MM/DD 1,000,000 A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE X OCCUR X 2016-17838 7/1/2020 7/1/2021 PREMISES(ERENTED occu ante $ 520,000 X Professional 1M/2M A MED EXP An one arson $ 20,000 PERSONAL&AOV INJURY $ 11000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE _ 21000,000 POLICY❑PRO ❑ LOC PRODUCTS-COMP/OP AGG $ 2,000,000 JECT OTHER: SEXUAL ABUSE 1 M $ A AUTOMOBILE LIABILITY fE,accide COMBINED'SINGLE LIMIT $ 1,000,000 X ANY AUTO 2016-17838 7/1/2020 7/1/2021 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ A X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAB HX CLAIMS-MADE X 2020-17838-UMB 7/1/2020 7/1/2021 AGGREGATE $ 1,000,000 X DED I I RETENTION$ 10,000 $ B WORKERS COMPENSATION X STATUTE OTH- AND EMPLOYERS'LIABILITY QQQ0583899 7/1/2020 711/2021 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE Y❑ NIA E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? 1,000,000 (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ C CrimeIERISA 22BDDHK5511 7/1/2020 7/1/2021 1,000,000 D D&O/Employment Pract LH68785106 7/1/2020 7/1/2021 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD iOl,Additional Remarks Schedule,may be attached If more space Is required) It is understood and agreed that the certificate holder is included as additional insured as respects General Liability as required by written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Orange County ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 8181 Hillsborough,NC 27278 AUTHORIZED REPRESENTATIVE ((�� 39On1,.(Pt Sun^nir l 5 ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD