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HomeMy WebLinkAbout2021-118-E Arts Commission-Kidzu Childrens Museum outside agency agreement DocuSign Envelope ID:A2DC2EF9-6C9A-438D-A97D-84CEA493644C OUTSIDE AGENCY PERFORMANCE AGREEMENT THIS AGREEMENT, made and entered into the twelfth day February of 2021, ("Effective Date") by and between the County of Orange, a political subdivision of the State of North Carolina,Post Office Box 8181, Hillsborough,North Carolina,27278,("County")and Kidzu Children's Museum,a not-for-profit corporation, located at 201 S. Estes Dr. Suite A9, Chapel Hill,NC 27514("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 Kidzu Children's Museum 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 A, Scope of Services and more particularly described in the Revised Program Budget, the maximum sum of$13,301. b. All funds appropriated shall be used for purposes described in Exhibit A. Any funds not used for the purposes stated shall be returned to the County. Any changes in the use of funds must be authorized in writing by the County prior to any expenditure of the funds by the Provider. If the funds are expended not in accordance with the 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$3325.25. 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. Kidzu Children's Museum Orange County Outside Agency Performance Agreement Revised 712018 Page I of 9 DocuSign Envelope ID:A2DC2EF9-6C9A-438D-A97D-84CEA493644C 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 10,April 10, and July 10 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. Orange County Outside Agency Performance Agreement Page 2 of 9 Rev. 1121 DocuSign Envelope ID:A2DC2EF9-6C9A-438D-A97D-84CEA493644C 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. Orange County Outside Agency Performance Agreement Page 3 of 9 Rev. 1121 DocuSign Envelope ID:A2DC2EF9-6C9A-438D-A97D-84CEA493644C 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 $ 15.40 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 Provider shall be in writing and mailed to the party addressed as follows: County: Finance&Administrative Services Provider: Kidzu Children's Museum Orange County Outside Agency Performance Agreement Page 4 of 9 Rev. 1121 DocuSign Envelope ID:A2DC2EF9-6C9A-438D-A97D-84CEA493644C Orange County 201 S. Estes Dr. Suite A9 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 and on behalf of the Provider DocuSigned by: Sa. Vale, PUMNA, 2/15/2021 4."BVEmPAman,Executive Director Date For and on behalf of Orange County Government DocuSigned by: �jblAdA lt, � I, 2/21/2021 4KY?mmersley, County Manager Date Orange County Outside Agency Performance Agreement Page S of 9 Rev. 1121 DocuSign Envelope ID:A2DC2EF9-6C9A-438D-A97D-84CEA493644C ORANGE COUNTY—DEPARTMENT USE ONLY Party/Vendor Name: Kidzu Children's Museum Party/Vendor Contact Person Lisa Van Deman Contact Phone: 919/933-1455 Party/Vendor Address: 201 S.Estes Dr Suite A9 City Chapel Hill State:NC Zip: 27514 Department: Cnty Manager Amount: $13,301 Purpose:20-21 Outside Agencies Grant Budget Code(s): 10692020 720274 Vendor #60102 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No❑ Contract Type: (Check one)New❑ Renewal❑ Amendment ❑ Effective Date Approved by Board Yes❑No❑ Agenda Date: This agreement is approved as to technical form and content and I as Department Director affirmatively state work on this project has not been initiated prior to execution of the agreement: DocuSigned by: Department Director's Signature �r_r S run, Date: 2/15/2021 Agreements for emergency services� &tMfVftWsubject to the above affirmation. If services related to this agreement have already begun or been completed please briefly describe the nature of the emergency condition that was addressed: Information Technologies (Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is approved as to information technology content and specifications: Office of the Chief Information Officer Date: Risk Management This agreement is approved for sufficiency of insurance standards,specifications,and requirements: DocuSigned""by. '' Office of the Risk Management Officer USA, (hmk i11ii b Date: 2/15/2021 7FDCF9176800498... Financial Services This instrument has been pre-audited in thegj@41 iS brpuired by the Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officerr_r;-_M Date: 2/15/2021 7D4E5181ACC1409... Legal Services This agreement is approved as to 1 BJfATJaa4d sufficiency: Office of the County Attorney mu_ Date: 2/21/2021 4035CB8304CA4A9... Clerk to the Board Received for record retention: All Docusign contracts must be copied to the Clerk upon completion: occlerkdocs@orangecountync.gov The following signature block is for hard copies only and is not required for Docusign contracts: Office of the Clerk to the Board Date: Orange County Outside Agency Performance Agreement Page 6 of 9 Rev. 1121 DocuSign Envelope ID:A2DC2EF9-6C9A-438D-A97D-84CEA493644C ATTACHMENT "A" Orange County Certifications—FY 2019-20 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: Certified by:L Sa VWA, UUMa'' Title: Executive Director Date: 2/15/2021 �rovic�er'"�s signature) Orange County Outside Agency Performance Agreement Page 9 of 9 Rev. 1121 DocuSign Envelope ID:A2DC2EF9-6C9A-438D-A97D-84CEA493644C EXHIBIT A COVER PAGE Applicant Contact Information Applicant Organization's Legal Name: Chapel Hill/ Carrboro Children's Museum Applicant Organization's Physical Address: 201 S. Estes Drive, Suite A-9 Chapel Hill, NC 27514 Applicant Organization's Mailing Address: As above Applicant Organization's Web Address: www.kidzuchildrensmuseum.ora Executive Director: Lisa Van Delman Telephone Number: 919 933 1455 E-Mail: vandeman(a�kidzuchildrensmuseum.ora Tax ID Number: 20-2058235 Funding Request Please list all Fiscal Year 2021 Human Services (HS) funding requested for all rograms and the proposed use of funds please list pro ram name only) Program Carrboro - Chapel Oranae Total HS Hill - HS Coun -HS Ex. Youth Afterschool Program $10,000 $15,000 $5,000 $30,000 Operations or Personnel Operations Personnel Operations Adaptive Playdates $5,000 Operations STEM based Open Access $22,395 programs during out of school time Operations Totals $5,000 $22,395 $27,395 Cover Page P a g e 6 o f 2 5 DocuSign Envelope ID:A2DC2EF9-6C9A-438D-A97D-84CEA493644C Briefly explain your imposed use of funds: The funds support vital STEM based out of school time educational support for children and families living throughout Orange County.The funds enable Kidzu to provide free access to Kidzu for low income residents of Orange County and support classroom based instruction for elementary and middle school age students from Cedar Grove, Efland Cheeks, New Hope and other rural areas of Orange County. 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: 1/13/2020 Executive Director - Date Z 11�/ Signature. 1/13/2020 Board Chairperson Date Cover Page P a g e 7 o f 2 5 DocuSign Envelope ID:A2DC2EF9-6C9A-438D-A97D-84CEA493644C 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? ® 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 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: �" ` 1/13/2020 Executive Director Date Signature: 1/13/2020 Cover Page P a g e 8 o f 2 5 DocuSign Envelope ID:A2DC2EF9-6C9A-438D-A97D-84CEA493644C AGENCY INFORMATION Please provide the following information about your agency: 1. Date of Incorporation (Month/Year): FEBRUARY, 2005 2. Agency's Purpose/Mission (no more than a few sentences): With a focus on STEM education, the arts, child health and emerging literacy, Kidzu Children's Museum inspires children and the adults in their lives to learn through creative, purposeful play. 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). Since 2006 Kidzu has been the leading and primary early learning cultural institution in Chapel Hill. Since 2015, Kidzu has facilitated out of school time STEM programs serving over 10,000 children and families throughout Orange County. The free STEM based programs bridge the gap between classroom instruction and extend the "learning day" through innovative educational activities. Alongside this, Kidzu has provided free access to Kidzu one day per month for the community since 2006. Kidzu has a positive track record securing and managing grant funding from multiple sized corporations and private foundations. Foundation funding makes up the majority of our direct support revenue (which maintains over 65% of our general operating budget). Throughout the years, Kidzu has received different funding sources to support our Open Access programs (GlaxoSmithKline, Wells Fargo, Strowd Roses, Ronald McDonald) but relies heavily on the funds from Orange County to ensure the programming remains free for local children. Kidzu has consistently met reporting deadlines and budget objectives for all funding awards. 4. Living Wage: Does this agency pay permanent employees a minimum living wage? (Yes/No) Yes and No If yes, is this agency an Orange County Living Wage Certified Emloyer? No If no, please briefly explain. All salaried staff receive a living wage. Part time hourly staff receive different hourly rates based on education and work experience. Many of our hourly employees are undergraduate students and our base pay matches that of work study students ($10.10) which is already the second highest tier of WS pay rates. Schedule of Positions: # of FTE — Full-Time Paid Positons: 6.5 # of FTE — Part- Time Paid Positions: 6.0 PROGRAM INFORMATION Program information P a g e 10 o f 2 5 DocuSign Envelope ID:A2DC2EF9-6C9A-438D-A97D-84CEA493644C I *Please submit for each program if applying for funding for more than one program. 5. Program Name: Community Connections Yr. 4 Program Primary Contact and Title: Kate Sullivan Telephone Number:919.933.1455 E-Mail: Sullivan(a�kidzuchildrensmuseum.ora 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) Addressing BOCC's goal to "ensure a high quality of life and lifelong learning that champions diversity, education at all levels..." Kidzu plans to continue providing rigorous and engaging out of school time STEM programs and free access to Kidzu for children living in poverty throughout Orange County. Our STEM activities scaffold current classroom instruction and the programs at Kidzu support early childhood goals laid out by the state of NC. Families from Cedar Grove, Efland Cheeks and New Hope will engage in their child's learning during Family STEM Nights at their schools and benefit from additional educational activities at Kidzu through 6 free Sundays at the museum. The program is designed to connect with families in their community during after school hours and then provide free access to Kidzu during the monthly free Sundays. We are expanding the number of individuals served this year by expanding the programs at the museum. 7. Target Population: Please complete the table below with numbers (not percentages) of individuals served and projected to be served. Program Target Population Demographics Projecte Actual Projecte d 2018- Projected d 2018-19 19 2019-20 2020-21 Gender Men 307 247 321 936 Women 381 303 379 1,144 Nonbinary/Genderqueer 4 Self-Describe 2 Total 694 550 700 2,080 Race and Ethnicity Black or African-American 372 172 280 520 American Indian or Alaska Native 25 Asian 69 110 84 416 White 112 165 118 782 Native Hawaiian or other Pacific Islander 2 6 Two or more races Program information P a g e 1 1 o f 2 5 DocuSign Envelope ID:A2DC2EF9-6C9A-438D-A97D-84CEA493644C Some other race 5 6 30 Total 553 452 490 1,1779 Of the above, how many Hispanic/Latino 141 98 210 301 Of the above, how many non-Hispanic/Latino 553 452 490 1,779 Total 694 550 700 2,080 Age 0-5 years 184 198 220 832 6-18 years 310 117 200 416 19-50 years 110 102 150 416 51+ years 90 83 130 416 Total 694 550 7001 2,080 Geographic Location Town of Chapel Hill 25 280 Town of Carrboro 200 Orange County ( Outside of Chapel Hill/Carrboro) 694 525 700 1,500 Outside of Orange County 100 Total 694 550 700 2,080 Income Low-income (80% of the Area Median Income and 560 1,664 Below) Please see income table in the attachments 381 339 Total 381 339 560 1,664 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. Actual 2018- Projected 2019- Projected 2020- 19 20 21 Total Cost of Program $12,992 $13,301 $22,395 Total # of Individuals 550 700 2,080 Cost Per Individual $23.62 $19 $10.76 9. Performance Indicators Program information P a g e 12 o f 2 5 DocuSign Envelope ID:A2DC2EF9-6C9A-438D-A97D-84CEA493644C f - ORANGE CT NQF] I'E I f ti , ti' I NA 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. Youth 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. Support grade level STEM learning through standard Program Goal # 1 based experiential STEM activities. 1 . Post program quantitative survey data measuring understanding and educational value of key STEM learning concepts. 2. Post program quantitative survey data measuring program participants that improve Performance Measure science grades by end of program period. 3. Post program quantitative and qualitative survey (How will you accomplish measuring increased interest in STEM based your goal?) post-secondary education and STEM future careers. 85% (268) of students reported an increase in Actual Results understanding STEM learning concepts following Kidzu's STEM activities (Outcome) 90% (284) of children and caregivers reported value in Ending FY18-19 Kidzu's STEM programming (supporting classroom instruction). Program informatioi. P a g e 13 o f 2 5 DocuSign Envelope ID:A2DC2EF9-6C9A-438D-A97D-84CEA493644C f - ORANGE CT NQF] 111 f ti , ti' I NA Outside Agencies/Human Services 75% (236) of students reported an increased interest in STEM based post-secondary education and STEM future careers. 90% (378) of students report an increase in understanding STEM learning concepts following Kidzu's STEM activities 85% ( 357) of children report an improvement in Projected Results science grades at the end of the program. (Outcome) 85% (357) of children report an increased interest in Ending FY2020 STEM based post-secondary education and STEM future careers. 95% ( 1,186) of students report an increase in understanding STEM learning concepts following Kidzu's STEM activities Projected Results 90% (1 ,122) of children report an improvement in (Outcome) science grades at the end of the program. Ending FY2021 90% (1 ,122) of children report an increased interest in STEM based post-secondary education and STEM future careers. Support the development of other fundamental Program Goal # 2 cognitive, physical and social/ emotional skills and attitudes towards learning. Performance Measure Post program qualitative and quantitative surveys (How will you accomplish measuring an increased love of learning (the student) your goal?) Program information P a g e 14 o f 2 5 DocuSign Envelope ID:A2DC2EF9-6C9A-438D-A97D-84CEA493644C f - ORANGE CT NO3:: 111 f ti — ti' I NA Outside Agencies/Human Services Post program quantitative and qualitative surveys measuring an improvement in classroom behavior at the end of the program. Qualitative surveys measuring greater confidence in ability to be successful at school Post program qualitative surveys measuring the positive impact of the learning experience. Actual Results We did not measure this goal in 2018-19. (Outcome) Ending FY18-19 80% (336) report an increased love of learning (the student) Projected Results 85% (357) report improving their classroom behavior at the end of the program. (Outcome) 85% (357) report experiencing greater confidence in Ending FY2020 ability to be successful at school 90% (378) report a positive impact of the learning experience. 85% (1,060) report an increased love of learning (the student) Projected Results 85% (1 ,060) report improving their classroom behavior at the end of the program. (Outcome) 85% (1 ,060) report experiencing greater confidence in Ending FY2021 ability to be successful at school 95% (1 ,185) report a positive impact of the learning experience. Program Goal # 3 Serve 80%+ low income children and families living in OC. MEMO- Program information P a g e 15 o f 2 5 DocuSign Envelope ID:A2DC2EF9-6C9A-438D-A97D-84CEA493644C f - ORANGE CT NQF] 111 f ti — ti' I NA Outside Agencies/Human Services 1 . Program attendance, tracking ages, ethnicity and residence Performance Measure 2. Quantitative and qualitative surveys measuring (How will you accomplish the value and impact of programs on child's your goal?) learning experience Actual Results 62% of attendees were classified as low income (Outcome) 80% (252) caregivers reported value and impact of program on child's learning Ending FY18-19 Projected Results We project serving 80% low income residents. (Outcome) 80% (336) caregivers reported value and impact of program on child's learning Ending FY2020 Projected Results We project serving 80% low income residents. (Outcome) 80% (998) caregivers reported value and impact of Ending FY2021 program on child's learning Program information P a g e 16 o f 2 5 DocuSign Envelope ID:A2DC2EF9-6C9A-438D-A97D-84CEA493644C Agency Budget Operating Budget for Entire Agency AGENCY NAME: Kidzu Children's Museum Actual Estimated Projected Percent AGENCY REVENUE 2018-19 2019-20 2020-21 Change Private Donations $ 84,896 $ 90,214 $ 95,000 5% Agency Generated Revenue (fees) $ 375,303 $ 328,187 $ 335,000 2% Local Government Grants: Human Services-Town of Carrboro $ 1,000 $ - $ - 0 Other-Town of Carrboro $ - $ - $ - 0 Human Services -Town of Chapel Hill $ 5,000 $ - $ - 0 Other-Town of Chapel Hill $ - $ 5,000 $ 5,000 0% Human Services -Orange County $ - $ - $ - 0 Other-Orange County $ 12,992 $ 13,301 $ 31,000 133% Other-Town of Hillsborough $ - $ - $ - 0 Other Government Grants Triangle United Way $ - $ - $ - 0 State Government $ 30,511.00 $ 16,721.00 $ 16,721.00 $ - Federal Government (CDBG/HOME/etc.) $ - $ 45,920.00 $ 45,920.00 $ - Private Foundation Grants $ 325,269.00 $ 229,134.00 $ 235,000.00 $ 0.03 Other Revenue $ - $ - $ - 0 Total Agency Revenue $ 834,971 $ 728,477 1 $ 763,641 5% AGENCY EXPENSES Compensation $ 622,606 $ 557,157 $ 575,000 3% Rent& Utilities $ 65,710 $ 30,759 $ 30,000 -2% Supplies & Equipment $ 59,403 $ 49,433 $ 55,000 1 1% Travel &Training $ 12,309 $ 7,441 $ 7,210 -3% Other Expenses: $ 74,943 1 $ 83,687 1 $ 96,431 1 15% Total Agency Expenses $ 834,971 $ 728,477 $ 763,641 5% SURPLUS/(DEFICIT) FOR PERIOD: $ - $ - $ - 0 FY 2018-19 Agency Budget DocuSign Envelope ID:A2DC2EF9-6C9A-438D-A97D-84CEA493644C Program Budget Operating Budget for Program PROGRAM NAME: Community Connections Yr.4 Actual Estimated Projected Percent PROGRAM REVENUE 2018-19 2019-20 2020-21 Change Private Donations $ - $ - $ - 0 Program Generated Revenue $ - $ - $ - 0 Local Government Grants: Human Services-Town of Carrboro $ - $ - $ - 0 Other-Town of Carrboro $ - $ - $ - 0 Human Services-Town of Chapel Hill $ - $ - $ - 0 Other-Town of Chapel Hill $ - $ - $ - 0 Human Services-Orange County $ 12,992 $ 13,301 $ 22,395 68% Other-Orange County $ - $ - $ - 0 Other-Town of Hillsborough $ - $ - $ - 0 Other Government Grants ME Triangle United Way $ - $ - $ - 0 State Government $ - $ - $ - 0 Federal Government (CDBG/HOME/etc.) $ - $ - $ - 0 Private Foundation Grants $ - $ - $ - 0 Other Revenue $ - $ - $ - 0 Total Program Revenue $ 12,992 $ 13,301 $ 22,395 68% PROGRAM EXPENSES Compensation $ 9,032 $ 5,766 $ 10,100 759%. Rent&Utilities $ 452 $ 1,884 $ 2,554 36% Supplies &Equipment $ 1,626 $ 3,030 $ 4,465 47% Travel &Training $ 661 $ 1,373 $ 1,951 42% Other Expenses: $ 1,221 $ 1,248 $ 3,325 16696 Total Program Expenses $ 12,992 $ 13,301 $ 22,395 68% SURPLUS/(DEFICIT) FOR PERIOD: $ - $ - $ 1 0 FY 2018-19 Program Budget DocuSign Envelope ID:A2DC2EF9-6C9A-438D-A97D-84CEA493644C EXHIBIT "B" Scope of Services—FY 2020-21 Outside Agency Performance Agreement > > Agency Name: Chapel Hill-Carrboro Children s Museum dba Kidzu Children s Museum g Y p � ) Program Name: SiuM'"ar—ni—irg and En-ga-g a ent for All Funding Award: $13,301.00 Outline how the agency will spend Orange County's funding award. Expense Description Amount Targeted Virtual STEM Learning Programs for Prelk,K-5th graders (New Hope& S5,000 Mindsnacks) Weekly Virtual Supported Playgroups for OC caregivers and children 0-3 S3,301 Community outreach& monthly community Facebook Live STEMBOX events $5,000 Program Services Outline the critical services(activities)the agency will employ to attain the Anticipated Outcomes below,by June 30,2021. • Provide weekly learning activities to'l'ABLE&PORCH hunger relief recipient children/families. • Provide 2 in-person/virtual STEM Learning programs for New Hope Elementary • Provide 1-hour weekly virtual supported playgroups for under-resourced FFN (family, friends and neighbors) caregivers and children 0-3. Logistical support provided in collaboration with Orange County Partnership for Young Children. • Provide additional (COVID-friendly) community outreach through promoted Facebook Live events held monthly. Anticipated Outcomes The Anticipated Results column must include quantifiable results in the form of number of persons/units served within Oranee Coun ,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 erformance measu•e. Performance Measures Anticipated Results Number of participants served through each strategy(Mindsnacks,New hope STEM 1,200 learning,virtual playgroups and Facebook live monthly community programs) DocuSign Envelope ID:A2DC2EF9-6C9A-438D-A97D-84CEA493644C Percentage of repeat users of playgroup sessions(each session block is 8 weeks) 60% Certified by An 0/1 Akk-.Title: fV 61 t Date: ZI (Provider's Electro is Signature) "You will sign this document electronically with your performance agreement. Eb DocuSigned by: so. VaiA, PumauA, Executive Director 2/15/2021 9BB8EB277C5A475... DocuSign Envelope ID:A2DC2EF9-6C9A-438D-A97D-84CEA493644C KIDZHIL-01 ZDIAMOND ,4coR0` CERTIFICATE OF LIABILITY INSURANCE FDATE(MM/DD/YYYY) 2/10/2021 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 NAME: High&Rubish Insurance PHONE FAX 6015 Farrington Rd.,Ste 101 (A/C,No,Ext):(919)913-1144 (A/C,No):(919)913-1155 Chapel Hill,NC 27517 ADDRESS: INSURERS AFFORDING COVERAGE NAIC# INSURER A:Philadelphia Insurance Co INSURED INSURER B:Hartford Underwriters Ins. 30104 Kidzu Children's Museum INSURER C: 201 S Estes Dr,Ste A9 INSURER D: Chapel Hill,NC 27514 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 ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR IN SD WVD MM/DD/YYYY MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE Flrl X OCCUR PHPK2217162 2/20/2021 2/20/2022 DAMAGE TO RENTED 100,000 X PREMISES Ea occurrence $ MED EXP(Any oneperson) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY El jE LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: Empl Dishonesty $ 100,000 A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 Ea accident $ ANY AUTO PHPK2217162 2/20/2021 2/20/2022 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ X HIRED X NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ A UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 X EXCESS LIAB CLAIMS-MADE PHUB749839 2/20/2021 2/20/2022 AGGREGATE $ 1,000,000 DED X RETENTION$ 10,000 $ ER B WORKERS COMPENSATION X STATUTE EERH AND EMPLOYERS'LIABILITY Y/N 22WECNY6264 4/10/2020 4/10/2021 500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Sexual Abuse/Mole PHPK2217162 2/20/2021 2/20/2022 Each Occu and aggr 1,000,000 A Directors&Officers PHSD1532483 4/10/2020 4/10/2021 D&O liability 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Childrens Museum/located at University Place,201 S Estes Drive Suite A9 Chapel Hill,N C 27514 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Orange Count Government THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 9 Y ACCORDANCE WITH THE POLICY PROVISIONS. 300 W Tryon St Hillsborough,NC 27278 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD