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HomeMy WebLinkAbout2021-203-E-Human Rights Relations-Orange County Living Wage-Outside Agency Performance Agreement DocuSign Envelope ID:650510CC-1 E40-4E7E-A21 D-3B96055FB69D OUTSIDE AGENCY PERFORMANCE AGREEMENT THIS AGREEMENT,made and entered into the first day of July, ("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 Orange County Living Wage,a not-for-profit corporation, located at 218 Lake Manor Road, Chapel Hill,North Carolina 27516("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 Orange County Living Wage agree as follows: 1. Term of the Agreement. The term of this Agreement shall be a program year beginning July 1, j 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$18,588. 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$4,647. 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. i 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. Orange County Living Wage Orange County Outside Agency Performance Agreement Revised 712018 Page 1 of 9 DocuSign Envelope ID:650510CC-1 E40-4E7E-A21 D-3B96055FB69D 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. i i 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"), j 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 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 i I 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:650510CC-1 E40-4E7E-A21 D-3B96055FB69D 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. I 6. Insurance. j 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 j including loss of use resulting thereof; j I iii. Comprehensive Automobile Liability Insurance, including hired and non-owned j 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 j i d. Nothing in this section is intended to affect or abrogate the County's sovereign immunity defenses. II Orange County Outside Agency Performance Agreement Page 3 of 9 Rev. 1121 DocuSign Envelope ID:650510CC-1 E40-4E7E-A21 D-3B96055FB69D 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 j qualified and shall be authorized and permitted under federal, state and local law to perform such services. i 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 I 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, includingdeath or roe damage, to an person or persons caused in whole or in art b the property g � YP P P Y 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 Provides shall be in writing and mailed to the party addressed as follows: County: Finance&Administrative Services Provider: Orange County Living Wage Orange County Outside Agency Performance Agreement Page 4 of 9 Rev. 1121 DocuSign Envelope ID:650510CC-1 E40-4E7E-A21 D-3B96055FB69D Orange County 218 Lake Manor Road Post Office Box 8181 Chapel Hill,NC 27516 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. I 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 1 IA 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 gff Q,1,1d4g.Provider SItiSAln, r6maA14)� 4/23/2021 Susan Romaine,Mecu ive Director Date For and on be o4; rge County Government f 6V-'W*L (1AdMwtwsb—, 4/23/2021 Bonnie Hammers ey, County Manager Date Orange County Outside Agency Performance Agreement Page S of 9 Rev. 1121 DocuSign Envelope ID:650510CC-1 E40-4E7E-A21 D-3B96055FB69D ORANGE COUNTY—DEPARTMENT USE ONLY i Party/Vendor Name_Orange County Living Wage Party/Vendor Contact Person: Susan Romaine Contact Phone: 919- 619-3408 Party/Vendor Address: P.O. Box 1502 City: Carrboro State: NC Zip: 27510 Department: Human Rights&Relations Amount: $18,588.00 Purpose: Outside Agency Performance Agreement Budget,Code(s): Vendor #801564 (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: July 1,2020 to June 30,2021 i This agreement is approved as to technical form and content and I as Department Director affirmatively state work on j this project has not been initiated prior to execution of the agreement: DocuSigned by: i F Department Director's Signature Date: 4/23/2021 Agreements for emergency services or repair are not su gee o4 e a�ove affirmation. If services related to this agreement have already begun or been completed please briefly describe the nature of the emergency condition that i 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 .§1*cifications, and requirements: Office of the Risk Management Officer auSa Cbvvulib Date: 4/25/2021 Financial Services This instrument has been pre-audited in the manner re q ' d*� €dlbmcal Government Budget and Fiscal Control Act: Office of the Chief Financial Officer Date: 4/26/2021 Legal Services This agreement is approved as to legal form and suf A44etkeySigned by: Office of the County Attorney 9"'(1 L T6Slb Date: 4/26/2021 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:650510CC-1 E40-4E7E-A21 D-3B96055FB69D Exhibit A Provider's Outside Agency Application Orange County Outside Agency Performance Agreement Page 7 of 9 Rev. 1121 DocuSign Envelope ID:650510CC-1 E40-4E7E-A21 D-3B96055FB69D COVER PAGE 7771 Applicant Contact Information Applicant Organization's Legal Name: Orange County Living Wage Applicant Organization's Physical Address: 218 Lake Manor Road, Chapel Hill, NC 27516 Applicant Organization's Mailing Address: P.O. BOX 1502, Carrboro, NC, 27510 Applicant Organization's Web Address: www.orangecountylivingwape.org Executive Director:Susan Romaine Telephone Number: (919) 619-3408 E-Mail: susan(@orangecountylivingwage.org Tax ID Number:47-4595087 Funding Request Please list all Fiscal-Year 2021 Human Services (HS)funding requested for all programs and the proposed use of funds(please list program name only) Program Carrboro-HS Chapel Hill-HS Orange Total County-HS Living Wage Certification Program $1,000 $3,000 $25,000 $29,0000 Program Supplies Website/lob Personnel/ Board Operations Totals $1,000 $3,000 $25,000 $29,0000 Briefly explain your proposed use of funds: Funds will be used to: • Maintain OCLW's website and social media presence Add a new job board listing job openings for certified living WdeU employers • Purchase program supplies and marketing materials for certified employers 0 Compensate OCLW's certification coordinator, administrative assistant, and communications Specialist. 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 f i Signature: "I�t, '? ��_SYV��`�'zt,'It�, Board Chairperson Date DocuSign Envelope ID:650510CC-1 E40-4E7E-A21 D-3B96055FB69D 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 Z ❑ a) Employees of or closely related to employees of the Town of Carrboro, the Town of Chapel Hill, or Orange County? 0 ❑ 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? ❑ 0 c) Current beneficiaries of the program for which funds are being requested? ❑ 0 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. Orange County Living Wage Steering Committee Member, Mark Marcoplos, is an Orange County Commissioner. OCLW Executive Director and Board Chairperson, Susan Romaine, is a Carrboro Town Council Member.As such, Mark and Susan are salaried employees of local government, 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 terminations of any grant awarded. Signature: Executive Director Date Signature: �L1<tLL Board Chairperson Date DocuSign Envelope ID:650510CC-1 E40-4E7E-A21 D-3B96055FB69D AUNCY;INFORMATION Please provide the following information about your agency: 1. Date of incorporation(Month/Year):0 2015 2. Agency's Purpose/Mission(no more than o few sentences): Orange County Living Wage (OCLW) is a 501(c)3 nonprofit that promotes a living wage as the minimum wage a worker needs to provide for basic needs (rent, utilities, food, transportation, medicine, day care, clothes, etc.), without any reliance on governmental assistance. Through our voluntary employer certification program, we certify public, private, and non-profit employers in Orange County that pay full- and part-time employees a living wage. As of January 1, 2020, our living wage is defined as$14.90/hour, or$13.40/hour with employer-provided health insurance. 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. In FY 2015-16 and FY 2016-17,OCLW certified 64 and 59 new employers, respectively. In FY 2017-2018, OCLW certified 49 new employers and re-certified 52 employers. In FY 2018-2019, OCLW certified 39 new employers and re-certified 48 employers.Since our inception in 2015, OCLW has Injected$3 million into the regional economy through$754,000 in increased wages paid by our living wage employers. OCLW has been able to meet proposed budgets and timetables through a combination of outside funding grants from the Towns of Chapel Hill and Carrboro and Orange County,and the leveraging of additional funds from private donations,fundraisers,and grants from non-governmental entities. 4. Living Wage: Does this agency pay permanent employees a minimum living wage?(Yes/No) i a if yes,is this agency an Orange County Living Wage Certified Employer?YES* If no,please briefly explain. *OCLW does not have any permanent employees, but it pays its independent contractors a living wage. Schedule of Positions: #of FTE—Full-Time Paid Positions: 0 #of FTE—Part-Time Paid Positions:0 Pra;;r;am !nfo rnladon Page 3 Oi S DocuSign Envelope ID:650510CC-1 E40-4E7E-A21 D-3B96055FB69D PROGRAM INFORMATION *Please submit for each program if applying for funding for more than one program. 5. Program Name: Living Wage Certification Program Program Primary Contact and Title: Susan Romaine Telephone Number: (919) 619-3408 E-Mail: SusanPorangecountylivingwaQe.org 6. Please briefly describe the proposed program, including an explanation of how it aligns with the Town of Chanel Hill and Carrboro's Results Framework, and Orange County HOCC Goals and Priorities, and the target population to benefit from the program. (100 words or less) Through our voluntary employer certification program, OCLW advocates for county-wide wage gains for its target population of lower-wage workers. This directly aligns with Town of Chapel Hill-Carrboro and Orange County BOCC goals of economic well-being for all residents; a balanced, dynamic local economy; and sufficient revenue raised and spent in a way that reflects community values. Using the widely accepted Universal Living Wage Formula, OCLW's living wage is indexed to the cost of housing in Orange and nearby Alamance, Chatham, and Durham Counties. OCLW provides a clear reference point for Orange County employers looking to increase their workers' livelihood security and the affordability of the local housing market. OCLW also provides incentives for employers to certify and raise wages by actively promoting our living wage roster through our website and social media, WCHL radio, newsletters, rack cards, storefront decals, framed certificates, and a new job board to be rolled out this year. 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 72j(019-20 ected Projected 2018-19 2018-19 2020-21 Gender Men 2373 2500 2600 Women 6650 6900 7100 Nonbinary/Genderqueer Self-Describe Total 8300 9023 9400 9700 Race and Ethnicity Black or African-American American Indian or Alaska Native Asian White Native Hawaiian or other Pacific Islander Two or more races DocuSign Envelope ID:650510CC-1 E40-4E7E-A21 D-3B96055FB69D Some other race Total 8300 9023 9400 9700 Of the above,how many Hispanic/Latino Of the above,how many non-Hispanic/Latino Total 8300 9023 9400 9700 Age 0-5 years 6-18 years 19-50 years 51+years Total 8300 9023 9400 9700 Geographic Location-of certified employers Town of Chapel Hill 108 112 130 Town of Carrboro 54 58 65 Orange County(Outside of Chapel Hill/Carrboro) 47 50 55 Outside of Orange County Total 209 220 250 Income Low-income(80%of the Area Median Income and Below) Please see income table in the attachments Total 8300 9023 9400 9700 ***Our numbers above reference the total number of employees covered by our living wage certifications as of 12/19/2019.At our inception in July 2015,OCLW did not track the demographics of our living wage employers or employees. Effective January 1, 2019,OCLW added limited demographic questions to our employer application.The number of men and women employed by living wage employers reported here is estimated from information from a sample of living wage employers, i.e.,those that have certified or recertified since the change in application.Geographic location is the location of the employer and includes some employers with multiple locations In Orange County. 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 201849. ,'Projected 2019.20 Projected 2020-21 Total Cost of Program 24,001.37 32,000.00 45,000.00 Total#of Individuals 209 220 250 Cost Per Individual 114.84 145.45 180.00 *The"individual'is each certified employer. DocuSign Envelope ID:650510CC-1 E40-4E7E-A21 D-3B96055FB69D 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 uac front X Residents Increase their livelihood security the Results Framework) ❑ Residents improve their health outcomes Intermediate 2.2: Residents increase job skills appropriate for the local economy* Result (please choose one front *OCLW's living wage certification program does not specifically increase job skills. lire Results Framework) However,the performance indicators used within this intermediate result align with OCLW's living wage certification program.Therefore,this seems to be the most applicable intermediate result. RESUhTS Actual Projected Projected 201849 2019-20 2020-21 Performance %and 10% 10% 10% Indicators #of participants who increase 8 employers 10 employers 10 employers (Please choose at least wages* one performance indicator to report on from die Results Framework,and add additional performance Indicators drat you would like to report to lite Towns. Please insert additional rows as needed,listing one per row). *These numbers reflect raised wages during an employer's original certification and the subsequent two-year recertifications at a rent-adjusted living wage. Over the past 4 A years, 207 certified employers have raised wages a cumulative total of$754,000, resulting in a $3 million cumulative impact on the regional economy. FIro,o.rarn Informahon Page 6 of 8 DocuSign Envelope ID:650510CC-1 E40-4E7E-A21 D-3B96055FB69D 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. Other If you selected other, please tell us what function area best aligns with your organization: Employment 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 Performance Measure Certify 35 New Employers (How will you accomplish yourgoal?) Actual Results 39 (Outcome) Ending FY18-19. Projected Results 43 (Outcome) Ending FY2020 Projected Results 35 (Outcome) Ending FY2021 Program Goal#2 Performance Measure Re-Certify 85%of Employers (How will you accomplish your goal?) Actual Results 86% [48 out of 5fi eligible employers] (Outcome) Ending FY18-19 Projected Results 85% (Outcome) [83 out of 98 eligible employers] Ending FY2020. Projected Results 85% (Outcome) 173 out of 86 eligible employers] Ending FY2021 Pro� :r� 'rorrr is 7 . DocuSign Envelope ID:650510CC-1 E40-4E7E-A21 D-3B96055FB69D Program Goal #3 Performance Measure Raise Wages by at least$50,000 (111m 1411 ou(Icc0111PAY11 yore goal!) Actual Results $36,920 (Outcome) Ending F178-19 "` 1 Projected Results $75,000 (Outcome) Ending FY2020 Projected Results $50,000 I (Outcome) Endin g FY2021 I i 1 I i DocuSign Envelope ID:650510CC-1 E40-4E7E-A21 D-3B96055FB69D Program Budget Operating Budget for Program PROGRAM NAME Living Wage Certification Program Actual Estimated Projected Percent PROGRAM REVENUE 2018-19 2019-20 2020-21 Change Private Donations $ 2,659 $ 8,000 $ 10,000 25% Program Generated Revenue $ 7,715 $ 2,000 $ 3,500 75% Local Government Grants: Human Services-Town of Carrboro $ 500 $ 500 $ 1,000 100% Other-Town of Carrboro $ - $ - $ - 0 Human Services-Town of Chapel Hill $ 2,000 $ 2,000 $ 3,000 50% Other-Town of Chapel Hill $ - $ - $ - 0 Human Services-Orange County $ 18,237 $ 18,588 $ 25,000 34% 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 $ - $ 1,000.00 $ 3,000.00 $ 2.00 Other Revenue $ 120 $ - $ - 0 Total Program Revenue $ 31,232 $ 32,088 $ 45,500 42% PROGRAM EXPENSES Compensation $ 14,441 $ 20,000 $ 28,000 40% Rent& Utilities $ - $ - $ - 0 Supplies &Equipment $ 2,361 $ 3,000 $ 5,000 67% Travel &Training $ - $ - $ - 0 Other Expenses: $ 7,199 $ 9,000 $ 12,000 330ya Total Program Expenses $ 24,001 $ 32,000 $ 45,000 41% SURPLUS/(DEFICIT) FOR PERIOD: $ 7,230 $ 88 $ 500 468% FY 2018-19 Program Budget DocuSign Envelope ID:650510CC-1 E40-4E7E-A21 D-3B96055FB69D Agency Budget Operating Budget for Entire Agency AGENCY NAME: Orange County Living Wage Actual Estimated Projected Percent AGENCY REVENUE 2018-19 2019-20 2020-21 Change Private Donations $ 2,659 $ 8,000 $ 10,000 25% Agency Generated Revenue (fees) $ 7,715 $ 2,000 $ 3,500 75% Local Government Grants: Human Services-Town of Carrboro $ 500 $ 500 $ 1,000 100% Other-Town of Carrboro $ - $ - $ - 0 Human Services-Town of Chapel Hill $ 2,000 $ 2,000 $ 3,000 50% Other-Town of Chapel Hill $ - $ - $ - 0 Human Services-Orange County $ 18,237 $ 18,588 $ 25,000 34% 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 $ 1,000.00 $ 3,000.00 $ 2.00 Other Revenue $ 120 $ - $ - 0 Total Agency Revenue $ 31,232 $ 32,088 1 $ 45,500 42% AGENCY EXPENSES Compensation $ 14,441 $ 20,000 $ 28,000 40% Rent&Utilities $ - $ - $ - 0 Supplies & Equipment $ 2,361 $ 3,000 $ 5,000 67% Travel &Training $ - $ - $ - 0 Other Expenses: $ 7,199 1 $ 9,000 $ 12,000 1 330yo Total Agency Expenses $ 24,001 $ 32,000 $ 45,000 41%YJ6 SURPLUS/(DEFICIT) FOR PERIOD: $ 7,231 $ 88 $ 500 4682 FY 2018-19 Agency Budget DocuSign Envelope ID:650510CC-1 E40-4E7E-A21 D-3B96055FB69D Exhibit B Provider's Revised Scope of Services and Program Budget Orange County Outside Agency Performance Agreement Page 8 of 9 Rev. 1121 DocuSign Envelope ID:650510CC-1 E40-4E7E-A21 D-3B96055FB69D EXHIBIT `B" Scope of Services—FY 2020-21 Outside Agency Performance Agreement Agency Name: Orange County Living Wage Program Name: Living Wage Certification Program Funding Award: $18,588.00 Outline how the agency will spend Orange County's funding award. Expense Description Amount Personnel/Operations $25,000 Program Services Outline the critical services(activities)the agency will employ to attain the Anticipated Outcomes below,by June 30,2021. • Community outreach in order to contact and certify new living wage employers. • Contact and assist eligible employers during recertification. Potentially raising wages in the process. • Raise living wage awareness through OCLW's newsletter, social media,job board, and website. • Compensate communications specialist, administrative assistant, and others to maintain OCLW's website, update job board, and create a strong social media presence. Anti cipatedAnticipated 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 Certify 35 New Employers 35 Re-Certify 85% of Employers 85% (73/86) Raise Wages by at least$50,000 $50,000 DocuSigned by: FS �S� r6m� Executive Di rect 4/23/2021 Certified by: Title: °15ate: (Provider's Signature) DocuSign Envelope ID:650510CC-1 E40-4E7E-A21 D-3B96055FB69D ATTACHMENT "A" Orange County Certifications—FY 2019-20 Outside Agency Performance Agreement i 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. I i 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: SILLWA, PMa'" - Title: Executive Di rectJate: 4/23/2021 (Provider's ignature Orange County Outside Agency Performance Agreement Page 9 of 9 Rev. 1121 DocuSign Envelope ID:650510CC-1 E40-4E7E-A21 D-3B96055FB69D ___81N ORANCOU-08 MSUMMERS .411c,OR0 CERTIFICATE OF LIABILITY INSURANCE FDATE(MM/DD/YYYY) 1/4/2021 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: Summers Insurance Group PHONE FAX 2113 Cameron Street (A/C,No,Ext):(919)968-4472 (A/C,No):(919)942-4221 Suite 219 AD AIL info@STLinsure.com Raleigh,NC 27605-1370 INSURERS AFFORDING COVERAGE NAIC# INSURER A:Alliance for Non-Profits for Insurance Risk Retention Group 10023 INSURED INSURER B: Orange County Living Wage INSURERC: P.O.Box 1502 INSURER D: Carrboro,INC 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 ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR IN SD WVD MM DD MM DD A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR 2019-56572 8/23/2020 8/23/202, DAMAGE TO RENTED 500,000 X PREMISES Ea occurrence $ MED EXP(Any oneperson) $ 20,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PROO-- LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ HIRED NON-OWNED Per PROPERTY accident) $ AUTOS ONLY AUTOS ONLY UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Certificate holder is included as additional insured as respects general liability through written contract. 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 g Y ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Risk Manager 200 S Cameron Street PO Box 8181 AUTHORIZED REPRESENTATIVE Hillsborough, NC 27278 3911,�R 5 ACORD 25(2016/03) @ 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD