Loading...
HomeMy WebLinkAbout2021-330-Health-Farmer Foodshare-Outside Agency Farmer Foodshare Orange County Outside Agency Performance Agreement Revised 7/2018 Page 1 of 9 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, Post Office Box 8181, Hillsborough, North Carolina, 27278, ("County") and Farmer Foodshare, Inc., a not-for-profit corporation, located at 902 N. Mangum Street, Durham, North Carolina 27701 (“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 «Agencys_Name» 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 $7,375. 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 $1,843.75. The first payment is contingent upon receipt of the agency’s performance agreement; the remaining payments are contingent upon receipt of the request for reimbursement and related supporting documentation. d. The County’s obligation to make the quarterly payments is contingent upon receipt of Progress Reports, which show satisfactory progress toward completion of performance measures and an accounting of expenditures as detailed in the attached Scope of Services. DocuSign Envelope ID: 8C888F46-91B5-4337-8927-E87F20B28ADC Orange County Outside Agency Performance Agreement Page 2 of 9 Rev. 1/21 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. DocuSign Envelope ID: 8C888F46-91B5-4337-8927-E87F20B28ADC Orange County Outside Agency Performance Agreement Page 3 of 9 Rev. 1/21 c. Notwithstanding the foregoing, either party may terminate the agreement at any time without penalty; provided that written notice of such termination is furnished to the other party at least 30 days prior to termination. In the event of such termination, any payment due shall be prorated to the date of termination and any unused funds shall be returned to the County within 10 days of termination. d. Any termination of this Agreement for default under this section that is later deemed to be unjustified shall be deemed a termination for convenience. 6. Insurance. a. General Requirements. The Provider shall purchase and maintain, during the period of performance of this Agreement, insurance: i. Worker’s Compensation. For protection from claims under workers' or workmen's compensation acts; ii. Comprehensive General Liability Insurance covering claims arising out of or relating to bodily injury, including bodily injury, sickness, disease or death of any of the Consultant's employees or any other person and to real and personal property including loss of use resulting thereof; iii. Comprehensive Automobile Liability Insurance, including hired and non-owned vehicles, if any, covering personal injury or death, and property damage; and iv. Professional Liability Insurance, covering personal injury, bodily injury and property damage and claims arising out of or related to the performance under this Agreement by the Consultant or his agents, consultants and employees. b. Limits of Coverage: Minimum limits of insurance coverage shall be as follows: INSURANCE DESCRIPTION MINIMUM REQUIRED COVERAGE • Worker's Compensation Limits for Coverage A - Statutory State NC & Coverage B - Employers Liability $500,000 each accident, disease policy limit and disease each employee • Commercial General $1,000,000 Each Occurrence Liability $2,000,000 Aggregate • Automobile Liability $500,000 Combined Single Limit • Professional Liability $1,000,000 Each Occurrence $2,000,000 Aggregate c. All insurance policies (with the exception of Worker's Compensation and Professional Liability) required under this Agreement shall name the County as an additional insured party and as a certificate holder. Evidence of such insurance and all correspondence shall be sent to: Orange County Risk Manager Post Office Box 8181 Hillsborough, NC 27278 d. Nothing in this section is intended to affect or abrogate the County’s sovereign immunity defenses. DocuSign Envelope ID: 8C888F46-91B5-4337-8927-E87F20B28ADC Orange County Outside Agency Performance Agreement Page 4 of 9 Rev. 1/21 7. Relationship of the Parties. Provider is an independent contractor of the County. Provider represents that they have or will secure, at his own expense, all personnel required in performing the services under this Agreement. Such personnel shall not be employees or have any contractual relationship with the County. All personnel engaged in work under this Agreement shall be fully qualified and shall be authorized and permitted under federal, state and local law to perform such services. 8. Compliance with all Laws. The Provider, at its sole expense, shall comply with all laws, ordinances, orders and regulations of the federal, state or local governments, as well as their respective departments, commissions, boards, and officers, which are in effect at the time of execution of this Agreement or are adopted at any time following execution of this agreement. 9. Subcontract. The County and Provider deem the services provided under this Agreement to be personal in nature and Provider may not subcontract any rights or duties under this Agreement to any other party without prior written consent from the County. 10. Assignment. The Provider shall not assign this Agreement, including the rights to payment, to any other party without the prior written consent of the County. 11. Indemnification. Provider agrees to defend, indemnify, and hold harmless the County, for all loss, liability, claims or expense (including reasonable attorney's fees) arising from bodily injury, including death or property damage, to any person or persons caused in whole or in part by the negligence or willful misconduct of the Provider, except to the extent same are caused by the negligence or willful misconduct of the County. It is the intent of this section to require Provider to indemnify the County to the extent permitted under North Carolina law. Nothing in this section is intended to affect or abrogate the County’s sovereign immunity defenses. 12. Non-Appropriation. This Agreement is subject to the availability of funds to purchase the specified services and may be terminated at any time if such funds become unavailable. 13. Non-Discrimination. Provider agrees as part of consideration of the granting of funds by Orange County the parties hereto for themselves, their agents, officials, employees and servants agree not to discriminate in any manner of these basis of race, color, gender, national origin, age, handicap, religion, sexual orientation, familial status or veterans status with reference to any activities carried out by the grantee, no matter how remote. The parties hereto further agree in all respects to conform to the provision and intent of Orange County Civil Rights Ordinance, as amended and the Orange County Non-discrimination Policy. This provision is enforced by action for specific performance, injunctive relief, or other remedy as by law provided; this provision shall be binding on the grantees, the successors and assigns of the parties hereto with reference to the above subject manner. 14. Living Wage. Orange County is committed to providing its employees with a living wage and encourages agencies if funds to pursue the same goal. The County’s living wage is $ 14.95 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: Finance & Administrative Services Provider: Farmer Foodshare, Inc. DocuSign Envelope ID: 8C888F46-91B5-4337-8927-E87F20B28ADC Orange County Outside Agency Performance Agreement Page 5 of 9 Rev. 1/21 16. E n tire 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 _____________________________ _______________________ Craig Lloyd, Executive Director Date For and on behalf of Orange County Government _______________________________ ________________________ Bonnie Hammersley, County Manager Date Orange County Post Office Box 8181 Hillsborough, NC 27278 902 N. Mangum Street Durham, NC 27701 DocuSign Envelope ID: 8C888F46-91B5-4337-8927-E87F20B28ADC 6/29/2021 6/29/2021 Orange County Outside Agency Performance Agreement Page 6 of 9 Rev. 1/21 ORANGE COUNTY—DEPARTMENT USE ONLY ______________________________________________________________________________ Party/Vendor Name: Farmer Foodshare Party/Vendor Contact Person: Craig Lloyd Contact Phone: 919-923-3988 Party/Vendor Address: 902 N. Mangum Street City Durham State: NC Zip: 27701 Department: Health Amount: $7,375 Purpose: Outside Agency Budget Code(s): 10695050-720170 Vendor # 838481 (N/A if new vendor) Vendor is a BOCC consultant? Yes No Contract Type: (Check one) New Renewal Amendment Effective Date 7-1-20 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: Department Director’s Signature ________________________________________ Date: ________ Agreements for emergency services or repair are not subject to the above affirmation. If services related to this agreement have already begun or been completed please briefly describe the nature of the emergency condition that was addressed: Turnover in original department generating contract. 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: Office of the Risk Management Officer___________________________________ Date: _________ Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officer ____________________________________ Date: _________ Legal Services This agreement is approved as to legal form and sufficiency: Office of the County Attorney __________________________________________Date: ________ 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:_________ DocuSign Envelope ID: 8C888F46-91B5-4337-8927-E87F20B28ADC 6/29/2021 6/29/2021 6/29/2021 6/29/2021 EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION DocuSign Envelope ID: 8C888F46-91B5-4337-8927-E87F20B28ADC Cover Page Page 8 of 22 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: 1.14.2020 Executive Director Date Signature: 1.14.2020 Board Chairperson Date (Interim) EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION DocuSign Envelope ID: 8C888F46-91B5-4337-8927-E87F20B28ADC Program information Page 9 of 22 AGENCY INFORMATION Please provide the following information about your agency: 1. Date of Incorporation (Month/Year): 09/2010 2. Agency’s Purpose/Mission (no more than a few sentences): Farmer Foodshare’s mission is to reshape the disconnected food system by removing barriers to growing and accessing local food. Operating through the lenses of food sovereignty, food distribution and food education, we create markets for North Carolina farmers to sell what they grow and deliver fresh, healthy food to people in need. 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). For the past decade, Farmer Foodshare has partnered with farmers, community members, institutions and hunger relief agencies to build a healthy, sustainable food system in Orange County and across North Carolina. Donation Stations, the program that launched Farmer Foodshare, has operated consistently at four Orange County farmers markets for years, benefiting thousands of residents annually while also supporting NC farmers. Out of these experiences, we have launched a successful Wholesale Market and developed educational programming in schools that deepens the community’s engagement with local food and the people who grow it. 4. Living Wage: Does this agency pay permanent employees a minimum living wage? (Yes / No) Yes If yes, is this agency an Orange County Living Wage Certified Employer? No If no, please briefly explain. We hold a living wage certification from Durham County because our office is physically located in Durham County. Schedule of Positions: # of FTE – Full-Time Paid Positions: 8 # of FTE – Part-Time Paid Positions: 3 PROGRAM INFORMATION *Please submit for each program if applying for funding for more than one program. 5. Program Name: Donation Stations Program Primary Contact and Title: Braedyn Mallard, Program Manager Telephone Number: 919.274.6166 E-Mail: Braedyn@farmerfoodshare.org EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION DocuSign Envelope ID: 8C888F46-91B5-4337-8927-E87F20B28ADC Program information Page 10 of 22 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) Farmer Foodshare (FF) seeks to increase consumption of fresh food (CH/Carrboro) and create a balanced, dynamic local economy and promote well-being (OC) by collecting and donating fresh, local food at four Orange County farmers markets. This food is either purchased from farmers with funds donated by shoppers or gleaned from farmers at the end of market. All food is delivered to partner agencies in Orange County the day it is collected and then distributed to the individuals that agency serves. The agencies (Refugee Community Partnership, IFC, IFC-Homestart, Club Nova, Friends of the DSS, and Central Elementary) are selected in conjunction with the farmers markets to ensure that the community’s most urgent hunger needs are being addressed through fresh food. This program helps build a healthy, sustainable food system by supporting the livelihoods of our local farmers while creating community through the practice of healthy eating. 7. Target Population: Please complete the table below with numbers (not percentages) of individuals served and projected to be served. Note: Our partner agencies report the number of individuals served through the Donation Station program. Because they do not provide consistent demographic information, we have not included this level of detail; however, all are considered low-income. The number of participants dropped after 2018-19 because TABLE, PORCH and CASA discontinued using produce donated through the Donation Stations. They instead purchase food through our Wholesale Market. This means that more food went to the remaining recipient agencies. Program Target Population Demographics Projected 2018-19 Actual 2018-19 Projected 2019-20 Projected 2020-21 Gender Men Women Nonbinary/Genderqueer Self-Describe Total 5243 5243 3936 3936 Race and Ethnicity Black or African-American American Indian or Alaska Native Asian White EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION DocuSign Envelope ID: 8C888F46-91B5-4337-8927-E87F20B28ADC Program information Page 11 of 22 Native Hawaiian or other Pacific Islander Two or more races Some other race Total 5243 5243 3936 3936 Of the above, how many Hispanic/Latino Of the above, how many non-Hispanic/Latino Total 5243 5243 3936 3936 Age 0-5 years 6-18 years 19-50 years 51+ years Total 5243 5243 3936 3936 Geographic Location Town of Chapel Hill Town of Carrboro Orange County ( Outside of Chapel Hill/Carrboro) Outside of Orange County Total 5243 5243 3936 3936 Income Low-income (80% of the Area Median Income and Below) Please see income table in the attachments 5243 5243 3936 3936 Total 5243 5243 3936 3936 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. Note: The number of participants dropped after 2018-19 because TABLE, PORCH and CASA discontinued using produce donated through the Donation Stations. They instead purchase food through our Wholesale Market. This means that more donated food went to the remaining recipient agencies. Actual 2018-19 Projected 2019-20 Projected 2020-21 Total Cost of Program $26,649 $24,727 $29,200 Total # of Individuals 5243 3936 3936 Cost Per Individual $5.08 $6.28 $7.42 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. EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION DocuSign Envelope ID: 8C888F46-91B5-4337-8927-E87F20B28ADC Program information Page 12 of 22 Program Name: Donation Stations Strategic Objective o Children improve their educational outcomes o Residents Increase their livelihood security ü Residents improve their health outcomes Intermediate Result Residents demonstrate new healthy lifestyle behaviors RESULTS Actual 2018-19 Projected 2019-20 Projected 2020-21 Performance Indicators % and # of program participants that consume fresh food 100% / 5,243 100% / 3,936 100% / 3,936 # of pounds of food distributed (1 lb = 4 meals supplemented) 16,549 10,340 12,911 $ spent with local farmers $9,976 $6,057 $7,700 EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION DocuSign Envelope ID: 8C888F46-91B5-4337-8927-E87F20B28ADC Outside Agencies/Human Services Program information Page 13 of 22 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: 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 Orange County residents have access to fresh food Performance Measure (How will you accomplish your goal?) # of participants that receive food over 12 months Actual Results (Outcome) Ending FY18-19 5,243 Projected Results (Outcome) Ending FY2020 3,936 Projected Results (Outcome) Ending FY2021 3,936 Program Goal # 2 Orange County residents receive fresh produce to supplement meals Performance Measure (How will you accomplish your goal?) # of pounds of food distributed over 12 months (1 pound = 4 meals supplemented) Actual Results (Outcome) Ending FY18-19 16,549 Projected Results (Outcome) Ending FY2020 10,340 Projected Results (Outcome) Ending FY2021 12,911 _________________ EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION DocuSign Envelope ID: 8C888F46-91B5-4337-8927-E87F20B28ADC Outside Agencies/Human Services Program information Page 14 of 22 Program Goal # 3 Support local economic development by helping Orange County farmers thrive Performance Measure (How will you accomplish your goal?) $ spent with local farmers over 12 months Actual Results (Outcome) Ending FY18-19 $9,976 Projected Results (Outcome) Ending FY2020 $6,057 Projected Results (Outcome) Ending FY2021 $7,700 Notes: The performance of the Donation Stations is highly dependent on the participation of volunteers to encourage participation, as well as the weather (which influences market attendance and donation rates). In the coming year, we anticipate beginning to transition the staffing of volunteers at Donation Stations to recipient agencies, as our experience statewide has shown that when volunteers from recipient agencies staff the stations, shopper participation rates go up. EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION DocuSign Envelope ID: 8C888F46-91B5-4337-8927-E87F20B28ADC FY 2018-19 Agency Budget Agency Budget Operating Budget for Entire Agency Actual 2018-19 Estimated 2019-20 Projected 2020-21 Percent Change 179,099$ 72,454$ 150,000$ 107% 776,370$ 1,031,171$ 1,200,000$ 16% 2,000$ 900$ 2,500$ 178% -$ -$ -$ 0 -$ 5,000$ 5,000$ 0% -$ -$ -$ 0 7,375$ 7,375$ 10,000$ 36% -$ -$ -$ 0 -$ -$ -$ 0 -$ -$ -$ 0 -$ -$ -$ 0 191,512.70$ 153488.91 300,000.00$ 0.95$ Private Foundation Grants 157,430.00$ 220000 175,000.00$ (0.20)$ 152,881$ 91,017$ -$ (1.00)$ In-Kind Donations 70,076 20073.92 70,500$ Corporate Donations 22,499 42271.38 50,000$ Consulting Income 12,177 8150 7,850$ General 28,113 514.99 -$ Interest Income 16 6.81 15$ Durham County Grants 20,000 20000 20,000$ 1,466,668$ 1,581,406$ 1,913,000$ 21% 479,922$ 516,077$ 640,545$ 24% 36,285$ 48,206$ 54,520$ 13% 73,704$ 72,915$ 128,795$ 77% 38,584$ 30,726$ 50,142$ 63% 784,872$ 895,780$ 1,038,998$ 16% Cost of goods sold 695,830$ 799,258$ 911,351$ Fees for service 49,155$ 67,484$ 81,450$ Other expenses 39,887$ 29,037$ 46,197$ 1,413,367$ 1,563,703$ 1,913,000$ 22% 53,301$ 17,703$ (0)$ -100% Total Agency Revenue Agency Generated Revenue (fees) AGENCY NAME: Other Revenue SURPLUS/(DEFICIT) FOR PERIOD: Other Government Grants Triangle United Way State Government Federal Government (CDBG/HOME/etc.) Compensation Rent & Utilities Other Expenses: Total Agency Expenses Supplies & Equipment Travel & Training AGENCY EXPENSES AGENCY REVENUE Private Donations Other - Town of Chapel Hill Human Services - Orange County Other - Orange County Other - Town of Hillsborough Farmer Foodshare Local Government Grants: Human Services - Town of Carrboro Other - Town of Carrboro Human Services - Town of Chapel Hill EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION DocuSign Envelope ID: 8C888F46-91B5-4337-8927-E87F20B28ADC FY 2018-19 Program Budget Program Budget Operating Budget for Program Actual 2018-19 Estimated 2019-20 Projected 2020-21 Percent Change 4,350$ 1,451$ 1,500$ 3% 9,976$ 6,057$ 7,700$ 27% 2,000$ 900$ 2,500$ 178% -$ -$ -$ 0 -$ 5,000$ 5,000$ 0% -$ -$ -$ 0 7,375$ 7,375$ 10,000$ 36% -$ -$ -$ 0 -$ -$ -$ 0 -$ -$ -$ 0 -$ -$ -$ 0 -$ -$ -$ 0 Private Foundation Grants -$ 5,000.00$ 2,500.00$ (0.50)$ -$ -$ -$ 0 23,701$ 25,783$ 29,200$ 13% 16,000$ 18,000$ 20,500$ 14% 247$ 247$ 300$ 21% 226$ 300$ 400$ 33% 200$ 123$ 300$ 144% 9,976$ 6,057$ 7,700$ 27% 26,649$ 24,727$ 29,200$ 18% (2,948)$ 1,056$ -$ -100%SURPLUS/(DEFICIT) FOR PERIOD: Total Program Expenses Travel & Training Other Expenses: spend-down of $ donated for food purchasing Federal Government (CDBG/HOME/etc.) Supplies & Equipment Other Revenue Total Program Revenue PROGRAM EXPENSES Compensation Rent & Utilities Other Government Grants Triangle United Way State Government Human Services - Orange County Other - Orange County Other - Town of Hillsborough Other - Town of Carrboro Human Services - Town of Chapel Hill Other - Town of Chapel Hill Private Donations Program Generated Revenue: $ donated for food purchasing Local Government Grants: Human Services - Town of Carrboro PROGRAM REVENUE PROGRAM NAME:Donation Stations (Orange Co) EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION DocuSign Envelope ID: 8C888F46-91B5-4337-8927-E87F20B28ADC Certified by: _______________________ Title: __________________________ Date: ____________ (Provider’s Signature) EXHIBIT “B” Scope of Services – FY 2020-21 Outside Agency Performance Agreement Agency Name: Farmer Foodshare Program Name: Fresh Food Distribution Funding Award: $7,375 Outline how the agency will spend Orange County’s funding award. Program Services Outline the critical services (activities) the agency will employ to attain the Anticipated Outcomes below, by June 30, 2021. • Source, aggregate, and deliver fresh, NC-grown produce to families in need on a biweekly basis • • 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 program participants that consume fresh food 100% / 500 $ spent with local farmers $6,875 Expense Description Amount Operations: Fresh food purchasing $6,875 Personnel $500 DocuSign Envelope ID: 8C888F46-91B5-4337-8927-E87F20B28ADC Executive Director 6/29/2021 Orange County Outside Agency Performance Agreement Page 9 of 9 Rev. 1/21 ATTACHMENT “A” Orange County Certifications – FY 2020-21 Outside Agency Performance Agreement Chief Contact, Administrators, Chief Executive Officer and Chief Financial Officer I certify that I have provided a list of the chief contact, administrators, chief executive officer and chief financial officer for my agency with this Agreement and that I will keep it current to the County of Orange. The list should be in writing with the name, title, residential address; phone and email address and if possible, fax number. Officers and Board of Directors I certify that I have provided a current list of the Officers and Board of Directors with this Agreement and that we will continue to update the list as changes occur. The list should be in writing, with the name, physical address, mailing address and if possible, phone, fax and email address. Budget Submission I certify that I have provided a budget for the period to be covered by funding Orange County, and that any substantive changes made to this budget have been in advance authorized in writing by Orange County. Annual Financial Review I certify that I have provided a copy of the latest annual Financial Review for our agency and the budget adopted by the agency for the fiscal years encompassing this Agreement. If not, please explain on a separate sheet of paper. Alignment with Organization’s Mission I certify that the programs and services for which this funding is requested align with the mission of the organization. Intended Purpose I certify that the funds provided to the agency under the terms of this Agreement will be used for a public purpose and shall only be used for the purposes intended and any money not used for those purposes will be promptly returned to Orange County. Certified by: _______________________ Title: __________________________ Date: ___________ (Provider’s Signature) DocuSign Envelope ID: 8C888F46-91B5-4337-8927-E87F20B28ADC 6/29/2021Executive Director ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? INSR ADDL SUBR LTR INSD WVD PRODUCER CONTACT NAME: FAXPHONE (A/C, No):(A/C, No, Ext): E-MAIL ADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY)(MM/DD/YYYY) AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATION AND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE EACH OCCURRENCE $ DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence) MED EXP (Any one person)$ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $ PRO-POLICY LOC PRODUCTS - COMP/OP AGGJECT OTHER:$ COMBINED SINGLE LIMIT $(Ea accident) ANY AUTO BODILY INJURY (Per person)$ OWNED SCHEDULED BODILY INJURY (Per accident)$AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $AUTOS ONLY AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE CLAIMS-MADE AGGREGATE $ DED RETENTION $ PER OTH- STATUTE ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.L. DISEASE - POLICY LIMITDESCRIPTION OF OPERATIONS below INSURER(S) AFFORDING COVERAGE NAIC # COMMERCIAL GENERAL LIABILITY Y / N N / A (Mandatory in NH) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 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. 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). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved.ACORD 25 (2016/03) CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) $ $ $ $ $ The ACORD name and logo are registered marks of ACORD Alex Maiolo FARME-3 OP ID: MA 06/28/2021 Martin Hall Lee-Moore Insurance Agency Inc P.O. Box 667 West End, NC 27376 Alex Maiolo 919-932-9990 919-933-0155 leemoore.martin@gmail.com AUTO-OWNERS INS. COMPANY AON Association Services Farmer Foodshare 902 N Mangum St Durham, NC 27701 A 2,000,000 X X 35269000 06/15/2021 06/15/2022 300,000 10,000 2,000,000 2,000,000 2,000,000 A 35269000 06/15/2021 06/15/2022 2,000,000 X X XA X 35278607 05/29/2021 05/29/2022 1,000,000 1,000,000 1,000,000 Orange County, its officers, official agents, and employees are listed as additional insured on General Liability policy. Orange County Goverment Risk Management PO Box 8101 Hillsborough, NC 27278 919-932-9990 18988 DocuSign Envelope ID: 8C888F46-91B5-4337-8927-E87F20B28ADC