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HomeMy WebLinkAbout2021-584-E-Aging-Fathers on the Move-Outside agencyRevised 06/21 NORTH CAROLINA CONTRACT AMENDMENT ORANGE COUNTY THIS CONTRACT AMENDMENT (“Amendment”) is made and entered into this _6__ day of October 2021 by and between ORANGE COUNTY (hereinafter referred to as “County”) and Charles House (hereinafter referred to as “Provider”). WITNESSETH: THAT WHEREAS, the County and Provider entered into an Outside Agency Performance Agreement dated July 1, 2021, (hereinafter the “Original Agreement”); and WHEREAS, the County and Provider desire to amend the Original Agreement while keeping in effect all terms and conditions of the Original Agreement not inconsistent with the terms and conditions set forth below. NOW THEREFORE, for and in consideration of the mutual covenants and agreements made herein, the parties agree to amend the Original Agreement as follows: 1. The second paragraph under “WITNESSETH” is revised as follows: “NOW THEREFORE, in consideration of the above and the mutual conditions hereafter set forth, the County and Charles House agree as follows:”. 2. Paragraphs 8(k) through 8(s) are hereby struck from the Original Agreement. 3. “ARPA Funds” is hereby struck from the footer to the Original Agreement. 4. Except for the changes made herein, the Original Agreement shall remain in full force and effect to the extent it is not inconsistent with this Amendment. In the event there is a conflict between the terms of the Original Agreement and the terms of this Amendment, this Amendment shall control. IN TESTIMONY WHEREOF, this Amendment has been executed by the parties hereto, as of the date first above written. ORANGE COUNTY PROVIDER ______________________________ __________________________________ Bonnie Hammersley Paul Kleever _____ County Manager Charles House DocuSign Envelope ID: E7DC514C-46EB-4996-B09C-84502C393363 Orange County Outside Agency Performance Agreement Page 10 of 13 Rev.9/21 ORANGE COUNTY—DEPARTMENT USE ONLY ______________________________________________________________________________ Party/Vendor Name: Charles House Party/Vendor Contact Person: Paul Kleever Contact Phone: 919-967-7570 Party/Vendor Address: 7511 Sunrise Rd, City Chapel Hill State: NC Zip: 27514 Department: Aging Amount: $23363 Purpose: Outside Agencies Budget Code(s): 10495050-710029 Vendor # 800031 (N/A if new vendor) Vendor is a BOCC consultant? Yes No Contract Type: (Check one) New Renewal Amendment Effective Date July1, 2021 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: 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: E7DC514C-46EB-4996-B09C-84502C393363 10/14/2021 10/14/2021 10/18/2021 10/18/2021 ANY PROPRIETOR/PARTNER/EXECUTIVEOFFICER/MEMBER EXCLUDED? INSR ADDL SUBRLTR INSD WVD PRODUCER CONTACTNAME: FAXPHONE(A/C, No):(A/C, No, Ext): E-MAILADDRESS: 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 COMPENSATIONAND 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 7/13/2021 (919) 636-3252 2 Charles House Association 7511 Sunrise Road Chapel Hill, NC 27514 A 1,000,000 X PHPK2129948 5/10/2021 5/10/2022 100,000 5,000 1,000,000 3,000,000 3,000,000 1,000,000A PHPK2129948 5/10/2021 5/10/2022 1,000,000A PHUB721449 5/10/2021 5/10/2022 1,000,000 B WC23000-2020 6/25/2021 6/25/2022 500,000 500,000 500,000 A E&O PHPK2129948 5/10/2021 Each Claim 1,000,000 A E&O PHPK2129948 5/10/2021 5/10/2022 Aggregate 3,000,000 Certificate holder is added as Additional Insured as respects General Liability as required by written contract. Orange County Government P.O. Box 8181 Hillsborough, NC 27278 CHARHOU-01 VDECAMP Titan Risk Consultants LLC107 Conner Drive, Suite 225Chapel Hill, NC 27514 Victoria DeCamp v.decamp@titanriskconsultants.com Philadelphia Indemnity Insurance Company Carolina Mutual Insurance Company 5/10/2022 X X X X X X DocuSign Envelope ID: E7DC514C-46EB-4996-B09C-84502C393363 CHARLES HOUSE ASSOCIATION BOARD OF DIRECTORS Beth Tillman, Vice President (Second term ends: 10/23) Attorney Tillman, Whichard & Cagle, PLLC 919-402-1740 95 Glen Eden Ct. Chapel Hill, NC 27516 Suzanne Kalbas, Secretary (Second term ends: 10/22) Community Leader 75001 Miller Chapel Hill, NC 27517 Robert Spransy, Treasurer (First term ends: 10/21) CPA 257 Abercorn Circle Chapel Hill, NC 27516 Cell: 919-672-3339 Melvin S. Hurston, Past President (Second term ends: 1/22) Senior Vice President Professional & Support Services UNC Hospitals 984-974-4423 10003 Hammock Bend Chapel Hill, NC 27517 Jesse Basnight, Jr. (Second term ends: 10/22) Vice President, S.H. Basnight & Sons 919-942-3158 204 Cobblestone Dr. Chapel Hill, NC 27516 Anna Beeber (First term ends: 9/21) Associate Professor School of Nursing, UNC 919-843-9489; (Cell) 919-610-8412 110 Purple Leaf Place Carrboro, NC 27510 Brad Fox (Second term ends: 1/22) President, Medical Claims Rx, Inc. 919-942-7211 3011 Silas Lane Hillsborough, NC 27278 Nancy Jones (Second term ends: 10/22) Retired Public School Teacher 115 Essex Dr. Chapel Hill, NC 27514 919-967-1414 Joel I. Levy (Second term ends: 10/22) Joel I. Levy, CPA, PLLC 919-3707631 76505 Rice Chapel Hill, NC 27517 Julia Lunsford, MD (First term ends: 7/21) Clinical Asst. Professor Dept. of Psychiatry UNC Healthcare/School of Medicine 984-974-3853 357 Tenney Circle Chapel Hill, NC 27514 Paul Klever, Executive Director Charles House Association 7511 Sunrise Road Chapel Hill, NC 27514 919-967-7570 paul@charleshouse.org DocuSign Envelope ID: E7DC514C-46EB-4996-B09C-84502C393363 DocuSign Envelope ID: E7DC514C-46EB-4996-B09C-84502C393363 DocuSign Envelope ID: E7DC514C-46EB-4996-B09C-84502C393363