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HomeMy WebLinkAbout2022-155-E-AMS-Rebuilding Together of the Triangle-Replacement Program - Energy Efficient HVACRebuilding Together of the Triangle Orange County Community Climate Action Grant Program Performance Agreement Rev. 2/21 Page 1 of 11 COMMUNITY CLIMATE ACTION GRANT PERFORMANCE AGREEMENT THIS AGREEMENT, made and entered into this 20th day of April 2022, (“Effective Date”) by and between the County of Orange, a political subdivision of the State of North Carolina, 200 South Cameron Street, Hillsborough, North Carolina, 27278, ("County") and Rebuilding Together of the Triangle, a legal entity located at 200 Trans Air Drive, Suite 200, Morrisville, NC 27560, NC (“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 progr am addresses an important community equity and climate action need, as identified by the Board of Commissioners; NOW, THEREFORE, in consideration of the above and the mutual covenants and conditions hereafter set forth, the County and Provider agree as follows: 1. Term of the Agreement. The term of this Agreement shall be two years beginning - April 19, 2022 to April 20, 2024. 2. Scope of Services. a. Provider will provide services, as outlined in the attached Community Climate Action Grant Program 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, the Community Climate Action Grant Program Performance Application, Exhibit B, the Revised, Scope of Services and more particularly described in the Revised Program Budget, the maximum sum of $113,000. 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 installments in the amount of Exhibit C to be paid as follows: Exhibit C. 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, related supporting documentation and performance outlined in the Revised Scope of Services and Project Budget in Exhibit B. If the project described in Exhibit A requires funds to be provided on a different or more accelerated schedule, the Provider may request an alternate payment schedule, which if approved, will be attached to this Agreement as Exhibit C, Alternative Payment Schedule. Should an Alternative Payment DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A Rebuilding Together of the Triangle Orange County Community Climate Action Grant Program Performance Agreement Rev. 2/21 Page 2 of 11 Schedule be approved, the Provider will still be required to submit quarterly Progress Reports for the duration of the Term of the Agreement. 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 Exhibits B and C. d. Once Provider has satisfied its obligations as provided in (c) 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. e. The County is not obligated to provide any other support to Provider in this or in succeeding fiscal years. 4. Agency Reporting. a. Provider will provide Orange County a Progress Report that includes a fiscal report and updates on performance measures as outlined in the Exhibit B, Revised Scope of Services. Progress Report dates are: April 1 - June 30, July 1 – September 30, October 1 – December 31, and January 1 – March 31. Reports are due on July 15, October 15, January 15, and April 15 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 sat isfactory 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 DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A Rebuilding Together of the Triangle Orange County Community Climate Action Grant Program Performance Agreement Rev. 2/21 Page 3 of 11 from written notice of default. The County may (but shall not be required to) grant the Provider an opportunity to cure the default without termination of this Agreement. This clause shall not be interpreted to limit the County’s remedies in law or in equity. c. Notwithstanding the foregoing, either party may terminate the agreement at any time without penalty; provided that written notice of such termination is furnished to the other party at least 30 days prior to termination. In the event of such termination, any payment due shall be prorated to the date of termination and any unused funds shall be returned to the County within 10 days of termination. d. Any termination of this Agreement for default under this section that is later deemed to be unjustified shall be deemed a termination for convenience. 6. Insurance. a. General Requirements. The Provider shall purchase and maintain, during the period of performance of this Agreement, insurance: i. Worker’s Compensation. For protection from claims under workers' or workmen's compensation acts; ii. Comprehensive General Liability Insurance covering claims arising out of or relating to bodily injury, including bodily injury, sickness, disease or death of any of the Consultant's employees or any other person and to real and personal property including loss of use resulting thereof; iii. Comprehensive Automobile Liability Insurance, including hired and non-owned vehicles, if any, covering personal injury or death, and property damage; and iv. Professional Liability Insurance, covering personal injury, bodily injury and property damage and claims arising out of or related to the performance under this Agreement by the Consultant or his agents, consultants and employees. b. Limits of Coverage: Minimum limits of insurance coverage shall be as follows: INSURANCE DESCRIPTION MINIMUM REQUIRED COVERAGE  Worker's Compensation Limits for Coverage A - Statutory State NC & Coverage B - Employers Liability $500,000 each accident, $500,000 Bodily Injury by Disease (BID) for each employee. $500,000 for BID limit  Commercial General $1,000,000 Each Occurrence Liability $2,000,000 Aggregate  Automobile Liability $1,000,000 Each Occurrence  Professional Liability $1,000,000 Each Occurrence $2,000,000 Aggregate  Sexual Abuse & Molestation $1,000,000 Each Occurrence $2,000,000 Aggregate  Cyber Liability $1,000,000 Each Occurrence $2,000,000 Aggregate DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A Rebuilding Together of the Triangle Orange County Community Climate Action Grant Program Performance Agreement Rev. 2/21 Page 4 of 11  Environmental/Pollution $1 million Each Occurrence Liability (Required if demolition, use of hazardous material or environmentally sensitive) 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. 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 cau sed 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 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 DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A Rebuilding Together of the Triangle Orange County Community Climate Action Grant Program Performance Agreement Rev. 2/21 Page 5 of 11 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 provides 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 Orange County Post Office Box 8181 Hillsborough, NC 27278 Provider: Rebuilding Together of the Triangle 200 Trans Air Drive, Suite 200 Morrisville, NC 27560 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 , Date DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A 4/20/2022 Rebuilding Together of the Triangle Orange County Community Climate Action Grant Program Performance Agreement Rev. 2/21 Page 6 of 11 For and on behalf of Orange County Government Bonnie Hammersley, County Manager Date DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A 4/23/2022 Rebuilding Together of the Triangle Orange County Community Climate Action Grant Program Performance Agreement Rev. 2/21 Page 7 of 11 ORANGE COUNTY—DEPARTMENT USE ONLY Department Party/Vendor Name: Rebuilding Together of the Triangle Party/Vendor Contact Person: Daniel Sargent Contact Phone: 919-996-0999 Party/Vendor Address: 200 Trans Air Drive, Suite 200 City Morrisville State: NC Zip: 27560 Department: Asset Management Services Amount: $113,000 Purpose: Replacement Program - Energy Efficient HVAC Budget Code(s):61370035-803070-30052 Vendor #N/A (N/A if new vendor) Vendor is a BOCC consultant? Yes No X Contract Type: (Check one) New X Renewal Amendment Effective Date 4/20/2022 Approved by Board: Yes X No Agenda Date: 10/19/2021 This agreement is approved as to technical form and content: Department Director’s Signature Date: 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: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A 4/20/2022 4/21/2022 4/22/2022 4/23/2022 Rebuilding Together of the Triangle Orange County Community Climate Action Grant Program Performance Agreement Rev. 2/21 Page 8 of 11 Exhibit A Community Climate Action Grant Program Application -Final Orange County Climate Action Grant -Application FY21-22 - Agenda – 10.19.21 BOCC Board Meeting – Item 6a DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A Rebuilding Together of the Triangle Orange County Community Climate Action Grant Program Performance Agreement Rev. 2/21 Page 9 of 11 Exhibit B Community Climate Action Grant Program’s Revised Scope of Services and Program Budget Not Applicable DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A Rebuilding Together of the Triangle Orange County Community Climate Action Grant Program Performance Agreement Rev. 2/21 Page 10 of 11 Exhibit C Community Climate Action Grant Program’s Alternative Payment Schedule 200 Trans Air Dr. Suite 200 Morrisville, NC 27560 919.341.5980 MEMORANDUM From: Dan Sargent, Executive Director, Rebuilding Together of the Triangle Date: April 14, 2022 Subject: Alternative Payment Schedule Rebuilding Together of the Triangle Reason Proposed Payment Schedule Breakdown: Quarter Dates Covered Proposed Payment Quarter 1 April – June, 2022 18,833.33 Quarter 2 July – September, 2022 18,833.33 Quarter 3 October – December 2022 18,833.34 Quarter 4 January – March, 2023 18,833.33 Quarter 5 April – June, 2023 18,833.33 Quarter 6 July – September, 2022 18,833.34 Quarter 7 October – December, 2022 0 Quarter 8 January – March 2024 0 TOTAL - $113,000 DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A Rebuilding Together of the Triangle Orange County Community Climate Action Grant Program Performance Agreement Rev. 2/21 Page 11 of 11 ATTACHMENT “A” Orange County Certifications – FY 2020-21 Community Climate Action Grant Program Performance Agreement Primary Contact, Chief Executive Officer / Executive Director, and Chief Financial Officer I certify that I have provided the primary contact and chief executive officer or executive director, 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, phone and email address and if possible, fax number. Board of Directors and Officers of the Board I certify that I have provided a current list of the Board of Directors and Officers of the Board 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. Project Budget Submission I certify that I have provided a project budget for the period to be covered by Orange County funding, and that any substantive changes made to this budget have been in advance authorized in writing by Orange County. Agency Budget Submission I certify that I have provided the requested information from the latest 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: (Provider’s Signature) Title: Date: DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A 4/20/2022Executive Director P a g e 1 Community Climate Action Grant Program Application FY 2021-22 SUBMISSION CHECKLIST Primary Applicant Organization: ____Rebuilding Together of the Triangle_____ Project Name: Program for low-income Orange County homeowners to replace inefficient furnaces with energy efficient, electric heat pump HVAC systems Section Subsection Cover Page Applicant and Collaborator/Partner Contact Information Funding Request Summary Signed Application Cover Page Disclosure Signed Disclosure of Conflicts of Interest and Clause Applicant Organization and Collaborator Information Applicant organization’s Date of Incorporation (if applicable) Applicant organization’s Purpose/Mission (if applicable) Living Wage Schedule of Positions (if applicable) Project Information Project Name Project Description and Climate Plan Alignment Collaborator Information (if applicable) Criteria-Specific Sections 1-7 DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A P a g e 2 Attachments (A description of these items is available on page 13: “Description of Required Attachments.” Please contact us if it will not be possible to provide any of these required attachments at the time of application: bbouma@orangecountync. gov) Applicant Organization’s Annual Budget and Proposed Project Budget (Use template provided) Applicable Financial Records to prove eligibility: IRS Federal Form 990 or Applicant Organization’s Tax Returns from 2019 Applicable Financial Records to prove eligibility of collaborator/partner (if they are receiving project funds): IRS Federal Form 990 or Tax Returns from 2019 List of members of organization’s Governing Board (if Board exists) Solid Waste Program Fee (SWPF) Verification (for commercial property owners and renters) Certificate of Insurance DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A P a g e 3 COVER PAGE Applicant Organization’s Contact Information Organization’s Legal Name: Rebuilding Together of the Triangle Physical Address: 200 Trans Air Drive, Suite 200, Morrisville, NC 27560 Mailing Address: 200 Trans Air Drive, Suite 200, Morrisville, NC 27560 Web Address: www.rttriangle.org Telephone Number: 919-341-5980 E-Mail: info@rttriangle.org Tax ID Number: 56-1955629 Funding Request Summary Please list all Fiscal Year 21-22 Community Climate Action Grant funding requested for the project you are proposing and the proposed use of funds (please list project name only). Applicants will be asked to provide more details on their proposed project budget in the Budget Worksheets attachment. Project Equipment Operations Personnel Total Ex. Youth Climate Leadership Project $10,000 $15,000 $5,000 $30,000 Heat Pump for Gas Furnace replacement program $113,000 $0 $0 $113,000 Briefly explain your proposed use of funds (2-4 sentences): To the best of my knowledge and belief all information and data in this application is true and current. Signature: __________________ July 28, 2021 Applicant’s Authorized Signatory Date This program will replace home heating furnaces with electric heat pump heating systems for low-income homeowners in Orange County. Priority will be given to homeowners who have experienced a system failure and are without adequate heating. DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A P a g e 4 POTENTIAL CONFLICTS OF INTEREST AND NON-DISCRIMINATION CLAUSE Are any of the Board Members or employees of the organization which will be carrying out this project or their named project collaborators/partners or members of their immediate families, or their business associates… YES NO a) Employees of or closely related to employees of Orange County? b) Members of or closely related to members of the governing bodies of 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? 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: July 28, 2021 Applicant’s Authorized Signatory Date DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A P.O. Box 8181 * Hillsborough, North Carolina 27278 Telephone: 919 245-2626 Applicant Organization & Collaborator Information Please provide the following information about the primary applicant organization: Contact Information for Primary Contact, Chief Executive Officer / Executive Director, and Chief Financial Officer Primary Contact Name Daniel Sargent Title Executive Director Preferred phone number 919-996-0999 Email address dsargent@rttriangle.org Fax number (if applicable) 919-651-0034 Chief Executive Officer / Executive Director Name Daniel Sargent Title Executive Director Preferred phone number 919-996-0999 Email address dsargent@rttriangle.org Fax number (if applicable) 919-651-0034 Chief Financial Officer Name Dan Crosley Title Board Treasurer Preferred phone number 803.369.1811 Email address dcrosley13@gmail.com Fax number (if applicable) DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A P.O. Box 8181 * Hillsborough, North Carolina 27278 Telephone: 919 245-2626 1. Date of Incorporation (Month/Year): January 1996 2. Applicant organization’s Purpose/Mission (2-4 sentences): The mission of Rebuilding Together of the Triangle (RTT) is repairing homes, revitalizing communities, and rebuilding lives. Our critical home repairs and accessibility modifications make a sustainable impact, ensuring vulnerable homeowners – including seniors, individuals with disabilities, and families with children – live in safe, healthy homes. 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 (2-4 sentences): Applicants from the Orange County Home Preservation Coalition are referred to RTT for comprehensive repair assessments. The resulting work statements provide clarity regarding repair priorities, enabling the Coalition to develop comprehensive, budgeted treatment plans for each home repair. RTT directly repairs more than 100 homes each year and has developed numerous partnerships around environmentally sound home repairs/upgrades. As just one example, RTT works in collaboration with the Ellerbe Creek Watershed Association, the City of Durham and Durham County to provide stormwater intervention and weatherization for eligible homeowners to reduce runoff and improve water quality. 4. Living Wage: Does this organization pay permanent employees a minimum living wage? (Yes / No) Yes If yes, is this organization an Orange County Living Wage Certified Employer? (Yes / No) If no, please briefly explain. No, because Rebuilding Together of the Triangle is based out of Wake County. 5. Schedule of Positions: a. Number of Full-Time Paid Positons: 10 b. Number of Part-Time Paid Positions: 2 c. Number of volunteers: 250 Average hours worked per volunteer per month 4 DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A P.O. Box 8181 * Hillsborough, North Carolina 27278 Telephone: 919 245-2626 Collaborators: Please provide the following information about all significant collaborators and partners whether or not they will be receiving grant funding for this project. Feel free to copy and paste Questions “a” through ”e” as needed if you have more than one significant collaborator/partner: a. Date of Incorporation (Month/Year): N/A b. Applicant organization’s Purpose/Mission (2-4 sentences): N/A c. 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 (2-4 sentences): N/A d. Living Wage: Does this organization pay permanent employees a minimum living wage? (Yes / No) If yes, is this organization an Orange County Living Wage Certified Employer? (Yes / No) If no, please briefly explain. e. Schedule of Positions: a. Number of Full-Time Paid Positons: b. Number of Part-Time Paid Positions: c. Number of volunteers: Average hours worked per volunteer per month DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A P.O. Box 8181 * Hillsborough, North Carolina 27278 Telephone: 919 245-2626 Project Information *Please submit for each project if applying for funding for more than one project. 6. Project Name: Program for low-income Orange County homeowners to replace inefficient furnaces with energy efficient, electric heat pump HVAC systems 7. Please briefly describe the proposed project and the target population to benefit from the program. How many people will benefit? (100-300 words) This project was designed to help low-income, Orange County households to transition from inefficient, greenhouse gas generating furnaces to highly efficient, greenhouse gas minimizing heat pump HVAC systems. Applicants to the Orange County Home Preservation Coalition(OCHCP) for weatherization, energy efficiency, urgent repair, or other related services constitute the target population for this project. During application intake the applicant's house is evaluated for potential benefit from this project. Benefits of this project, lower utility bills and lower greenhouse gas emissions, are then explained to the chosen applicants. With agreement of the chosen applicant appropriate modifications are made to the house to transition from an inefficient HVAC system to an efficient heat pump HVAC System. This project was also designed to cost effectively reduce greenhouse gas emissions. The cost for each pound of yearly CO2e emissions reduction by a $25k electric automobile is about $5. The cost for each pound of yearly CO2e emissions reduction by rooftop solar is about $4. The cost for each pound of yearly CO2e emissions reduction by a heat-pump HVAC system is about $2. 8. Please choose the best description for the type of project: ☐ Infrastructure/Clean Tech: New ☐ Infrastructure/Clean Tech: Repair X Infrastructure/Clean Tech: Replacement ☐ Communication/Education ☐ Natural Systems Management/Restoration ☐ Circular Economy/Waste reduction ☐ Analysis/Plan ☐ Other (Please describe): 9. Please choose the primary climate change mitigation focus for this project (select all that apply): ☐ Energy Efficiency ☐ Renewable Energy X Beneficial Electrification ☐ Carbon Sequestration ☐ Other (Please describe): DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A P.O. Box 8181 * Hillsborough, North Carolina 27278 Telephone: 919 245-2626 10. Has your organization or have your collaborators/partners completed projects of this type in the past? If so, what funds were used? ☒ Yes ☒ Funding used (Please describe): For example, we have utilized Climate Action Program funding for supplemental weatherization have received more than $500,000 over five years from the Duke Energy Helping Home Fund for HVAC replacement. ☐ No 11. If this project is not selected for funding in this round, what other funding might be used to support it within the next 5 yrs? ☐ Other capital or operational funds X None. This is a unique opportunity. ☐ Unknown (please describe): 12. Please select the jurisdiction(s) where your project is focused and briefly state how your project aligns with the relevant Climate Action Plans (2-4 sentences). Please name the action items from each relevant plan that best align with your proposed project: ☒ Carrboro: https://townofcarrboro.org/928/Community-Climate- Action-Plan ☒ Chapel Hill: https://www.sustainchapelhill.org/featured/2020/2/18/climate- action-and-response-plan ☒ Orange County: In progress, please instead show alignment with the Orange County BOCC Goals and Priorities. Extracts from Orange County jurisdiction climate action plans with which this project's goals align as follows: Carrboro: Recommendations are provided around the themes of community integration, energy efficiency of buildings, transportation, renewable energy, ecosystem protection and restoration, and food choices. Chapel Hill: Climate action is any activity that reduces our greenhouse gas emissions, or that helps us respond to our changing climate by making Chapel Hill a stronger and more resilient community. Orange County: Create, preserve, and protect a natural environment that includes clean water, clean air, wildlife, important natural lands, and sustainable energy for present and future generations. Energy efficiency and beneficial electrification are primary objectives of the previously identified climate action plans. This project contributes significantly to energy efficiency by replacing furnaces (a high-efficiency gas furnace is about 95% efficient) with more highly energy efficient heat-pump HVAC systems (Under ideal conditions, a heat pump can transfer 300% more energy than it consumes). A heat pump's source of energy is electricity. DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A P.O. Box 8181 * Hillsborough, North Carolina 27278 Telephone: 919 245-2626 Collaborators and Partners In some projects, collaborators and partners provide essential capacity and connections. If collaborators or partners are an essential part of your project whether or not they are receiving grant funds, please use this section to provide more details. If you are not working with collaborators or partners, please feel free to write N/A in this section and move to the Social Justice and Racial Equity section. 13. Please describe one to three key partnerships/collaborations that add the most value to the success of the proposed project: Duke Energy is supporting this effort with rebates amounting to $350 per HVAC replacement. The Orange County Home Preservation Coalition is identifying households that have requested weatherization, energy efficiency, urgent repair, or other related services Criterion 1 - Social Justice and Racial Equity 14. Who will directly or indirectly benefit from your project? Please be as specific as possible on the characteristics of those who will benefit including, gender, race, age, income level and geographic location. Also, what are the demographics of the area where your project takes place? Does your project help to address any racial disparities in the location it is proposed for? Please list any data sources used and show the steps of any calculations: Applicants to the Orange County Home Preservation Coalition for repair and energy efficiency services are candidates to directly benefit from this proposal. This pool of applicants is continually increasing. Upon grant award, this project will select households that can benefit from an HVAC replacement. This project has requested funds to replace inefficient HVAC systems in 30 households. We believe that each selected household will directly benefit from reduced utility bills, improved home comfort, and reduced greenhouse gas emissions. . We believe that each selected household will directly benefit from reduced utility bills (assuming $0.10/kwh and $0.90/therm)and reduced greenhouse gas emissions. The demographics of the OCHPC applicants that could directly benefit from an HVAC replacement are: Gender Male: 12 Female: 70 Race/ethnicity Black or African American: 54 White: 16 Latine: 6 American Indian or Alaskan Native: 2 2 or more races: 1 Other: 1 DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A P.O. Box 8181 * Hillsborough, North Carolina 27278 Telephone: 919 245-2626 Age 20-29: 1 30-39: 2 40-49: 4 50-59: 10 60-69: 26 70-79: 23 80-89: 9 >90: 3 Geographic location Carrboro: 6 Cedar Grove: 7 Chapel Hill: 26 Durham: 4 Efland: 11 Hillsborough: 15 Hurdle Mills: 2 Mebane: 9 Rougemont: 2 Jurisdiction: Orange County: 61 Town of Carrboro: 6 Town of Chapel Hill: 15 80%AMI and below (Self-Reported Annual Income) 79 This project covers all of Orange County but only serves the community with the previously described demographics. This selection strongly favors Orange County residents with lower incomes and who are members of racial minorities. 15. Please describe any ways in which low‐income or marginalized communities/households were engaged in the creation of this project proposal: The creation of this project was highly dependent on the foundation established by the Orange County Home Preservation Coalition (OCHPC). The OCHPC is a collaborative of 12 local government and community organizations that provide home repairs and modifications to Orange County residents primarily low-income or marginalized households. These households actively apply for energy efficiency services that they could not provide for themselves. The relationship that the OCHPC developed with these marginalized households was a critical stepping stone to helping these households reduce their utility bills. DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A P.O. Box 8181 * Hillsborough, North Carolina 27278 Telephone: 919 245-2626 16. Please describe any potential negative side effects of the project and describe the steps you are taking/will take to eliminate or minimize these impacts to any low‐income or marginalized communities/households: We do not anticipate any negative side effects of the project to the households that we serve or to the greater community. 17. Are the impacted residents already aware of the potential positive and negative impacts of your project and the steps you are taking? If not, please describe your plan to engage with them and how you will act based on their input: Clients of this project will most likely not be aware of the benefits of a heat-pump HVAC system. Upon introduction of the program, we will explain with prepared literature (and a socially-distanced dialog) the benefits not only to households but also to the community. We will patiently answer any questions homeowners may have about the project. If they have any residual reservations, we will not proceed. 18. During and after the project, what will your continued engagement with the community be? Rebuilding Together of the Triangle has a long term commitment to this community to preserve affordable homeownership and revitalize neighborhoods by providing home repair and renovation services free of charge to those in need. 19. Please describe any other aspect of your project that is relevant to Social Justice and Racial Equity: This project relies heavily on the participation of the Orange County Home Preservation Coalition (OCHPC). The OCHPC seeks to increase communication and collaboration among home repair organizations to decrease burden on clients and service seekers. Going beyond direct repair service, the OCHPC seeks to advocate for solutions that address the mechanisms that cause or perpetuate racial disparities in access to home repair and modifications in Orange County (including tax assessments, zoning, and mobile home ownership.) Criterion 2 - Emissions Reduced 20. How many tons of greenhouse gas emissions will your project reduce/avoid each year? Please list any data sources used and show the steps of any calculations. Feel free to submit in a separate document if clearly labelled: About 38 tons. The underlying assumptions and calculations for this estimate are documented in an attached spreadsheet, “HVAC Replacement GHG Reduction Calculations.xls”. 21. For how many years will this emissions reduction take place as a result of your project? Please consider the expected lifetime of the It depends on the lifetime of the heat-pump HVAC system which can vary dramatically. A reasonable average lifetime for a heat- pump HVAC system is about 15 years. DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A P.O. Box 8181 * Hillsborough, North Carolina 27278 Telephone: 919 245-2626 technology/program/impact etc. 22. Please describe the location of the emissions reduction. Where would fossil fuels have been burned if not for your project? For projects creating electricity usage reductions, it can be difficult to determine the location of the power produced. Please feel free to state “Grid-tied electricity reduction” Emissions reduction will occur in the homes of Orange County residents. 23. Please describe any other aspect of your project that is relevant to the amount of emissions that it will reduce or avoid. N/A Criterion 3 - Efficient use of Funds 1. Please estimate the impact of your project per grant dollar requested. This cost per unit of impact must reflect the total program budget divided by the total impact of the project described in this application. If the proposed project is new, please write N/A in the first column of the table below, and just fill out the second column. Actual Annual Project Costs (If your proposed project expands or accelerates an ongoing effort) Projected Project Costs Total Cost of Project N/A $113,000.00 Unit of Impact: Total # of tons of greenhouse gases reduced N/A 563 tons over 15 years Cost Per Ton of GHG’s Reduced N/A $200.00 Unit of Impact: Total # of individuals served/benefitted N/A 40 Cost Per Individual Served/Benefitted N/A $2,825.00 Other Unit of Impact: Please describe here N/A Cost Per Unit of Impact N/A Other Unit of Impact: Please describe here N/A Cost Per Unit of Impact N/A (Please feel free to add rows if necessary to show any additional units of impact.) DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A P.O. Box 8181 * Hillsborough, North Carolina 27278 Telephone: 919 245-2626 24. Please describe any avoided financial costs or savings related to the project and over what period of time those costs will be avoided/reduced: Future costs for natural gas and electricity are extremely difficult to forecast accurately as are the benefits to public health and safety from reducing GHGemissions. Our government, some businesses, and some US citizens believe that the cost of continued emissions of GHG is too great for our society. From the Environmental Defense Fund the current central estimate of the social cost of carbon is over $50 per ton in today's dollars. By that measure this project would avert over $28,000 in future damages from climate change. Some experts believe this estimate is far below the potential damages. 25. Does your project accelerate or expand on existing programs that already show positive impact? This program is carefully designed to utilize the program infrastructure pioneered by the Orange County Home Preservation Collaborative. The existing home repair and weatherization programming, and the shared intake and assessment process that under-girds it, provide this program with a pipeline of qualified homeowners, a system for evaluating and prioritizing projects, and a model for sharing resources to allow multiple agencies to invest in repairs in a comprehensive, efficient way. So, while this is a new program, it is essentially an expansion of services within this existing framework. 26. Does your project also take advantage of other funding sources? This project expects to receive $50,000 from private donors. It also expects support from Duke Energy and the Orange County Home Preservation Coalition. Duke Energy's program is designed to provide home owners with a $350 rebate for replacing HVAC systems. We have shared this program proposal with Duke Energy, and they have expressed full support (telecon with Sue Dinnsen). The second source is the existing work of the Orange County Home Preservation Coalition (OCHPC). The group has secured funding from various sources to help support the process involving application intake, home assessment and shared work write up. This has created the pipeline of evaluated, prepared projects that allow this program to very efficiently identify candidates for HVAC upgrades. The OCHPC cost of assessment per home is about $500. Typically, a project with a specific intervention like this requires assessment of 3-4 homes to identify an appropriate client. Thus, on average, it takes about $2000 for assessment to select and prepare a client for this project. 27. Would your proposed project help you to take advantage of funding from other sources besides this grant in the future? At this time, we do not have other sources of funding identified that would replace the Climate Action Funding that Orange County has made available. The leadership that Orange County is exercising in this space is exceptional, but that means there are not large numbers of funders working on these issues directly – yet. That said, we are pursuing funds to assist with beneficial electrification and energy efficiency work around HVAC system replacement, and we are hopeful that this demonstration project will unlock future funding from other sources focused on the shared benefit this program will provide to our economically DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A P.O. Box 8181 * Hillsborough, North Carolina 27278 Telephone: 919 245-2626 vulnerable neighbors, as well as our climate. 28. Please describe any other aspect of your project that is relevant to the efficient use of grant funds: Duke Energy is supporting this effort with rebates amounting to $350 per HVAC replacement. Criterion 4 - Capacity of Applicant 29. Please describe any projects that you have completed successfully in the past which are similar to the project you are proposing: Rebuilding Together of the Triangle has an expansive, proven, and well-known track record of completing quality and affordable repairs for Orange County residents. 30. If you are proposing to collaborate with other organizations on this project, please briefly describe their relevant experience to the project and/or the target population: A key collaboration is with the Orange County Home Preservation Coalition. The OCHPC maintains a comprehensive, online, homeowner database that constitutes the target population for this project. RTT will select project clients from this database. The OCHPC will also track the energy efficiency services that RTT provides to project clients. At monthly OCHPC meetings RTT will provide progress updates and will discuss any service issues with the OCHPC. 31. Please describe any other relevant expertise or capacity to carry out the project in your application: As a result of our expansive housing rehabilitation footprint, RTT has strong existing relationships with prequalified, skilled contractors to carry out this work effectively and efficiently. Criterion 5 - Local Economic Development 32. How many Orange County residents are employed by your organization? Rebuilding Together directly employs 2 Orange County residents and prioritizes working with local businesses and contractors within Orange County to complete repair services. DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A P.O. Box 8181 * Hillsborough, North Carolina 27278 Telephone: 919 245-2626 33. What percent of project materials will be purchased from sources within Orange County or North Carolina? Rebuilding Together prioritizes purchasing goods and services locally. We expect that 100% of project materials will be purchased from a local retailer in Orange County. 34. Please describe any other aspect of your project that is relevant to local economic development. This project strives to utilize local, minority subcontractors when possible. Criterion 6 - Amount and Duration of Engagement 35. Please describe how you will engage with and/or educate project participants. The OCHPC Outreach and Education Committee, which is composed of OCHPC members and recommended community partners, is currently implementing a home maintenance curriculum targeting our service population. Current plans include hosting a monthly one-hour workshop exploring a specific home maintenance topic. Workshop planning emphasizes involving community members in the process. With support of Orange County Government, we intend to incorporate an energy conservation and climate impact topics into the workshop curriculum. Specific to this initiative, we will seek to educate homeowners on the benefits of installing heat-pump HVAC systems. An informational handout will be provided to homeowners during the assessment stage of the repair process. Afterwards, a Rebuilding Together staff member will meet individually with homeowners to discuss the costs, benefits and climate impact associated with different types of HVAC systems. 36. How will you measure the success of that engagement or educational effort? We will utilize existing OCHPC evaluation methods to effectively measure the quantitative and qualitative outcomes in the educational efforts of this initiative. Measures include number of homeowners receiving information, change in behaviors, and knowledge gained. 37. Please describe any other aspect of your project that is relevant to the amount, or quality, or length of engagement and/or education that your project will produce. N/A DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A P.O. Box 8181 * Hillsborough, North Carolina 27278 Telephone: 919 245-2626 Criterion 7 - Time to Complete 38. How much time will your project require to demonstrate the positive impacts you describe? Households should see reduced utility bills within weeks of installation of the heat pump HVAC system. All proposed HVAC replacements should be complete within 18 months of grant funding but could extend to two years depending on circumstances. Submission Guidance Applications are to be submitted as email attachments to Orange County Sustainability Coordinator, Brennan Bouma at bbouma@orangecountync.gov. Please also CC the lead staff member supporting the Commission of the Environment, Wesley Poole at wpoole@orangecountync.gov. The Application Submittal Deadline for the Fiscal Year 21-22 round of the Community Climate Action Grant is Friday, July 30th 2021 at 5pm. Please note that late, handwritten, or incomplete applications will not be accepted. Submit all documents including attachments in PDF format. This will ensure the original content and formatting is preserved. Digital signatures on applications are accepted. Accommodations for applicants with disabilities or those in need of technical assistance are available upon request. Please contact the Orange County Sustainability Coordinator, Brennan Bouma (919-245- 2626, bbouma@orangecountync,gov) to discuss what is needed. ATTACHMENTS Description of Required Attachments  Applicant Organization’s Budget and Project Budget Please complete the provided budget worksheets for your organization and your proposed project or submit your own budget file (as long as it contains the same information, and in a similar format, as requested in the provided worksheets. Please explain other in your budget). The Budget Worksheets file is available for download from the County website here. Please submit the budget in PDF form as well as in the original editable Excel format.  IRS Federal Form 990 or 2019 Tax Returns A copy of the applicant organization’s most recent Form 990 or IRS Tax Returns is required to determine eligibility. The specific form depends upon the applicant organization’s financial activity. Review the IRS’ guide, for more details. For Form 990-N (e-postcard) filers, include a copy of the postcard, with the organization’s application materials. DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A P.O. Box 8181 * Hillsborough, North Carolina 27278 Telephone: 919 245-2626  List of Board of Directors (if applicable) Provide the following information about each board of director’s member: name, telephone number, and address, of each member and the list must identify the principal officers of the governing body, and length of term. Please feel free to use the template provided in Table 2 of the appendix or your own format.  Solid Waste Program Fee (SWPF) Verification This fee finances Orange County's recycling and waste reduction program. Submit either a.) proof of payment of the applicant organization’s FY 2019-20 Solid Waste Program Fee, OR b.) a statement on the applicant organization’s letterhead indicating exemption and specify the person(s), business, etc. that is responsible for paying this fee.  Certificate of Liability Insurance A copy of the applicant organization’s current certificate, from the organization’s insurance carrier. Table 1 below outlines insurance types and minimums required, for each jurisdiction. If exempt from Worker’s Compensation compliance, include a statement explaining why, with the applicant organization’s application materials. NOTE: Proof of insurance is not required at the time of application sub mission. If your agency is approved for funding, documentation of insurance must be provided to the jurisdiction awarding the funding when the contract is awarded. The insurance certificate should reflect the funding jurisdiction as an additional insured party and certificate holder and provide coverage for the duration of the funding period (two years, beginning as early as October 1, 2021). If proof of insurance can only be written for one year, an update will be required for all ongoing projects. Renewal certificates must be sent to the jurisdiction 30 days prior to any expiration date, cancellation or modification of any stipulated insurance coverage. NOTE: Upon request, insurance requirements may be reviewed on a case by case basis by the County. Please contact the staff identified on the Submission Requirements on Page 15 if you have questions or would like to request a review of your insurance requirements. DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A P.O. Box 8181 * Hillsborough, North Carolina 27278 Telephone: 919 245-2626 APPENDIX Table 1. Forms of Liability Insurance and Minimum Policy Amounts Required INSURANCE ORANGE COUNTY3 Worker's Compensation1 Limits for Coverage A - Statutory State NC, for each employee Limits for Coverage B - Employers Liability of: $500,000 each accident, $500,000 Bodily Injury by Disease (BID).for each employee $500,000 for BID limit Commercial General Liability $1 million Each Occurrence $2 million Aggregate Automobile Liability $1 million Each Occurrence Professional Liability $1 million Each Occurrence $2 million Aggregate Sexual Abuse & Molestation $1 million Each Occurrence $2 million Aggregate Cyber Liability $1 million Each Occurrence $2 million Aggregate Environmental/Pollut ion Liability (Required if demolition, use of hazardous material or environmentally sensitive) $1 million Each Occurrence  Visit the NC Industrial Commission’s website for more information regarding Coverage A. Also, note that if an agency uses subcontractors, it must require subcontractors to have workmen’s compensation insurance.  Please visit Orange County’s Risk Management page for more information about the County’s Minimum Insurance Requirements. DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A P.O. Box 8181 * Hillsborough, North Carolina 27278 Telephone: 919 245-2626 Rebuilding Together of the Triangle Board of Directors Name (also title and term length if Officer) Physical/Mailing Address Phone number Email address Fax number (if applicable ) Katy Patton, Chair 2501 Blue Ridge Rd. Suite 470, Raleigh, NC 27617 (919) 867- 2811 kpatton@riversagency.com Matthew Duncan, Secretary 3737 Glenwood Ave Suite 450, Raleigh, NC 27707 (919) 743- 7329 Matthew.duncan@sas.com Dan Crosley, Treasurer 100 E Davie Street, Raleigh, NC 27601 (803) 369- 1811 Dcrosley13@gmail.com Brandon Moorefield 4700 Falls of Neuse Rd. Suite 190, Raleigh, NC 27609 (919) 719- 9570 Brandon.Moorefield@marshm ma.com Michael Byers 3600 Glenwood Ave Suite 300, Raleigh, NC 27609 (919) 881- 1666 byersm@fnb-corp.com Anne Stoddard 3700 Glenwood Ave, Raleigh, NC 27607 (919) 614- 3214 astoddard@grubbventures.com Tyler Grimes 3600 Glenwood Ave Suite 300, Raleigh, NC 27607 (919 810- 6200 tgrimes15@gmail.com Marcelle Thomas 429 Foster Street, Durham, NC 27701 (919) 815- 4411 marcelle@urbandurham.com Mike Trainor 103 Milky Way Dr., Apex, NC 27502 (919) 645- 8607 mtrainor7473@gmail.com Shelley McPhatter 600 N Duke St, Durham, NC 27701 (919) 761- 0511 smcphatter@bridgepointnc.com DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A ORANGE COUNTY BOARD OF COMMISSIONERS ACTION AGENDA ITEM ABSTRACT Meeting Date: October 19, 2021 Action Agenda Item No. 6-a SUBJECT: Community Climate Action Grant (CCAG) – FY 2021-22 Project Selection for General Applicants DEPARTMENT: Asset Management Services ATTACHMENT(S): 1) CCAG 2021-22 Project Descriptions, Scoring, and Comments for General Applicants 2) CCAG 2021-22 Project Descriptions, Scoring, and Comments for School Application INFORMATION CONTACT: Brennan Bouma, (919) 245-2626 Steven Arndt, (919) 245-2658 PURPOSE: To: 1) Receive the grant project funding recommendations from the Human Relations Commission (HRC) and the Commission for the Environment for the FY 2021-22 Orange County Community Climate Action Grant Program; 2) Approve funding for the recommended Community Climate Action Grant projects for FY 2021-22 as outlined in the attached report; and 3) Receive and approve the request from the HRC to shift one point in the scoring rubric from “Time to Complete” to “Social Justice/ Racial Equity” in future rounds of grant funding. BACKGROUND: As part of the FY 2019-20 budget, the Board of Orange County Commissioners (BOCC) created the Orange County Climate Action Fund dedicated to accelerating climate change mitigation actions in Orange County. This decision was motivated in part to help the County meet the climate change mitigation goals set by the Board in recent years:  Reduce greenhouse gas emissions community-wide by 26 percent by 2025 (from 2005 levels).  Transition to a 100% renewable energy based economy by 2050. For the 2021-22 funding cycle, $536,665 in funding was budgeted to support climate action projects that will benefit Orange County residents both socially and financially. Following the direction of the Board of Orange County Commissioners (BOCC), the process for soliciting and selecting projects to receive funding was conducted through a formal Community Climate Action Grant (CCAG) program. DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A For this grant cycle, the BOCC reserved half of the total funding for this grant program ($268,332.50) to be awarded to projects subm itted by either of Orange County’s two public school districts. The remaining half ($268,332.50) was to be made available to all other eligible general applicants in this round. Only one project totaling $68,616 has been submitted from either School district, and no funding allocated for the schools has yet been recommended for approval. Attachment 2 provides additional information. In light of the Board’s interest in supporting school climate action projects and the special challenges facing schools as they operate during a pandemic, the current grant deadline for school projects will be extended through the end of November. County staff have already begun reaching back out to the schools to offer direct assistance in generating proje ct proposals for this extended FY2021-22 round of funding as well as the FY2022-23 round of funding set to open later this year. The information below describes the scoring, ranking, and reasoning of the review of general applications. The Community Climate Action grant program received seven (7) applications in this round from a variety of general applicants representing non -profit and public organizations whose total requests add up to more than $880,000. While staff fielded some questions from pros pective applicants from the private sector, no private sector applications were received. Grant applications were completed over the summer and reviewed and scored by the Commission for the Environment (CFE) and the Human Relations Commission (HRC). On September 13, 2021, each of these Commissions voted to forward their final scoring and comments to the BOCC. The following is a rank-order summary table of the combined project scoring and recommendations, and more details on each project are available in Attachment 1: Project Applicant Funding Requested Recommended Funding Level Running total Total Score (Out of 25 pts) Rank* (Out of 7 applicati ons) Low Income HVAC Replacement Rebuilding Together of the Triangle $113,000 $113,000 $113,000 22.8 1 Neighborhood Energy Resiliency Project (NERP) NC Sustainable Energy Association $115,000 $90,000 $203,000.00 21.2 2 Food Waste Monitor Town of Carrboro $4,000 $4,000 $207,000.00 20.4 3 Food Waste Monitor Eno River Farmer’s Market $3,765 $3,765 $210,765.00 19.6 4 Sustainability Upgrades (Bike Rack and Charging Carrboro Arts Center $17,000 $17,000** $227,765.00 18.4 5 DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A Station element only) 203 Project Solar PV Array and Green Roof Town of Carrboro $178,507 $40,567.50** $268,332.50 17.7 6 Wayfinding Implementation Town of Chapel Hill $100,000 $0 $268,332.50 14.9 7 Sustainability Upgrades (Full Project) Carrboro Arts Center $371,290 $0 $268,332.50 13.8 8 Total Requested by General Applicants (Funds available for 2021-22: $268,332.50 $885,562 $268,332.50 * All projects, including those that tied in their scoring and those that exceed the funding limit were placed in rank order by CFE and HRC voting. ** The HRC recommended funding only the Bike Rack and Charging Station element of the Carrboro Arts Center. The CFE did not recommend funding any portion of the ArtsCenter application in favor of adding to the partial funding of Carrboro’s 203 Project. In addition to providing feedback on the FY 2021-22 round of grant applications, the HRC also made a suggestion regarding an improvement to the scoring rubric used for the grant evaluations. The HRC suggested reducing the weight given to the “Time to Complete ” scoring category and adding a point to the “Social Justice/ Racial Equity” category to better reflect the grant program values. FINANCIAL IMPACT: The Climate Action Tax is projected to generate $536,665 in funds in FY 2021-22, and the Board of Orange County Commissioners intends to identify impactful projects and distribute these funds promptly to accelerate action on the urgent issue of climate change and help to further stimulate the local economy. SOCIAL JUSTICE IMPACT: The following Orange County Social Justice Goals are applicable to this item:  GOAL: ENSURE ECONOMIC SELF-SUFFICIENCY The creation and preservation of infrastructure, policies, programs and funding necessary for residents to provide shelter, food, clothing and medical care for themselves and their dependents. Social Justice and Racial Equity is the most heavily-weighted factor in scoring projects proposed through this grant program, ensuring that the equitable distribution of funds and the repair of environmental inequities are a central element of each funded project. Local investments in energy efficiency and renewable energy in Orange County provides direct reduction of monthly energy bills and supports jobs and investments in clean energy technologies.  GOAL: ESTABLISH SUSTAINABLE AND EQUITABLE LAND-USE AND ENVIRONMENTAL POLICIES DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A The fair treatment and meaningful involvement of people of all races, cultures, incomes and educational levels with respect to the development and enforcement of environmental laws, regulations, policies, and decisions. Fair treatment means that no group of people should bear a disproportionate share of the negative environmental consequences resulting from industrial, governmental and commercial operations or policies. Reducing energy usage from the electric grid improves air quality impacts. Improving local air quality helps to protect the health of vulnerable populations in Orange County whose health is disproportionately affected by ground-level ozone and other emissions. ENVIRONMENTAL IMPACT: The following Orange County Environmental Responsibility Goal impacts are applicable to this item:  ENERGY EFFICIENCY AND WASTE REDUCTION Initiate policies and programs that: 1) conserve energy; 2) reduce resource consumption; 3) increase the use of recycled and renewable resources; and 4) minimize waste stream impacts on the environment. Investing in local climate change mitigation actions will conserve energy, reduce resource consumption, and increase the use of renewable resources.  RESULTANT IMPACT ON NATURAL RESOURCES AND AIR QUALITY Assess and where possible mitigate adverse impacts created to the natural resources of the site and adjoining area. Minimize production of greenhouse gases. The Climate Action Fund will continue to support high-impact projects which will improve local air quality and minimize the local production of greenhouse gases, reducing Orange County’s contribution to the adverse impacts of climate change on human and natural resources both inside and outside of the County. RECOMMENDATION(S): The Manager recommends that the Board 1) Receive the grant project funding recommendations from the Human Relations Commission and the Commission for the Environment for the FY 2021-22 Orange County Community Climate Action Grant Program; 2) Approve funding for the recommended Community Climate Action Grant projects for FY 2021-22; and 3) Approve the request from the HRC to shift one point in the scoring rubric from “Time to Complete” to “Social Justice/ Racial Equity” in future rounds of grant funding. DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A Applicant Organization's Budget Actual Total for Previous Year Estimated Total for Current Year Projected Total for Next Year Percent Change 481,412$ 397,500$ 450,000$ 13% 7,275$ 130,000$ 150,000$ 15% 175,000$ 548,000$ 550,000$ 0% 4,000$ 314,000$ 375,000$ 19% 105,194$ 207,000$ 230,000$ 11% 436,000$ 421,000$ 575,000$ 37% -$ -$ -$ 0 50,000.00$ -$ -$ 0 -$ -$ -$ 0 Private Foundation Grants 197,733.00$ 275,500.00$ 310,000.00$ 0.13$ Other Revenue: please briefly explain here -$ 100,000$ -$ (1.00)$ 1,456,614$ 2,393,000$ 2,640,000$ 10% 509,645$ 693,000$ 745,000$ 8% 70,775$ 72,000$ 75,000$ 4% 86,451$ 105,000$ 109,000$ 4% 4,217$ 16,000$ 20,000$ 25% 785,526$ 1,507,000$ 1,691,000$ 12% 1,456,614$ 2,393,000$ 2,640,000$ 10% -$ -$ -$ 0 AGENCY EXPENSES (Most recent complete calendar year or fiscal year) ORGANIZATION REVENUE Private Donations Rebuilding Together of the Triangle Local Government Grants (Please list separately): Wake Count ( including various towns) Durham (including both city and county} Chatham County Starting date: January 1, 2020 Ending Date: December 31, 2020 Total Organization Revenue Generated Revenue (fees, sales, etc) ORGANIZATION NAME: Other Expenses: please briefly explain here Total Agency Expenses Construction Program Costs Supplies & Equipment Travel & Training SURPLUS/(DEFICIT) FOR PERIOD: Other Government Grants Triangle United Way State Government Federal Government (CDBG/HOME/etc.) Compensation Rent & Utilities PPP LOAN FORGIVENESS Orange County ( including towns) FY 2018-19 Agency Budget DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A Department oi tlte Treasury Bevenue A For the 2020 calendar t",r 990 B Check if applicable: -AddressI lchange f lchange I-lnitialI lrelurn f----] FinalI lreturn/ tennin ated f lAmendedLlreturn nApplicaI ltron pending J Website:WWW.RTTR]ANGLE. ORG ion number 1 Briefly describe the organization's mission or most significant activities: SEEKS TO MAKE A SUSTAINABLE IMPACT ON PRESERV]NG AND REVITALIZ]NG HOMES AW 2 Check this box )lf the organization discontinued its operations or disposecl of more lhan 25%o of its net assets 3 Number of voting members of the governing body (paft Vl, line 1a) 4 Number of independent voting members of the governing bocly (par1 Vl, line 1b) 5 Total number of individuals employed in calendar year 2OZO (part V, line 2a) 6 Total number of volunteers (estjmate if necessary) 7 a Total unrelated business revenue from Part Vlll, column (C), line 12 taxable income 990-T, Pad l, line 11 10 10 15 0. 0. 0. oo o o (5 od o .9E .z o 0) o o TE Return of Organization Exempt From lncome Tax Under section 501(c),527, or 4947(a)(1) of the lnternal Bevenue Code (except private foundations) ) Do not enter social security numbers on this form as it may be made public. D Employer identification number 56-1955629 E Telephone number L9-341-5980 cross receipts g 1 463 522. H(a) ls this a group return for subordinate"z .. [-] yu" lTl r.ro H(b) nrc att suboroinates incr.ded? f_-] y"a f -l ruo lf "No," attach a list. See instruc'tions NC I27 1,449 ,497 . 7 ,275. -1 47. 509 ,645. 113 277 . 622 097 . 453 272. 511 . 7 6]-. that I exarnined this retLrrn, including accompanying schedules and statements, and to the best ol my knowleclge and belief, it is of er is based on all inlormati0n of rvhich DAN SARGENT EXECUT]VE DIRECTOR 0. Under penallies ol per true, cor recl, and Sign Here ure C Name of organization REBUILDING TOGETHER OF THE TRTANGLE Number and street (or P.0. box if mail is not delivered to slreet address) 2OO TRANS A]R DR]VE City or town, state or province, country, and Zlp or foreign postal cocleRR]SV]LLE, NC 27 F Nanre and address of principal officer: DAN SARGENT 2OO TRANS A]R DRTVE, SUITE 2OO, MORRTSVILLE formation: l-995 6 I 't0 1'l 12 L ,525 , gg'l . 20 ,320. 13 Grants and similar amounts paid (part lX, column (A), lines 1"3) 14 Benefits paid to or for members (Part lX, column (A), line 4) 15 salaries, other compensation, employee benefits (part lX, column (A), lines 5.10) . .. 16a Professionalfundraising fees (Part lX, column (A), line 11e) b Total fundraising expenses (Part lX, column (D), line 25) 17 Other expenses (Par1 lX, column (A), lines j j a-11d, l1f .24e) 18 Total expenses. Add ljnes 13.17 (must equal pad lX, column (A), line 25) 19 Revenue less expenses. Subtract line 1B from line 12 40L,732. 907,L84. 20 21 22 Total assets (Parl X, line 16) Total liabilities (Pad X, line 26) 330,259. 118,401. 211_, BsB. Print/Type Jlreparer's name AVTD BOYCE Preparer's sionature Fir nr's name KOONCE, I^IOOTEN & HAYWOOD, LLp Firrn'sacldress;,. P. O. BOX 17806 RALEIGH, NC 2761.9-7806 Type or print name and tille Paid Preparer Use 0nly PT 01368646 Firm's EIN 56 0517823 no.9l-9 -782-9265 12-23 r0 LHA For Paperwork Reduction Act Notice, see the separate instructions. SEE SCHEDULE O FOR ORGANIZATION MISS]ON STATEMENT CONTTNUATION Contributions and grants (Par1 Vlll, line t h) Program service revenue (Part Vlll, line 29) lnvestment income (Part Vlll, column (A), lines 3, 4, and 7d) Other revenue (Part Vlll, column (A), lines 5, 6d, Bc, 9c, 10c, and 11e) 0. DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A 56-1955629 Check if Schedule O contains a response or note to anv line in this part lll ................... . ........ E1 Briefly describe the organization's mission: SEEKS TO MAKE A SUSTAINABLE IMPACT ON PRESERVTNG AND REVITALIZ]NG HOM ELDERLY AND DISABLED TO FAI4ILIES WITH CHI AND ]NDEPENDENCE. 2 Did the organization undertake any significant program services during the year which were not listed on the prior Form 990 or 990.E2? lf "Yes," describe these new services on Schedule O. Did the orgarrization cease conducting, or make significant changes in how it conducts. any program services? flv"' [Xiruo f-]y". [X]ruo lf 'Yes, describe these changes on Schedule O. Describe the organization's program service accomplishments for each of rts three largest program services, as measured by expenses. Section 501 (cX3) and 501 (c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenr:e, if anv, for each proqram service reported.,4a (coo", _)(expenses$ L,486,7B7. incrudinssrantsorg )F**-7,275. 1REBUILDING, REPAIRING AND REVTTAL]ZING LOW_]\rcOME HOUSING FOR THEELDERLY, DISABLED AND FAMTLIES WITH CHILDRE}T. 4b (cooe: _ ) (expenses $including grants of $) (nevenue $ 4c (c".r., _ ) (e,p".".= s including grants of $(Revenue $ 4d Other program services (Describe on Schedule O.) rorm 990 lzozoy 12,23 20 3 4 DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A 2 3 TOGETHER OF THE 56-1 1 ls the organization described in section 501(cX3) or 4947(a)(1) (other than a private foundation)? lf "Yes," complete Schedule A .. . ..... ls the organization required to complete Schedule B, Schedute of Contributors? Did the organization engage in direct or indrrect political campaign activities on behalf of or in opposition to candidates for public office? lf "yes," complete Schedute C, part I Section 501(c)(3) organizations. Did the organization engage in Iobbying activities, or have a section 50-1(h) electjon in effect ls the organizat,on a sectjon 501(c)(a), 501(c)(5), or 501 (c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Bevenue Procedure 9B-19? // ',yes,,, comptete Schedule C, paft lll Did the orgarrizatjon maintain any donor advised funcls or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? lf ',yes," complete scl,tedute D, part t Did the organization receive or hold a conservation easement, including easements to preserve open space, the environment, historic land areas, or historic structures? lf 'yes,,, complete Schedute D, part il8 Did the organization maintain collections of works of ad, historical treasures. or other similar assets? lf ',yes,, complete Schedule D, Paft lll Did the organization repofi an amount in Part X, ilne 21, for escrow or custodial account liabrlity, serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? Did the organization, directly or through a related organization, hold assets in donor-restricted endowments or in quasi endowments? tf "yes," complete Schedute D, paft V lf the organization's answer to any of the following questions js "Yes," then complete Schedule D, parls Vl, Vll, Vlll, lX, or X as applicable. Did the organization repod an amount for land, buildings, and equipment in pad x, line 1 0? lf "yes," complete schedure D, Did the organization reporl an amount for investments-other securities in Pad X, line 12, that js 5% or more of its total assets reported in Parl X, line 16? lf "yes," complete Schedule D, paft Vll Did the organization repod an amount for investments - program related in part X, line 13, that is 5%o or more of its total assets reponed in Part X, line 16? lf "yes," comptete Schedule D, paftVllt Did the organization repod an amount for other assets in Parl X, line 15, that iss,yoor more of its total assets reported in Part X, line 16? lf ,yes," complete Schedule D, paft lX e I Did the organization report an amount for other liabilities in parl X, line 25? lf ,,yes,,, complete Schedule D, paft X . . . . Did the organization's separate or consolidated financial statements for the tax year include a footnote that addresses the organization's liability for uncedain tax positions under FIN 4g (ASC 74O)? lf ,,yes,,, complete Schedule D, paft X Did the organization obtain separate, independent audrted financial statements for the tax year? 1s ',yes," complete Was the organization inclucled in consolidated, independent audited financial statements for the tax year? x x x x x 11 b 13 14a b 15 16 17 12a 20a b 21 x x x x X x x x lf "Yes," and if the organization answered "No" to line 12a, then compteting Schedute D, pafts Xl and Xl! is optional ls the organization a school described in sectjon i 70(b)(jXAXii)? tf ,,yes,,, cotllplete Schedule E .. . Did the organization maintain an office, employees, or agents outsrde of the United states? Did the organization have aggregate revenues or expenses of more than $lo,ooo trorn g,rntrnrt. ng ,rnorut. ng, ;;.i;;.; investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? lf "Yes,'complete Schedule F, pafts t and tV Did the organization report on parl lX, column (A), line 3, more than $5,000 of grants or other assistance to or tor any foreign organizalion? tf "yes,' complete Schedute F, pafts il and lV Did the organization repod on part lX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign ind jviduals? tf ',yes,', comptete Schedute F, pafts ilt and tV Did the organization report a total of more than $15,000 of expenses for professional fundraising services on part lX, Did the organization operate one or more hospital facilities? tf ,,yes,, complete Schedule H lf "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic column (A), lines 6 and 11e? lf "yes," complete Schedute G, paft t 18 Did the organrzation repod mole than $15,ooo total of fundraising event gross income and contributrons on parl vlll, lines 1c and Ba? tf ,Yes," complete Schedule G, part lt 19 Did the organization report more than $15,000 of gross income from gaming activities on parl Vlll, line 9a./ lf ,'yes.,, complete Schedu/e G, Paft lll x X X 032003 12,23,20 porn-,990 lzozo; DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A 55-1-955629LDINGOF THE TRIANGLE 22 Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Parl lX, column (A), line 2? tf "yes," complete Schedule t, pafts I and lll 23 Did the organization answer "Yes" to Part Vll, Section A, line 3, 4, or 5 about compensation of the organization,s current and former officers, directors, trustees, key employees, and highest compensated employees? lf "yes," complete Schedule J ......... ..... 24a Did the organization have a tax'exempt bond issue with an outstanding principal amount of more than $i 00,000 as of the last day of the year, that was issued after December 31 ,2002? /f ,,yes,,, answer liles 24b through 24d and complete Schedule K. lf "No," go to line 2Sa ................ b Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception? c Did the organization maintain an escrow account other than a refunding escrow at any time during the year to defease any tax-exempt bonds? d 25a Did the organization act as an "on behalf of " issuer for bonds outstanding at any time dr-rring the year? Section 501(c)(3), 50t(c)(a), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? 11 ' yes,,, complete Schedule L, parl Ib ls the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization's prior Forms g9O or 990-EZ? tf ,,yes," complete Schedu/e L, Paft I Did the organization report any amount on Part X, line 5 or 22, for receivables from or payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35Zo controlled entity or family member of any of these persons? tf ,,yes,,, complete Schedute L, paft fi Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor or employee thereof , a grant selection committee member, or to a 35o% controlled entity (including an employee thereof) or family member of any of these persons? ff ,,yes,, complete Schedule L, paft lll Was the organization a pady to a business transaction with one of the following parties (see Schedule L, parl IV instructions, for applicable filing thresholds, conclitions, and exceptions): A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? 71 A family member of any individual described in line 2ga? tf ,,yes,,, complete Schedule L, part tV A 35% controlled entity of one or more indivrduals and/or organizations described jn lines 2Ba or 2Bb? 1S Did the organization receive more than $25,000 in non.cash contributions? lf ,,yes,,, complete Schedute M Did the organization receive contributions of ad, historical treasures, or other similar assets, or qualif ied conservatron contributions? tf "yes,, complete Schedule M . Did the organization liquidate, terminate, or drssolve and cease operations? lf ,,yes,,, complete Schedute N, part I .....Did the orqanization sell, exchange, dispose of, or transfer more than 25%o of its net assets? lf ',yes," complete Schedule N, Part ll Did the organization own looyo of an entrty disregarded as separate from the organization under Regulations 26 27 29 30 31 32 33 x x x x x b c sections 3O1 .7701.2 and 301 .77Oj.3? lf ',yes,' complete Schedule R, part I34 Was the orqanization related to any tax.exempt or taxable enlity? tf ,,yes,,, complete Schedule B, paft il, ilt, or lV, and 35a Did the organ jzation have a controlled entity within the meaning of section 5l2(b)(13)? b lf "Yes" to Iine 35a, did the organization recejve any payment from or engage in any transaction with a controlled entity within the meaning of section 512(bxi3)? lf "yes,,, complete Schecjute R, paft V, line 2 .......36 Section 501(c)(3) organizations' Did the organization make any transfers to an exempt non.charitable reiated organization? lf "Yes,' complete Schedule R, paft V, line 2 .... ...... Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a padnershjp for federal income tax pr_rrposes? ff ,yes,,, complete Schedute R, paft Vl Did the organization complete Schedule o and provide explanations in Schedule O for parl Vl, lines 1i b and j9./ ngs ax Check if Schedule O contains a response or note to 1a b c 03200J 12,23-20 to prize winners? line in this Parl V rorm 990 lzozo; DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A Form LDING TOGETHER F THE TRIANGLE ax ce 2a Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements, filed for the calendar year ending with or within the year covered by this return b lf at least one is reported on line 2a, did the organization file all required federal employment tax returns? Note: lf the sum of lines 1 a and 2a is greater than 250, you may be require d lo s-1;1s (see instructions) .... Did the organization have unrelated business gross income of $1 ,000 or more during the year? lf "Yes,"hasitfiledaFormgg0-Tforthisyear? tf "No"toline3b,provideanexplanationonSchecluleO At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial accountinaforeigncountry(suchasabankaccount,securitiesaccount,orotherfinancial account)? .... lf "Yes," enterthe name of theforeign countrV ) See instructions forfiling requirements for FinCEN Form 114, Repod of Foreign Bank arrcl Financial Accounts (FBAR). Was the organization a party to a prohibited tax shelter transaction at any time during the lax year? Did any taxable party notify the organization that it was or is a parly to a prohibited tax shelter transaction? lf "Yes" to line 5a or 5b, did the organizatlon file Form B886.T? Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributior.rs that were not tax deductible as charitable contributions? lf "Yes," did the organization include with every solicitation an express statement that such contributjons or gifts were not tax deductible? 7 organizalions that may receive deductible contributions under section 170(c). a Did the organization receive a payment jn excess ol $75 made partly as a contributi0n and partly for goocls ancl services providecl t0 the payor?b lf"Yes,"didtheorganizationnotifythedonorofthevalueofthegoodsorseruicesprovided? c Did the organization sell, exchange, or otherwise dispose of tangible personal propefty for which it was required lf "Yes," indicate the number of Forms 8282 filed during the year 7d Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract? Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefjt contract? lftheorganizationrecetvedacontributionofqualifiedintellectual property,didtheorganizationfileFormBgggasrequired?.. lf the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1OSB-C? Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during fl-re year? Sponsoring organizations maintaining donor advised funcls. Did the sponsoring organization make any taxable distributrons under section 4966? Did the sponsoring organization make a distribution to a donor, donor advisor, or related person? 55629 2a 3a b 4a 5a b c 6a d e f g h x x a b 10 a b 11 a b Section 501(c)(7) organizations. Enter: lnrtiation fees and capital contributtons included on parl Vlll, line 12 ......... Gross receipts, included on Form 990, part Vlll. line 12, for public use of club facilities Section 501(cX12) organizations. Enter: Gross income from members or shareholders 11a Gross income from other sources (Do not net amounts due or paid to other sources against amounts due or received from them.) 'l2a Section gaT@)(1) non-exempt charitable trusts. ls the organization filing Form ggo in ljeu ol Fotm 1o41./b lf "Yes," enter the amount of tax-exempt interest received or accrued during the year I ,zu13 Section 501(c)(29) qualified nonprofit health insurance issuers. a ls the organization licensed to issue qualified health plans in more than one state? Note: See the instructions for additional information the organization must report on Schedule o. Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans Enter the amount of reserves on hand Did the organization recerve any payments for indoortanning services clurrng the raxyear? l{'Yes,"hasitfiledaFormT20toreponthesepayments? tf "No,,,provicleanexplanationonScheduteO ls the organization subject to the section 4960 tax on payment(s) of more than $i,o00,oOO in remuneration or excess parachute payment(s) during the year? lf "Yes." see instructions and file Form 4720. Schedule N. ls the organization an educational institution subiect to the section 4968 excise tax on net investment income? "Yes. " b 14a b 15 16 21 x 032005 12-23 20 DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A to line Ba, Bb, or 10b below, describe the circumstarces, processes, or changes on Schedule O. See instructions, and ment Formee0(2020) REBUILDING TOGETHER OF THE TRIANGLE 56-1955632-_-pu*-g. o " response 1a Enter the number of voting members of the governing body at the errd of the tax year lf there are material differences in voting rights among members of the qoverning boc1y, or if the governing ll0dy delegated brOad authority to an executive commiltee or similar c0riltnitlee, explain on SchecJule O.b Enter the number of voting members included on lir-re l a, above, who are independent .. . . .... . ...2 Did any officer, director, trustee, or key employee have a farnily relationship or a business relationship with any other Did the organization delegate controi over management duties customarily perlormed by or under the direct supervisro; of officers, directors, trustees, or key enrployees to a management company or other person? Did the organization make any significant changes to jts governing documents sjnce the prior Forrr g9O was fjled? .Did the organizatlon llecome aware during the year of a significant diversion of the organization,s assets? Did the organization have menrbers or stockholders? Did the organization have members, stockholders, or other persons who had the power to elect o, uppoint onu o1 Are any governance decisions of the organization reserved to (or sr-rbject to approval by) mentbers, stockhoiders, or persons other than the govenring body? Did the organization contemporaneously clocument the meetings helcl or rvritten actions undertaken riuring the year by L, rJf u*1,,g, The governing body? .. Each committee with authority to act on behalf of the governing body? ls there any officer, director, trustee, or key employee listed in Pan Vll, Section A, who cannot be reached at the 3 4 q t) 7a b 8 a b I x x x x Sec on B. Policies Did the organization have local chapters, branches, or affjliaies? lf "Yes," drd the organization have written policies and procedures governrng the activities of such chapters, affjliates, and branches to ensure their operations are consistent with the organization's exempt purposes? Has the organization provided a complete copy of this Form g9O to all nrembers of its governing body before filing the form? Describe in schedule o the process, if any, used by the organization to review this Form gg0. Did the organization have a writterr conflict of tnterest policy? 11 ,,No, ,, go to line 13 Were oflicers, ditectors, or trustees, ancl key employees required to ciisclose annually interests lhat corrld give rise to confljcts? Did the organization regularly and consistently monitor and enforce compliance with the policy? 11 ',yes,, describe Did the organization have a written whistleblower policy? Did the organization have a written document retention and destruction policy? Did tl-re process for determining cornpensation of the following persons include a review and approval by indepenc.lent persons, comparability data, and contemporarleous substantiatron of the deliberation and decisjon? The organization's CEO, Executtve Director, or top management official Other officers or key employees of the organization If "Yes" to line 15a or.l5b, describe the process in Schedule o (see instructions). Did the organizatjon invest in, contribute assets to, or parlicipate in a loint venture or simrlar arrangement wjth a 1f "Yes," did the organizatron follow a written policy or procedure requiring the organizatlon to evaluate its pafiicipation in joint venture arrangements under applicable federal tax law. and take steps to sateguard the organjzation,s Sec C. Disclosure List the states with wl-rich a copy of this Form 990 is reqr-rired to be filecl F NONE No10a b 11a b 12a b c 1Q 14 15 a b 16a b x 17 18 ' :^:"j:": :':t'" ,n!'t"l atr organizatton to make its Forms 1023 (1024 or 1o24-A, if appricabre), 990, and g90.T (section 501(c)(3)s onty) avaitablefor public inspection. rncricate how you made these avairabre. check ail that apply.f-l or"n websire f--l Another,s website I Xl upon ,"lro.t f-l Otfl", (exptain on Schedule O)19 Describe on schedule o whether (and if so how) the organization made its governing documents. conflict of interest policy. and financial staternents available to the public cluring the tax year 2oStatethename,address,andtelephonenumberoftheperSonwhopossessestheorganization,SbookSandrecords> DAN SARGENT - 919*341-5980 2OO TRANS 0s2oo6 12-23-20 rorm 990 lzozo; DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A Employees, and lndependent Contractors rNG TOGETHER 56-l_955629 , vrr vvtvt r, I I sJrvuo, Check if Schedule O contains a or note t0 any line in this Paft Vll section A. officers, Directors, Trustees, Kev Emplovees, and Highest compensated Emplovees 1a Complete this table for all persons required to be listed. Beporl compensation for the calendar year ending with or within the organization,s tax year. o List all of the organization's current officers, dtrectors, trustees (whether indlviduals or organizations), regardless of amount of compensation. Enter-0- in columns (D), (E), and (F) if no compensation was paid. o List all of the organization's current key employees, if any. See instructions for definition of "key employee.,, o List the organization'slwe current highest compensated employees (other than an officer, director, trustee, or key employee) who received report-able compensation (Box 5 of Form W2 and/or Box 7 of Form 1099-MISC) of more than $1 0O,OO0 from the organization and any related organizations. o List all of the organization's former offrcers, key employees, and l'righest compensated employees who received more than $1O0,OOO ofreportable compensation from the organization and any related organizations. o List all of the organization's former directors or trustees that received, in the capacity as a former director or trustee of the organization,more than $10,000 of reportable compensation from the organization and any related organiiations. See instructrons for the order in which to list the persons above. if neither the current officer (A) Name and title (1) DAN SARGENT EXECUTIVE DIRECTOR 10,785.12) KATY PATTON PRESIDENT (3) TYLER GRIMES VICE PRES]DENT (4) MATTHEW DUNCAN SECRETARY (5) DAN CROSLEY TREASURER (6) CA],IERON BOIVIN BOARD MEMBER (7 ) ANNE STODDARD BOARD MEMBER (B) M]CHAEL BYERS BOARD MEMBER (9) BRANDON MOOREF'IELD BOARD MEMBER (10) TIM WILSON BOARD MEMBER (11) MARCELLE THOMAS BOARD MEMBER (F) Estimated amount of other compensation from the organization and related organizations 0. 0. 0. 0. 0. 0. 0. 0. 0. (B) Average hours per week (list any hours for related (c) Position (do not check mor e than one box, unless person is boih an officer and a direclor/truslee) (D) Repodable compensation from the organization (w-2l1099,MtSC) (E) Repodable compensation from related organizations (w,2/10e9.rvtsc) E ,= 87,056. 032007 12-23 20 DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A ING TOGETHER OF THE Trus (A) Name and title 1b Subtotal c Total from continuation sheets to part Vll, Section A 2 f olal number of indivjduals (lncludlng but not limited to those listed above) who received more than $i 00,000 of reporlable 3 Did the organization list any former officer, director, trustee. key employee, or highest compensated employee on 4 For any individual listed on line 1a, is the sum of repoftable compensation and other compensation from the organization and related organizations greater than $150,000? lf ,,yes,,, complete Schedule J for such individual ......5 Did any person listed on ljne 1a receive or accrue compensation from any unrelated organizatlorl or individual for services Section B. lndependent Contractors 0. (F) Estimated amount of other compensation from the orgarrization and related organizations 10 1_0 785. 785. 0 No ;,r x (B) Average hours per week (list any hours for related izations (c) Position (do not check more than one box, unless person is both an officer and a director/trustee) (D) Reportable compensation from the organization (w-2l1099-tVtSC) (E) Bepodable compensation from related organizations (w-2l1099-MrSC) E ,= 87,056. 87,0s6. 'I Complete this table for your five highest compensated independent contractors that received more than $i OO,o0O of "orp"nartion f[il the with or wi tion's tax (A) Name and business address NONE 2 rolal number of independent contractors (including but not limited to those listed above) who received 11o* ,h- (c) Compensatlon por.-n990 lzozo) 032008 12 23-20 56-t- DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A Formee0(2020) REBUILDING TOGETHER OF THE TRIANGLE 55-1955629 &89. Related or exempt function revenue 1 a Federated campaigns b Membership dues c Fundraising events d Relatedorganizations e Government grarrts (contributions) f All other c0ntributi0ns, 0ilts, 0rants, and similar amounts n0t included above . . Q Noncash contriblllions tncluded in lines 1a-1f L10,000. 770,194. 569,303. 40,560. 449 ,497 . 2a b c d e I CONSULTING FEES All other program service revenue 230000 3 lnvestment income (including dividends, interest, and other similar amounts) 4 lncome from investment of tax exempt bond proceeds 5 Royalties Gross rents Less: rental expenses Rental income or (loss) Net rental income or (loss) Gross amount lrom sales ol assets other than inventory Less: cost or other basis and sales expenses . . .. Gain or (loss) . Net gain or (loss) Gross income lrom fundraising events (not contributions reported on line 1c). See Part lV, line 18 ... Less: direcl expenses . Net income or (loss) from fundraising events Gross income from gaming activities. See Paft lV, line 19 b Less: djrect expense; c Net income or (loss) from gaming activitles 10 a Gross sales of inventory less returns and allowances b Less. cosl of Uoods sold I (ii) Other .l 1 a b c d e All other revenue Total. Add lines 1 1a-] 1d 454 ,825 . Check if Schedule O contain or note to anv line in this Part Vlll o (! o ut i5 ui o fo co Revenue exclLlded from tax under sections 512 - 514 -1 947 1 oo oa E 0.)5 o oE C) o o5oo s6o ,9 = 03200s 12,23-20 Fornr 941 . DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A Formee0(2020) REBUILDfNG TOGETHER OF THE TRIANGLE 55-19555!J_pg.l9 S""tion 501(")(3, urd 5O1(")(4t orgurir"tior, *rrt ro Check if Schedr-rle O contarns a response or note to any line in this part lX Do not include amounts rcpofted on lines 6b, 7b, Bb, 9b, and 10b of Paft Vlll.Fundraising SES 1 Grants and other assislance t0 d0mestic organizations and domestic governments. See Part lV, line 2l 2 Grants and other assistance to domestic individuals. See Pan N, fine 22 3 Grants and other assistance to foreign organizations, foreign governments. and foreign irrdividuals. See Pan lV, lines i5 and i6 . . 4 Benefits paid to or for members 5 Compensatjon of current officers, directors. trustees, and key employees 6 Compensati0n not included ailove t0 clisqualifieri persons (as defined Lrnder section 4958(f)(l)) and persons described in secti0n 4958(c)(3)(B) 7 Other salaries and wages 8 Pension plan accruals and contributions (inclucle section 401(k) and 403(b) employer contribLrtions) I Other employee benefits 10 Payroll taxes .. 11 Fees for services (nonemployees): 29,352 5,651 2 ,556 a Management ..... ... b Legal c Accounting d Lobbying e Professional fundraising services. See part lV, ljne l7 f lnvestment management fees . .... ......g Other. (lf line 1 1g amount exceeds l0% ol line 25, column (A) anrount, list line l lg expenses on Sch O.) Advedising and promotion Office expense lnformation technology Royalties Occupancy Travel Payments of travel or entedainment expenses for any federal, state, or local public officials Conferences, corrventions, and meetings 800. 378 597. 823. lnterest Payments to affiliates Depreciation, depletiorr, and amortization . . lnsurance 0ther expenses. llemize expenses not covercrl above (l rst miscellarreous cxpenses on line 24e. lf line 24e arnounl excee(ls '10oro ol line 25. colLlmn tAl arrrorrrrl. lrsi lrle 24c experrses on Scltcrlllle O.) CONTRACT LABOR BUILDTNG MAM BU]LDING SITE INCTDENTA B, BO7 a b c d e PUES, LICENSES, & MEMBE All other expenses 306. Total lunctional es, Add lines 1 ) 24e 5B 35326 Joint costs. Complete this line only il the organization reported jn column (B) joint costs f rom a combined educational campai0n and f undraising solicitation. Check here 12 13 14 15 't6 17 18 19 20 21 22 23 24 B3 91 ,841,.48 ,921_ .19,568 37 5 ,293 .336,785.?a otr? 36,511.29 ,939 . 48,232.40 ,997 . BB, O71 7 4 ,860 655,6s6.655,6s6. 1-9 0 , 4Bg 1,90 , 48g 48 ,606 .48 ,606 . 1-7 ,902 1-7,736 29 ,]-1_3 .26,327. 1 ,622 ,922 1_,486 ,787 '1'1 10aI I , t 9a 032010 12-23 20 soP 98 2 (ASC 958-720) rorm 990 lzoeo; DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A REBUILDTNG TOGETHER OF THE TRIANGLE or note to 55-1955629 (B) End of year 237 ,575. L47 ,03L. 1,9 250 . 42 816 . 5,600. 453 272. 160 256 . 249 255 . 409 511 . 43 /6L. 43,76L. 453 ,212. o q)oo q .9 E -o .gJ ooo fo ! l! o o (,oo 0)z 1 Cash-non-interest.bearing ...... 2 Savings and temporary cash investments .... . ..3 Pledges and grants receivable, net 4 Accounts receivable, net .... .. 5 Loans and other receivables from any current or former offjcer, director, trustee, key employee, creator or founder. substantial contributor, or 35o% controlled entity or family member of any of these persons 6 Loans and other receivables from other disqualified persons (as defined under section 4958(0(f), and persons described in section 95B(c)(3XB) 7 Notes and loans receivable, net .. . .. 8 lnventories for sale or 9 Prepaid expenses and deferred charges 10a Land, buildings, and equipment: cost or other basis. Complete Part Vl of Schedule O I tOa 67 ,045. b Less: accumulated depreciation 11 lnvestments , publicly traded securities 13 lnvestments program.related. See parl lV, line 1.1 15 Other assets. See Part lV. line i 1 tal assels. Add lines I throuqh 1 1_L5 ,527 . 1"77 ,256. 1-9 ,325 . 24 ,229 .10,551 330,259. 17 Accounts payable and accrued expenses 18 Grants payable 19 Deferred revenue 20 Tax-exempt bond liabilities 21 Escrow or custodial account liability. Complete pad lV of Schedule D .....22 Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contrjbutor, or 35% controlled entity or family member of any of these persons Secured mortgages and notes payable to unrelated third parties Unsecured notes and loans payable to unrelated third parlies Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines l7_24). Complete parl X l_15,068 118 , 4 01_ Organizations that follow FASB ASC g58, check here ) and complete lines 27, 28, 32, and 33. 27 Net assets withorit donor restrictions 28 Net assets with donor restrictions Organizations that do not follow FASB ASC ,S;, ;;";; ;;r; ; and complete lines 29 through 33. 29 Capital stock or trust principal, or current funds 30 Paid-in or capital surplus, or land, building, or equipment fund 31 Retained earnings, endowment, accumulated income. or other funds 32 Total net assets or fund balances L]-8,766. 93 ,092 . 211, ,858 . 330 ,259 . porn-, 990 lzozo; 032011 12 23-20 DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A lh-JVrlA I Pan xl I Reconciliation of Net Assets 1 2 3 4 5 6 7 o 10 if Schedule O note to any line in this Part Xl Total revenue (must equal Part Vlll, column (A), line 12) Total expenses (must equal Parl lX, column (A), Iine 25) Revenue less expenses. Sr.rbtract line 2 from line 1 Net assets or fund balances at beginning of year (must equal parl X, line 32, column (A)) Net unrealized gains (losses) on investments Donated services and use of facilities lnvestment expenses ....... Prior period adjustments Other changes in net assets or fur-rd balances (explain on Schedule O) Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal part X, line 32 Financial Statements and Reporting Check if O contains a line in this 1 Accounting method used to prepare the Form 990: fl casn I Xl Rccrual f_l otl,l", lf the organization changed its method of accounting from a prior year or checked "Other,', explain in Schedule O. Were the organization's financial statements compiled or reviewed by an independent accountanl? lf "Yes," check a box below to inclicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both: f_-] Separate basis f_.l Consolidated basis f-l eotn consolidated and separate basis were the organizatior.r's financial statements audited by an independent accountant? lf "Yes," check a box below to indicate whether the fjnancial statements for the year were audited on a separate basis, consolidated basis, or both: fXl separate basis f -l Consolidated basrs f l gotn consolidated and separate basis lf "Yes" to line 2a or 2b, does the organization have a commrttee that assumes responsibility for oversight ot the audit. review, or compilation of its financial statements and selection of an independent accountant ? lf the organizatjon changed either its oversight process or selection process during the tax year, explain on Schedule o. As a result of a Jederal award. was the organization required to undergo an audit or audits as set fodh in the Single Audit Act and OMB Circular A.133? lf "Yes," did the organization undergo the required audit or audits? lf the organization dld not r:ndergo the requjred audit or audi on 454 825 622 ,922. -1-68 091 .2tt B5B. 43 7 61, 3a rorm 990 1zozo1 032012 12-23-20 DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A SCHEDULE A (Form 990 or 99O-EZ) Deparlment of the Treasury lnternal Revenue Servlce Public Charity Status and Public Support Complete if the organization is a section 501(c)(3) organization or a section 4947 la)(1) nonexempt charitable trust.) Attach to Form 990 or Form 990-EZ. OMB No. 1545-0047 2020 6fl 7 lTl 8f_lsfl 10 f-l )> Go to www for instructions and the latest information. Name of the organization Employer identif ication number REBUILDI TOGETHER OF THE ANGLE 56-195s62 (All organizaiions must complete this par1.) See instructions city, and state 5L]Anorganizationoperatedforthebenefitor, section 170(bXtXAXiv). (Complete Parl il.) A federal, state, or local government or governmental unit described in section 1ZO(b)(f )(A)(v). An organization that normally receives a substantial pad of its support from a governmental unit or from the general public described in section 17O(b)(1)(A)(vi). (Comptete part il.) A community trust described in section 170(b)(1)(A)(vi). (Complete parl ll.) An agricultural research organization described in section rz0(b)(r)(A)(ix) operated in conjunction with a land grant college or university or a non'land-grant college of agriculture (see instructions). Enter the name, ciiy, and state of the college or university: An organization that normally receives (1) more than 33 1/3%o of its support f rom contributions, membership fees, and gross recerpts f rom (vi) Amount of other suppod (see instrucl,ons) activities related to its exernpt functions, subject to ceftajn exceptions; and (2) no more tharr 33 1 /3%o oI its supporl f rom gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1g75. See section 509(a)(2). (Complete parl llt ) 11 [] An organlzation organized and operated exclusively to test for pr-rblic safety. See section 509(a)(a). P f ) An organization organized and operated exclusively for the benefit of, to pedorm the functiorrs of, or to carry oLrt the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in -lines 12a through 12d that describes the type of supporling organization and complete lines j2e, 121, and 12g.u fl Type l. A supporling organization operated, supervised, or controlled by its supporled organization(s). typically by giving the supporled organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization, You must complete part lV, Sections A and B. b T f Type ll' A sr-rpporling organization supervised or controlled in connection wrth its supported organization(s), by having control or management of the suppofiing organization vested in the same persons that control or manage the suppoded organization(s). You must complete part lV, Sections A and C. " f_] Type lll functionally integrated. A suppodrng organization operated in connection with. and functionally integrated with, its supported organization(s) (see instructions). You must complete part lV, Sections A, D, and E.d f_l Type lll non-functionally integrated. A suppofiing organization operated in connection with its supporled organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentjveness requjrement (see instructions). You must complete Part lV, Sections A and D, and part V.t fl Checkthisboxif theorganizationrecejveclawrittendeterrninatior-rfromthelRsthatitisaTypet. Iypell.Typelll functionally integrated, or Type lll non-functionally integrated suppofiing organization. , Enter the number of supported organizations the (i) Name ol supporled organ jzation (iii) Type of organization (described on lines 1 1O (v) Amount oi monetary suppon (see instructions) LHA For Paperwork Reduction Act Notice, see the lnstructions for Form 990 or 99o-EZ.o32o21 ot.zs 21 Schedule A (Form 99O or 99O-EZ)2O2O DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A 990 or REBUILDING TOGETHER OF THE TRIANGLE 56-195562tan (Complete only if you checked the box on line 5, 7, or B of Part I or if the organization failed to qualify under Part lll. lf the organization fails to qualify under the tests listed below, please complete paft lll.) Calendar year (or liscal year beginning in) ) 1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ...... 2 Tax revenues levied for the organ. ization's benefit and either paid to or expended on its behalf 3 The value of services or facilities furnished by a governmental unit to the organization without charge ... 4 Total. Add lines 1 through 3 5 The podion of total contributions by each person (other than a governmental unrt or publicly slrppoft ed organization) rncluded on line 1 that exceeds 2%o of lhe amount shown on line 1-l , column (f) 5BB9O1B 5BB9O B. Subtract line 5 lrom line 4 889018. Total ort Calendar year (or fiscal year beginning in) ) 7 Amounts from line 4 ... .............. 8 Gross income from interest, dividends, payments received on securities loans, rents, royalties, and income from similar sources 9 Net income from unrelated business actrvities, whether or not the business is regularly carried on '10 Other income. Do noi include gain or loss from the sale of capital assets (Explain in Part Vl.) Total 5BB90l-B Total support. Add lines 7 through 10 5889018. Gross receipts from related activities, etc. (see instructions)45 ,669 . First 5 years. lf the Form 990 is for the organization's first, second, third, fourlh, or fifth tax year as a section 5ol (c)(3) Section tion o 14 Public slrppod percentage tor2ozo (rine 6, column (f), divided by rirre 11, corumn (f)) 15 Public suppod percentage from 201 9 Schedule A, part ll, line i 4 100.00 % 100.00 16a 33 1/3% support test - 202o' lf the organization did not check the box on line 13, and line l4 is 33 1/3%or more, check this Oo, o,,,.t b33 1/3%supporttest-2019' lf theorganizationdidnotcheckaboxonlinel3orl6a,andlinel5is33 1/3o/oormore.checkthisbox 17a looh -facts-and-circumstances test - 2020' lf the organization did not check a box on line i3, 16a. or l6b, and line l4 is lo%oor more, and if the oroanization meets the facts'and'circumstances tes1. check this box and stop here. Explain in parl Vl how the organization nreets the facts and'circumstances test. The organization qualifies as a publicly supporled organizalion b1o%-facts-and-circumstancestest-2019. fitheorganizationdidnotcheckaboxonilnel3,j6a,i6b,or17a,andline15islO%or more,andiftheorganizationmeetsthefacts-and'circumstancestest,checkthisboxand stophere.ExplaininparlVl howthe organ'zation meets the facts'and-circumstances test. The organization qualifies as a publicly supporled organization > f]18 Private fotrrldation. lf the orclanizatron did not check a box on lir-re l3. 16a. l6b. lTa. or lTb. check this box and see instruction. """ > f l Schedule A (Form 99O or 990-EZ) 202O 'I 1 12 13 >E >E >E 032022 01-25-21 DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A 2O2O REBUILDING TOGETHER OF THE LE s6-1955629 ule lor (Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part ll. lf the organization fails to qualify under the tests listed below. olease comDlete Part ll.) Section A. Public Support Calendar year (or fiscal year beginning in) ) 1 Gifts, grants, contributions, and membership fees received. (Do not include any "ur.'tusual grarrts.") .. 2 Gross receipts from admissions, merchandise sold or services per. fornred. or facilities fr:rnished in any activity that is related to the organizatior.r's tax,exempt purpose 3 Gross receipts from activities that are not an unrelated trade or bus. iness under section 51 3 4 Tax revenues levied for the organ. ization's benefit and either paid to or expended on its behalf 5 The value of services or facilities furnished by a governmental unit to the organization without charge ... 6 Total. Add lines 1 through 5 .... 7a Amounts included on iines 1, 2, and 3 received from disqualified persor-rs I Amounts inc]uded of ines 2 and 3 recerved from olher than dlsqLralified persons that exceed the greater ol $5,000 or 10% of the amount on line 13 Ior the year c Add lines 7a and 7b Calendar year (or liscal year beginning in) ) 9 Amounts from line 6 10a Gross income from interest, dividends. payments received on securitjes loans, rents, royalties, and income from similar soLtTCes b Unrelated bLrsiness taxable income (less section 51 1 taxes) from businesses acqLrireri after JLrne 30, 1975 c Add lines l Oa and 10b 11 Net income from unrelateJ business activities not included in line 10b, whether or not the busil]ess rs regr rlarly carried on 12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Parl Vl.)13 Total support. (Add I nes 9 10c. 1 1, and 12.) 14 First 5 years. lf the Form g9O is for the orgarrization's first, second, third, foufth, or fifth tax year as a section 501 (c)(3) organization. k rhi on c.of Public 15 Publicsuppodpercentagelor2o2o(lineB.column(f).dividedbylinel3,colLrmn(f)) D.of lnvestment lncome 17 lnvestment income percentage for 2o2o (line 1oc, colr:mn (f), divided by line 13, column (0) 18 lnvestment income percentage from 20 j9 Schedule A, parl lll, line 17 '19a33 1/3%supporttests-2020. lf theorganizationdidnotcirecktheboxonlinel4.andlinel5isnrorethan33 1/3ya.andlinelTisnot more than 33 1/3% check this box and stop here. The organization qualifies as a publicly sLrpporled organization b 33 1/3% support tests - 2019. If the organization did not check a box on line 14 or line 19a, and line i6 is more than 33 1/3%o. ancj >tI line 1B is not more than 33 1/3%o. check this box and stop here. The organization qualifies as a publicly suppofied organization .. . .. > f]20 Private foundation. lf the orqanrzation did rrot check a box on line 14. 19a. or 1gb. check this box and see instructions > f_-l 032023 01'2s-21 Schedule A (Form 99o or 99o-EZ) 202o DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A Schedule tfform e90 or 990fzt 20?0 TEBUILD (Complete only if you checked a box in line 12 on Parl l. lf you checked box 12a, Pan l, complete Sections A and B. lf you checked box 12b, Paft l, complete Sections A and C. lf you checked box .12c, Paft l, complete Sections and E. If you checked box 12d, Part ions A and D, and te Pad V A. AII 1 Are all of the organization's supported organizations listed by name in the organization's governing documerrts? lf "No," describs in ParlYl how the suppofted organizations are clesignated. lf clesignated by c/ass or purpose, describe the designation. lf historic and continuing relationship, exptain. 2 Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? 11 ,'yes,' explain in Part Vl how the organization cletermined that the suppofted organization was described in section 509(a)(1) or (2). 3a Did the organization have a supported organization described in section 501 (cXa) (5), or (6)? lf 'yes," answer lines 3b and 3c below. b Did the organization confirm that each supporled organization qualified under section 501 (c)(a), (5) or (6) and satisfied the public suppod tests under section 509(a)(2)? lf 'yes,,, describe;p part Vl when ancl how the organ ization made the determination. c Did the organization ensure that all suppofi to such organizations was used exclusively for section j7O(cXzXe) purposes? lf "Yes," explain in ParlYl vvl12t controls the organization put in place to ensure such use. 4a Was any supporled organization not organized in the United States ("foretgn supported organizalion"\? 1y "Yes," and if you checked box 12a or 12b in paft t, answer lines 4b and 4c below. b Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign suppoded organization? lf "Yes," describe rn Part Vl how the organization had such control and discretion despite being controlled or superuised by or in connection withits supportec/ orqanizations. c Did the organization suppoft any foreign suppoded organization that does not have an IBS determination under sections 501(c)(3) and 509(a)(1) or (2)? t "yes,', explain 7a part Vl what controls |.te organization used to ensure that all suppotl to the f oreign suppofted organization was used exclL)sively f or section I l0(c)(2)(B) ptl/poses. 5a Did the organization add. substitute, or remove any supporled organizations during the tax year? lf 'yes,,, answer lines 5b and 5c below (if applicabte). Also, provide cletait in Part Vl, inctuding (i) the names and EtN numbers of the suppofted organizations aclded, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document). b Type I or Type ll only' Was ar-ry added or substituted supporled organization parl of a class already designated in the organization's organizing document? c Substitutions only. Was the substitution the result of an event beyond the organization's control? 6 Did the organization provide suppod (whether in the form of grants or the provision of servrces or facilities) to anyone other than (i) its suppoded organizations, (ii) individuals that are paft of the charitable class benefited by one or more of its supporled organizations, or (iii) other supporling organizations that also suppofi or benefjt one or more of the filing organization's supported organizations? lf 'yes," provicle detail in Part Vl. 7 Did the organization provide a grant, loan, compensation, or other simjlar payrnent to a sllbstantial contributor (as defined in section +9S8(c)(3)(C)) a family member of a substantial contributor. or a 35%o controlled entitv with regard to a substantial contributor? lf 'yes," complete paft t of Schedule L (Form 990 or 990-EZ).I Did the organization make a loan to a disquali{ied person (as defined in section 4958) not described in line 7? lf "Yes,' complete Paft I of Schedute L (Form 990 or ggo EZ). 9a Was the organization controlled djrectly or indirectly at any time during the tax year by one or more disqualified persons. as defined jn section 4946 (other than foundation managers and organizations described in section 509(a)(i ) or (Z)l? 1y ' yes, ' provide detait in part Vt. b Did one or more disqualified persons (as defined in line 9a) hold a controlling jnterest in any entity ip which the supporling organization had an interest? lf ,yes,,, provide detail in part Vl. c Did a disqualified person (as defined in line 9a) have an ownership interest in. or derive any personal benefit from,assetsinwhichthesupportingorganizationalsohadaninterest? lf,yes,,,providedetail inpartVl. 10a Was the organization subject to the excess br:siness holdings rules of section 4943 because of section 4943(f) (regarding cerlain Type llsupporlirrg organizations. and all Type llt non.f;urctionally integrated supporting organizations)? lf ,yes," answer line 1Ob betow. b Did the organization have any excess business holdings in the tax yea] ()se schedule C, Form 4720, to 03202J 01-25 21 Schedule A (Form 990 or 990-EZ) 2020 DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A or 990 2O2O REBU]LDTNG ETHER OF THE TRIANGLE 56-1 5s62 11 an Has the organization accepted a gift or contribution from any of the following persons? A person who directly or indirectly conirols, either alone or together with persons described in lines I 1b and l.'l c below, the governing body of a supporled organizaiion? A family member of a person described in [ne 11a above? A35%controlled entityof a person described in line 1Ia or 1jb above? lf 'yes' to line 11c, provide Part Vl. B.I Sup anizations Did the governing body, members of the governing body, offrcers acting in their official capacity. or membership of one or rnore suppofted organizations have the power to regularly appoint or elect at least a nrajority o{ the organization's officers, directors, or trustees at all times during the tax year? lf "No,' describs jn parlyl how the suppofted organization(S) effectively operated, supervisecl, or controlled the organization's activities. tf the organization had more than one supporTed organization, describe how the powers to appoint andlor remove officers, directors, or t/ustees were allocated among the suppofted organizatiorts and what conditions or restrictions, if any, applied to such powers cluring the tax year. Did the organization operate for the benefit of any suppoded organization other thap the supporled organization(s) that operated, supervised, or controlled the supporling organization? tf "yes,', explain in PartYl fi6tv pvoviding such benefit carried out the purposes of the suppoftecl organization(s) that operated, ction G. T'll Suppor anizations Were a majority of the organization's directors or trustees during the tax year also a majority of the directors or trustees of each of the organization's suppoded organization(s)? tf "No,, describe 4 part Vl how control or management of the suppotling organization was vested in the same pelsors that controtlect or malaged Section 'ype lll Su ting ations Did the organization provide to each of its suppofted organizations, by the last day of the fifth month of the organization's tax year, (i) a written notice describing the type and amount of supporl provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization's governing documents in effect on the date of rrotification. to the extent not previously provided? Were any of the organization's officers, directors, or trustees either (i) appointed or elected by the suppofted organization(s) or (ii) serving on the governing body of a supported organization? lf ',No,' explain in parlvl how the organization matntained a close and continuous working retationship with the suppofted organization(s). By reason of the relationship described in line 2, above, did the organization's supporled organizations have a significant voice in the organization's investment policies and in directing the use of the orgar-rization,s income or assets at all times during the tax year? lf ',yes,,, describe rn part Vl the role the organization,s E.T unctional lntegra Organ Activities Test. Answer lines 2a and 2b below. Did substantially all of the organization's activities during the tax year directly fudher the exempt purposes of the suppoded organization(s) to which the organization was responsive? tf ,yes,,' then 2 part Vl identify those supported organizations and explain how these activities direcily furlhered their exempt purposes, how the organization was responsive to rhose suppofted organizations, antJ rtow the orqanization cretermined lhat these activities constituted sLtbstantially alt of its activities. Djd the activities described in line 2a. above, constitute activities that, bu1 for the organization's involvement. one or more of the organization s suppoded orgar-rization(s) would have been engaged in? tf ,yes,,, explain in Part Vl ths reasons for the organization's position that its supported organization(s) would have engaged in these activities but for the organization's involvement. Parent of Supporled Organizations. Answer lines 3a and 3b below. Did the organizatiotr have the power to regr,rlarly appoint or elect a majority of the officers. directors. or trusteesof eachof thesupponedorganizations? lf ,yes'or,,No,,providedetailsin partVl. Did the organization exercise a substantial degree of direction over the policies. programs. and actrvities of each b c a b c 032025 01 25-21 tvt Schedule A (Form 9gO or 99O-EZ)2O2O DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A orm 990 or REBUTLD]NG ETHER OF THE TR]ANGLE 56-1 629 r ons Check here if the organization satisfied the lntegral Part Test as a qualifying trust on Nov. 20, 1970 ( explain rn Part Vl). See instructions. All other Type lll non-functionaliv inteqrated su tions must complete Sections A throuqh E Section A - Adjusted Net lncome (B) Cunent Year (optional) Net shorl-term capital 2 Recoveries of prior distributions ther qross income see instruct Add lines 1 eciation and 6 Porlion of operating expenses paid or incurred for prodr:ction or collection of gross income or for management, conservation, or tenance of tion of itlcome Other expenses (see instruct Net lncome (subtr lines 5, 6 and 7 from line 4 Section B - Minimum Asset Amount (B) Current Year (optional) 1 Aggregate fair market value of all non.exempt-use assets (see for short tax Vear or as month hel cash balances Fair market value of other -use assets d Total (add lines 1a,.1 b, and e Discount claimed for blockage or other factors sition indebtedrress to non-e 3 Subtract line 2 from line 1d 4 Cash deemed held for exempt use.Enter 0.015 of line 3 (for greater amount, see instruction value of non-exe act line 4 from b Aver 6 MLrl line 5 Section C - Distributable Amount line 7 to Current Year ed net income from Section line B, column 2 Enter 0.85 of line 1 asset amount for from Section column 4 Enter line 2 or line 3. Distributable Amount. Subtract line 5 from line 4, unless subject to reduction (see instructiont-I I check here if the current year is the organization's first as a non-functjonally integrated Type lll suppofting organization (see Schedule A (Form 990 or 990-EZ) 2020 032026 01-25-21 DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A 2O2O REBUILDING TOGETHER OF THE TRIANGLE D - Distributions Amounts paid to zations to she 2 Amounts paid to perform activity that directly furthers exempt purposes of suppofied in excess of income from activit 3 Administ to acquire e assets t-aside amounts (prior IBS P art Other distributions Part Vl See instructions tions. Add lines 1 8 Distributions to attentive suppoded organizations to which the organizatior.r is responsive Part Vl). See i 9 Drs amount Ior 2020 lron divided Section E - Distribution Allocations (see instructions) ributable amount for Section C, line 6 2 Underdistributions, if any, for years prior Io 2O2O (reason- use required instructions. 3 Excess dis if any, to 2020 From 2016 c From2017 2018 e From 2019 tal of lines 3a thr stributions of to 2O2O distribut ons 56-1955629 Current Year (iii) Distributable Amount lor 2O2O 15 not . Subtract 3h, and 3i from line 3f 4 Distributions for 2020 from Section D, line 7: ributions of Io 2020 distributable amount Subtract lines 4a and 4b from line 4. Remaining underdistributions for years prior to 2020. if any. Subtract lines 39 and 4a from line 2. For result greater Vl. See instructions Remaining underdistrrbr-rtions for 2020. Subtract lines 3h and 4b from line 1 . For result greater than zero, explain tn VI. See instruct Excess distributions carryover lo 2021. Add lines 3j and 4 of line 7 a Excess from 201 6 Irom 2O17 c Excess from 201 d Excess from 201 9 i Carr Schedule A (Form 990 or 990-EZ) 2O2O 032021 a1-25 21 DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A scheduleA(FormeeooreeoEZ)2920 REBUILDING TOGETHER OF THE TRIANGLE 56-i-955629 paoeeffi I Hart vl I Supplemental lnfOrmatiOfi. pr6y;66 the explanations required by parl il, tine 1O; parl lt, tine i7a or 17b; parl lll, line 12; Pafi lV, Section A, lines 1,2,3b,3c,4b,4c,5a,6,9a,9b,9c, 11a, 11b, and 1.1c; Part lV, Section B, lines 1 and 2; Part lV, Section C, line 1 ; Paft lV, Section D, lines 2 and 3; Part lV, Section E, lines 1c, 2a,2b,3a, and 3b; Pan V, line 1; Parl V, Section B, Iine 1e; part V, Section D, Iines 5, 6, and B; and Part V, Section E, lines 2, 5, and 6, Also complete this parl for any additional informati0n. (See instructions.) 032028 01 25,21 Schedule A (Form 990 or 990-EZ) 2020 DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A Schedule B (Form 990,990-EZ, or 990-PF) Deputment ol the Treasury lnternal Revenue Service Name of the organization REBUILD Organization type (check one): Filers of: Section: Form 990 or 990-EZ Form 990-PF Schedule of Contributors ) Attach to Form 990, Form 990-EZ, or Form 990-PF, ) Go to www.irs.gov/Form99O for the latest information. ETHER OF THE Employer identification number 55629 OMB No. 1545-0047 2020 [Xl sol (c)( 3 ) (enter number) organization f-l aOAl6yl) nonexempt charitable trust not treated as a private foundation I I 52 / political organization f-l sot (.Xg) exempt private foundation f 1 aO+11n111) nonexempt charitable trust treated as a private foundatjon f l sOr 1"11S1 taxable private foundation Check jf your organization rs covered by the General Rule or a Special Rule. Note: Only a section 501(c)(7), (B), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions. General Bule [] fol. an organizatron f iling Form 990, 99O,EZ, or 990.pF that propedy) from any one contributor. Complete parls I and ll. Special Rules received, during the year, contributions totaling $5,OOO or more (in money or See instrr-rctions for determining a contributor's total contributions. For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33 1/3%suppoft test of the regulations under sections509(a)(1)and170(b)(1)(A)(vi) thatcheckedScheduleA(Form99Oor99O-EZ),par1 ll, line13, l6a,orl6b,andthatreceivedfrorn anyonecontributor,duringtheyear,total contributionsof thegreaterof (1) $5,ooo; or(2)z%of theamounton(i) Formggo,partVlll, linelh; or (ii) Form 990-EZ, line 1. Comptete parts I and ll. For an organization described in section 501(c)(7), (B), or (l0) filing Form 990 or 990-EZ that received from any one contributor, during the year, total contributions of more than $1 ,000 exclusively for religious, charitable, scjentific, literary, or educational purposes, or Ior the preventjon of cruelty to children or animals. Complete parts I (entering "N/A" in column (b) instead of the contributor name and address), ll. and lll. l l rotanorganizationdescribedinsection50l(c)(7),(B) or(10) filingForm990or990-EZthatreceivedfromanyonecontributor,durjngthe year, contributions exclusively for religious. charrtable, etc., purposes, but no such contrrbutions totaled more than $1 ,000. lf this box is checked, enter here the total contributjons that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the pads unless the General Rule applies to this organization because it received nonexclusively reliqious. charitable. etc.. contributions totaling $5.ooo or more cluring the year > $ Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990, 990.E2, or 990.pF). but it must answer "No' on Pad lV, line 2, of its Form 990; or check the box on line H of its Form 99O.EZ or on rts Form ggo.pF, pad l, lane 2, to cenify that it doesn't meet the filing requirements of Schedule B (Form 990, 99o.EZ, or 990-pF). LHA For Paperwork Reduction Act Notice, see the instrLrctions for Form 990,99O-EZ, or 99O pF. [U fl 023451 11-25 20 Sclredule B (Form 99O, 99O-EZ, or 99O,pF) (2020) DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A Schedule B (Form 990, 990'EZ, or 990-PF Name of organization REBUILDING THER OF THE TRIANGLE Employer identification number 56-19s5629 tF ill Contributors (see instructions). Use duplicate copies of Part I if additionat space is needed. (a) No. (b) Name, address, and ZIP + 4 (c) Total contributions (d) of contribution 1 REEUTLDTNG TOGETHER (NATIONAL) 999 N. CAP]TOL STREET SU]TE 7 01, WASHTNGTON, DC 2OOO2 110 000. Person E Payroll t] Noncash [_] (Complete Parl il for noncash contributions.) (a) No. (b) Name, address, and ZIP + 4 (c) Total contributions (d) Tvpe of contribution .)UNITED WAY OF CHATHAM COUNTY 72 H]LLSBORO ST #202 P]TTSBORO, NC 4.1 )1a 34 644. Person E Payroll E Noncash E (Complete Paft ll for noncash contributions.) (a) No. (b) Name, address, and ZIP + 4 (c) Total contributions (d) Tvpe of contribution 3 CHATHAM COUNTY COUNCTL AGING 365 NC-87 PITTSBORO 27 3L2 132 663. Person E Payroll E Noncash E (Complete Parl ll for noncash contributions.) (a) No. (b) Name, address, and ZIP + 4 (c) Total contributions (d) Tvpe o{ contribution 4 TRTANGLE COMMUNITY FOUNDATION 8OO PARK OFFICES DRTVE SUTTE 201 RESEARCH TRIANGLE PARK, NC 27709 33 446. Person E Payroll E Noncash t ] (Complete Pad llfor noncash contributions.) (a) No. (b) Name, address, and ZIP + 4 (c) Total contributions (d) Tvpe of contribution 5 NC HOUS]NG F]NANCE AGENCY 35OB BUSH STREET RALETGH, NC 27 609 50 000. Person tE Payroll E Noncash I] (Complete Parl ll for noncash contributions.) (a) No. (b) Name, address, and ZIP + 4 (c) Total contributions (d) of contribution 6 TRIANGLE J COUNCIL OF 4307 EMPEROR BLVD DURHAM, NC 27703 GOVERNMENTS L5B ,31_2 . Person E Payrolt t] Noncash E (Complete Part ll for noncash contributions.) 023.152 1 1-25,20 Schedule B (Form 990, 99O-EZ, or 990-pF) (2020) DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A Schedule B (Form 990, 990,E2, or 990, Name of organization REBUILDING TOGETHER OF THE TRIANGLE Employer identification number s6-19ss629 trrt-f ContributorS (see instructions). Use duplicate copies of parl I if additional space is needed. (a) No. (b) Name, address, and ZIP + 4 (c) Total contributions (d) of contribution 7 NORTH CAROLTNA COMMUNITY FOUNDAT]ON 3131 GLENWOOD AVE #460 RALEIGH, NC 27672 42 ,500 . Person E Payroll E Noncash E (Complete Parl ll for noncash contributions.) (a) No. (b) Name, acldress, and ZIP + 4 (c) Total contributions (d) of contribution B OF CARY 316 N. ACADEMY ST CARY NC 27 51_3 l-00,000. person E Payroll E Noncash t] (Complete Parl ll for noncash contributions.) (a) No. (b) Name, address, and ZIP + 4 (c) Total contributions (d) Tvpe of contribution 9 DUKE HHF 4428 LOUISBURG RD STE 101 RALE]GH, NC 276T6 62 41,5 . Person E Payrotl t] Noncash t] (Complete Parl ll for noncash contributions.) (a) No. 10 (b) Name, address, and ZIP + 4 (c) Total contributions (d) of contributionSTATE OF NORTH CAROLTNA DEPARTMENT OF PUBL]C SAFETY 51.2 NORTH SALTSBURY STREET RALEIGH 27604 B7 333. Person Payroll Noncash EtlE (Complete Parl ll for noncash contributions.) (a) No. 11 (b) Name, address, and ZIP + 4 (c) Total contributions (d) of contribution ORANGE COUNTY 3OO WEST TRYON STREET HTLLqBOROUGH, NC 21218 74 859. Person E Payrolt t] Noncash t] (Complete Parl ll for noncash contributiotrs.) (a) No. (b) Name, address, and ZIP + 4 (c) Total contributions (d) of contritrrriion t2 CHATHAM COUNTY L2 EAST STREET PITTSBORO, NC 21312 70 000. Person E Payroll L- l Noncash t] (Complete Part ll for noncash contributions.) 023,152 11-25 20 Schedule B (Form 990, 99O-EZ, or 990-pF) (2020) DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A Schedule B (Form 990, 990-EZ Name of organization REBUILD TOGETHER OF THE TRIANGLE Employer identification number s6-1955629 [P?Jtfl Contributors (see instructions). Use duplicate copies of Part I if additional space is needed. (a) No. (b) Name, address, and ZIP + 4 (c) Total contributions (d) of contribution 13 NORTH CAROLTNA ,JUSTICE CENTER 224 S. DAWSON STREET RALEIGH NC 27601 45 000. Person E Payroll E Noncash [] (Complete Parl ll for noncash contributions.) (a) No. (b) Name, address, and ZIP + 4 (c) Total contributions (d) of contribution L4 TOWN OF CARRBORO 301 W MAIN STREET CARRBORO, NC 27 51-O 37 485. Person E Payroll L] Noncash E (Complete Part ll for noncash contributions.) (a) No. (b) Name, address, and ZIP + 4 (c) Total contributions (d) Tvpe of contribution Person E Payrott tl Noncash t] (Complete Parl ll for noncash contributions.) (a) No. (b) Name, address, and ZIP + 4 (c) Total contributions (d) Tvpe of contribution Person Payroll Noncash EEE (Complete Part ll for noncash contributions.) (a) No. (b) Name, address, and ZIP + 4 (c) Total contributions (d) Tvpe of contribution Person E Payroll t] Noncash E (Complete Parl ll for noncash contributions.) (a) No. (b) Name, address, and ZIP + 4 (c) Total contributions (d) of contribution Person f-] Payroll L] Noncash t] (Complete Parl ll for noncash contributions.) 023452 11-25-20 Schedule B (Form gg0, 99O-EZ, or 990-PF) (2020) $ DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A Schedule B (Form 990-EZ or 990- Name of organization REBUILD TOGETHER OF THE TRIANGLE Employer identification number 56-1955629 lF rtTl Noncash Property (see instructions). Use duplicate copies of part il if additionat space is needed. (a) No. from Part I (b) Description of noncash property given (c) FMV (or estimate) (See instructions.) (d) Date received $ (a) No. from Part I (b) Description of noncash property given (c) FMV (or estimate) (See instructions,) (d) Date received $ (a) No. from Part I (b) Description of noncash property given (c) FMV (or estimate) (See instructions.) (d) Date received $ (a) No. from Part I (b) Description of noncash property given (c) FMV (or estimate) (See instructions.) (d) Date received $ (a) No. from Part I (b) Description of noncash property given (c) FMV (or estimate) (See instructions.) (d) Date received $ (a) No. from Part I (b) Description of noncash property given (c) FMV (or estimate) (See instrr-rctions.) (d) Date receivecl $ 023,153 1 1-25-20 Schedule B (Form 99O, 99O-EZ, or 990-pF) (2020) DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A Schedule B (Form 990, 990.E2 or 990- Name of organization Employer identification number 56-1955629REBUILDING TOGETHER OF THE TRIANGI,E xclusively religious, charitable, etc., contributions to organizations described in section 501(cX7), (A), o1 (1Cr) that more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations cornpleling Part lll, enler the lotal of excluslvely religious, charitable, etc., contributions of $1,OOO of less tor ttre year /Efler lnts tnl0 once I ) $- Use duplicate of Pad lll if is needed. (d) Description of how gift is held (e) Transfer of gift Transferee's ZIP+4 andZlP + 4 ZIP+4 of transferor (d) Description of how gift is held (e) Transfer of gift to transferee (d) Description of how gift is hetd (e) Transfer of gift 's name transferee (d) Description of how gift is held of transferor (b) Purpose of gift (c) Use of gift (b) Purpose of gift (c) Use of gift (c) Use of gift 023454 11,25-20 and ZIP + 4 (e) Transfer of gift Schedule B (Form 99O, 990-EZ, or 99O-PF) (2020) DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A SCHEDULE D (Form 990) Supplemental Financial Statements ) Complete if the organization answered "Yes" on Form 990, Part lV, line6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.) Attach to Form 990.Department of the Treasury Bevenue Service Name of the organization rLD TOGETHER OF THE TRI or answered "Yes" on Form 990. Parl lV line 6. .,| 2 J 4 5 Total nurrber at end of year Aggregate value of contributions to (during year) Aggregate value of grants from (durlng year) Aggregate value at end of year Did the organization irtform all donors and donor advisors in writing that the assets held in donor advised fr:nds are the organization's propedy, sublect to the organization's exclusive legal control? 6 Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes atrd not for the benefit of the donor or donor advisor, or for any other purpose conferring 2020 Employer identif ication number 56-1955629 ts' Complete if the (b) Funds and other accounts f l vu" I-_l ruo a b c d answered "Yes" on Form 990, Part lV, line 7 Purpose(s) o{ conservation easements held by the organization (check all that apply). l l Preservation of land for public use (for example, recreation or eclucation) fl Preseruation of a historically impoftant land area f I protection of natural habitat f l preservation of a ceftaf,ed historic structure f] Preservation of open space Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a day of the tax year. Total number of conservation easements Total acreage restricted by conservation easements Number of conservation easements on a certrfied historic structure included in (a) Number of conservation easements included in (c) acquired after 7/25/06, and not on a hjstoric structure listed in the National Register Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the tax year )> Number of states where property subject to conservation easement is located ) Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds?ll y". f__] ruo Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements durilrg the year Anrount of expenses incurred in monitoring, inspecting, handling of violatiorrs. and enforcing conservation easements during the yearL'- 8 Does each conservation easement reported on line 2(d) above satisfy the requirements of section f TOhX4XBX|) and section 1 70(hX4)(B)(ii)?f_-] y".f-l ruo9 ln Pad Xlll, describe how the organization reports conservation easements in jts revenue and expense statement and balance sheet, and include, if applicable, the text of the footnote to the organization's financial stalernents that clescribes the 4 5 Tax Year Complete if the ation answered "Yes" on Form 990, pad lV, line B 1a lf the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, htstorical treasures, or other similar assets held for public exhibltion. education. or research in fudherance of public service provide irr Parl Xlll the text of the footnote to its financial statements that describes these items. b lf the organizatlon elected, as pernritted under FASB ASC 958, to repod in its revenLre statement and balance sheet works of ar1. historjcal treasules. or other similar assets held for public exhibition, education. or research in furlherance of public service, provide the following amounts relating to these items: (i) Revenue included on Form 990, Parl Vlll, line 1 ...... ...... (ii) Assets included in Form 990, Part X 2 lf the organization t'eceived or held works of art. hjstorical treasures, or other similar assets for financial gain, provrde the following amour'lts required to be repofied under FASB ASC 958 relating to these items: a Revenue included on Form 990, Paft Vlll, line i >$ >$ >$ LHA For Paperwork Reduction Act Notice, see the lnstructions for Form 990. 03:051 1l 0i-20 Schedule D (Form 990) 2020 DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A SchedureD(Formee0)2020 REBUILDING TOGETHER OF THE TRIANGLE 56-1955e29 nd- nnrr,r"O' 3 Using the organization's acquisition, accession, and other records, check any of the following that make significant use of its collection items (check all that apply): , f] Pubtic exhibition b E Scholarly research . f..l Preservation for future generatjons 4 Provlde a description of the organization's collections and explain how they fudher the organization's exempt purpose in part Xlll. 5 During the year. did the organization solicit or receive donations of ad, historical treasures, or other similar assets to be sold to raise funds rather than to be rrintan"d ur pn,f of th" . Gments'Completeiitheorganizationanswered,,Yes,onForm990,PadlV,lineg.or repofted an amount on Form 990, part X, ljne 21. ls the organization an agent, trustee, custodian or other intermecliary for contributions or other assets not included lf "Yes." explain the arrangement in Part Xlll ancl complete the following table: f_l Y""fl ruo Beginning balance Additions during the year Distributions durirrg the year Ending balance Did the organization include an amount on Form 990, Parl X, line 21, for escrow or custodial account liability? lf "Yes," explain the a if the ation answered "Yes" on Form 990, Part lV, line 10. 1a b c d Beginning of year balance Contributions Net investment earnings, gains, and losses Grants or scholarships . . Other expenditures for facjlities and programs f s 2 a b c Administrative expenses Lnd o{ year balance Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as: Board designated or quasi.endowment ) % Permanent endowment ) Term endowment ) The percentages on lines 2a,2b, and 2c should equal 100%. 3a Are there endowment funds not in the possession of the organization that are held and administerecl for the oroanization by: (i) Unrelaled organizations (ii) Related organizations b lf "Yes" on line 3a(ii), are the related organizations listed as required on Schedule R? d n Loan orexchange program . f l oth", c d e t 2a % Complete rf the Description oJ propefiy answered "Yes" on Form Part lV, line 11a. See Form 990, Parl X, line 10. 1a b c d Land (d) Book value 42 816 . 1,6 . Buildings Leasehold improvements Equipment (a) Cost or other basis (investment) (c) Accumulated depreciation 61 ,045 24,229. Schedule D (Form 990) 2020 032052 12 01-20 DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A cLE 5G-1955629 prqe3 I Part Vlll lnvestments - Other Securities. if the organization answered "Yes" on Form 990, Parl IV, line i i b. See Form 9g0, part X, line 12. (a) Description of security 0r Calegory (inctudins name of security)(c) Method of valuation: Cost or end-of-year market value (1) Financial derivatives (2) Closely held equity interests (3) Other lnvestments - Program Related. if the orqanization answered "Yes"ar1 lV, line'l 1c. See Form (a) Description of investment (c) Method of valuation: Cost or end.of year market value te if the answered 'Yes" on Form 990, Parl lV, line lid. See Fornt 9gO, parl X, line 15. (a) Description (b) Book value if the ion answered "Yes" on Form 990, Parl lV, line 1 1e or 11f . See Form (a) Description of (b) Book value income taxes 2' Liability for uncedain lax positions. ln Pafi Xlll. provide the text of the footnote to the otganization's financlal statements that reporrs ttre orqaniTatlon s liabllitV for uncenarn tax Dositions llnder l-ASR ASC /4o Cha.k ho,o ,r rh6 r."r ^r rh- r^^r^^r^ h-. h^^- ^,^.,:!^r ,- n^- -,,, I Schedule D (Form 990) 2020 031053 1a-01 20 DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A 56-1-955629 answered "Yes" on Form 990, Part lV, line 12a. 1 2 Total revenue, gains, and other support per audited financial statements Amounts included on line 1 but not on Form 990, part Vlll, line 12: Net unrealized gains (losses) on investments t , 463 ,522 . a b c d 3 4 a b c Donated services and use of facilities Recoveries of prior year grants Other (Describe in Parl Xlll.) Add lines 2a through 2d Subtract line 2e from line 1 B ,691 . 1_ , 454 ,825 . Amounts included on Form 990, Parl Vlll, line 12, but not on line.1 : Irrvestment expenses not included on Form 990, parl Vlll, line 7b Other (Describe in Parl Xlll.) Add lines 4a and 4b 1,,4s4 xpenses per ments if the answered "Yes" on Form 990. Parl lV. line 12a. 1 2 a b c d J 4 a b c Total expenses and losses per audited financial statements 1- ,631 ,6L9 . Amounts included on line I but not on Form g9O, part lX, line 25: Donated services and use of facilities Prior year adjustments Other losses Other (Descrlbe in Parl Xlll.) Add lines 2a ltuough 2d Subtract line 2e from line 1 8 ,691 . Amounts included on Form 990, Part lX, line 25, but not on line l: 1- ,622 ,922 . lnvestment expenses not included on Form 990, part Vlll, line 7b Other (Describe in Part Xlll.) Add lines 4a and 4b T ProvidethedescriptionsrequiredforParlll, lines3,5,andg; Parllll, ljnes 1aand4;PadlV, lineslband2b; partV, line4; parlX,tin"zlpurtxt, lines 2d and 4b; and Parl Xll, lines 2ci and 4b. Also complete this parl to provrde any additional information. PART XT LINE 2D - OTHER ADJUSTMENTS: FUNDRAISER EVENTS EXPENSES B ,69l . PART XT]LTNE 2D - OTHER ADJUSTMENTS: FUNDRATSER EVENTS EXPENSES 697. 032054 12-0 1-20 Schedule D (Form 99O)2O2O DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A SCHEDULE M (Form 990) Departmenl of the Treasury lnternal RevenLie Service Noncash Contributions Complete if the organizations answered ,'Yes,, on Form 99O, Part lV, lines 29 or 30. Attach to Form 990. Go to www.irs,gov/Formgg0 for instructions and the latest information. REBUILD]OF THE TR OllB No. 15.15-00.17 2020 Employer identification number 56-195s629 (d) Method of determintng noncash contribution amounts 1 2 o 4 A o 7 o o 10 ''I 1 Name of the organization ypes Ad-Works of art ...... . An - Historical treasures Art - Fractional interests Books and publications Clothing and household goods ....... . ...... Cars and other vehicles . Boats and planes ... ....... lntellectual property Securities - Publicly traded Securities- Closely held stock Securities- Padnership, LLC, or trust interests 12 Securities , Miscellaneous 13 Qualified conservation contributton - Historic structures Qualified conservation contributlon - Other Real estate - Residential Real estate - Commercial Real estate' Other '18 Collectibles 14 15 16 17 19 20 21 22 23 24 25 Food inventory Taxidermy Historical artifacts Scientific specimens Archeological adifacts Number of Forms B2B3 received by the organization during the tax year for contributions for which the organization completed Form g283, parl V, Donee Acknowredgement 30a During the year, did the organization receive by contribution any properly repofied in parl l, lines 1 through 28, that it must hold for at least three years from the date of the initial contribution, and which isn't required to be used Ior exempt purposes for the entire holding period? b lf "Yes," describe the arrangement jn part ll. 31 Does the organization have a gift acceptance policy that requires the review of any nonstandard contributions? 32a Does the organization hire or use third pafties or related organizations to solicit, process. or sell noncash contributions? b lf "Yes." describe in Part ll. 33 lf the organization didn't repod an amount in column (c) for a type of property for which column (a) is checked, il For Paperwork Beduction Act Notice, see the r,rstructions for Form 990. 0321J1 11 23 20 Schedule M (Forrn 99O) 2020 29 DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A WIIMIDTNG ToGETHER oF no"z I HarI ll I SUpplemental lnfOrmatiOfl, provide the information required by parl l, lir.res 30b,32b, and 33, and whetherthe organization is reporling in Part l, column (b), the number of contributions, the number of items received, or a combination of both. Also complete thrs part for any additional information. 0321-12 11 23-20 Schedule M (Form 990) 2020 DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A SCHEDULE O (Form 990 or 990-EZ) Department of the Treasury Name of the organization Supplemental lnformation to Form gg0 or ggO-EZ Complete to provide information for responses to speci{ic questions onFormeeo*ti'ffi Hti'#,.'#srTl."33;:onarinrormation' REBUILD ER OF THE ANGLE 2020 Employer identification number 56-629 FORM 990, PART r, LINE 1 DESCRIPTION OF ORGANTZATION M]SSION: ASSURTNG THAT LOW_]NCOME HOMEOWNERS, FROM THE ELDERLY AND DISABLED TO FAMILIES WTTH CH]LDREN LTVE TN WARMTH, SAFETY AND INDEPENDENCE. FORM 990 PART VI SECTION B LINE 11B: MANAGEMENT AND THE TREASUREB REVTEWS THE 990 PRTOR TO FTLING. FORM 990, PART V]SECTTON B, LINE 1.2C: THE ORGANIZATION IS CAREFUL NqT TO ENGAGE IN BUSINESS TRANSACTIONS WITH COMPANTES IN WHICH BOARD MEMBERS AND STAFF HAVE MATERIAL INTERESTS. FORM 990, PART VI SECTION B LINE 15A: THE ORGANTZATTON USED SALARY DATA FROM THE NC CENTER FOR NON-PROF]TS AND OTHER SOURCES TO ENSURE THAT COMPENSATION WAS REASONABLE. FORM 990, PART VT SECTION C L]NE 19: THE ORGANTZATTON'S FORM 990 AND GOVERNTNG DOCUMENTS ARE AVAILABLE TO THE PUBL]C UPON R LHA 032211 For Paperwork Beduction Act Notice, see the lnstructions for Form 99o or 990-EZ. 1 1-20-20 Schedule O (Form 99O or 990-EZ) 202O DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A oNoN ooo E olt tr -9 Eo oa ..E O^(U93 (t E'=o do,o) E otr o ocoEo L* ; ooo do z o o of ot'Ef j ]rolo.6-(!- o!tLa N o N oo o Eaoz H ida,< B r trl F, Hpo U FI r,l F] al FIln ,]o ErHA4U ; o n N U2H d rrl E-' F]oo Er o HA F] H D ra r,l 14 z- LIJ O_E!l 6LN6- 996n- E.q-.{!OotrL z- la IElx IXI;l* lo,lo l5lololElo le l*lsl3lo)lnl-l$l: l5 IElflolo) IEloIrt:lotot>t;lo a); e(0 tr .o (5 .Nc(! g, o o E =0) o E. Eoo ti o Itr(! o)Lo -o E 0)xillj (!*EG .-FA'o#oo) 6P6ort.C*\o6 62EOG'Eo(! EHtr(gOo)!x tlt lEl EJ o _o G .oEo>(5.! _o =TL! a) 6'a ! -c0J(Uo)-0) aqO- -5o (( O C oz o o {,Co! ooo CC -O o) 0)J j! o -o\ua (g E.T 0_ Lrl otrl I r.o LN c) E tr o (! o 'a= 0)p o -9o Eut oNoN lc/)lco lolc l=ILldlel.tololE o LL co o ! c) a) B C(s C .9 (! .N Co O) o o.c ! 0) oe Eo (_) oo E uJ ! 0) o o .9o o o o F o fl lsl tel o FIH D FAHfr Co .Nc6 o) o oE o o E Gz l-(D o d(') Oti ,gE OciLo3 Eg {> EEoo-(!B698t-Eo)trbr -u- = t o: E=rE:fE hIf.E g^ OQ.Nhc_c(E.E PNOE1,g "9;(!io':trf -o Eoo a c(F t!^ ti8 r I.IJ tr E: a! o d6) 3 DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A oNoN ooo E o lJ- t I o oo O- o = o ^(U_o-v(\ E'= 0- zc l.!.o 9o '-c /io^ @p --n a-' -(!O; z- o (! 0) 0) o E o 0)Co !(!! .'E 0)af(d Oo -o $ co o ,g i !(u 0- oo)o) E o lJ- Co 0) a ! a) o B C(( C .9 (! .NEo0) o 0).C =0) 0)o EoO +io 3F Lo co E3o>OxbsO o.>c5oo)(Ec o'E -o!(o-xaGfLL o!cOOCFO(EFN(n'Eb 6aP5oo ooP6G-odcct E+g .43 (!EocdE.tc(!Or,)!> z_ ut .o 9N ui6 (E 0: !- ^(!o6 C 2" q2 -ECUL+ !l iE x6'- YPN ^ F-ct_o A=:@ - c .i ra'=E* -ts9! 5 E-E oo:D=o -t::_ @ lolo)lfr lplo) loIELlolo Co !6c ;alooo -o -t cc 0) .tr E(o o_ j o)o) E o LL Co a 0) ! 0) o 3 C(! C .9 (E .Ntr(! o) o or. =o 0) o- Eo O LO ot r{ I(o rl F] .4 o 0) (E..o-ao9 3r o! -oxcij ils,F'r O=ED.9o 6 .l: N y.l'=o(Etthoo-!(U9q6'u63cE6btc,^OEFO .99 Edto o)l!xl f{o DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A oNoN 6'o,o) E olr trI ! 0) oa fal n HH ! 0) o .c c:lo E(! O) E 0) q.)o o !o -c 0) zH d tqi4H trl(,o Er c .9 CU .N C(n o) o -n (U b o o Eoz XIXIXIXIX XIXIX uu e09 .eu4vXNirj o .N ,o u 6 v'qe-o oqX oSoJ N! (!190 !o90o.190 Ei! I-oPo ol 6 !! 5 N6 U CC trEt aa!a _o-: FFd) oonEE. O o ac G ,.a : : ro::^tEJz :-Nc:CO:6E)D(!: LN:o'- :no)0)o): 60-On: :>t o9:c_: E.:oB:'-a AahN^ aY, i:o!E;Nl-cts@0J .oY' u* bd(!!EpL F6=bE3o=o .!2o!1..4ox{Eo.Yo h:- oo:()Fu EooEo)o:.c.c E(sdo-c_co-au) :a;c;.9 rcd:.N:C:(i :o:*.0) NT o aco F(! ! .o o0 o.l .c .q(d ! C = og -ca a).o Eo E o a a)o't oa o o O C(g E ot 0)o_r I : Ico.F (! .N C(d o) o !o 6 o Eo a a) a(! o! o o;Co .g lu 0) U; .o ='o N o o G O)l 0:c:o'P (d .N c (U o) o ! 0) 6 o o a c)0a(! 0)I o o c O E.s fo 0) U; .o =Oe o 0)aGoI : I : I i : a C .o (! .N C(g o) o !o (s o ! .-E 0 oaa cd o o c') C(n !ox LIJ ; a c .9 G .Nc(! o) o !o (g o Eo a q) aa CU o a)tltoI O fI a -O irNNC aru(ug) P)6u!na) (do LOtr* LO aa!NCtsoo !q).>Eoa : i : : i : Co (U N c (E O) o 1lo (! o -o a 0) 0) c(g of(,, C fdo o ac(g oJ q) c.':; T::: I ati; t:il{!:::0-i:: CI:: !tlloi:i .a::: a:::g: Oi:ipl(U:: .N:il ctl:(!:: o:.1 o:il !t:loi :l(g::l o::: o;: o:ri !i:ioi:i o;::criio::: TI: F:'=: o>\l: Ot.:: ELbo:(Er: 96 (d^ o]q:: <d Bb:: ;* lL :+C^-Eo-@. "L!r^ ^>Y:Y-E-ft F.o co=:90 o uir! X =ooo)": llL= o !1 o c{-=oo a ol:_ c-(0iO .Y:=Ocin it-^oo ocllu., c _.o --O O =(uLL#+=c.Y? uvvv.\ ;v_t!Ld6o.og>! o o f._ L O O O' d^!!ET=UU6 o=rj.i! ++(!(Uo :'=ooo 53EEXoccooi o_Qo! lol= IEl5lq IE IE l> b =j aIo o_ .C !o a .a ! Co C(n L OJ ,E o 0E tr oO o; oz oc's O)I.-.- :z - E c O fl ] lE ls ,l ! dl s El e Hl a Hl €lErl $ "l eEIII =El .eE{l trdl g Hl q aool 5 EI Eal E Hl f, El ft: Bl 5 Nlo--JColoEI E slEr EI EI DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A 6Pr ^ o 60 = dq: dEo 6 x:<6- -Yo@/.-- EE C= !l N xh '_ Y*N v c -Y.n c:9E o E -.-E Ooy=o .,c Od\'= i-Eoa O.YLC -uol EoQ )a oNoN oo o) F o]t. E I 0) oa z UJ !c(! G OicvLO!*!oo d E Cgz lsl5t> IH tgl-lola IBla l* lEt>l!ln lsla IEIElslaIE t.ali-t;t:lPl5IO ls let:INl€lolb lEln lfll! *lRil-6 16q lEtl-olo*ls'5loc legl* ElE slt(0 lqEl9;lc* loo t?: lE x l(Uo)loc I . pl l: El lX el l;€ii- -t 9 pt H ql g #l * !tc.9 I; EIE clt Gl ^OlE bl PEI E -*lo -lI rl5 ;lo dlo >t; ilI itrl N cr) 0) .S t & d o) o) E o LL Co oq) ! c) a) B C(! C .e 16 .N C C! o) o 0)c L 0) oo Eo O .d o oE (o (L DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A Provide additjonal information for responses to questjons on schedule R. see jnstructions. 032t65 10 28-20 Schedule R (Form 990) 2O2O DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A ro', 8868 (Rev. January 2020) Department oi the Treasury lnternal Revenue Service Application for Automatic Extension of rime To File anExempt Organization Return OMB No. 1545.0047) File a separate application for each return. ) Go to www.irs.gov/Formgg6g for the latest information. Electronicfiling(e-file).YoucanelectronicalIyfileFormB86BtorequeStuo., forms listed below with the exception of Form 8870, lnformation Return for Transfers Associated with certain personal Benefitcontracts' for which an extension request must be sent to the IRS in paper format (see instructions). For more details on the electronicfiling of this form, visil tlvtlvt /.ivs.gov/e-fite-providers/e-fire./or-charities-and-non-profits. AllcorporatlonsrequiredtofileanincometaxreturnotherthanFormg90.T{in"t, must use Form 7oo4 to request an extension of time to file income tax returns. Type or print File by the due date for fi,ing your return. See instructions. Number, street, and room or suite no. lf a p.O. box, see instructions.2OO TRANS ArR DRIVE, NO. 2OO city, town or post office, state, and Zlp code. For a foreign address, see instructionsMORRISV]LLE, NC 27560 Taxpayer identification number Il N) s6-195s629 Return En,"r rh" R",rrn Cod" for,h" r.",rrn ,hu, ,hi" uplli"*ion iJfoi6Gl application for each return) Application Form Form Form 4 Form LAUREN ,JOYCEo The books are in the care of ) 2 0 0 TRANS AIR DRIVE SUITE 2OO - MORRISVTLI.,E 07 09 '1 1 Name of exempt organization or other filer, see instructions. REBUTLDING TOGETHER OF THE TRIANGLE relephone No. ) 919 -34L-5980 NC 27550 Fax No. ) ' lf the organization does not have an office or place of business in the United stut"=, "h".k thi. b*>T: n I'.::r i-:r:rl Return, enter the organization,s four digit Group Exemption Number (GEN) 1 I request an automatic 6.month extension of time until NOVEMBER 15 2021 , to file the exempt organizatron return forthe organization named above. The extension is for the organization,s return for:>E calendar year2020 o, )' f_l tax y"r, o"gin;;-, and ending lf this application is for Forms 990-BL, 990,pF,99O-f ,4720, or 6069, enter the tentative tax. less See instructions. b lf this application is for Forms 990-pF, ggo-r, 4720, or tj069, enter any r"trnoJt" "[d,t.lna " :^1T::*^..,jro]rr": rile f o rrlm tine 3a. tnclude your payment with this form, if required, by Caution: lf you are going to make an electronic funds withdrawal (directinstructions.debit) with f'l Initiar return f-l Final return 0 Form 8453-EO and Form Bg79.EO for payment lffie tax year entered tn line 1 is for less than .j 2 months, check reason:f-l Chrng. in accounting period 0238:11 04-01-20 this Form 8868, see Form 8868 (Rev. 1.2020) For Privacy Act and paperwork Reduction Act Notice, see instructions. DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A 0.,, gBTg-EO Deparlment of the Treasury lnternal Bevenue Service I R S. e-file Signatule AuthorizationIor an Exempt Organization For calendar year 2020. or fiscal year beginning , 2020, and ending ,20 Do not send to the lBS, Keep for your records. for theGo OMB No. 1545-0047 2020 number Nameofexe@ REBUILDTNG TOGETHER OF THE TRTANGLE Nanre and title of officer or ilerson sUbject to taxDAN SARGENT axpayer s6-195s629 XECUTIVE DTRECTOR ype of Beturn N,"""Ty!g l,l?-'""y,j:l:"ly:g:-Td (:lil " o;19 ;r *y;Ei,,ia ii,pbil',li,,i fln?i,il: l:j,:l:,:Xl*n:i:'.,1g:,;[il ;;;;' (d;;i',o"Erir' Ll,iviB,software for payment of the federaitr*". o*Li b, irii. 1p3y,11"I-tr,I must,contacr rhe U.S. Treasury Financiat(settiement) date. I atso rut oriiel.,e ri"""JJr'i"iiiiriiJ,'. PIN: check one box only [X] I ar:u'rorize KOONCE WOOTEN & HAYWOOD LLP Form ggOcheck here > tX=] q rotar revenue, if any(Form 990, partVilr, corumn (A), rine l2)Form 99o-EZ check here > t] b Total revenue, if any (Form 990-EZ, line 9)Form 'l 120-POL check here > t] b Totat tax (Form 1120.pOL, tine 22) ..........Form 99o-PF check here > f] b rax based on investment income (Form 990.pF, part Vl, line 5)Form 8868 check here > t] b Balance due (Form 8868, line 3c) Dollars ChecktheboXforthereturnforwhichyouareusingthisFormB879'Eo,nount", :::j ]:: j:1,::,1:^' .,:,::, ::, :?, 2?, ??, or la below, and the amount on that rjne for rhe return beins filed with rhis form wasblank, then leave rine rb, 2b,3b,4b, sb, 6b, or 7b, whichever is appricabre, br"rk i;;;;;il;;l) ffi, ;;:T;T:['J:J::T-X:return, then enter'0-on the applicable lir-re below. Do not complete more than one line in part l. 1a 2a 3a 4a 5a 6a 7a 1b 2b 3b 4b 5b 6b 4s4 825. ::::::::::::ii:1" - tS : l'oltax (Form eeo r' part rrr, rine 4) or to TaxUnder penalties of perjury, I declare that I am an officer of the above organization or I am a person subject to tax wrth respect to(name of organization) , (ElN)........- and that I have examined a copy l'J';f"";ii3'"ii*'filH5i"'l:xg.l;,:Isx*:l'i:r""jfij: :ifl:piy: q]!J",lff ??:.'.""]f,'"i","# :38;3??n?"J'3';,',,1",',"',.,",,,." 1"':J"T[i?"1]1",H"1x{l:r::i:n::ixiii:"""}j:? *::n l,,"rliii{ii:it *[,?,i]ffi:,'JiHil"1i:i""::',I8i:?ff ffi'.?,"-s:{!r uu,serr r0 arow mv rntermedrate service provider. transmitter, or erectronic return origl?lg:giy" from the tRS (a)an acl.ro*teJgJmi;ioiot"ipt or reason for reiecrion of the N,^".""",?lg 1,1?^'"^r^,,I o,, i"lrig. nld (g) r6e dare or *y ,Ei*o. ii"u"ppii.r'oi,J,"l'ulinor,iru ionrioenliir inioi'",jioi;;UJ#;i;^;ij3*#ii.];li;:"t!liJS"li:S gJl:". ?Jffiffili:fJ fX"r;]ffi:i?:f",JJ."Jl.3r taxes to .e'ceive rdentifrcation number (PlN) as my signature for the electroni"ieirin-rn,rliiii6priijor", the consent to erectronie fr rnrrq ra,iiherrarn,-r b) the reason for any delay in ry and its designated Financial rnt indicated in the lax preparation the entry 1o this account. [o revol,to this account. io revoke busrness d6ys prlor to the payment , the consent to electronic funbs withdrawal to enter my PIN 548 iTil,l li*iTliil;i" as my signature on the tax year2020 electronicallyflled return. lf lhave rndicated within this return that a copy of the return is being tjled with I il* nJ.:;J;.]::::H;,r"".[T.:n::,::X ", the rBS Fed/state prosram, I arso authorize the aforementjoned ERo to enter my fl et an officer or person subiect to tax with respect to the organization, I will enter my plN as my signature on the tax year 2ozoelectronically filed return lf I have indicated within this return that a copy of the return is being fileJ wrth a state agency(ies)regulating charities as pad of the IRS Fed/state program, I will enter myplN on the return,s djsclosure consent screen. ERO lirm name ERO's EFIN/PlN. Enter your sjx.digit electronic filing identification number (EFIN) followed by your five digit self.selected ptN.55e2s254821 Do nol enter all zeros f,",i yjillJ:"-;::i::i:::: :'ll^::":r^:lTr,yj::! . mv sisnarureon the 2o2o erectronicaily rired return indicated above r conrirmthat I am submittins this retLrrn tn accordance with the requirements or pub. .ru;,;;";];:iffi l;j:l; [fl:;t",L:?:ffi:?lt$IRS e-l/e Providers for Business Returns. EB0's signature ) Date )vqtv T Do Not Submit rhis Form to the rRS Unress Requested ro Do So LHA For Our"r*@ 023051 11-03-20 DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A 200 Trans Air Dr. Suite 200 Morrisville, NC 27560 919.341.5980 Repairing Homes. Revitalizing Communities. Rebuilding Lives. July 28, 2021 Orange County Financial Services 200 South Cameron Street Hillsborough, NC 27278 Re: 3-R Fee for Rebuilding Together of the Triangle To whom it may concern, Rebuilding Together of the Triangle operates our home repair program throughout the county but does not maintain a facility in Orange County. We are, therefore, not assessed the 3-R fee. Thank you for your attention in this matter. Regards, Daniel Sargent Executive Director Rebuilding Together of the Triangle DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 3/14/2022 Arthur J.Gallagher &Co.Insurance Brokers of CA.,Inc. 595 Market Street Suite 2100 San Francisco CA 94105 Darby Hughes 415-546-9300 415-536-8499 Darby_Hughes@ajg.com License#:0726293 Philadelphia Indemnity Insurance Company 18058 REBUTOG-92 Tokio Marine Specialty Ins Co 23850RebuildingTogether,Inc.(Affiliates) Rebuilding Together of the Triangle 999 N.Capitol St.,NE,Suite 701 Washington DC 20002 1791540798 A X 1,000,000 X 100,000 5,000 1,000,000 2,000,000 X X Stop Gap Liab Y PHPK2389341 3/15/2022 3/15/2023 2,000,000 STP GAP/ND OH WA WY 1,000,000 A 1,000,000 X X X PHPK2389341 3/15/2022 3/15/2023 A X X 10,000,000PHUB8064263/15/2022 3/15/2023 10,000,000 X 10,000 B B Contractors Pollution/Prof Liab Commercial Crime (Fidelity)PPK2389330 PSD1699056 3/15/2022 3/15/2022 3/15/2023 3/15/2023 $1,000,000 Limit $25,000 $50,000 Orange County Housing and Community Development are included as additional insured as required by written contract. Orange County Housing and Community Development 300 W Tryon Street Hillsborough NC 27278 DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG 20 26 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CG 20 26 04 13 © Insurance Services Office, Inc., 2012 Page of ADDITIONAL INSURED – DESIGNATED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s): Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II – Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following is added to Section III – Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. PHPK2246006PHPK2389341 DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A 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 10/6/2021 (919) 469-2473 (919) 467-4987 10166 Rebuilding Together Of The 324 S. Wilmington St; 118 Raleigh, NC 27601 A WCV6116776 9/15/2021 9/15/2022 500,000 500,000 500,000 Operations of the Named Insured covered by the above referenced policies. Orange County Housing and Community Development 300 W Tryon Street Hillsborough, NC 27278 REBUTOG-01 SPARKER Trisure, an Alera Group Company4325 Lake Boone Trail, Suite 200Raleigh, NC 27607 Sterling S. Parker sparker@trisure.com Accident Fund Insurance Company of America X DocuSign Envelope ID: E86DD11C-7C3F-4DD6-97F0-CADB5D52D35A