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2022-366-E-Health-Farmer Foodshare-Outside Agency Agreement
Orange County Outside Agency Performance Agreement Revised 06/22 Page 1 of 10 OUTSIDE AGENCY PERFORMANCE AGREEMENT THIS AGREEMENT, made and entered into the first day of July 2022, (“Effective Date”) by and between the County of Orange, a political subdivision of the State of North Carolina, Post Office Box 8181, Hillsborough, North Carolina, 27278, ("County") and Farmer Foodshare, Inc., a not-for-profit corporation, located at 902 N. Mangum Street, Durham, North Carolina 27701 (“Provider”). WITNESSETH: WHEREAS, it is in the interests of the County that said program be assisted by the County and thereby enhance its availability to residents of the County, and said program addresses an important community human services need, as identified by the Board of Commissioners. NOW, THEREFORE, in consideration of the above and the mutual covenants and conditions hereafter set forth, the County and Provider agree as follows: 1. Term of the Agreement. The term of this Agreement shall be a program year beginning July 1, 2022 to June 30, 2023. 2. Scope of Services. a. Provider will provide services, as outlined in the attached Outside Agency Funding Application and any amendments or revision thereto which is attached as Exhibit “A” and incorporated by reference, to the residents of Orange County. The Scope of Services and the Program Budget may be different from the original application based on County appropriation; however, any revisions or amendments to this Agreement must be approved in writing by the County and attached to this Agreement as Exhibit B. b. The Provider shall be solely responsible for the means, methods, techniques, sequence, safety program and procedures necessary to properly and fully complete the work set forth in the Scope of Services. 3. Funding. a. The County agrees to appropriate for the provision of services described in Exhibit A, Scope of Services and more particularly described in the Revised Program Budget, the maximum sum of $7,650. b. All funds appropriated shall be used for purposes described in Exhibit A. Any funds not used for the purposes stated shall be returned to the County. Any changes in the use of funds must be authorized in writing by the County prior to any expenditure of the funds by the Provider. If the funds are expended not in accordance with the Scope of Services, at the discretion of the County the Provider may be required to repay the funds to the County. c. The Provider shall be paid in four equal installments in the amount of $1,912.50. The first payment is contingent upon receipt of the agency’s performance agreement; the remaining payments are contingent upon receipt of the request for reimbursement and related supporting documentation. d. The County’s obligation to make the quarterly payments is contingent upon receipt of Progress Reports, which show satisfactory progress toward completion of performance measures and an accounting of expenditures as detailed in the attached Scope of Services. DocuSign Envelope ID: BC021861-30DF-4F8A-9FA3-8AE2B71D28D0 Orange County Outside Agency Performance Agreement Page 2 of 10 Rev.06/22 e. Once Provider has satisfied its obligations as provided in (d) payment will be made 21 days after receipt of the Progress Report and Request for Reimbursement or 21 days after due date of Progress Report whichever is later. f. The County is not obligated to provide any other support to Provider in this or in succeeding fiscal years. 4. Agency Reporting. a. Provider will provide Orange County a Progress Report that includes a fiscal report and updates on performance measures as outlined in the Scope of Services. Progress Report dates are: July 1 – December 31; January 1 – March 31 and April 1 - June 30. Reports are due on January 9, April 10, and July 10 of the program fiscal year. b. Provider agrees to allow the County to inspect its financial books and records, which document costs of those services, upon reasonable notice during normal working hours. 5. Termination. a. Termination for Cause. In the event of any of the circumstances set forth below (hereinafter referred to as “default”), the County may immediately terminate this Agreement, in whole or in part, and from time to time. Notice of termination must be in writing, state the reason or reasons for the termination, and specify the effective date of the termination: i. In the event that Provider shall cease to exist as an organization or shall enter bankruptcy proceedings, be declared insolvent, or liquidate all or substantially all of its assets, or significantly reduce its services or accessibility to Orange County residents during the term of this Agreement; or ii. In the event that Provider shall fail to render a satisfactory accounting as provided section 4 above, the County may terminate this Agreement and Provider shall return all payments already made to it by the County for services which have not been provided or for which no satisfactory accounting has been rendered; or iii. In the event of any fraudulent representation by the Provider in an invoice or other verification required to obtain payment under this Agreement or other dishonesty on a material matter relating to the performance of services under this Agreement. iv. Nonperformance, incomplete service or performance, or failure to satisfactorily perform any part of the work identified in the Scope of Services or to comply with any provision of this Agreement, as determined by the County in its sole discretion. v. Failure to adhere to the terms of applicable county, state or federal laws, regulations, or stated public policy. b. In the event of default by the Provider, the county may elect to terminate this Agreement, in whole or in part and/or require the Provider to repay the funds within ten (10) business days from written notice of default. The County may (but shall not be required to) grant the Provider an opportunity to cure the default without termination of this Agreement. This clause shall not be interpreted to limit the County’s remedies in law or in equity. 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 DocuSign Envelope ID: BC021861-30DF-4F8A-9FA3-8AE2B71D28D0 Orange County Outside Agency Performance Agreement Page 3 of 10 Rev.06/22 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. e.Waiver. The payment of any sums by the County under this Agreement or the failure of the County to require compliance by the Provider with any provisions of this Agreement or the waiver by the County of any breach of this Agreement shall not constitute a waiver of any claim for damages by the County for any breach of this Agreement or a waiver of any other required compliance with this Agreement. 6.Responsibilities of the County. Cooperation and Coordination. The County has designated (Quintana Stewart) to act as the County's representative with respect to the Project who shall have the authority to render decisions within guidelines established by the County Manager or the County Board of Commissioners and who shall be available during working hours as often as may be reasonably required to render decisions and to furnish information. 7.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.Cyber Liability. For protection from claims resulting from data breach, virus, and cyberattack; iii.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; iv.Comprehensive Automobile Liability Insurance, including hired and non-owned vehicles, if any, covering personal injury or death, and property damage; and v.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. vi.Sexual Misconduct. Sexual Abuse/Molestation Insurance is required when Provider works directly one-on-one with children, elderly or other at-risk populations. 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 DocuSign Envelope ID: BC021861-30DF-4F8A-9FA3-8AE2B71D28D0 Orange County Outside Agency Performance Agreement Page 4 of 10 Rev.06/22 NC & Coverage B - Employers Liability $500,000 each accident, disease policy limit and disease each employee •Cyber Liability $1,000,000 Each Occurrence; $2,000,000 Aggregate •Commercial General $1,000,000 Each Occurrence Liability $2,000,000 Aggregate •Automobile Liability $1,000,000 Combined Single Limit •Professional Liability $1,000,000 Each Occurrence $2,000,000 Aggregate •Sexual Misconduct $1,000,000 Each Occurrence $2,000,000 Aggregate c.All insurance policies (with the exception of Worker's Compensation and Professional Liability) required under this Agreement shall name the County as an additional insured party and as a certificate holder. For more information see the Orange County Risk Transfer Policy and Orange County Minimum Insurance Coverage Requirements, (each document is incorporated herein by reference and may be viewed at http://www.orangecountync.gov/departments/purchasing_division/contracts.php.) 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. 8.General Provisions. 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 identified, on the list created by the State Treasurer pursuant to G.S. 147-86.58. By executing this Agreement Provider certifies that Provider has not been identified, and has not utilized the services of any agent or subcontractor identified, on the list created by the State Treasurer pursuant to G.S. 147-86.81. b.Non-Discrimination. Provider agrees as part of consideration of the granting of funds by Orange County the parties hereto for themselves, their agents, officials, employees and servants agree not to discriminate in any manner of these basis of race, color, gender, national origin, age, handicap, religion, sexual orientation, familial status or veterans status with reference to any activities carried out by the grantee, no matter how remote. The parties hereto further agree in all respects to conform to the provision and intent of Orange County Civil Rights Ordinance, as amended and the Orange County Non-discrimination Policy, which is incorporated herein by reference and can be viewed at http://www.orangecountync.gov/departments/purchasing_division/contracts.php. The County may enforce this provision by an 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. DocuSign Envelope ID: BC021861-30DF-4F8A-9FA3-8AE2B71D28D0 Orange County Outside Agency Performance Agreement Page 5 of 10 Rev.06/22 c.Dispute Resolution. Any and all suits or actions to enforce, interpret or seek damages with respect to any provision of, or the performance or non-performance of, this Agreement shall be brought in the General Court of Justice of North Carolina sitting in Orange County, North Carolina. It is agreed by the parties that no other court shall have jurisdiction or venue with respect to such suits or actions. Binding arbitration may not be initiated by either Party, however, the Parties may agree to nonbinding mediation of any dispute prior to the bringing of such suit or action. d.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 Orange County Living Wage Policy, which is incorporated herein by reference, can be viewed at: http://www.orangecountync.gov/departments/purchasing_division/contracts.php. The County’s living wage is $15.85 per hour. To the extent possible, Orange County recommends that Provider provide a living wage to its employees. e.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. f.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. g.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. h.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. i.Indemnification. Provider agrees to defend, indemnify, and hold harmless the County, for all loss, liability, claims or expense (including reasonable attorney's fees) arising from bodily injury, including death or property damage, to any person or persons caused in whole or in part by the negligence or willful misconduct of the Provider, except to the extent same are caused by the negligence or willful misconduct of the County. It is the intent of this section to require Provider to indemnify the County to the extent permitted under North Carolina law. Nothing in this section is intended to affect or abrogate the County’s sovereign immunity defenses. j.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. k. 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 DocuSign Envelope ID: BC021861-30DF-4F8A-9FA3-8AE2B71D28D0 Orange County Outside Agency Performance Agreement Page 6 of 10 Rev.06/22 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. l.Entire Agreement. This Agreement represents the entire and integrated agreement between the County and the Provider and supersedes all prior negotiations, representations or agreements, either written or oral. This Agreement may be amended only by written instrument signed by both parties. Modifications may be evidenced by facsimile signatures. m.Notices. Any notice required by this Agreement shall be in writing and delivered by certified or registered mail, return receipt requested to the following: Orange County Attention: Kimberlee Quatrone P.O. Box 8181 Hillsborough, NC 27278 Provider’s Name: Farmer Foodshare Attention: Kelly O'Neill Crane Address: 902 N. Mangum Street Durham, NC 27701 Email:kquatrone@orangecountync.gov Email: info@farmerfoodshare.org n. 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 _____________________________ _______________________ Kelly O'Neill Crane, Executive Director Date For and on behalf of Orange County Government _______________________________ ________________________ Bonnie Hammersley, County Manager Date DocuSign Envelope ID: BC021861-30DF-4F8A-9FA3-8AE2B71D28D0 8/12/2022 8/16/2022 Orange County Outside Agency Performance Agreement Page 7 of 10 Rev.06/22 ORANGE COUNTY—DEPARTMENT USE ONLY ______________________________________________________________________________ Party/Vendor Name: Farmer Foodshare Party/Vendor Contact Person: Terry Billie Contact Phone: 919-925-2656 Party/Vendor Address: 902 N. Mangum St. City Durham State: NC Zip: 27701 Department: Health Amount: $7,650 Purpose: Outside Agency Agreement Budget Code(s): 10290050-719082 Vendor # N/A (N/A if new vendor) Vendor is a BOCC consultant? Yes No Contract Type: (Check one) New Renewal Amendment Effective Date 7-1-22 Approved by Board Yes No Agenda Date: June 21, 2022 This agreement is approved as to technical form and content and I as Department Director affirmatively state work on this project has not been initiated prior to execution of the agreement: Department Director’s Signature ________________________________________ Date: ________ Agreements for emergency services or repair are not subject to the above affirmation. If services related to this agreement have already begun or been completed please briefly describe the nature of the emergency condition that was addressed: Information Technologies (Applicable only to hardware/software purchases or related services) This agreement has been reviewed and is approved as to information technology content and specifications: Office of the Chief Information Officer___________________________________ Date: ________ Risk Management This agreement is approved for sufficiency of insurance standards, specifications, and requirements: Office of the Risk Management Officer___________________________________ Date: _________ Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officer ____________________________________ Date: _________ Legal Services This agreement is approved as to legal form and sufficiency: Office of the County Attorney __________________________________________Date: ________ Clerk to the Board Received for record retention: All Docusign contracts must be copied to the Clerk upon completion: occlerkdocs@orangecountync.gov The following signature block is for hard copies only and is not required for Docusign contracts: Office of the Clerk to the Board __________________________________________Date:_________ DocuSign Envelope ID: BC021861-30DF-4F8A-9FA3-8AE2B71D28D0 8/12/2022 8/12/2022 8/16/2022 8/16/2022 Cover Page Page 6 of 37 COVER PAGE Applicant Contact Information Applicant Organization’s Legal Name: Farmer Foodshare, Inc. Applicant Organization’s Physical Address: 902 N Mangum St, Durham, NC 27701 Applicant Organization’s Mailing Address: 902 N Mangum St, Durham, NC 27701 Applicant Organization’s Web Address: www.farmerfoodshare.org Executive Director: Dave Baylock (interim); Kelly O'Neill Crane (starts 1/17/2022) Telephone Number: 919.701.2543 E-Mail: info@farmerfoodshare.org Tax ID Number: Funding Request Please list all Fiscal Year 2023 Human Services (HS) funding requested for all programs and the proposed use of funds (please list program name only) Program Carrboro - HS Chapel Hill - HS Orange County-HS Total Fresh Food Purchasing (with Carolina Jews for Justice) $11,000 Operations $4,300 Personnel $0 $0 $15,300 Fresh Food Purchasing (with TABLE) $0 $11,000 Operations $4,300 Personnel $0 $15,300 Fresh Food Purchasing (with Local Food Connection & Eno River Farmers Market) $0 $0 $11,000 Operations $4,300 Personnel $15,300 Totals $15,300 $15,300 $15,300 $45,900 Briefly explain your proposed use of funds: To the best of my knowledge and belief all information and data in this application is true and current. The document has been duly authorized by the governing board of the applicant. Source, aggregate, and deliver fresh, NC-grown produce to families in need on a bi- weekly, weekly, or monthly basis, as determined by partner needs. Operations = fresh food costs. Personnel = staff time required for sourcing and delivering the fresh food. EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION DocuSign Envelope ID: BC021861-30DF-4F8A-9FA3-8AE2B71D28D0 Cover Page Page 7 of 37 Signature: (Interim) Executive Director Date Signature: Board Chairperson Date 1/13/2022 01/13/2022 EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION DocuSign Envelope ID: BC021861-30DF-4F8A-9FA3-8AE2B71D28D0 Cover Page Page 8 of 37 DISCLOSURE OF POTENTIAL CONFLICTS OF INTEREST AND NON- DISCRIMINATION CLAUSE Are any of the Board Members or employees of the agency which will be carrying out this program or members of their immediate families, or their business associates. YES NO a) Employees of or closely related to employees of the Town of Carrboro, the Town of Chapel Hill, or Orange County? b) Members of or closely related to members of the governing bodies of the Town of Carrboro, the Town of Chapel Hill, or Orange County? c) Current beneficiaries of the program for which funds are being requested? d) Paid providers of goods or services to the program or having other financial interest in the program? If you have answered YES to any question, please provide a full explanation below. NON-DISCRIMINATION Provider agrees as part of consideration of the granting of funds by funding agencies to the parties hereto for themselves, their agents, officials, employees and servants agree not to discriminate in any manner of these basis of race, color, gender, national origin, age, handicap, religion, sexual orientation, gender identity/expression, familial status or veterans status with reference to any activities carried out by the grantee, no matter how remote. The parties hereto further agree in all respects to conform to the provision and intent of Orange County Civil Rights Ordinance, as amended and the Orange County Anti-discrimination Policy. This provision is enforced by action for specific performance, injunctive relief, or other remedy as by law provided; this provision shall be binding on the grantees, the successors and assigns of the parties hereto with reference to the above subject manner. To the best of my knowledge and belief all of the above information is true and current. I acknowledge and understand that the existence of a potential conflict of interest does not necessarily make the program ineligible for funding, but the existence of an undisclosed conflict may result in the termination of any grant awarded. Signature: (Interim) Executive Director Date Signature: Board Chairperson Date 1/13/2022 01/13/2022 EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION DocuSign Envelope ID: BC021861-30DF-4F8A-9FA3-8AE2B71D28D0 Program information Page 9 of 37 AGENCY INFORMATION Please provide the following information about your agency: 1. Date of Incorporation (Month/Year): 10/23/2010 2. Agency’s Purpose/Mission (no more than a few sentences): Farmer Foodshare mission is to reshape the disconnected food system by removing barriers to growing and accessing local food. We envision a healthier world in which all people have access to nutritious food. 3. Please provide a brief description of your organization’s past achievements in carrying out similar projects and evidence of successful record of meeting proposed budgets and timetables (no more than 100 words). Since 2009, Farmer Foodshare has sourced fresh food from NC farms and provided it year-round to community members in need through partnerships with local nonprofits that work directly with these individuals. This relationship benefits all involved. For the organizations, it streamlines the time-consuming process of reliably sourcing produce, which is critical to improving health outcomes. For farms – particularly small growers like those in Orange County – our ability to coordinate orders ensures a reliable revenue stream, contributing to economic development. In 2021, we partnered with 16+ agencies across the Triangle to reliably supply $105,000+ worth of locally-grown produce to these organizations. 4. Living Wage: Does this agency pay permanent employees a minimum living wage? Yes If yes, is this agency an Orange County Living Wage Certified Employer? No If no, please briefly explain. We have applied for Living Wage Certification from Durham County because our office is physically located in Durham County. Schedule of Positions: # of FTE – Full-Time Paid Positions: 6 # of FTE – Part-Time Paid Positions: 1 NEW THIS YEAR Consistent with our commitment to equity and inclusion, the Towns of Chapel Hill and Carrboro and Orange County Government are taking steps together to center racial equity in the Human Services Funding Program. Over the course of the next year, the Towns and County will conduct a comprehensive racial-equity analysis of the program and we are requesting basic information about your organization’s racial equity work. a. Please describe how you have involved the intended beneficiaries of the proposed project in the planning and design process (in 100 words or less). EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION DocuSign Envelope ID: BC021861-30DF-4F8A-9FA3-8AE2B71D28D0 Program information Page 10 of 37 Through our work with partners, we know two things: (1) there is universal need for fresh food, and (2) the types of food needed and the best mechanisms for getting that food to people in need vary by community. Farmer Foodshare relies on partners to elicit feedback from those they serve (exclusively low-income individuals and predominantly BIPOC) and develop solutions that match these needs. While each of the partnerships described in this application involves food distribution, the frequency and method of distribution and the product mix and quantities partners choose to purchase will vary based on input from beneficiaries. b. How has your organization incorporated racial equity goals into your organizational goals? In 2018, Farmer Foodshare published a Diversity Strategic Plan that outlined its commitment to cultivating and maintaining a culture of inclusion. The plan outlined FF’s objectives to (1) recruit and retain a board of directors that reflects our community’s demographics, (2) create and maintain a culture of inclusion and cultural competency on the board through ongoing training. We successfully implemented this plan and continue to adhere to its principles in our ongoing efforts to incorporate racial equity into our operations. Further, our hiring protocols reflect our efforts to intentionally seek out staff members with diverse life experiences that will enrich our understanding and deepen the quality of service we provide. Our demographics reflect our efforts on this front. Additionally, all staff and board members participate in racial equity training, most recently in summer 2021. c. Please fill in the below questions and provide any additional context on the racial composition of the organization and board leadership: i. % of staff that are Black, Indigenous, or People of Color (BIPOC) : 71% ii. % of board that are BIPOC: 43% iii. % of staff that have attended racial equity training: 100% d. Please describe any additional activities your organization is doing to address racial equity. A history of systemic racism has created huge hurdles for BIPOC farmers, as well as female and beginning farmers. These farms often have difficulty obtaining financing due to lack of credit history, the increased risk associated with lending to an inexperienced farmer, or continued discrimination against people of color. Farmer Foodshare is working to create awareness of these issues as well as specific opportunities for these farms. In recent years, we hosted a speaker series focused on understanding the legacy of race and farming for BIPOC farmers. We also are working with the Farmers of Color Network coordinated through Rural Advancement Foundation International (RAFI- USA) to incorporate more BIPOC farms into our sourcing network. Most recently, we added Durham-based Jireh Family Farm, a small-scale producer of herbs, pork, and chicken. In 2022, we plan to launch a competitive mini-grants program aimed at providing BIPOC farms with funding for equipment upgrades and technical assistance that will aid them in preparing to sell wholesale. EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION DocuSign Envelope ID: BC021861-30DF-4F8A-9FA3-8AE2B71D28D0 Program information Page 11 of 37 PROGRAM INFORMATION *Please submit for each program if applying for funding for more than one program. 6. Program Name: Fresh Food Purchasing (with Carolina Jews for Justice) Program Primary Contact and Title: Carlo Wright, Client Relations Coordinator Telephone Number: 919.925.2651 E-Mail: carlo@farmerfoodshare.org 7. Please briefly describe the proposed program, including an explanation of how it aligns with the Town of Chapel Hill and Carrboro’s Results Framework, and Orange County BOCC Goals and Priorities, and the target population to benefit from the program. (250 words or less) Farmer Foodshare uses funds from a variety of sources to source exclusively NC-grown produce through our Wholesale Market. We then deliver the food to our partner organizations, who provide it to individuals in need. In this way, local farmers (including those located in Orange County) receive an economic boost because we’re paying them for what they grow, and residents receive and consume the fresh food they need to improve their health outcomes (in alignment with Chapel Hill/Carrboro Strategic Objective 3 and Orange County Goals/Priorities 1-2). Through our proposed partnership with Carolina Jews for Justice, human services funding would be used to purchase and distribute food boxes filled with fresh, seasonal produce (valued at approximately $18/ea) twice monthly. With the full amount of funding requested, we would be able to serve 100 low-income, predominantly BIPOC Orange County residents at each of 6 distributions (for a total of 600 individual distributions). Each participant will also receive nutrition/usage information with each distribution to encourage consumption of the food. The food will be incorporated into the Fed Up campaign, a collaboration of Carolina Jews for Justice, NC Raise Up – Fight for $15, and the NC Poor People’s Campaign, with support from Farmer Foodshare. It was created to nourish our communities with fresh food and critical knowledge. Each box of food comes with reading material and an invitation to get involved in the movement to eliminate poverty wages and cultivate a voice in workplace policies that negatively affect our communities. 8. Target Population: Please complete the table below with numbers (not percentages) of individuals served and projected to be served. *Note: The following demographics reflect information provided to us by Carolina Jews for Justice. They do not collect all of the requested demographics. They anticipate serving 1,520 individuals over the course of 2022-23. Our figures anticipate providing food to 100 of these individuals (those located in Orange County) 6 times each (for a total of 600 individuals served), provided that our proposal is funded in full. We have scaled the demographics for these 600 based on the proportions reported for Carolina Jews for Justice’s overall population. EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION DocuSign Envelope ID: BC021861-30DF-4F8A-9FA3-8AE2B71D28D0 Program information Page 18 of 37 Program Target Population Demographics Projected 2020-2021 Actual 2020- 2021 Projected 2021-2022 Projected 2022-2023 Gender Men 575 Women 525 Nonbinary/Genderqueer 0 Self-Describe 0 Total 0 0 0 1,100 Race and Ethnicity Black or African-American 301 American Indian or Alaska Native 0 Asian Indian (Asian) 151 White (note: this includes all Latinx participants) 457 Native Hawaiian or other Pacific Islander 0 Chinese / Japanese / Vietnamese / Filipino / Korean 0 Two or more races or Unknown 191 Total 0 0 0 1,100 Of the above, how many Hispanic, Latino or Spanish origin 389 Of the above, how many non-Hispanic, Latino or Spanish origin 595 Unknown 116 Total 0 0 0 1,100 Age 0-5 years 190 6-18 years 865 19-50 years 45 51+ years 0 Total 0 0 0 1,100 Geographic Location Town of Chapel Hill 686 Town of Carrboro 286 Orange County ( Outside of Chapel Hill/Carrboro) 120 Outside of Orange County 0 Unknown 8 Total 0 0 0 1,100 Income Low-income (80% of the Area Median Income and Below) Please see income table in the attachments 737 Income Unknown/not tracked 363 Total 0 0 0 1,100 EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION DocuSign Envelope ID: BC021861-30DF-4F8A-9FA3-8AE2B71D28D0 Program information Page 13 of 37 9. Cost Per Individual This cost per individual must reflect the total program budget divided by the total number of program individuals in this application. Actual 2020-2021 Projected 2021-2022 Projected 2022-2023 Total Cost of Program n/a n/a $15,300 Total # of Individuals n/a n/a 600 Cost Per Individual n/a n/a $25.50 Note: 100 recipients x 6 food distributions (food value: $18.33/distribution). Cost per individual is higher than other proposed programs because this partner is choosing to provide recipients with more food at each distribution. 10. Performance Indicators For Chapel Hill and Carrboro applicants: Please complete the following chart with information about the Strategic Objective, Intermediate Result, and the Agency Performance Indicator for each program for which you are applying for funding. Please see the Results Framework in the Attachments section as a reference. Program Name: Fresh Food Purchasing (in partnership with Carolina Jews for Justice) Strategic Objective o Children improve their educational outcomes o Residents Increase their livelihood security o Residents improve their health outcomes Intermediate Result Residents demonstrate new healthy lifestyle behaviors RESULTS Actual 2020-2021 Projected 2021-2022 Projected 2022-2023 Performance Indicators % and # of program participants who consume fresh food n/a n/a 100% / 600 % and # of program participants who receive nutrition/usage information related to the food distributed n/a n/a 100% / 600 $ spent with local farmers, promoting economic development n/a n/a $11,000 EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION DocuSign Envelope ID: BC021861-30DF-4F8A-9FA3-8AE2B71D28D0 Outside Agencies/Human Services Program information Page 14 of 37 Please use the drop down menu below to select which function area best aligns with your agency and program(s) in which you are requesting funding. Please select only one from the drop- down menu below. Food and Nutritional Services If you selected other, please tell us what function area best aligns with your organization: Please indicate three program goals/performance measures below. A few notes: • If you use percentages, please put the actual number equivalence. • Please ensure your performance measures are outcome based and not outputs. Program Goal # 1 Increase the number of individuals who have access to fresh, nutritious food Performance Measure (How will you accomplish your goal?) Percentage and number of program participants that receive/consume fresh food Actual Results (Outcome) Ending FY2021 N/A – Orange County did not fund our work with this partner in FY2021. Projected Results (Outcome) Ending FY2022 N/A – Orange County did not fund our work with this partner in FY2022. Projected Results (Outcome) Ending FY2023 100% / 600 Program Goal # 2 Increase recipients’ awareness of the value and usage of fresh, nutritious food Performance Measure (How will you accomplish your goal?) Percentage and number of program participants who receive nutrition/usage information related to the food distributed Actual Results (Outcome) Ending FY2021 N/A – Orange County did not fund our work with this partner in FY2021. Projected Results (Outcome) Ending FY2022 N/A – Orange County did not fund our work with this partner in FY2022. Projected Results (Outcome) Ending FY2023 100% / 600 _________________ EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION DocuSign Envelope ID: BC021861-30DF-4F8A-9FA3-8AE2B71D28D0 Outside Agencies/Human Services Program information Page 15 of 37 Program Goal # 3 Support local economic development by increasing the incomes of NC farms, helping them stay on their land Performance Measure (How will you accomplish your goal?) $ spent with local farmers Actual Results (Outcome) Ending FY2021 N/A – Orange County did not fund our work with this partner in FY2021. Projected Results (Outcome) Ending FY2022 N/A – Orange County did not fund our work with this partner in FY2022. Projected Results (Outcome) Ending FY2023 $11,000 EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION DocuSign Envelope ID: BC021861-30DF-4F8A-9FA3-8AE2B71D28D0 Program information Page 17 of 37 PROGRAM INFORMATION *Please submit for each program if applying for funding for more than one program. 6. Program Name: Fresh Food Purchasing (with TABLE) Program Primary Contact and Title: Carlo Wright, Client Relations Coordinator Telephone Number: 919.925.2651 E-Mail: carlo@farmerfoodshare.org 7. Please briefly describe the proposed program, including an explanation of how it aligns with the Town of Chapel Hill and Carrboro’s Results Framework, and Orange County BOCC Goals and Priorities, and the target population to benefit from the program. (250 words or less) Farmer Foodshare uses funds from a variety of sources to source exclusively NC-grown produce through our Wholesale Market. We then deliver the food to our partner organizations, who provide it to individuals in need. In this way, local farmers (including those located in Orange County) receive an economic boost because we’re paying them for what they grow, and residents receive and consume the fresh food they need to improve their health outcomes (in alignment with Chapel Hill/Carrboro Strategic Objective 3 and Orange County Goals/Priorities 1-2). Through our proposed partnership with TABLE, human services funding would be used to purchase and distribute pallets of fresh, seasonal food to be incorporated into the TABLE@Home program. TABLE@Home provides healthy non-perishables and fresh produce to children attending Chapel Hill-Carrboro and Orange County schools year- round. This extra food ensures children have plenty to eat when they do not have access to school meals on the weekends, during the holidays, and over the summer. TABLE anticipates ordering approximately $10 worth of produce per participant to include in weekly distributions to children participating in the program. The full amount of funding would provide 22 kids with 50 distributions of food over the course of 12 months (1,100 individual distributions). Each participant will also receive nutrition/usage information with each distribution to encourage consumption of the food. 8. Target Population: Please complete the table below with numbers (not percentages) of individuals served and projected to be served. Note: The following demographics reflect information provided to us by TABLE. TABLE anticipates serving 800 kids over the course of 2022-2023. Our figures anticipate providing food to 22 of those children 50 times each (for a total of 1,100 individuals served), provided our proposal is funded in full. We have scaled our demographics to maintain the percentages reflected in TABLE’s overall population. EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION DocuSign Envelope ID: BC021861-30DF-4F8A-9FA3-8AE2B71D28D0 Program information Page 18 of 37 Program Target Population Demographics Projected 2020-2021 Actual 2020- 2021 Projected 2021-2022 Projected 2022-2023 Gender Men 575 Women 525 Nonbinary/Genderqueer 0 Self-Describe 0 Total 0 0 0 1,100 Race and Ethnicity Black or African-American 301 American Indian or Alaska Native 0 Asian Indian (Asian) 151 White (note: this includes all Latinx participants) 457 Native Hawaiian or other Pacific Islander 0 Chinese / Japanese / Vietnamese / Filipino / Korean 0 Two or more races or Unknown 191 Total 0 0 0 1,100 Of the above, how many Hispanic, Latino or Spanish origin 389 Of the above, how many non-Hispanic, Latino or Spanish origin 595 Unknown 116 Total 0 0 0 1,100 Age 0-5 years 190 6-18 years 865 19-50 years 0 51+ years 0 Total 0 0 0 1,100 Geographic Location Town of Chapel Hill 686 Town of Carrboro 286 Orange County ( Outside of Chapel Hill/Carrboro) 120 Outside of Orange County 0 Unknown 8 Total 0 0 0 1,100 Income Low-income (80% of the Area Median Income and Below) Please see income table in the attachments 737 Income Unknown/not tracked 363 Total 0 0 0 1,100 EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION DocuSign Envelope ID: BC021861-30DF-4F8A-9FA3-8AE2B71D28D0 Program information Page 19 of 37 9. Cost Per Individual This cost per individual must reflect the total program budget divided by the total number of program individuals in this application. Actual 2020-2021 Projected 2021-2022 Projected 2022-2023 Total Cost of Program n/a n/a $15,300 Total # of Individuals n/a n/a 1,100 Cost Per Individual n/a n/a $13.90 Note: 22 kids x 50 food distributions = 1,100 (food value: $10/distribution) 10. Performance Indicators For Chapel Hill and Carrboro applicants: Please complete the following chart with information about the Strategic Objective, Intermediate Result, and the Agency Performance Indicator for each program for which you are applying for funding. Please see the Results Framework in the Attachments section as a reference. Program Name: Fresh Food Purchasing (in partnership with TABLE) Strategic Objective o Children improve their educational outcomes o Residents Increase their livelihood security o Residents improve their health outcomes Intermediate Result Residents demonstrate new healthy lifestyle behaviors RESULTS Actual 2020-2021 Projected 2021-2022 Projected 2022-2023 Performance Indicators % and # of program participants who consume fresh food n/a n/a 100% / 1,100 % and # of program participants who receive nutrition/usage information related to the food distributed n/a n/a 100% / 1,100 $ spent with local farmers, promoting economic development n/a n/a $11,000 EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION DocuSign Envelope ID: BC021861-30DF-4F8A-9FA3-8AE2B71D28D0 Outside Agencies/Human Services Program information Page 20 of 37 Please use the drop down menu below to select which function area best aligns with your agency and program(s) in which you are requesting funding. Please select only one from the drop- down menu below. Food and Nutritional Services If you selected other, please tell us what function area best aligns with your organization: Please indicate three program goals/performance measures below. A few notes: • If you use percentages, please put the actual number equivalence. • Please ensure your performance measures are outcome based and not outputs. Program Goal # 1 Increase the number of individuals who have access to fresh, nutritious food Performance Measure (How will you accomplish your goal?) Percentage and number of program participants that receive/consume fresh food Actual Results (Outcome) Ending FY2021 N/A – Orange County did not fund our work with this partner in FY2021. Projected Results (Outcome) Ending FY2022 N/A – Orange County did not fund our work with this partner in FY2022. Projected Results (Outcome) Ending FY2023 100% / 1,100 Program Goal # 2 Increase recipients’ awareness of the value and usage of fresh, nutritious food Performance Measure (How will you accomplish your goal?) Percentage and number of program participants who receive nutrition/usage information related to the food distributed Actual Results (Outcome) Ending FY2021 N/A – Orange County did not fund our work with this partner in FY2021. Projected Results (Outcome) Ending FY2022 N/A – Orange County did not fund our work with this partner in FY2022. Projected Results (Outcome) Ending FY2023 100% / 1,100 _________________ EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION DocuSign Envelope ID: BC021861-30DF-4F8A-9FA3-8AE2B71D28D0 Outside Agencies/Human Services Program information Page 21 of 37 Program Goal # 3 Support local economic development by increasing the incomes of NC farms, helping them stay on their land Performance Measure (How will you accomplish your goal?) $ spent with local farmers Actual Results (Outcome) Ending FY2021 N/A – Orange County did not fund our work with this partner in FY2021. Projected Results (Outcome) Ending FY2022 N/A – Orange County did not fund our work with this partner in FY2022. Projected Results (Outcome) Ending FY2023 $11,000 EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION DocuSign Envelope ID: BC021861-30DF-4F8A-9FA3-8AE2B71D28D0 Program information Page 23 of 37 PROGRAM INFORMATION *Please submit for each program if applying for funding for more than one program. 6. Program Name: Fresh Food Purchasing (with Local Food Connection & Eno River Farmers Market) Program Primary Contact and Title: Carlo Wright, Client Relations Coordinator Telephone Number: 919.925.2651 E-Mail: carlo@farmerfoodshare.org 7. Please briefly describe the proposed program, including an explanation of how it aligns with the Town of Chapel Hill and Carrboro’s Results Framework, and Orange County BOCC Goals and Priorities, and the target population to benefit from the program. (250 words or less) Farmer Foodshare uses funds from a variety of sources to source exclusively NC-grown produce through our Wholesale Market. We then deliver the food to our partner organizations, who provide it to individuals in need. In this way, local farmers (including those located in Orange County) receive an economic boost because we’re paying them for what they grow, and residents receive and consume the fresh food they need to improve their health outcomes (in alignment with Chapel Hill/Carrboro Strategic Objective 3 and Orange County Goals/Priorities 1-2). Through our proposed partnership with Local Food Connection (LFC) and the Eno River Farmers Market (ERFM), human services funding would be used to purchase and deliver pallets of fresh, seasonal food that is then divided into food boxes. The boxes would be distributed monthly to 22 families (100 people) in crisis who have been referred by Orange County Schools social workers at River Park Elementary School and Orange Middle School. LFC anticipates ordering approximately $9 worth of produce per participant to include in the distributions. The full amount of funding would provide 100 individuals with 12 distributions of food over the course of a year (1,200 individual distributions). Corly Jones, manager of the ERFM, augments the boxes with produce purchased with funds donated by shoppers at the market. Because recipient families typically lack access to transportation, Corly delivers the food to their homes and offers verbal education on how to cook and store the food (sometimes with a translator). Boxes also include written educational material. 8. Target Population: Please complete the table below with numbers (not percentages) of individuals served and projected to be served. Note: The following demographics reflect information provided to us by Local Food Connection and Eno River Farmers Market. We anticipate providing food to 100 people monthly (for a total of 1,200 individuals served), provided our proposal is funded in full. We have scaled our figures accordingly while maintaining the demographic percentages reflected in Local Food Connection’s core population. EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION DocuSign Envelope ID: BC021861-30DF-4F8A-9FA3-8AE2B71D28D0 Program information Page 24 of 37 Program Target Population Demographics Projected 2020-2021 Actual 2020- 2021 Projected 2021-2022 Projected 2022-2023 Gender Men 612 447 Women 1032 753 Nonbinary/Genderqueer 0 0 Self-Describe 0 0 Total 1644 1,200 Race and Ethnicity Black or African-American 402 294 American Indian or Alaska Native 0 0 Asian Indian 0 0 White 228 166 Native Hawaiian or other Pacific Islander 0 Chinese 0 Japanese 0 Vietnamese 0 Filipino 0 Korean 0 Some other race (Hispanic, since not reported separately) 1014 740 Total 1644 1,200 Of the above, how many Hispanic, Latino or Spanish origin 1014 740 Of the above, how many non-Hispanic, Latino or Spanish origin 630 460 Total 1644 1,200 Age 0-5 years 122 89 6-18 years 682 498 19-50 years 700 511 51+ years 140 102 Total 1644 1,200 Geographic Location Town of Chapel Hill 0 0 Town of Carrboro 0 0 Orange County ( Outside of Chapel Hill/Carrboro) 1644 1,200 Outside of Orange County 0 0 Total 1644 1,200 Income Low-income (80% of the Area Median Income and Below) Please see income table in the attachments 1644 1,200 Total 1644 1,200 EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION DocuSign Envelope ID: BC021861-30DF-4F8A-9FA3-8AE2B71D28D0 Program information Page 25 of 37 9. Cost Per Individual This cost per individual must reflect the total program budget divided by the total number of program individuals in this application. Actual 2020-2021 Projected 2021-2022 Projected 2022-2023 Total Cost of Program $7375 n/a $15,300 Total # of Individuals 1,644 n/a 1,200 Cost Per Individual $4.48 n/a $12.75 Note: 100 individuals x 12 food distributions = 1,200 (food value: $9/distribution) While Farmer Foodshare operated this program with the same partner in 2020-2021, it does not offer a true comparison. The program served more people at lesser cost per individual in 2020-21, but this is because there were far more distributions than originally projected, each containing less food per box. The funding also did not adequately cover the staff costs incurred in sourcing and delivering the produce (we prioritized purchasing food for people in need). Farmer Foodshare did not apply for funding for 2021-2022. 10. Performance Indicators For Chapel Hill and Carrboro applicants: Please complete the following chart with information about the Strategic Objective, Intermediate Result, and the Agency Performance Indicator for each program for which you are applying for funding. Please see the Results Framework in the Attachments section as a reference. Program Name: Fresh Food Purchasing (in partnership with Local Food Connection & Eno River Farmers Market) Strategic Objective o Children improve their educational outcomes o Residents Increase their livelihood security o Residents improve their health outcomes Intermediate Result Residents demonstrate new healthy lifestyle behaviors RESULTS Actual 2020-2021 Projected 2021- 2022 Projected 2022-2023 Performance Indicators % and # of program participants who consume fresh food 100% / 1,644 n/a 100% / 1,200 EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION DocuSign Envelope ID: BC021861-30DF-4F8A-9FA3-8AE2B71D28D0 Program information Page 26 of 37 % and # of program participants who receive nutrition/usage information related to the food distributed 100 / 1,644 n/a 100% / 1,200 $ spent with local farmers, promoting economic development $6,873.90 n/a $11,000 EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION DocuSign Envelope ID: BC021861-30DF-4F8A-9FA3-8AE2B71D28D0 Outside Agencies/Human Services Program information Page 27 of 37 Please use the drop down menu below to select which function area best aligns with your agency and program(s) in which you are requesting funding. Please select only one from the drop- down menu below. Food and Nutritional Services If you selected other, please tell us what function area best aligns with your organization: Please indicate three program goals/performance measures below. A few notes: • If you use percentages, please put the actual number equivalence. • Please ensure your performance measures are outcome based and not outputs. Program Goal # 1 Increase the number of individuals who have access to fresh, nutritious food Performance Measure (How will you accomplish your goal?) Percentage and number of program participants that receive/consume fresh food Actual Results (Outcome) Ending FY2021 100% / 1644 Projected Results (Outcome) Ending FY2022 N/A – Orange County did not fund our work with this partner in FY2022. Projected Results (Outcome) Ending FY2023 100% / 1,200 Program Goal # 2 Increase recipients’ awareness of the value and usage of fresh, nutritious food Performance Measure (How will you accomplish your goal?) Percentage and number of program participants who receive nutrition/usage information related to the food distributed Actual Results (Outcome) Ending FY2021 100% / 1,644 Projected Results (Outcome) Ending FY2022 N/A – Orange County did not fund our work with this partner in FY2022. Projected Results (Outcome) Ending FY2023 100% / 1,200 _________________ EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION DocuSign Envelope ID: BC021861-30DF-4F8A-9FA3-8AE2B71D28D0 Outside Agencies/Human Services Program information Page 28 of 37 Program Goal # 3 Support local economic development by increasing the incomes of NC farms, helping them stay on their land Performance Measure (How will you accomplish your goal?) $ spent with local farmers Actual Results (Outcome) Ending FY2021 $6,873.90 Projected Results (Outcome) Ending FY2022 N/A – Orange County did not fund our work with this partner in FY2022. Projected Results (Outcome) Ending FY2023 $11,000 Note: While Farmer Foodshare operated this program with the same partner in 2020- 2021, it does not offer a true comparison. The program served more people at lesser cost per individual in 2020-21, but this is because there were far more distributions than originally projected, each containing less food per box. The funding also did not adequately cover the staff costs incurred in sourcing and delivering the produce (we prioritized purchasing food for people in need). Farmer Foodshare did not apply for funding for 2021-2022. EXHIBIT A: PROVIDER'S OUTSIDE AGENCY APPLICATION DocuSign Envelope ID: BC021861-30DF-4F8A-9FA3-8AE2B71D28D0 DocuSign Envelope ID: BC021861-30DF-4F8A-9FA3-8AE2B71D28D0 Orange County Outside Agency Performance Agreement Page 10 of 10 Rev.06/22 ATTACHMENT “A” Orange County Certifications – FY 20 - Outside Agency Performance Agreement Chief Contact, Administrators, Chief Executive Officer and Chief Financial Officer I certify that I have provided a list of the chief contact, administrators, chief executive officer and chief financial officer for my agency with this Agreement and that I will keep it current to the County of Orange. The list should be in writing with the name, title, residential address; phone and email address and if possible, fax number. Officers and Board of Directors I certify that I have provided a current list of the Officers and Board of Directors with this Agreement and that we will continue to update the list as changes occur. The list should be in writing, with the name, physical address, mailing address and if possible, phone, fax and email address. Budget Submission I certify that I have provided a budget for the period to be covered by funding Orange County, and that any substantive changes made to this budget have been in advance authorized in writing by Orange County. Annual Financial Review I certify that I have provided a copy of the latest annual Financial Review for our agency and the budget adopted by the agency for the fiscal years encompassing this Agreement. If not, please explain on a separate sheet of paper. Alignment with Organization’s Mission I certify that the programs and services for which this funding is requested align with the mission of the organization. Intended Purpose I certify that the funds provided to the agency under the terms of this Agreement will be used for a public purpose and shall only be used for the purposes intended and any money not used for those purposes will be promptly returned to Orange County. Certified by: _______________________ Title: __________________________ Date: ___________ (Provider’s Signature) DocuSign Envelope ID: BC021861-30DF-4F8A-9FA3-8AE2B71D28D0 Executive Director 8/12/2022 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? INSR ADDL SUBR LTR INSD WVD PRODUCER CONTACT NAME: FAXPHONE (A/C, No):(A/C, No, Ext): E-MAIL ADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY)(MM/DD/YYYY) AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATION AND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE EACH OCCURRENCE $ DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence) MED EXP (Any one person)$ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $ PRO-POLICY LOC PRODUCTS - COMP/OP AGGJECT OTHER:$ COMBINED SINGLE LIMIT $(Ea accident) ANY AUTO BODILY INJURY (Per person)$ OWNED SCHEDULED BODILY INJURY (Per accident)$AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $AUTOS ONLY AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE CLAIMS-MADE AGGREGATE $ DED RETENTION $ PER OTH- STATUTE ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.L. DISEASE - POLICY LIMITDESCRIPTION OF OPERATIONS below INSURER(S) AFFORDING COVERAGE NAIC # COMMERCIAL GENERAL LIABILITY Y / N N / A (Mandatory in NH) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved.ACORD 25 (2016/03) CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) $ $ $ $ $ The ACORD name and logo are registered marks of ACORD Alex Maiolo FARME-3 OP ID: MA 08/04/2022 Martin Hall Lee-Moore Insurance Agency Inc P.O. Box 667 West End, NC 27376 Alex Maiolo 919-932-9990 919-933-0155 leemoore.martin@gmail.com AUTO-OWNERS INS. COMPANY Farmer Foodshare 902 N Mangum St Durham, NC 27701 A 2,000,000 X X 35269000 06/15/2022 06/15/2023 300,000 10,000 2,000,000 2,000,000 2,000,000 A 35269000 06/15/2022 06/15/2023 2,000,000 X X XA X 35278607 05/29/2022 05/29/2023 1,000,000 1,000,000 1,000,000 Orange County, its officers, official agents, and employees are listed as additional insured on General Liability policy. Orange County Goverment Risk Management PO Box 8101 Hillsborough, NC 27278 919-932-9990 18988 DocuSign Envelope ID: BC021861-30DF-4F8A-9FA3-8AE2B71D28D0