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HomeMy WebLinkAbout2022-405-E-Social Svc-Orange County Disability Awareness Council-outside agency awardOrange 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 Orange County Disability Awareness Council, a not- for-profit corporation, located at 2501 Homestead Rd, Chapel Hill, North Carolina 27516 (“Provider”). WITNESSETH: WHEREAS, it is in the interests of the County that said program be assisted by the County and thereby enhance its availability to residents of the County, and said program addresses an important community human services need, as identified by the Board of Commissioners. NOW, THEREFORE, in consideration of the above and the mutual covenants and conditions hereafter set forth, the County and 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 $22,500. 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 $5,625. 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: 85C6B855-1F25-4EEC-B204-9380B8F79B70 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: 85C6B855-1F25-4EEC-B204-9380B8F79B70 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 (Nancy Coston) 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: 85C6B855-1F25-4EEC-B204-9380B8F79B70 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: 85C6B855-1F25-4EEC-B204-9380B8F79B70 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: 85C6B855-1F25-4EEC-B204-9380B8F79B70 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 Provider’s Name Orange County Disability Awareness Council Attention: Nancy Coston Attention: Timothy Miles P.O. Box 8181 Address: PO Box 3513 Hillsborough, NC 27278 Chapel Hill, NC 27515 Email:ncoston@orangecountync.gov Email: info@triangledac.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 _____________________________ _______________________ Timothy Miles, Director Date For and on behalf of Orange County Government _______________________________ ________________________ Bonnie Hammersley, County Manager Date DocuSign Envelope ID: 85C6B855-1F25-4EEC-B204-9380B8F79B70 8/25/2022 8/30/2022 Orange County Outside Agency Performance Agreement Page 7 of 10 Rev.06/22 ORANGE COUNTY—DEPARTMENT USE ONLY ______________________________________________________________________________ Party/Vendor Name: Orange County Disability Awareness Council Party/Vendor Contact Person: Timothy Miles Contact Phone: 919-245-4337 Party/Vendor Address: PO Box 3513 City Chapel Hill State: NC Zip: 27515 Department: Social Services Amount: 22,500 Purpose: outside agency award Budget Code(s): 10290050-710032 Vendor # 800037 (N/A if new vendor) Vendor is a BOCC consultant? Yes No Contract Type: (Check one) New Renewal Amendment Effective Date 7/1/2022 Approved by Board Yes No Agenda Date: 6/21/2022 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: 85C6B855-1F25-4EEC-B204-9380B8F79B70 8/25/2022 8/26/2022 8/29/2022 8/29/2022 8/30/2022 Orange County Outside Agency Performance Agreement Page 8 of 10 Rev.06/22 Exhibit A Provider’s Outside Agency Application DocuSign Envelope ID: 85C6B855-1F25-4EEC-B204-9380B8F79B70 Cover Page P a g e 6 o f 24 COVER PAGE Applicant Contact Information Applicant Organization’s Legal Name: Orange County Disability Awareness Council (OCDAC) Applicant Organization’s Physical Address: 2501 Homestead Rd, #103, Chapel Hill, NC-27516 Applicant Organization’s Mailing Address: PO Box 3513, Chapel Hill, NC-27515 Applicant Organization’s Web Address: www.triangledac.org Executive Director: Timoty Miles Telephone Number: 919-245-4337 E-Mail: info@triangledac.org Tax ID Number: 58-2062891 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 PAR (Program for Accessible Resources) Operations $27,000 Operations $28,000 Operations $30,000 Operations $85,000 Totals $27,000 $28,000 $30,000 $85,000 DocuSign Envelope ID: 85C6B855-1F25-4EEC-B204-9380B8F79B70 Cover Page P a g e 7 o f 24 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. Signature: Executive Director Date Signature: Board Chairperson Date Funds are budgeted for Staff ½ time positions, software, research and development, and support to run the programs and daily operation. Implementation of the Program for Accessible Resources (PAR) trains our clients virtually the use of assistive technology. This program is a core part of our day-to-day operations during the pandemic and afterwards. Operational Budget: Staff: Executive Director, Administrative Assistant, Bookkeeper Instructors, Interpreters, IT Support, Student-Internships, Social Media Marketer etc. cost approximately $33,000. Technology: Licenses, Zoom Licenses, TeamViewer Web Maintenance, Cyber & Liability Insurance, magnifiers, Tech Lab upgrades, for e.g., laptops, webcams, headsets, etc. cost approximately $15,000. Adaptive Software: Fusion (Speech Output), Dragon (Voice Input), ZoomText, Learning Disability Software cost approximately $17,000. DocuSign Envelope ID: 85C6B855-1F25-4EEC-B204-9380B8F79B70 Cover Page P a g e 8 o f 24 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: Executive Director Date Signature: Board Chairperson Date DocuSign Envelope ID: 85C6B855-1F25-4EEC-B204-9380B8F79B70 Program information P a g e 9 o f 24 AGENCY INFORMATION Please provide the following information about your agency: 1. Date of Incorporation (Month/Year): 02/1999 2. Agency’s Purpose/Mission (no more than a few sentences): TDAC is a grass roots nonprofit agency providing education and training opportunities for persons with disabilities. Our goal is to provide equal access to programs and services and to eliminate attitudinal and physical barriers to program/services that exist within the disabled population. TDAC conducts educational workshops and classes concentrating on transportation, equal access to housing and public buildings, and education to make technology accessible. 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). • We have earned several cash awards based on community relationships in tying technology to the needs of disabled. These cash awards include UPS, JCPenney Golden Rule, and IBM Community Development in Special Technology. • Established a technology lab for persons with moderate to severe disabilities and conducted technology workshops on Zoom for 40-50 registrants. • Our successful record of meeting proposed budgets and timetables is evident in our partnerships with established agencies in North Carolina such as NC Works, NC ADA Network NC Developmental Disabilities Council , A Helping Hand, The Volunteer Center, NC Fair Housing Project, UNC Center for Public Service and NC Food bank. 4. Living Wage: Does this agency pay permanent employees a minimum living wage? (Yes YES No If yes, is this agency an Orange County Living Wage Certified Employer? If no, please briefly explain. The Council pays contract employees to provide a mina amount od support but needs to have permanent ½ time staff support to provide consistent and stable support to meet the business challenges all businesses face, e.g., marketing, staff training, social media, contract and grants etc. Schedule of Positions: # of FTE – Full-Time Paid Positions: __ # of PTE –4 Part-Time Paid Positions: 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 DocuSign Envelope ID: 85C6B855-1F25-4EEC-B204-9380B8F79B70 Program information P a g e 10 o f 24 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). The Orange County Disability Awareness Council has involved individuals from its members, leadership team and individuals from the public who may be participants in program activities by gathering data through focus group sessions and survey instruments. This data provides essential input on improving the program’s goals and activities, in effort to better match the needs of participants. We also plan to hire a social media specialist to enhance our platform and reach through examples like chat rooms and community posts to share stories as a mechanism to foster relationships. b. How has your organization incorporated racial equity goals into your organizational goals? The Orange County Disability Awareness Council prides itself on racial equity in leadership and membership. Since we are constantly faced with different types of biases, it is part of our mission to be totally inclusive. Our leadership draws from people of all background such as Native Americans, Hispanic/Latinx, African American, Asian, Arab, and Caucasian. c. Please fill in the below questions and provide any additional context on the racial composition of the organization and board leadership: 1. 75% of our staff is African American, Indigenous, or People of Color (BIPOC) 2. 75% of our board is (BIPOC) 3. 25% of our board has attended racial equity training d. Please describe any additional activities your organization is doing to address racial equity. We partner with a variety of community organizations that empower BIPOC such as African American churches, Native American Cultural reservations, and state agencies. We are making connections with other community partners to expand over service of BIPOC populations. DocuSign Envelope ID: 85C6B855-1F25-4EEC-B204-9380B8F79B70 Program information P a g e 11 o f 24 PROGRAM INFORMATION *Please submit for each program if applying for funding for more than one program. 6. Program Name: Program for Accessible Resources Program Primary Contact and Title: Timothy Miles, Executive Director Telephone Number: 919-245-4337 E-Mail: info@triangledac.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) 8. Target Population: Please complete the table below with numbers (not percentages) of individuals served and projected to be served. Program Target Population Demographics Projected 2020-2021 Actual 2020- 2021 Projected 2021-2022 Projected 2022-2023 Gender Men 350 350 360 360 Women 235 235 245 250 Nonbinary/Genderqueer Self-Describe Total 585 585 605 615 Race and Ethnicity Black or African-American 305 305 315 320 American Indian or Alaska Native Asian Indian 20 20 25 30 White 225 225 225 225 Native Hawaiian or other Pacific Islander Chinese Japanese Vietnamese Filipino Korean Some other race 35 35 40 40 Total 585 585 605 615 Of the above, how many Hispanic, Latino or Spanish origin 35 35 40 40 Of the above, how many non-Hispanic, Latino or Spanish origin 550 550 565 570 Total 585 585 605 615 DocuSign Envelope ID: 85C6B855-1F25-4EEC-B204-9380B8F79B70 Program information P a g e 12 o f 24 Age 0-5 years 6-18 years 60 60 65 70 19-50 years 350 350 360 360 51+ years 175 175 180 185 Total 585 585 605 615 Geographic Location Town of Chapel Hill 420 420 430 435 Town of Carrboro 65 65 70 75 Orange County ( Outside of Chapel Hill/Carrboro) 60 60 65 65 Outside of Orange County 45 40 45 45 Total 585 585 605 615 Income Low-income (80% of the Area Median Income and Below) Please see income table in the attachments 585 585 605 615 Total 585 585 605 615 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 $30,000 $50,000 $85,000 Total # of Individuals 585 605 615 Cost Per Individual $53.10 $51.28 $138.21 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: Program for Accessible Resources Strategic Objective (please choose one from the Results Framework) Children improve their educational outcomes X Residents Increase their livelihood security Residents improve their health outcomes DocuSign Envelope ID: 85C6B855-1F25-4EEC-B204-9380B8F79B70 Program information P a g e 13 o f 24 Intermediate Result (please choose one from the Results Framework) Residents access the most appropriate social safety net services and community- based information, which allows them to increase social-wellbeing and opportunities for disenfranchised citizens. RESULTS Actual 2020-2021 Projected 2021-2022 Projected 2022-2023 Performance Indicators (Please choose at least one performance indicator to report on from the Results Framework, and add additional performance indicators that you would like to report to the Towns. Please insert additional rows as needed, listing one per row). Knowledge of appropriate social services Maintain or improve housing status 200 200 200 200 200 200 DocuSign Envelope ID: 85C6B855-1F25-4EEC-B204-9380B8F79B70 Outside Agencies/Human Services Program information P a g e 14 o f 24 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. Human Rights and Community 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 Upon completion, people primarily with visual/print disabilities will know how to use assistive technology hardware and software to access mainstream technology which increases employability, reduces unemployment, and encourages independent living Performance Measure (How will you accomplish your goal?) Progress will be measured via end-of-course exams and follow up surveys Actual Results (Outcome) Ending FY2021 30 Projected Results (Outcome) Ending FY2022 30 Projected Results (Outcome) Ending FY2023 30 Program Goal # 2 Upon completion, people with disabilities will be able to confidently use Zoom and access various web-based human service applications Performance Measure (How will you accomplish your goal?) Progress will be measured via end-of-course exams and follow up surveys Actual Results (Outcome) Ending FY2021 30 Projected Results 30 _________________ DocuSign Envelope ID: 85C6B855-1F25-4EEC-B204-9380B8F79B70 Outside Agencies/Human Services Program information P a g e 15 o f 24 (Outcome) Ending FY2022 Projected Results (Outcome) Ending FY2023 30 Program Goal # 3 Upon completion, people with disabilities will be able to confidently navigate the internet and use social media Performance Measure (How will you accomplish your goal?) Progress will be measured via end-of-course exams and follow up surveys Actual Results (Outcome) Ending FY2021 30 Projected Results (Outcome) Ending FY2022 30 Projected Results (Outcome) Ending FY2023 30 DocuSign Envelope ID: 85C6B855-1F25-4EEC-B204-9380B8F79B70 DocuSign Envelope ID: 85C6B855-1F25-4EEC-B204-9380B8F79B70 DocuSign Envelope ID: 85C6B855-1F25-4EEC-B204-9380B8F79B70 DocuSign Envelope ID: 85C6B855-1F25-4EEC-B204-9380B8F79B70 Orange County Outside Agency Performance Agreement Page 9 of 10 Rev.06/22 Exhibit B Provider’s Revised Scope of Services and Program Budget DocuSign Envelope ID: 85C6B855-1F25-4EEC-B204-9380B8F79B70 Certified by: _______________________ Title: COO . Date: 8/3/2022 . (Provider’s Signature) EXHIBIT “B” Scope of Services – FY 2022-2023 Outside Agency Performance Agreement Agency Name: The Disability Awareness Council Program Name: Program for Accessible Resources Funding Award: $22,500 Outline how the agency will spend Orange County’s funding award. Expense Description Amount Half Time Salary Employees 10000 Rent & Utilities / Insurance 2250 Supplies & Equipment 6050 Travel + Postage + Advertising 1600 Internships 2000 Other Expenses: Internet + Telecoms + Memberships 600 Program Services Outline the critical services (activities) the agency will employ to attain the Anticipated Outcomes below, by June 30, 2023. ● Training Workshops : ADA addressing challenges that persons with disabilities face in pedestrian safety and job readiness preparedness; Emergency Preparedness providing educational materials, lectures and safety kits to raise awareness about common safety risks; Affordable Housing providing prospective tenants and landlords' rights and responsibility information and communications tools to readily identify housing discrimination. ● Continued use of the new norms including activities being modified including the use of Zoom and other remote services. ● Computer class for visually impaired – Classes will provide information and training to area students with disabilities who are or soon will be entering higher education. Anticipated Outcomes The Anticipated Results column must inc lude quantifiable results in the form of number of persons/units served within Orange County, only (all Towns and municipalities). If you use percentages, you must also provide the total number of participants within that measure’s description or for an earlier performance measure. Performance Measures Anticipate d Results Program Goal # 1: Upon completion, attendees will be able to use their ADA tool kit to access information about their civil rights. Performance Measure: Remote and/or handwritten telephone surveys will be used to measure the outcome of the program. 85 Residents Program Goal # 2: Upon completion, service providers will be proficient in disability etiquette, and older adults and people with disabilities will know how to create disaster kits, as well as gain knowledge of how to identify and access appropriate resources. Performance Measure: Quizzes and follow-up phone questionnaires will measure the effectiveness of the training. 85 Residents Program Goal # 3: Upon completion, people primarily with visual/print disabilities will know how to use assistive technology hardware and software to access mainstream technology which increases employability, reduces unemployment, and encourages independent living. Performance Measure: Progress will be measured via end-of- course exams and follow up surveys. 30 Residents DocuSign Envelope ID: 85C6B855-1F25-4EEC-B204-9380B8F79B70 Certified by: _______________________ Title: COO . Date: 8/3/2022 . (Provider’s Signature) DocuSign Envelope ID: 85C6B855-1F25-4EEC-B204-9380B8F79B70 Orange County Outside Agency Performance Agreement Page 10 of 10 Rev.06/22 ATTACHMENT “A” Orange County Certifications – FY 2022-23 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: 85C6B855-1F25-4EEC-B204-9380B8F79B70 INSR ADDL SUBR LTR INSR WVD DATE (MM/DD/YYYY) 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) COMMERCIAL GENERAL LIABILITY 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 INSURER(S) AFFORDING COVERAGE NAIC # Y / N N / A (Mandatory in NH) ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? EACH OCCURRENCE $ DAMAGE TO RENTED $PREMISES (Ea occurrence)CLAIMS-MADE OCCUR MED EXP (Any one person)$ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ $ PRO- OTHER: LOCJECT COMBINED SINGLE LIMIT $(Ea accident) BODILY INJURY (Per person)$ANY AUTO OWNED SCHEDULED BODILY INJURY (Per accident)$AUTOS ONLY AUTOS AUTOS ONLY HIRED PROPERTY DAMAGE $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 LIMIT $DESCRIPTION OF OPERATIONS below POLICY NON-OWNED 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 any 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. The ACORD name and logo are registered marks of ACORDACORD 25 (2016/03) ACORDTM CERTIFICATE OF LIABILITY INSURANCE Alliance of Nonprofits Ins RRG 8/18/2022 McGriff Insurance Services 7701 Airport Center Dr Suite 1800 Greensboro, NC 27409 888 743-2217 8888279861 Orange County Disability Awareness Council 2501 Homestead Road Chapel Hill, NC 27516 10023 A X X 202129484 09/14/2021 09/14/2022 1,000,000 500,000 20,000 1,000,000 2,000,000 2,000,000 A Directors & Offic 202129484DO 09/14/2021 09/14/2022 See Description of Ops Miscellaneous Coverage - Directors and Officers - Pol.# BINDER202129484DO Directors and Officers Limit #1: 1,000,000 Limit #2: 1,000,000 Orange County Department of Social Services 113 Mayo Street PO Box 8181 Hillsborough, NC 27278 1 of 1 #S30593409/M28702120 04ORANGCOU1Client#: 1865821 ANBAL 1 of 1 #S30593409/M28702120 DocuSign Envelope ID: 85C6B855-1F25-4EEC-B204-9380B8F79B70 This page has been left blank intentionally. DocuSign Envelope ID: 85C6B855-1F25-4EEC-B204-9380B8F79B70