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HomeMy WebLinkAbout2022-438-E-DEAPR-Triangle Bikeworks-Outside Agency FundingOrange 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 Triangle Bikeworks, a not-for-profit corporation, located at 117 W Main Street, Carrboro, North Carolina 27510 (“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 $3750. 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 $937.50. 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: 34CCD2E7-C2D0-4730-88A1-A14B7727456A 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: 34CCD2E7-C2D0-4730-88A1-A14B7727456A 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 (Ardra Webster) 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: 34CCD2E7-C2D0-4730-88A1-A14B7727456A 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: 34CCD2E7-C2D0-4730-88A1-A14B7727456A 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: 34CCD2E7-C2D0-4730-88A1-A14B7727456A 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 Triangle Bikeworks Attention: Ardra Webster Attention: Kevin Hicks P.O. Box 8181 Address: 117 W Main Street Hillsborough, NC 27278 Carrboro, NC 27510 Email:awebster@orangecountync.gov Email: kevin@trianglebikeworks.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 _____________________________ _______________________ Kevin Hicks, Triangle Bikeworks Date For and on behalf of Orange County Government _______________________________ ________________________ Bonnie Hammersley, County Manager Date DocuSign Envelope ID: 34CCD2E7-C2D0-4730-88A1-A14B7727456A 9/6/2022 9/7/2022 Orange County Outside Agency Performance Agreement Page 7 of 10 Rev.06/22 ORANGE COUNTY—DEPARTMENT USE ONLY ______________________________________________________________________________ Party/Vendor Name: Triangle Bikeworks Party/Vendor Contact Person: Kevin Hicks Contact Phone: 919-452-2272 Party/Vendor Address: 117 W Main Street City Carrboro State: NC Zip: 27510 Department: DEAPR Amount: $3750 Purpose: Outside Agency Funding Budget Code(s): 10290050 720271 Vendor # 800879 (N/A if new vendor) Vendor is a BOCC consultant? Yes No Contract Type: (Check one) New Renewal Amendment Effective Date July 1, 2022 Approved by Board Yes No Agenda Date: 6-21-22 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: 34CCD2E7-C2D0-4730-88A1-A14B7727456A 9/6/2022 9/6/2022 9/7/2022 9/7/2022 January 12, 2022 DocuSign Envelope ID: 34CCD2E7-C2D0-4730-88A1-A14B7727456A DocuSign Envelope ID: 34CCD2E7-C2D0-4730-88A1-A14B7727456A Program information Page 8 of 24 AGENCY INFORMATION Please provide the following information about your agency: 1. Date of Incorporation (Month/Year): April 4, 2014 2. Agency’s Purpose/Mission (no more than a few sentences): The mission of Triangle Bikeworks (TBW) is to strengthen the power of youth who are Black, Latine*, Asian, Indigenous, and People of Color to overcome challenges, achieve audacious goals, and discover their true selves. Our primary focus is providing experiential learning opportunities, social emotional support and leadership development through year-round cycling and educational programs, and community events. *We use the term Latine (lah-teen-eh) as a gender-neutral form of the word Latino. For more information visit: https://callmelatine.com/faq/ 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 2011, Triangle Bikeworks (TBW) has provided cycling and educational programs for youth of color, ages 11-18 in the Triangle area. Since then, TBW has successfully provided out-of-school programming with unique curriculums to 208 students including 13 cycling tours. In 2019, TBW became a year-round program, providing up to 50 hours a month of physical training, educational enrichment, and team building components. In 2020 the TYMBR Wolves mountain biking program was added. TBW stays within our budget and timetables and, as evidenced by the consistent support of local organizations and foundations, we fulfill all necessary reporting. 4. Living Wage: Does this agency pay permanent employees a minimum living wage? (Yes / No) Yes If yes, is this agency an Orange County Living Wage Certified Employer? Yes If no, please briefly explain. Schedule of Positions: # of FTE – Full-Time Paid Positions: _2__ # of FTE – Part-Time Paid Positions: _2_ 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). Youth are vital in shaping TBW’s programming and have opportunities to take leadership roles during their time in our programs. Leadership takes many forms: leading group calisthenics, leading group rides in training and on tours, speaking on behalf of the organization, recruiting other students, and joining our Board of Directors which holds 2 DocuSign Envelope ID: 34CCD2E7-C2D0-4730-88A1-A14B7727456A Program information Page 9 of 24 spots for youth members. On tours, youth help determine field trip locations, the day’s cycling route and mileage, and meals/snacks. Based on youth questioning and input, program schedules have changed, activities added, nutrition improved, guest speakers invited, and insightful questions developed for program educators and presenters. b. How has your organization incorporated racial equity goals into your organizational goals? Equity and anti-racist work have been the root of all actions taken by the leaders of TBW since its inception and we have made conscious efforts to provide equitable opportunities and programs for youth on an individual and systemic level. An overarching goal is to provide BIPOC youth with programs, support and background knowledge not directly provided in school. The lack of background knowledge of people, culture, and the world contributes to the opportunity gap for the youth in our community. Staff and Board of Directors continue to be deliberate about this work and in 2020 approved an Anti-Racism statement. 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): 75 ii. % of board that are BIPOC: 60 iii. % of staff that have attended racial equity training: 100 We make strong efforts to ensure that every part of the organization reflects the population we serve, BIPOC youth. Our Founder/Executive Director, Program Manager and Board of Directors are a diverse group that is representative of the youth they serve. The organization was founded by Kevin Hicks, an African American man and its Program Manager is Itza Salazar, a young adult Latina and an original member of Triangle Bikeworks’ programs. Our current Board of Directors consists of 8 adult members and two youth members. Two adult members are African American, one adult member is a Mexican woman, another is an Asian woman, and the remaining four members are Caucasian males. Out of the ten members, two are young adult alumni and active TBW mentors and volunteers. The current youth board members are African American and Latino males who have been part of our programs for 5 years now. d. Please describe any additional activities your organization is doing to address racial equity. Triangle Bikeworks’ curricula and programming are intentional about dismantling interior battles in the minds of youth through the uncovering of Untold Histories of people of color and the unveiling of decades of inequities in a restorative manner. The Executive Director and Program Manager consistently educate themselves and offer opportunities to others at TBW. The Program Manager has attended Racial Equity Institute (REI) workshops, and other Diversity, Equity and Inclusion (DEI) opportunities. As an organization we have implemented processes to support DEI opportunities in the workspace and encourage courageous conversations among the youth and staff. New interns and Americorps VISTA members are assigned to read and discuss the book "Stamped: Racism, Antiracism and You," by Jason Reynolds and Ibram X. Kendi, along with opportunities to attend REI DocuSign Envelope ID: 34CCD2E7-C2D0-4730-88A1-A14B7727456A Program information Page 10 of 24 workshops. TBW has an extensive onboarding process for volunteers to learn about Adverse Childhood Experiences, microaggressions and other DEI topics. PROGRAM INFORMATION *Please submit for each program if applying for funding for more than one program. 6. Program Name: Triangle Bikeworks Youth Development Program Primary Contact and Title: Kevin Hicks Telephone Number: 919-452-2272 E-Mail: kevin@trianglebikeworks.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) TBW’s youth development programs provide challenging out-of-school activities that prevent learning loss, develop youth leadership, and help build social-emotional learning competencies through three learning pathways: Cycling, Untold History, and Environmental Education. We serve BIPOC youth ages 11-18; 85% of our youth are from low-income households. In 2022/2023, TBW will provide 50 hours of afterschool and weekend programming that includes workshops, lectures, book studies, guest speakers, training rides, mindfulness practices and team-building activities. All of these activities have the goal of reducing learning loss, increasing social interactions, and helping youth grow in their resilience to challenges. These programs culminate in three-day, history-based weekend excursions. Youth who demonstrate readiness are invited to a 2-week immersive cross-country summer tour with stops at historical and educational sites. In 2020, we added a mountain biking program. In all TBW programs, students learn experientially about environmental awareness and history that is relevant to their communities. TBW’s theory of change is that after completing our program, youth will have an increased understanding of the world around them, increased social emotional awareness, and increased power to overcome challenges and achieve personal and collective goals. This increases the likelihood of improved academic outcomes and capacity to work with others to co-create a more healthy, just and equitable world. Our education-based program aligns well with the Towns’ Strategic Objective #1 (Children improve their education outcomes), as well as the OC BOCC Goals of promoting the well- being of all county residents and preserving and protecting the natural environment. 8. Target Population: Please complete the table below with numbers (not percentages) of individuals served and projected to be served. DocuSign Envelope ID: 34CCD2E7-C2D0-4730-88A1-A14B7727456A Program information Page 11 of 24 Program Target Population Demographics Projected 2020-2021 Actual 2020- 2021 Projected 2021-2022 Projected 2022-2023 Gender Men 30 37 48 50 Women 15 12 7 10 Nonbinary/Genderqueer Self-Describe Total 45 49 55 60 Race and Ethnicity Black or African-American 13 12 32 33 American Indian or Alaska Native 1 2 2 1 Asian Indian 1 1 3 3 White 2 1 1 1 Native Hawaiian or other Pacific Islander Chinese Japanese Vietnamese Filipino Korean Some other race 28 24 17 22 Total 45 49 55 60 Of the above, how many Hispanic, Latino or Spanish origin 25 21 5 7 Of the above, how many non-Hispanic, Latino or Spanish origin 20 28 50 53 Total 45 49 55 60 Age 0-5 years 6-18 years 42 46 50 57 19-50 years 3 3 5 3 51+ years Total 45 49 55 60 Geographic Location Town of Chapel Hill 15 11 15 15 Town of Carrboro 14 13 16 16 Orange County ( Outside of Chapel Hill/Carrboro) 3 3 5 5 Outside of Orange County 13 22 19 24 Total 45 49 55 60 Income Low-income (80% of the Area Median Income and Below) Please see income table in the attachments 45 44 45 50 Total 45 49 55 60 DocuSign Envelope ID: 34CCD2E7-C2D0-4730-88A1-A14B7727456A Program information Page 12 of 24 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 $52,758 $69,449 $69,449 Total # of Individuals 49 55 60 Cost Per Individual $1,077 $1,263 $1,157 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: Strategic Objective (please choose one from the Results Framework) X Children improve their educational outcomes o Residents Increase their livelihood security o Residents improve their health outcomes Intermediate Result (please choose one from the Results Framework) Insert Intermediate Result here. Children demonstrate new grade-level-appropriate skills! 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 Insert Performance Indicator here. % and # of program participants who plan on attending post-secondary education. ! 92% ! (45 out of 49) 91% ! (50 out of 55)! 90%! (54 out of 60) ! DocuSign Envelope ID: 34CCD2E7-C2D0-4730-88A1-A14B7727456A Program information Page 13 of 24 needed, listing one per row). % and # of program participants that are promoted to the next grade. 100%! (49 out of 49)! 93%! (51 out of 55)! 93%! (56 out of 60)! % and # of program participants that express greater confidence in their leadership and prosocial activities. 100%! (49 out of 49) 93%! (51 out of 55) ! 93%! (56 out of 60)! DocuSign Envelope ID: 34CCD2E7-C2D0-4730-88A1-A14B7727456A Outside Agencies/Human Services Program information Page 14 of 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. Youth 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 percentage of youth ages 11-18 that demonstrate new, improved or restored social skills. Performance Measure (How will you accomplish your goal?) % and # of youth participants who demonstrate new, improved or restored social skills. Actual Results (Outcome) Ending FY2021 100% (49 out of 49) Projected Results (Outcome) Ending FY2022 100% (55 out of 55) Projected Results (Outcome) Ending FY2023 100% (60 out of 60) Program Goal # 2 Increase percentage of youth participants that demonstrate healthy functionality and lifestyle behaviors. Performance Measure (How will you accomplish your goal?) % and # of youth that meet the wellness goal of cycling 21 miles within 2 hours. Actual Results (Outcome) Ending FY2021 100%! (49 out of 49)! _________________ DocuSign Envelope ID: 34CCD2E7-C2D0-4730-88A1-A14B7727456A Outside Agencies/Human Services Program information Page 15 of 24 Projected Results (Outcome) Ending FY2022 91% ! (50 out of 55) Projected Results (Outcome) Ending FY2023 90%! (54 out of 60) ! Program Goal # 3 Increase percentage of youth ages 11-18 that understand basic environmental principles. Performance Measure (How will you accomplish your goal?) % and # of participants that demonstrate knowledge of environmental principles. Actual Results (Outcome) Ending FY2021 100%! (49 out of 49) Projected Results (Outcome) Ending FY2022 91% ! (50 out of 55) ! Projected Results (Outcome) Ending FY2023 90%! (54 out of 60) ! DocuSign Envelope ID: 34CCD2E7-C2D0-4730-88A1-A14B7727456A Certified by: _______________________ Title: __________________________ Date: ____________ (Provider’s Signature) EXHIBIT “B” Scope of Services – FY 20-23 Outside Agency Performance Agreement Agency Name: Triangle Bikeworks Program Name: Triangle Bikeworks Youth Cycling Funding Award: 3,750 Outline how the agency will spend Orange County’s funding award. Program Services Outline the critical services (activities) the agency will employ to attain the Anticipated Outcomes below, by June 30, 20 .  Program youth will be able to complete 21 miles of cycling within two hours  Program youth will participate in weekly online gatherings to increase their levels of self awareness and cultural awareness  Youth will participate in challenging cycling programs that will be either physical or competitive Anticipated Outcomes The Anticipated Results column must include quantifiable results in the form of number of persons/units served within Orange County, only (all Towns and municipalities). If you use percentages, you must also provide the total number of participants within that measure’s description or for an earlier performance measure. Performance Measures Anticipated Results Program youth will be able to complete 21 miles of cycling within two hours 100%, 10 youth % and # of program participants that express greater confidence in their ability to be successful at school 100%, 10 youth % and # of program participants that are promoted to the next grade. 100%, 10 youth % and # of program participants who plan on attending post-secondary education. 100%, 10 youth Expense Description Amount Food and Snacks for Spring and Fall Excursions, TYMBR Wolves Mountain Biking 800 Supplement one Support Staff person 500 General Expenses 500 Accommodations such as camping 200 Registrations for TYMBR Wolves mountain biking 1750 DocuSign Envelope ID: 34CCD2E7-C2D0-4730-88A1-A14B7727456A 9/6/2022Executive Director 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: 34CCD2E7-C2D0-4730-88A1-A14B7727456A 9/6/2022Executive Director SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 8/25/2022 Marsh &McLennan Agency LLC 1400 Eastchester Drive,St 200 High Point NC 27265 Anita M.Chick,CIC,CISR,CIIP 336-899-2402 212-607-6550 Anita.Chick@marshmma.com Alliance of Nonprofits forInsurance RRG 10023 TRIAN03 Triangle Bikeworks Kevin Hicks 117 W Main Street Carrboro NC 27510 123050691 A X 1,000,000 X 500,000 1,000,000 3,000,000 X 202237804 6/11/2022 6/11/2023 3,000,000 A 1,000,000 X X X 202237804 6/11/2022 6/11/2023 Orange County (OC)Government 200 S Cameron Street Hillsborough NC 27278 DocuSign Envelope ID: 34CCD2E7-C2D0-4730-88A1-A14B7727456A