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2023-134-E-AMS-Rebuilding Together of the Triangle-Weatherization
Rebuilding Together of the Triangle Orange County Community Climate Action Grant Program Performance Agreement Rev. 4/23 Page 1 of 11 COMMUNITY CLIMATE ACTION GRANT PERFORMANCE AGREEMENT THIS AGREEMENT, made and entered into this 1st day of April 2023, (“Effective Date”) by and between the County of Orange, a political subdivision of the State of North Carolina, 200 South Cameron Street, Hillsborough, North Carolina, 27278, ("County") and Rebuilding Together of the Triangle, a legal entity located at 200 Trans Air Drive, Suite 200, Morrisville, NC 27560, NC (“Provider”). WITNESSETH: WHEREAS, it is in the interests of the County that said program be assisted by the County and thereby enhance its availability to residents of the County, and said progr am addresses an important community equity and climate action need, as identified by the Board of Commissioners; NOW, THEREFORE, in consideration of the above and the mutual covenants and conditions hereafter set forth, the County and Provider agree as follows: 1. Term of the Agreement. The term of this Agreement shall be two years beginning – April 1, 2023 to April 1, 2025. 2. Scope of Services. a. Provider will provide services, as outlined in the attached Community Climate Action Grant Program Application and any amendments or revision thereto which is attached as Exhibit “A” and incorporated by reference, to the residents of Orange County. The Scope of Services and the Program Budget may be different from the original application based on County appropriation; however, any revisions or amendments to this Agreement must be approved in writing by the County and attached to this Agreement as Exhibit B. b. The Provider shall be solely responsible for the means, methods, techniques, sequence, safety program and procedures necessary to properly and fully complete the work set forth in the Scope of Services. 3. Funding. a. The County agrees to appropriate for the provision of services described in Exhibit A, the Community Climate Action Grant Program Performance Application, Exhibit B, the Revised, Scope of Services and more particularly described in the Revised Program Budget, the maximum sum of $25,000. b. All funds appropriated shall be used for purposes described in Exhibit A. Any funds not used for the purposes stated shall be returned to the County. Any changes in the use of funds must be authorized in writing by the County prior to any expenditure of the funds by the Provider. If the funds are expended not in accordance with the Scope of Services, at the discretion of the County the Provider may be required to repay the funds to the County. c. The Provider shall be paid in installments in the amount of Exhibit C to be paid as follows: Exhibit C. The first payment is contingent upon receipt of the agency’s performance agreement; the remaining payments are contingent upon receipt of the request for reimbursement, related supporting documentation and performance outlined in the Revised Scope of Services and Project Budget in Exhibit B. If the project described in Exhibit A requires funds to be provided on a different or more accelerated schedule, the Provider may request an alternate payment schedule, which if approved, will be attached to this Agreement as Exhibit C, Alternative Payment Schedule. Should an Alternative Payment DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 Rebuilding Together of the Triangle Orange County Community Climate Action Grant Program Performance Agreement Rev. 4/23 Page 2 of 11 Schedule be approved, the Provider will still be required to submit quarterly Progress Reports for the duration of the Term of the Agreement. The County’s obligation to make the quarterly payments is contingent upon receipt of Progress Reports, which show satisfactory progress toward completion of performance measures and an accounting of expenditures as detailed in the attached Exhibits B and C. d. Once Provider has satisfied its obligations as provided in (c) payment will be made 21 days after receipt of the Progress Report and Request for Reimbursement or 21 days after due date of Progress Report whichever is later. e. The County is not obligated to provide any other support to Provider in this or in succeeding fiscal years. 4. Agency Reporting. a. Provider will provide Orange County a Progress Report that includes a fiscal report and updates on performance measures as outlined in the Exhibit B, Revised Scope of Services. Progress Report dates are: April 1 - June 30, July 1 – September 30, October 1 – December 31 and January 1 – March 31. Reports are due on July 15, October 15, January 15 and April 15 of the program fiscal year. b. Provider agrees to allow the County to inspect its financial books and records, which document costs of those services, upon reasonable notice during normal working hours. 5. Termination. a. In the event of any of the circumstances set forth below (hereinafter referred to as “default”), the County may immediately terminate this Agreement, in whole or in part, and from time to time. Notice of termination must be in writing, state the reason or reasons for the termination, and specify the effective date of the termination: i. In the event that Provider shall cease to exist as an organization or shall enter bankruptcy proceedings, be declared insolvent, or liquidate all or substantially all of its assets, or significantly reduce its services or accessibility to Orange County residents during the term of this Agreement; or ii. In the event that Provider shall fail to render a 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 DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 Rebuilding Together of the Triangle Orange County Community Climate Action Grant Program Performance Agreement Rev. 4/23 Page 3 of 11 from written notice of default. The County may (but shall not be required to) grant the Provider an opportunity to cure the default without termination of this Agreement. This clause shall not be interpreted to limit the County’s remedies in law or in equity. c. Notwithstanding the foregoing, either party may terminate the agreement at any time without penalty; provided that written notice of such termination is furnished to the other party at least 30 days prior to termination. In the event of such termination, any payment due shall be prorated to the date of termination an d any unused funds shall be returned to the County within 10 days of termination. d. Any termination of this Agreement for default under this section that is later deemed to be unjustified shall be deemed a termination for convenience. 6. Insurance. a. General R equirements. The Provider shall purchase and maintain, during the period of performance of this Agreement, insurance: i. Worker’s Compensation. For protection from claims under workers' or workmen's compensation acts; ii. Comprehensive General Liability Insurance covering claims arising out of or relating to bodily injury, including bodily injury, sickness, disease or death of any of the Consultant's employees or any other person and to real and personal property including loss of use resulting thereof; iii. Comprehensive Automobile Liability Insurance, including hired and non-owned vehicles, if any, covering personal injury or death, and property damage; and iv. Professional Liability Insurance, covering personal injury, bodily injury and property damage and cla ims arising out of or related to the performance under this Agreement by the Consultant or his agents, consultants and employees. b. Limits of Coverage: Minimum limits of insurance coverage shall be as follows: INSURANCE DESCRIPTION MINIMUM REQUIRED COVERAGE • Worker's Compensation Limits for Coverage A - Statutory State NC & Coverage B - Employers Liability $500,000 each accident, $500,000 Bodily Injury by Disease (BID) for each employee. $500,000 for BID limit • Commercial General $1,000,000 Each Occurrence Liability $2,000,000 Aggregate • Automobile Liability $1,000,000 Each Occurrence • Professional Liability $1,000,000 Each Occurrence $2,000,000 Aggregate • Sexual Abuse & Molestation $1,000,000 Each Occurrence $2,000,000 Aggregate • Cyber Liability $1,000,000 Each Occurrence $2,000,000 Aggregate DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 Rebuilding Together of the Triangle Orange County Community Climate Action Grant Program Performance Agreement Rev. 4/23 Page 4 of 11 • Environmental/Pollution $1 million Each Occurrence Liability (Required if demolition, use of hazardous material or environmentally sensitive) c. All insurance policies (with the exception of Worker's Compensation and Professional Liability) required under this Agreement shall name the County as an additional insured party and as a certificate holder. Evidence of such insurance and all correspondence shall be sent to: Orange County Risk Manager Post Office Box 8181 Hillsborough, NC 27278 d. Nothing in this section is intended to affect or abrogate the County’s sovereign immunity defenses. 7. Relationship of the Parties. Provider is an independent contractor of the County. Provider represents that they have or will secure, at his own expense, all personnel required in performing the services under this Agreement. Such personnel shall not be employees or have any contractual relationship with the County. All personnel engaged in work under this Agreement shall be fully qualified and shall be authorized and permitted under federal, state and local law to perform such services. 8. Compliance with all Laws. The Provider, at its sole expense, shall comply with all laws, ordinances, orders and regulations of the federal, state or local governments, as well as their respective departments, commissions, boards, and officers, which are in effect at the time of execution of this Agreement or are adopted at any time following execution of this agreement. 9. Subcontract. The County and Provider deem the services provided under this Agreement to be personal in nature and Provider may not subcontract any rights or duties under this Agreement to any other party without prior written consent from the County. 10. Assignment. The Provider shall not assign this Agreement, including the rights to payment, to any other party without the prior written consent of the County. 11. Indemnification. Provider agrees to defend, indemnify, and hold harmless the County, for all loss, liability, claims or expense (including reasonable attorney's fees) arising from bodily injury, including death or property damage, to any person or persons caused in whole or in part by the negligence or willful misconduct of the Provider, except to the extent same are 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. 12. Non-Appropriation. This Agreement is subject to the availability of funds to purchase the specified services and may be terminated at any time if such funds become unavailable. 13. Non-Discrimination. Provider agrees as part of consideration of the granting of funds by Orange County the parties hereto for themselves, their agents, officials, employees and servants agree not to discriminate in any manner of these basis of race, color, gender, national origin, age, handicap, religion, sexual orientation, familial status or veterans status with reference to any activities carried out by the grantee, no matter how remote. The parties hereto further agree in all respects to conform to the provision and intent of Orange County Civil Rights Ordinance, as amended and the Orange County Anti-discrimination Policy. This provision is enforced by action for specific performance, injunctive relief, or other remedy as by law provided; this provision shall be binding DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 Rebuilding Together of the Triangle Orange County Community Climate Action Grant Program Performance Agreement Rev. 4/23 Page 5 of 11 on the grantees, the successors and assigns of the parties hereto with reference to the above subject manner. 14. Living Wage. Orange County is committed to providing its employees with a living wage and encourages agencies if funds to pursue the same goal. The County’s living wage is $15.40 per hour. To the extent possible, Orange County recommends that Provider provides a living wage to its employees. 15. Notice. The Parties hereto agree and understand that written notice, mailed or delivered, to the last known address shall constitute sufficient notice to the County and the Provider. All notices required and/or made pursuant to this Agreement to be given to the County and the Provides shall be in writing and mailed to the party addressed as follows: County: Finance & Administrative Services Orange County Post Office Box 8181 Hillsborough, NC 27278 Provider: Rebuilding Together of the Triangle 200 Trans Air Drive, Suite 200 Morrisville, NC 27560 16. Entire Agreement. This Agreement, including any referenced attachments, constitutes the entire Agreement between the parties and shall supersede, replace or nullify any and all prior Agreements of understandings; written or oral, relating to the matters set forth herein, and any such prior Agreements or understandings shall have no force or affect whatsoever on this Agreement. The County and Provider have read this Agreement and agree to be bound by all of its terms, and further agree that this Agreement constitutes the complete and exclusive statement of the Agreement between the County and Provider. 17. Severability. All clauses found herein shall act independently of each other. If a clause is found to be illegal or unenforceable, it shall have no effect on the other provisions of this Agreement. It is understood by the parties hereto that if any part, term or provision of this Agreement is by the Courts held to be illegal or in conflict with any laws of the State of North Carolina or the United States, the validity of the remaining portions or provisions shall not be affected, and the rights and obligations of the parties shall be construed and enforced as if the Agreement did not contain the particular part, term or provision held to be invalid. a. Governing Law. This Agreement and the duties, responsibilities, obligations and rights of respective parties hereunder shall be governed by the laws of the State of North Carolina. By executing this Agreement Provider affirms that Provider and any subcontractors of Provider are and shall remain in compliance with Article 2 of Chapter 64 of the North Carolina General Statutes. By executing this Agreement Provider certifies that Provider has not been identified, and has not utilized the services of any agent or subcontractor, on the list created by the State Treasurer pursuant to G.S. 147-86.58. 18. Signatures. This Agreement together with any amendments or modifications may be executed electronically. All electronic signatures affixed hereto evidence the intent of the Parties to comply with Article 11A and Article 40 of North Carolina General Statute Chapter 66. IN WITNESS WHEREOF, the Orange County and the Provider have signed this Agreement, effective on the last date this Agreement is signed by both parties as indicated by the dates set forth under signatures below. For and on behalf of the Provider , Date DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 3/23/2023 Rebuilding Together of the Triangle Orange County Community Climate Action Grant Program Performance Agreement Rev. 4/23 Page 6 of 11 For and on behalf of Orange County Government Bonnie Hammersley, County Manager Date DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 3/23/2023 Rebuilding Together of the Triangle Orange County Community Climate Action Grant Program Performance Agreement Rev. 4/23 Page 7 of 11 ORANGE COUNTY—DEPARTMENT USE ONLY Department Party/Vendor Name: Rebuilding Together of the Triangle Party/Vendor Contact Person: Daniel Sargent Contact Phone: 919-996-0999 Party/Vendor Address: 200 Trans Air Drive, Suite 200 City Morrisville State: NC Zip: 27560 Department: Asset Management Services Amount: $25,000 Purpose: Weatherization Budget Code(s):61370035-803076-30052 Vendor #800197 (N/A if new vendor) Vendor is a BOCC consultant? Yes No X Contract Type: (Check one) New X Ren ewal Amendment Effective Date 4/1/2023 Approved by Board: Yes X No Agenda Date: 1/17/23 This agreement is approved as to technical form and content: Department Director’s Signature Date: Information Technologies (Applicable only to hardware/software purchases or related services) This agreement has been reviewed and is approved as to information technology content and specifications: Office of the Chief Information Officer Date: Risk Management This agreement is approved for sufficiency of insurance standards, specifications, and requirements: Office of the Risk Management Officer Date: Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officer Date: Legal Services This agreement is approved as to legal form and sufficiency: Office of the County Attorney Date: Clerk to the Board Received for record retention: All Docusign contracts must be copied to the Clerk upon completion: occlerkdocs@orangecountync.gov The following signature block is for hard copies only and is not required for Docusign contracts: Office of the Clerk to the Board Date: DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 3/23/2023 3/23/2023 3/23/2023 Rebuilding Together of the Triangle Orange County Community Climate Action Grant Program Performance Agreement Rev. 4/23 Page 8 of 11 Exhibit A Community Climate Action Grant Program Application - Orange County Climate Action Grant -Application FY22-23 - Agenda – 1.17.23 BOCC Board Meeting – Item 6b DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 Rebuilding Together of the Triangle Orange County Community Climate Action Grant Program Performance Agreement Rev. 4/23 Page 9 of 11 Exhibit B Community Climate Action Grant Program’s Revised Scope of Services and Program Budget No Revisions DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 Rebuilding Together of the Triangle Orange County Community Climate Action Grant Program Performance Agreement Rev. 4/23 Page 10 of 11 Exhibit C Community Climate Action Grant Program’s Alternative Payment Schedule 200 Trans Air Dr. Suite 200 Morrisville, NC 27560 919.341.5980 MEMORANDUM From: Dan Sargent, Executive Director, Rebuilding Together of the Triangle Date: March 6, 2023 Subject: Alternative Payment Schedule Rebuilding Together of the Triangle Reason Proposed Payment Schedule Breakdown: Quarter Dates Covered Proposed Payment Quarter 1 April – June, 2023 $5,000 Quarter 2 July – September, 2023 $5,000 Quarter 3 October – December 2023 $5,000 Quarter 4 January – March, 2024 $5,000 Quarter 5 April – June, 2024 $5,000 Quarter 6 July – September, 2024 0 Quarter 7 October – December, 2024 0 Quarter 8 January – March 2025 0 TOTAL - $25,000 DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 Rebuilding Together of the Triangle Orange County Community Climate Action Grant Program Performance Agreement Rev. 4/23 Page 11 of 11 ATTACHMENT “A” Orange County Certifications – FY 2022-23 Community Climate Action Grant Program Performance Agreement Primary Contact, Chief Executive Officer / Executive Director, and Chief Financial Officer I certify that I have provided the primary contact and chief executive officer or executive director, and chief financial officer for my agency with this Agreement and that I will keep it current to the County of Orange. The list should be in writing with the name, title, phone and email address and if possible, fax number. Board of Directors and Officers of the Board I certify that I have provided a current list of the Board of Directors and Officers of the Board with this Agreement and that we will continue to update the list as changes occur. The list should be in writing, with the name, physical address, mailing address and if possible, phone, fax and email address. Project Budget Submission I certify that I have provided a project budget for the period to be covered by Orange County funding, and that any substantive changes made to this budget have been in advance authorized in writing by Orange County. Agency Budget Submission I certify that I have provided the requested information from the latest budget adopted by the agency for the fiscal years encompassing this Agreement. If not, please explain on a separate sheet of paper. Alignment with Organization’s Mission I certify that the programs and services for which this funding is requested align with the mission of the organization. Intended Purpose I certify that the funds provided to the agency under the terms of this Agreement will be used for a public purpose and shall only be used for the purposes intended and any money not used for those purposes will be promptly returned to Orange County. Certified by: (Provider’s Signature) Title: Date: DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 3/23/2023Executive Director Communitv Climate Action Grant Program Application 2022-2023 SUBMISSION CHECKLIST Primary Applicant Organization: Rebuildins Tosether of the Triansle" Inc. Project Name: Supplemental Weatherization for Low-Income Orange County Homeowners xx X Applicant and Collaborator/Partner Contact Information Funding Request Summary Signed Application Cover Page [l Signed Disclosure of Conflicts of Interest and Clause Applicant Organization and Collaborator Information Applicant organization's Date of Incorporation (if applicable) Applicant organization's Purpose/Mission (if applicable) Living Wage Schedule of Positions (if applicable) xxxx Project Information Project Name Project Description and Climate Plan Alignment Collaborator Information (if applicable) Criteria-Specifi c Sections 1-7 xxxx Attachments (A description of these items is available on page 13: "Description of Required Attachments." Please contact us if it will not be possitrle to provide any of these required attachments at the time of application: aeckberg@orangecountync.qov I Applicant Organization's Annual Budget and Proposed Project Budget (t/se template provided) I Appticable Financial Records to prove eligibility: IRS Federal Form 990 or Applicant Organization's Tax Returns from 2021 [l Applicable Financial Records to prove eligibility of collaborator/partner (if they are receiving project funds): IRS Federal Form 990 or Tax Returns from 2021 [l Ust of members of organization's Governing Board (if Board exists) X Certificate of Insurance Page ,r, of 1,9 Section Subsection Cover Page Disclosure DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 Applicant Organization's Contact I nformation Organization's Legal Name:Rebuilding Together of the Triangle, lnc. PhysicalAddress:2201 Brentwood Road Suite 109 Raleigh NC 27604 Mailing Address:2201 Brentwood Road Suite 109 Raleigh NC27604 Web Address:www. rttria ngle.org Telephone Number:919-996-0999 E-Mail:fi na nce(o rttriangle.org Tax lD Number:56-1955629 COVER PAGE Funding Request Summarv Please list all Fiscal Year 22-23 Cornmunity Climate Action Grant funding requested for the pro-iect you are proposins andthe proposeduseoffunds(pleaselistprojectnameonly).Applicantswill beaskedtoprovidernoredetailsontheir Briefly explain your pronosed use offunds (2-4 senrerc'es): Rebuilding Together of the Triangle, Inc. (RTT) proposes expanding the provision of supplemental weatherization services to Orange County hotneowners below 80% of Area Median Incorne. These owners have been identified thlough the work of the Orange County Home Preservation Collaborative. Projects would include weatherization services for owners that are not eligible forthe state weatherization program, repairs that are preventing the state program fi'orn selving an otherwise-eligible client, or enhanced weatherization and electrification measures that go beyond what existing funding programs will supporl, such as window repairs, heat pump water heaters, fuel switching fi'om propane and natural gas furnaces to heat pumps, and replacement of gas cookstoves with electric induction rnodels. To the and data in this application is true and current. Signature:i;t;4 t'','; " "' in the Worksheets attachment. Proiect Equipment Operations Personnel Total Ex. Youth Climate Leadership Project Slo,ooo $L5,ooo s5,oo0 s3o,ooo Supplemental Weatherization for Low- lncome Orange Countv Homeowners S4o,ooo s80,000 s30,000 S150,ooo belief all in Page 2 of 15 DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 tr tr tr DISCLOSURE OF POTENTIAL CONF'LICTS OF'INTEREST AND NON- DISCRIMINATION CLAUSE Are any of the Board Members or employees of the organization which will be carrying out this project or their named project collaborators/paftners or tnembers of their immediate families, or their business associates: YES NO f, a) Ernployees of or closely related to eurployees of Orange County? ffi b) Vembers of or closely related to rnembers of the governing bodies of Orange Counq,? ffi c) Current beneficiaries ofthe program for which funds are being requested? n I a; laia providers ofgoods or services to the program or having other financial interest in the prograrn? lf you have answered YES to any question or know of any other potential conflict of interest regarding your application, please provide a full explanation here: 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 ofthe 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 Signature: Signatory Page 3 of 15 DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 P" i3 ORANGE COUNTY NORTH CAROLII\A Contact lnformation for Primary Contact, Chief Executive Officer / Executive Director, and Chief Financial Officer Primary Contact Name Dan Sargent Title Executive Director Preferred phone number 919-996-0999 Email address dsa rge nt@ rttria ngl e. org Fax number (if applicable)N/A Chief Executive Officer / Executive Director Name Dan Sargent Title Executive Director Preferred phone number 919-996-0999 Email address Dsa rsent@ rttria nsle.org Fax number (if applicable)N/A Chief Financial Officer Name Joel Groce Title Director of Finance and Operations Preferred phone number 919-862-4554 Email address igroce @ rttria ngle.org Fax number (if applicable)N/A Applic ant O r gantzatio n & C ollab o rator Info rmation Please provide the following information about the primary applicant organization: P.O. Box 8181 x Hillsborough, North Carolin a 27278 Telephone : 9L9 245-2626 DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 1. Date of lncorporation (Month/Year):1tlt996 2. Applicant organization's P u rpose/M i ssion (2-4 se nte n ces) : The mission of Rebuilding Together of the Triangle (RTT) is repairing homes, revitalizing communities, and rebuilding lives. Our critical home repairs and accessibility modifications make a sustainable impact, ensuring vulnerable homeowners - including seniors, individuals with disabilities, and families with children - live in safe, healthy homes. 3. Please provide a brief description of your organization's past achievements in carrying out similar projects and evidence of successful record of meeting proposed budgets and timetables (2-4 sentencesl: Applicants from the Orange County Home Preservation Coalition are referred to RTT for comprehensive repair assessments. The resulting work statements provide clarity regarding repair priorities, enabling the Coalition to develop comprehensive, budgeted treatment plans for each home repair. RTT directly repairs more than 150 homes each year and has developed numerous partnerships around environmentally sound home repairs/upgrades. RTT is currently working on two Climate Action projects, one related to replacement of heat pump water heaters and the other focused on converting combustion heating systems to efficient heat pumps. 4. Living Wage: Does this organization pay permanent employees a minimum living wase? (Yes / No) Yes lf yes, is this organization an Orange Countv Living Wase Certified Emplover? (Yes / No) lf no, please briefly explain. No, RTT does not have a physical office in Orange County; RTT is located in Wake County, but serves all of Orange County and all funds would be used in Orange County. 5. Schedule of Positions: a. Number of Full-Time Paid Positons:13 b. Number of Part-Time Paid Positions:L c. Number of volunteers:175 Average hours worked per volunteer per month 2-3 hours Collaborators: Please provide the following information about all significant collaborators and partners whether or not thev will be receivins erant funding for this proiect. Feel free to copy and paste Questions "a" through "e" as needed if you have more than one significant collaborator/partner: a.Date of lncorporation (Month/Year): Paee 5 o DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 b. Applicantorganization's P u rpose/M i ssion (2-4 se nte n ce s) : Please provide a brief description of your organization's past achievements in carrying out similar projects and evidence of successful record of meeting proposed budgets and timetables (2-4 sentencesl: d. Living Wage: Does this organization pay perma nent employees a minimum living wase? (Yes / No) lf yes, is this organization an Orange Countv Living Wase Certified Emplover? (Yes / No) lf no, please briefly explain. e. Schedule of Positions: a, Number of Full-Time Paid Positons: b. Number of Part-Time Paid Positions: c. Number of volunteers: Average hours worked per volunteer per month Page 6 ot 1 DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 Project Information *Please submit for each project f applyin,more than one project. 6. Project Name:Supplemental Weatherization Homeowners for Low-lncome Orange County 7.Please briefly describe the proposed project and the target population to benefit from the program. How many people will benefit? (100-300 words) RTT proposes expanding the provision of supplemental weatherization services to Orange County homeowners below 80% of Area Median Income. This is an expansion of the prograrn that was operated through the County Housing and Community Development Depaftment since 2020. Those funds are nearly depleted, and there remains a substantial need for additional services. Homeowners have been identified through the work of the Orange County Home Preservation Collaborative and are waiting for assistance. Eligible projects would include: (1) weatherization ser.vices for owners that are not eligible for the state weatherization program, (2) repairs to building systerxs or the building envelope that are preventing the state program frorr serving an otherwise-eligible client, and/or (3) enhanced weatherization and electrification measures that go beyond what existing weatherization pl'ograms will support, such as window repairs, heat pump water heaters, fuel switching fi'orn propane and natural gas furnaces to heat pumps, and replacement of gas cookstoves with electric induction models. The provision of these repairs will help ensure both that existing soul'ces offunding are leveraged to the greatest extent possible and at least 30 additional owners are suppofted with substantial energy efficiency and beneficial electrification improvements that address the County's climate and equity goals. 8. Please choose the best description for the type of project: I nfrastructure/Clea n Tech : New I nfrastructure/Clean Tech: Repai r I nfrastructure/Clean Tech: Replacement Com m unication/Education Natural Systems Management/Restoration Circular Economy/Waste reduction Analysis/Plan Other (Please describe): _ n X tr n n n T tr 9. Please choose the primary climate change mitigation focus for this project (select all that applv): Energy Efficiency Renewable Energy Beneficial Electrification Carbon Sequestration Other (Please describe): x tr x T tr 10. Has your organization or have your col laborators/partners completed projects of this type in the past? lf so, what funds were used? X Yes X Funding used (Please describe): Climate Action Fundins, CARES Funds, ARPA Funds, local government funds, CDBG funds, and private phi lanthropic funds E trto rt 1 DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 11. lf this project is not selected for funding in this round, what other funding might be used to support it within the next 5 years? n Other capital or operational funds X None. This is a unique opportunity. n Unknown (please describe):_ L2.Please select the jurisdiction(s) where your project is focused and briefly state how your project aligns with the relevant Climate Action Plans (2-4 sentences). Please name the action items from each relevant plan that best align with your proposed project: E Carrboro: https ://townofca rrboro.orsl928/Communitv-Cli mate- Action-Plan E Chapel Hill: https://www.susta i nchapel hil l.orelfe atured /2020 /2/ t8/ climate- action-a nd-response-pl a n X Orange County: ln progress, please instead show alignment with the Oranse Countv BOCC Goals and Priorities. This proposed project aligns with the above plan(s) in the following ways: The Supplemental Weatherization Program aligns closely with the County's priorities related to the provision of basic services to enhance resident well-being, equity for all residents and sustainability. These are themes identified in essentially all of the Board's Goals and Priorities, and RTT shares that vision of a community that supports the needs of every resident while preserving the earth we all enjoy for future generations. We believe this project has a strong natural alignment with these goals because it works in a space where the needs of low-income communities and homeowners overlap with the efforts toward a more sustainable relationship between the whole community and the natural environment. Homeowners in need will see lower utility costs and safer, more comfortable homes, while we all benefit from the reduction in emissions. ln some projects, collaborators and partners provide essential capacity and connections. lf collaborators or partners are an essential part of your project whether or not thev are receiving grant funds, please use this section to provide more details. lf you are not working with collaborators or partners, please feel free to write N/A in this section and move to the Social Justice and Racial Equity section. 13.Please describe one to three key pa rtnerships/col la borations that add the most value to the success of the proposed project: RTT works diligently as a member of the Orange County Home Preservation Collaborative. While this collection of agencies is not a legal entity, the important role this group plays in aligning resources to support the home repair, modification and weatherization needs of low-income homeowners is critical to our work. This project will be Collaborators and Partners DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 integrated into this work and help to leverage existing resources to the greatest extent possible. 14. Who will directly or indirectly benefit from your project? Please be as specific as possible on the characteristics of those who will benefit including, gender, race, age, income level and geogra phic location. Also, what are the demographics of the area where your project takes place? Does your project help to address any racial disparities in the location it is proposed for? Please list any data sources used and show the steps of any calculations: Applicants to the Orange County Home Preservation Coalition for repair and energy efficiency services are candidates to directly benefit from this proposal. This pool of applicants is continually increasing. Upon grant award, this project will select households that can benefit from supplemental weatherization. This project has requested funds to serve at least 30 households. Based on our experience, we estimate an average household size of 2,5 persons, which means we expect to directly serve 75 Orange County residents, We believe that each selected household will directly benefit from reduced utility bills, improved home comfort, and reduced greenhouse gas emissions. We believe that each selected household will directly benefit from reduced utility bills and better housing quality. Here is a projected breakdown of the demographics of OCHpC applicants that could directly benefit from supplemental weatherization: Gender Male: 20 Female:55 Race/ethnicity Black or African American: 48 White:1"8 Latinx:6 American lndian or Alaskan Native: 1 2 or more races: 1 Other: 1 Age 20-29:2 30-39: 3 40-49:5 50-59: 15 60-69: 20 70-79:20 80-89: 9 >90: 3 Page 9 of 19 Criterion 1 - SocialJustice and Racial DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 Geographic location Carrboro: 7 Cedar Grove: 9 Chapel Hill: 23 Durham: 1 Efland: 8 Hillsborough: 16 Hurdle Mills: 2 Mebane: 5 Rougemont: 3 Jurisdiction: Orange County: 57 Town of Carrboro: 7 Town of Chapel Hill: 11 80%AMl and below (Self-Reported Annual Income) 15 This project covers all ofOrange County but only serves the community with the previously described demographics. This selection strongly favors Orange County residents with lower incomes and who are members of racial minorities. 15. Please describe any ways in which low-income or marginalized com m unities/households were engaged in the creation of this project proposal: This project is built on the foundational work of the Orange County Home Preservation Coalition (OCHPC). The OCHpC is a collaborative of LZ local government and community organizations that provide home repairs and modifications to Orange County residents primarily low-income or marginalized households. These households actively apply for energy efficiency services that they could not provide for themselves. The relationship that the OCHPC developed with these marginalized households was a critical stepping stone to helping these households reduce their utility bills. 15. Please describe any potential negative side effects of the project and describe the steps you are taking/will take to eliminate or minimize these impacts to any low-income or marginalized comm unities/households: We do not anticipate any negative side effects of the project to the households that we serve or to the greater community. Page 10 of tg DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 17. Are the impacted residents already aware of the potential positive and negative impacts of your project and the steps you are taking? lf not, please describe your plan to engage with them and how you will act based on their input: Clients of this project will most likely be aware of the need they have for repairs or improvements, but many are likely not aware of the benefits of many of the weatherization measures that will be offered. Upon introduction of the program, we will explain the benefits of this work, not simply to the homeowner, but also to the broader community. We will patiently answer any questions homeowners may have about the project. lf they have any residual reservations, we will not proceed. 18. During and after the project, what will your continued engagement with the community be? Rebuilding Together of the Triangle has a long term commitment to this community to preserve affordable homeownership and revitalize neighborhoods by providing home repair and renovation services free of charge to those in need. 19. Please describe any other aspect of your project that is relevant to Social Justice and Racial Equity: This project relies heavily on the participation of the Orange County Home Preservation Coalition (OCHPC). The OCHPC seeks to increase communication and collaboration among home repair organizations to decrease burden on clients and service seekers. Going beyond direct repair service, the OCHPC seeks to advocate for solutions that address the mechanisms that cause or perpetuate racial disparities in access to home repair and modifications in Orange County (including tax assessments, zoning, and mobile home ownership.) 20.How many tons of greenhouse gas emissions will your project reduce/avoid each year? Please list any data sources used and show the steps of any calculations. Feel free to submit in a separate document if clearly labelled: Estimating the emissions reduction impact of this work precisely is challenging, because we do no precisely how much of what work is going to be done - that will be determined based on the need presented by the homeowners RTT serves. However, we have crafted some estimates for household usage of natural gas based on the US Energy lnformation Administration. The numbers are based on an average single-family residence and an emission factor for natural gas of 0.05302 metric tons of CO2e/mmBTU. These are yearly numbers for CO2e emissions for some common repairs: . HVAC Replacement 2 tons (short) . Water heater Replacement 0.75 tons (short) . Clothes Dryer Replacement 70 pounds . Gas Cook Stove Replacement - 140 pounds We are projecting the following electrification interventions, for the purpose of estimating. ofPage L1 19 Criterion 2 - Emissions Reduced DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 . 7 HVAC replacements (gasto-heat pump) . 5 Hybrid Water Heaters (gasto-electric) . 2 Clothes Dryer Replacements (Gasto-Electric) . 4 Stove Replacements (gasto-lnduction) Based on these assumptions, we estimate that we will reduce emissions based on electrification by 221.5 short tons over the next 15 years through the electrification efforts associated with this project. ln addition to the electrification work, we assume grid-level emissions reduction due to the energy efficiency work of weatherization and repair. This is harder to quantify, but we'll take a shot. The NC Department of Environmental Quality website states that weatherization can save participants around $300 per year on their energy bills. Using the Duke Energy Carolina's average rate, the number of homes we plan to serve, and DEC's 2021 Emissions factor, we can do a little math: $300 savings x $.1057 per kwh = 2838 kwh saved/yrlhome 20 homes x 2B3B kwh = 56,764 kwh saved/yr 56,764 kwh/yr x 15 yr = 851,466 kwh saved ever 15-yr period 851,466 kwh x DEC 2021 Emissions Factor 0.48 = 408,703 lbs 408,703 lbs of CO2 I 2000 = 204.25 short tons over 15 years ln total, based on our estimates, we expect that we can avoid carbon emissions of 425.75 short tons over 15 years with this project. 2L, For how many years will this emissions reduction take place as a result of your project? Please consider the expected lifetime of the tech nology/progra m/i m pact etc. We hope that these changes will have a lasting impact on emissions reduction, but for the purposes of this application, we are assuming a 15-year time horizon for the emissions reduction. That mirrors the life expectancy of most appliances and the other improvements RTT intends to make in these homes. 22. Please describe the location of the emissions reduction. Where would fossilfuels have been burned if not for your project? For projects creating electricity usage reductions, it can be difficultto determine the location of the power produced. Please feel free to state "Grid-tied electricity reduction" Some of the reduction will be grid-tied electricity - projects like insulation, air sealing and other energy efficiency interventions. For the beneficial electrification interventions like water heaters, induction stoves and other appliances, we will be reducing emissions from combustion within individual homes. We estimate that about 60% of the reduction will come at the grid level, with the remaining 40% coming at the individual home, however, those percentages could shift based on what work is actually completed in each home served. Page !2 of 19 DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 23.Please describe any other I Nln aspect of your project that is relevant to the amount of emissions that it will reduce or avoid. Criterion 3 - Efficient use of Funds 1. Please estimate the impact of your project per grant dollar requested. This cost per unit of impact must reflect the total program budget divided by the total impact of the project described in this application. lf the proposed project is new, please write N/A in the first column of the table below, and just fill out the second column. ActualAnnual Project Costs (lf your proposed project expands or accelerates an ongoins effort) Projected Project Costs Total Cost of Project s15o,ooo Unit of lmpact: Total # of tons of greenhouse gases reduced 425.75 short tons Cost Per Ton of GHG's Reduced S3s2.31 Unit of lmpact: Total # of individuals served/benefitted 75 Cost Per !ndividual Served/Benefitted s2ooo Other Unit of !mpact: Please describe here N/A Cost Per Unit of lmpact N/A Other Unit of lmpact: Pleose describe here N/A Cost Per Unit of Impact N/A (Please feel free to add rows if necessary to show any additional units of impact.) 24.Please describe any avoided financial costs or savings related to the project and over what period of time those costs will be avoided/reduced: Future costs for natural gas and electricity are extremely difficult to forecast accurately as are the benefits to public health and safety from reducing GHG emissions. Our government, some businesses, and some US citizens believe that the cost of continued emissions of GHG is too great for our society. From the Environmental Defense Fund the current central estimate of the social cost of carbon is over S50 per ton in today's dollars. By that measure this project would avert over $28,000 in future damages from climate change. Some experts believe this estimate is far below the potential damages. Page 13 of 1 DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 25. Does your project accelerate or expand on existing programs that already show positive impact? This project is designed to continue and enhance the work that was done using Climate Action funds through the Orange County Housing and Community Development since 2020. The supplement Weatherization funds there are nearly expended and have been instrumental in getting more weatherization and energy efficiency work done in the County. RTT expects this program to continue that excellent work and expand the impact through what we have learned. 26. Does your project also take advantage of other funding sources? This program takes advantage of numerous sources of leveraged funding, including the Duke Energy Helping Home Fund and Weatherization programs, the state Weatherization Assistance Program, and numerous repair programs operating as part of the Orange County Home Preservation Coalition. However, there is not leveraged funding reflected in the program budget. This project is designed to fill gaps that exist in other sources, so it doesn't reflect the leverage directly in the budget. That said, it is constructed in such a way that leverage from other sources is inherent in the program design. Would your proposed project help you to take advantage of funding from other sources besides this grant in the future? 27.At this time, we do not have other sources of funding identified that would replace the Climate Action Funding that Orange County has made available. The leadership that Orange County is exercising in this space is exceptional, but that means there are not large numbers of funders working on these issues directly - yet. That said, we are pursuing funds to assist with beneficial electrification and energy efficiency work around HVAC system replacement, and we are hopeful that this demonstration project will unlock future funding from other sources focused on the shared benefit this program will provide to our economically vulnerable neighbors, as well as our climate. 28. Please describe any other aspect of your project that is relevant to the efficient use of grant funds: N/A Page L4 of 1"9 Criterion 4 - Capacity of DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 29. Please describe any projects that you have completed successfully in the past which are similar to the project you are proposing: RTT has an expansive, proven, and well-known track record of completing quality and affordable repairs for Orange County residents. 30. lf you are proposing to collaborate with other organizations on this project, please briefly describe their relevant experience to the project and/or the target population: A key collaboration is with the Orange County Home Preservation Coalition. The OCHPC maintains a comprehensive, online, homeowner database that constitutes the target population for this project. RTT will select project clients from this database. The OCHPC will also track the energy efficiency services that RTT provides to project clients. At monthly OCHPC meetings RTT will provide progress updates and will discuss any service issues with the OCHPC. 31. Please describe any other relevant expertise or capacity to carry out the project in your application: As a result of our expansive housing rehabilitation footprint, RTT has strong existing relationships with prequalified, skilled contractors to carry out this work effectively and efficiently. 32. How many Orange County residents are employed by your organization? RTT directly employs 3 Orange County residents and prioritizes working with local businesses and contractors within Orange County to complete repair services. 33. What percent of project materials will be purchased from sources within Orange County or North Carolina? RTT prioritizes purchasing goods and services locally. We expect that 100% of project materials will be purchased from a local retailer within Orange County and/or North Carolina. 34. Please describe any other aspect of your project that is relevant to local economic development. This project strives to utilize local, minority subcontractors when possible. Page 15 of 19 Ir Criterion 5 - Local Economic Development II II Criterion 6 - Amount and Duration of Engagement I DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 35. Please describe how you will engage with and/or educate project participants. RTT will proactively work with homeowners served by this program, from the initial home assessment through completion of the project, to help them better understand how their home "works", what the interventions are designed to accomplish, and how to utilize and maintain the home in a manner that will promote efficiency and health. Due to the unique nature of each home and project, this is done on a case-by-case basis. 35. How will you measure the success of that engagement or educational effort? We will utilize existing OCHPC evaluation methods to effectively measure the quantitative and qualitative outcomes in the educational efforts of this initiative. Measures include number of homeowners receiving information, change in behaviors, and knowledge gained. 37. Please describe any other aspect of your project that is relevant to the amount, or quality, or length of engagement a nd/or education that your project will produce. N/A 38.How much time will your project require to demonstrate the positive impacts you describe? Households should see reduced utility bills within weeks of installation of supplemental weatherization measures. All proposed improvements should be complete within 18 months of grant funding but could extend to two years depending on circumstances. Applications are to be submitted as email attachments to Orange County Sustainability programs Manager, Amy Eckberg at aeckberg@oransecountync.gov. please also CC the lead staff member supporting the commission of the Environment, wesley poole at wpoole@orangecountvnc.gov. The Application Submittal Deadline for the Fiscal Year 22-23 round of the Community Climate Action Grant is Fridav. Aueust 19, 2022 at 5pm. Page 16 of 19 CriterionT-Timeto Submission Guidance DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 Please note that late, handwritten, or incomplete applications will not be accepted. Submit all documents including attachments in PDF format, This will ensure the original content and formatting is preserved. Digital signatures on applications are accepted. Accommodations for applicants with disabilities or those in need of technical assistance are available upon request. Please contact the Orange County Sustainability Programs Manager, Amy Eckberg (919- 245-2626, aeckbe rg@ora ngecountync.gov) to discuss what is needed. ATTACHMENTS Description of Required Attachments a) Applicant Organization's Budget and Project Budget Please complete the provided budget worksheets for your organization and your proposed project or submit your own budget file (as long as it contains the sarne information, and in a similar format, as requested in the provided worksheets. Please explain other in your budget). The Budget Worksheets file is available for download from the County website hcle. Please submit the budget in PDF form as well as in the original editable Excel format. b) IRS Federal Form 990 or2020 Tax Returns A copy of the applicant organization's most recent Form 990 or IRS Tax Returns is required to determine eligibility. The specific form depends upon the applicant organization's financial activity. Review the IRS' guide. for more details. For Form 990-N (e-postcard) filers, include a copy of the postcard, with the organization's application materials. c) List of Board of Directors (if applicable) Provide the following infonnation about each board of director's rnernber: name, telephone nurnber, and address, of each member and the list rnust identifz the principal officers of the governing body, and length of term. please feel fi'ee to use the template provided in Table 2 of the appendix or your own format. d) Certificate of Liability Insurance A copy of the applicant organization's current certificate, fi'om the organization's insurance carrier. Table I below outlines insurance types and minimums required, for each jurisdiction. If exempt from Worker's Compensation compliance, include a statement explaining why, with the applicant organization's application materials. NOTE: Proof of insurance is not required at the time of application submission. If your agency is approved for funding, documentation of insurance must be provided to the jurisdiction awarding the funding when the contract is awarded. The insurance certificate should reflect the funding jurisdiction as an additional insured party and certificatc holder and provide coverage for the duration ofthe funding period (two years, beginning as early as October | ,2022).If proof of insurance can only be written for one year, an update will be required for all ongoing projects. Renewal ceftificates must be sent to the jurisdiction 30 days prior to any expiration date, cancellation or rnodification of any stipulated insurance coverage. NOTE: Upon request, insurance requirements rnay be reviewed on a case by case basis by the County. Please contact the staff identified on the Submission Requirernents on Page l5 ifyou have questions or would like to request a review of your insurance requirements. APPENDIX Table 1. Forms of Liability Insurance and Minimum Policy Amounts Required g(of L9 DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 Worker's Compensationt Limits for Coverage A - Statutory State NC, for each employee lj,:j,:I. Co.verage B - Ernptoyers Liabitiry of: $500.000 each accident, $SOO,ObO Bodily tnjury Uy pllease (B lD).for each employe " " J -" J $500,000 for BID Iimit $1 million Each Occurrence $2 million Agg.egate $l million Each Occurrence $l million Each Occurrence $2 rnillion $l million Each Occurrence Cyber Liability $l million Each Occurrence $2 million Aggregate Environmental/pollution Liability (Required if demolition, use of hazardous material or environmental ly sensitive $l rnillion Each Occurrence Visit the NC lndustrial commission's website for more information regarding coverage A. Also, notethat if an agency uses subcontt*tort it must require subcontractors to have workmen,scompensation insurance. Please visit orange County's Risk Management page for more information about the county,sMinimum lnsurance Requirements. Email address Fax number (if applicable) Page 1"8 of 19 Onaucp Couxry3 DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 ORANGE COUNTY BOARD OF COMMISSIONERS ACTION AGENDA ITEM ABSTRACT Meeting Date: January 17, 2023 Action Agenda Item No. 6-b SUBJECT: Community Climate Action Grant (CCAG) – FY 2022-23 Project Selection for General Applicants and Schools DEPARTMENT: Asset Management Services ATTACHMENT(S): 1) CCAG 2022-23 Project Descriptions, Scoring, and Comments for General Applicants and Schools INFORMATION CONTACT: Amy Eckberg, (919) 245-2626 Steven Arndt, (919) 245-2658 PURPOSE: To: 1) Receive the grant project funding recommendations from the Commission for the Environment (CFE) and the Human Relations Commission (HRC) for the FY 2022 -23 Orange County Community Climate Action Grant Program; and 2) Approve funding for the recommended Community Climate Action Grant projects for FY 2022-23 as outlined in the attached report. BACKGROUND: As part of the FY 2019-20 budget, the Board of Orange County Commissioners (BOCC) created the Orange County Climate Action Fund dedicated to accelerating climate change mitigation actions in Orange County. This decision was motivated in part to hel p the County meet the climate change mitigation goals set by the Board in recent years: • Reduce greenhouse gas emissions community -wide by 26 percent by 2025 (from 2005 levels). • Transition to a 100% renewable energy based economy by 2050. For the 2022-23 funding cycle, $550,150 in funding was budgeted to support climate action projects that will benefit Orange County residents both socially and financially. Following the direction of the Board of Orange County Commissioners (BOCC), the process for solicitin g and selecting projects to receive funding was conducted through a formal Community Climate Action Grant (CCAG) program. For this grant cycle, the BOCC reserved half of the total funding for this grant program ($275,075) to be awarded to projects submitt ed by either of Orange County's two public school districts. The remaining half ($275,075) was to be made available to all other eligible general applicants in this round. The Community Climate Action grant program received seven (7) applications in this round from a variety of general applicants representing non -profit and public organizations whose total requests add up to $585,873. No private sector applications were received. One (1) project, totaling $368,000 was submitted from the Chapel Hill Carrboro City School district. DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 Grant applications were completed over the summer and reviewed and scored by the Commission for the Environment (CFE) and the Human Relations Commission (HRC). In fall 2022, each of these Commissions voted to forward their final s coring and comments to the BOCC. The following is a rank-order summary table of the combined project scoring and recommendations. More details on each project are available in Attachment 1: Project Applicant Funding Requested Recommended Funding Level Running total Total Score (Out of 26 pts) Rank* (Out of 7 applica- tions) General Applicants: Habitat Rooftop Solar Habitat for Humanity $112,000 $100,000 $100,000 24.2 1 Weatherization Rebuilding Together of the Triangle $150,000 $25,000 $125,000 23 2 Food Waste Monitors Eno River Farmers Market $4,500 $4,500 $129,500 21.8 3 203 Solar Project Town of Carrboro $89,243 $40,575 $170,075 17.1 4 Fleet Electrification Pilot Town of Chapel Hill $74,600 $50,000 $220,075 17 5 Solar Roof The ArtsCenter $134,664 $55,000 $275,075 15.8 6 Refillable Water Bottle Station The ArtsCenter $20,866 $0 $275,075 10.9 7 Total Requested by General Applicants: (Funds available: ($275,075) $585,873 $275,075 $275,075 School Applicants: Emission Reductions Through HVAC Replacements Chapel Hill Carrboro City Schools $368,000 $275,075 $275,075 19 1 Total Requested by Schools (Funds available: $275,075) $368,000 * All projects were placed in rank order by CFE and HRC voting. DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 FINANCIAL IMPACT: The Community Climate Action Grant Tax funding of $550,150 in FY 2022-23 intends to identify impactful projects and distribute these funds promptly to accelerate action on the urgent issue of climate change and to help further stimulate t he local economy. SOCIAL JUSTICE IMPACT: The following Orange County Social Justice Goals are applicable to this item: GOAL: ENSURE ECONOMIC SELF-SUFFICIENCY The creation and preservation of infrastructure, policies, programs and funding necessary for residents to provide shelter, food, clothing and medical care for themselves and their dependents. Social Justice and Racial Equity is the most heavily-weighted factor in scoring projects proposed through this grant program, ensuring that the equitable distr ibution of funds and the repair of environmental inequities are a central element of each funded project. Local investments in energy efficiency and renewable energy in Orange County provides direct reduction of monthly energy bills and supports jobs and investments in clean energy technologies. GOAL: ESTABLISH SUSTAINABLE AND EQUITABLE LAND-USE AND ENVIRONMENTAL POLICIES The fair treatment and meaningful involvement of people of all races, cultures, incomes and educational levels with respect to the development and enforcement of environmental laws, regulations, policies, and decisions. Fair treatment means that no group of people should bear a disproportionate share of the negative environmental consequences resulting from industrial, governmental an d commercial operations or policies. Reducing energy usage from the electric grid improves air quality impacts. Improving local air quality helps to protect the health of vulnerable populations in Orange County whose health is disproportionately affected by ground-level ozone and other emissions. ENVIRONMENTAL IMPACT: The following Orange County Environmental Responsibility Goal impacts are applicable to this item: ENERGY EFFICIENCY AND WASTE REDUCTION Initiate policies and programs that: 1) conserve ener gy; 2) reduce resource consumption; 3) increase the use of recycled and renewable resources; and 4) minimize waste stream impacts on the environment. Investing in local climate change mitigation actions will conserve energy, reduce resource consumption, and increase the use of renewable resources. RESULTANT IMPACT ON NATURAL RESOURCES AND AIR QUALITY Assess and where possible mitigate adverse impacts created to the natural resources of the site and adjoining area. Minimize production of greenhouse gases. The Climate Action Fund will continue to support high -impact projects which will improve local air quality and minimize the local production of greenhouse gases, reducing Orange County's contribution to the adverse impacts of climate change on human and n atural resources both inside and outside of the County. RECOMMENDATION(S): The Manager recommends that the Board DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 1) Receive the grant project funding recommendations from the Human Relations Commission and the Commission for the Environment for the FY 2022 -23 Orange County Community Climate Action Grant Program; and 2) Approve funding for the recommended Community Climate Action Grant projects for FY 2022-23. DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 Rebuilding Together of the Triangle 2022 Budget 2022 2021 BUDGET BUDGET Revenue 40000 Direct Support 4000 Corporate Contributions 130,000.00 101,500.00 4020 Governmental Funding 1,625,000.00 1,155,000.00 4025 Gifts in Kind - Goods 250,000.00 35,000.00 4040 Foundations / Faith Funding 515,000.00 885,500.00 4300 Non-Profit Consulting (Fee-for-Service)225,000.00 55,000.00 4400 Individual Contributions 55,000.00 55,000.00 4600 Disaster Recovery Funding 0.00 106,000.00 Total Revenue $ 2,800,000.00 $ 2,393,000.00 5000 Direct Expenditures 5100 Construction and Logistics 5101 Skilled Project Labor 1,026,000.00 941,000.00 5102 Building Materials 274,720.00 300,000.00 5103 Building Permits 4,000.00 5,500.00 5104 Dumpsters and Dump Fees 18,000.00 12,000.00 5105 Mobile Storage and Other Supplies 6,000.00 6,000.00 5106 Portable Toilets 6,000.00 7,500.00 5107 Meals - Events 2,000.00 4,000.00 5108 Volunteer Care Supplies 2,500.00 7,000.00 5109 Homeowner Relocation Costs 7,500.00 10,000.00 5110 Program Travel Costs 2,100.00 3,000.00 5100 Total Construction and Logistics $ 1,348,820.00 $ 1,296,000.00 5200 Tools, Equipment, and Vehicles 5201 Fuel and Maintenance - Vehicles 35,000.00 24,000.00 5202 Mileage Reimbursement (staff mileage)2,500.00 2,500.00 5203 Tools and Equipment 20,000.00 8,000.00 5204 Trailer 15,000.00 15,000.00 5205 Vehicle Purchase 45,000.00 45,000.00 5200 Total Tools, Equipment, and Vehicles $ 117,500.00 $ 94,500.00 Total Direct Cost $ 1,466,320.00 $ 1,390,500.00 G&A and Overhead 6000 Salary and Wages 6001 Director Payroll 107,050.00 93,000.00 6002 Payroll Staff 530,000.00 469,970.00 6004 Bonus 35,000.00 30,000.00 6005 AmeriCorps/ Internship Fees 10,000.00 10,000.00 DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 6006 - Executive Director Student Loan Repayment Benefit 5,250.00 0.00 Total 6000 Salary and Wages $ 687,300.00 $ 602,970.00 6100 Employees - Benefits and Taxes 6101 Employer Payroll Taxes 46,580.00 41,180.00 6102 401 (k)15,000.00 7,500.00 6103 Health Insurance 50,000.00 35,000.00 6104 Supplemental Insurance 8,500.00 6,500.00 6100 Total Employees - Benefits and taxes $ 120,080.00 $ 90,180.00 6200 Office and Administration 6201 Telephone, Telecommunications 4,000.00 3,500.00 6202 Cell Phone 2,000.00 7,500.00 6203 Finance Charges and Fees 2,500.00 1,000.00 6204 Bank fees 2,000.00 4,500.00 6206 Payroll Services Fees 3,000.00 2,400.00 6207 Property Taxes 0.00 150.00 6216 Memberships, Subscriptions, and Licenses 3,500.00 3,500.00 6208 Office and Warehouse Rent 125,000.00 40,000.00 6209 Warehouse Space 0.00 7,500.00 6210 Office Equipment 4,000.00 3,000.00 6213 Office Supplies - Admin 4,000.00 2,500.00 6212 Postage & Mailing - Admin 3,000.00 1,500.00 6215 RT National Membership Dues 20,000.00 20,000.00 6214Software Licenses 7,500.00 6,000.00 6211Utilities 9,000.00 4,000.00 Total 6200 Office & Admin $ 189,500.00 $ 107,050.00 6300 Insurance 6301 Auto Insurance 16,000.00 12,000.00 6302 Directors and Officers 1,300.00 1,300.00 6303 General Liability / Umbrella 7,500.00 5,500.00 6304 Property Insurance 0.00 0.00 6305 Workmen's Comp / Disability 40,000.00 35,000.00 6300 Total Insurance $ 64,800.00 $ 53,800.00 6400 Marketing and Development Expenses 6402 Other Event Rentals and Supplies 4,000.00 5,500.00 6403 Partnership Meetings 6,000.00 6,000.00 6405 Shuck-N-Cluck Expenses 10,000.00 12,500.00 6406 T-Shirts / Banners / Signage 7,500.00 4,500.00 6407 Printing & Mailing 6,500.00 4,000.00 6408 Social Media Marketing 2,500.00 2,500.00 6400 Total Marketing and Development Expenses $ 36,500.00 $ 35,000.00 6500 Consulting Services DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 6501Accounting Services 9,000.00 8,500.00 6502 Fund Development Services 0.00 0.00 6503 Marketing and Communications Services 10,000.00 10,000.00 6504 Strategic Planning Services 0.00 0.00 6505 Web. Email Cloud Hosting Services 3,000.00 4,000.00 Total 6500 Consulting Services $ 22,000.00 $ 22,500.00 6600 Training and Conferences 6601 National Conference Expenses 2,000.00 4,000.00 6603 Staff meeting expenses 5,500.00 4,500.00 6604 Staff Professional Development and Education 6,000.00 4,000.00 6600 Total Training and Conferences $ 13,500.00 $ 12,500.00 6700 Board Meeting Expenses 6701 RTT - Board Retreat 25,000.00 3,500.00 6700 Total Board Meeting Expenses $ 25,000.00 $ 3,500.00 6000 Total General and Administrative $ 1,158,680.00 $ 927,500.00 Transfer to inventory 75,000.00 0.00 Transfer to Reserves 100,000.00 75,000.00 Total Expenditures $ 2,800,000.00 $ 2,393,000.00 Net Operating Revenue $ 0.00 $ 0.00 DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 Department of the Treasury A For the 2021 calendar ",,990 B Check i, applicablei r-Address I lchange I lchange I-lnitial I lreturn f ---lFrnal I lrelurn/ termin- ated ---]AmendedI lreturn nApplica- L-----l tion pending llebsite: > WWW. RTTRIANGLE . ORG Form 132oo1 't2-os-21 LHA For Paperwork Reduction Act Notice, see the separate instructions.sEE SCHEDULE o FoR oRGANrzATroN MrssroN STATEMENT !t Return of Organization Exempt From lncome Tax Under section SO1lcl, 527, or 4947(a)(1) of the lnternal Bevenue Code (except private foundations) ) Do not enter social security numbers on this form as it may be made public. D Employer identification number s6-1955629 E Telephone number 9L9 -34t- OMB No, 1545-0047 oo (! o oo oU oo := o o 0) o IE :NC 1 Briefly describe the organization's mission or most,significant activities: WE PROVIDE HOME REPAIR SERVf CESTO ENSURE WLNERABLE HOMEOWNERS _ INCIUDiN ' posed of more than 2syoofits net assets.3 Number of voting members of the governing body (part Vl, line -1a) t7 245 7 a Total unrelated business revenue from part Vlll, column (C), line 12 0. Net unrelated busi income from 0. 560 519. 106 477 . -3 s6s. l-1-B 32 7 5. 0. 0. 537 212. 0. 840 43L. 377 End 784 092 33 9. 873. Under penalties of per I have examined this return, including accompanying schedules and stalements, ancl to lhe best of my knowleclge and belief, it is true, correct, and has anv know Sign Here DAN SARGENT EXECUTIVE DIRECTOR or print name and Paid Preparer Use 0nly 0l_358645 Firm's EIN 55-05L7823 9L9 -7 82-9255 G Gross r@eipts g 2,79L,52L. H(a) ls this a group return forsubordinatesz .. Iyes ITI p6 H(b) nre att subordinates inctuded? fl y"s fl ruo lf "No," attach a list. See instructions por, 9901zozr) CONTINUATION Print/Type preparer's name VID BOYCE KOONCE, WOOTEN & HAYWOOD, LLP Firm'saddress; P. O. BOX 1-7806 RALEIGH, NC 2761,9_7806 tax and 4 Number of independent voting members of the governing 5 Total number of individuals employed in calendar year 6 Total number of volunteers (estimate if necessary) . v_-.!.-._ .:..1 Number and street (or P.0. box if mail is not delivered to streel address) City or town, state or province, country, and Zlp or foreign postal code F Name and address of principal officer: DAN 8 I 10 't1 Contributions and grants (Parl Vlll, line t h) Program service revenue (Part Vlll, line 29) lnvestment income (Part Vlll, column (A), lines 3, 4, and 7d) Other revenue (Part Vlil, column (A), lines 5, 6d, Bc, 9c, 10c, and 11e) 13 Grants and similar amounts paid (part lX, column (A), lines 1.3) 14 Benefits paid to or for members (Part lX, column (A), line 4) 15 salaries, other compensation, employee benefits (part lX, column (A), lines 5- l0) ......... 16a Professional fundraising fees (Part lX, column (A), line 11e) b Total fundraising expenses (Part lX, column (D), line 25) > 9 B ,7 7 9 . 17 Other expenses (Part lX, column (A), lines '1 1a.1 1d, 11t.24e) 18 Total expenses. Add lines 13,17 (must equal part lX, column (A), line 25) 2O Total assets (Part X, line 16) 21 Total Iiabilities (Part X, tine 26) DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 I(. 1 Formee0(2021) REBUILDING TOGETHER OF THE TRIAI{GLE 55-1955629 pase2 Check if Schedule O contains a response or note to anv line in this part lll ......................................_........_................................... [-l1 Briefly describe the organizatlon's mission: WE PROVIDE HOME REPATR SERV]CES TO ENSURE WLNERABLE HOMEOWNERS INCLUDING SENIORS, INDIVTDUALS WITH DISAB CHILDREN - LIVE IN SAFE HEALTHY HOMES. 2 Did the organization undertake any significant program services during the year which were not listed on the prior Form 990 or 990.E2? fly"" |Xl lto lf "Yes," describe these new services on Schedule O. 3 Did the organization cease conducting, or make significant changes in how it conducts, any program services?l--lyes Dil ruo lf "Yes," describe these changes on Schedule O. 4 Describe the organization's program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(cX3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and ELDERLY, DTSABLED AND FAI{ILIES WITH CHTLDREN. revenue, if anv, for each prooram seryice.reported._ _4a (coa", - 11aro"n"""s = =., 2, 155, & incrudinssrantsof$ REBUTLDTNG, REPATRING AND REVfTAIJTzTNG Ldw-rNColIE HoUsrNG ron tnu 4b (c"au: _ ) (expenses $including grants of $(Revenue $ 4c (cooe;_)(expenses$including grants of $(nevenue $ 4d Other program services (Describe on Schedule O.) 4e Tbtalproqramserviceexpenses) 2,155,234. rorm 9901zozr; 132002 12-09-21 DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 5562 2 3 LDTNG TOGETHER TANGLE s6-1 ls the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? lf "Yes," complete Schedule A ls the organization required to complete schedule B, schedute of contributors? See instructions ..............-. Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? lf "Yes," complete Schedute C, part I Section 501(c)(3) organizations. Did the organization engage in lobbying aciivities, or have a section 501(h) election in effect during the tax year? lf ,'yes," complete Schedute C, paft ll ls the organization a section 501(c)(4), 501 (c)(5), or 501 (c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Rev. Proc. 98,1 9? // "yes,', complete Schedule C, paft lll Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? lf "yes,', complete Schedule D, parl t Did the organization receive or hold a conservation easement, including easements to preserve open space, the environment, historic land areas, or historic structures? tf ',yes,,' complete Schedule D, part tl Did the organization maintain collections of works of ad, historical treasures, or other similar assets? tf "yes,, complete Schedule D, Paft lll Did the organization repod an amount in Part X, line 21 , for escrow or custodial account liability, serve as a custodian for amounts not listed in Parl X; or provide credit counseling, debt management, credit repair, or debt negotiation services? lf "Yes," complete Schedule D, Part lV 1O Did the organization, directly or through a related organization, hold assets in donor-restricted endowments or in quasi endowments? tf ',yes,', complete Schedule D, paft V 'l 1 lf the organization's answer to any of the following questions is "Yes, " then complete Schedule D, parts Vl, Vll, Vlll, lX, or X. as applicable. a Did the organization report an amount for land, buildings, and equipment in Part X, line 10? lf "yes,', complete Schedute D, x x x x x x x x x x x x x x x x x x x x 13 14a b Did the organization report an amount for investments . other securities in assets reported in Paft X, line 16? lf ,'yes," complete Schedule D, partVll Did the organization report an amount for investments- program related in assets reported in Part X, line 16? lf "yes," complete Schedule D, partVlil d Did the organization repoft an amount for other assets in Part X, line 15, that is 5%o or more of its total assets reported in Part X, line 16? tf ,yes," comptete Schedute D, paft tX Did the organization repon an amount for other liabilities in part X, line 25? lf ,,yes,,, complete Schedule D, part X Did the organization's separate or consolidated financial statements for the tax year include a footnote that addresses the organization's liability for uncertain tax positions under FIN 48 (ASC 740)? tf ,,yes,,, complete Schedule D, paft X Did the organization obtain separate, independent audited financial statements for the tax year? 11 ',yes," comptete Schedule D, Parts Xl and Xll . ............. b Was the organization included in consolidated, independent audited financial statements for the tax year? lf "Yes," and if the organization answered "No" to tine 12a, then completing Schedute D, parts Xl and Xll is optional ls the organization a school described in section 170(b)(lXAXiD? lf ',yes,,, complete Schedute E . ..... Did the organization maintain an office, employees, or agents outside of the United states? Did the organization have aggregate revenues or expenses of more than $-1O,O0O from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? lf "Yes," complete Schedule F, pafts I and lV Did the organization repod on Part lX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organizalion? lf ',yes," complete Schedule F, parts ll and lV16 Did the organization report on Part lX, column (A), Iine 3, more than $5,000 of aggregate grants or other assistance to orforforeign individuals? If ',yes," complete Schedule F, pafts Ilt and lV'17 Did the organlzation report a total of more than $15,000 of expenses for professional fundraising services on part lX, column (A), lines 6 and 1 1e? tf ',yes,, complete Schedule G, paft l. See instructions 18 Did the organization repoft more than $15,000 total of fundraising event gross income and contributions on part Vlll. lines'1c and 8a? tf "Yes," complete Schedule G, part lt 19 Did the organization report more than $15,000 of gross income from gaming activities on part Vlll, line 9a? 11 ,'yss." complete Schedule G, Paft lll Pari X, line 12, that is 5%o or more of its total Pafi X, line 13, that is syo or more of its total e f 12a 20a b 21 Did the organization operate one or more hospital facilities? tf ,,yes,,, comptete Schedute H lf "Yes" to line 20a, did the organization attach a copy of its audited frnancial statements to this return? Did the organization report more than $5,OOO of grants or other assistance to any domestic organization or x x 132003 12-09-21 on Pafi (2O21) DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 62REBUTLDIs6-L 22 Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? tf "yes," complete Schedu/e l, parts I and llt 23 Did the organization answer "Yes" to Part Vll, Section A, line 3, 4, or 5, about compensation of the organization's current and former officers, directors, trustees, key employees, and highest compensated employees? lf "yes," complete Schedule J 24a Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31 ,2002? tf "yes," answer lines 24b through 24d and complete Schedule K. lf "No,'go to line 25a ................ No x b c d 25a b 26 27 2a a b c 29 30 31 32 Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception? Did the organization maintain an escrow account other than a refunding escrow at any time during the year to defease any tax-exempt bonds? .... Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year? Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? 11 "yes," complete Schedule L, pari I ls the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization's prior Forms 990 or g9O.EZ? lf "yes," comptete Schedule L, Pari I Did the organization report any amount on Pan X, line 5 or 22, for receivables from or payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35%o controlled entity or family member of any of these persons? lf "yes," complete Schedule L, part ll Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor or employee thereof, a grant selection committee member, or lo a35%o controlled entity (including an employee thereof) or family member of any of these persons? lf ,,yes,,, complete Schedute L, paft ilt ....... . Was the organization a party to a business transaction with one of the following parties (see the Schedule l- part lV, instructions for applicable filing thresholds, conditions, and exceptions): A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? if "Yes," complete Schedule L, Paft lV A family member of any individual described in line 28a? lf ',yes," complete Schedule L, part lV A 35% controlled entity of one or more rndividuals and/or organizations described in line 2Ba or 2Bb? lf "Yes," complete Schedule L, Paft IV Did the organization receive more than $25,000 in non-cash contributions? lf ,,yes,,, comptete Schedule M Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? tf "Yes," complete Schedule M Did the organization liquidate, terminate, or dissolve and cease operations? lf ,,yes,,, comptete Schedule N, paft t Did the organization sell, exchange, dispose of, or transfer more than 25%o of ils net assets? tf "yes," complete x x x x 35a b Schedule N, Part ll 33 Did the organization own 10o%o of an entity disregarded as separate from the organization under Regulations sections 3O1 .7701-2 and 301 .7701.3? lf "yes,', complete Schedule R, part I34 Was the organization related to any tax-exempt or taxable enlily? tf ,,yes,,, complete Schedule R, paft ll, 1il, or tV, and Did the organization have a controlled entity within the meaning of section 512(bX13)? lf "Yes" to iine 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(bX13)? lf "yes," complete Schedute R, pariV, line 236 Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non.charitable related organization? lf "Yes," complete Schedule R, Paft V, tine 2 ..... . Dld the organization conduct more than 5% of its activlties through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? lf ,,yes,,, complete Schedute R, paft Vt Did the organization complete Schedule O and provide explanations on Schedule O for part Vl, lines '1 1b and ax Check if Schedule O contains a or note to line in this Part V 1a Enter the number reported in box 3 of Form i096. Enter-0- if not applicable ....... I ,ub Enterthe number of Forms w-2G included on line 1a. Enter 0- if not applicable c Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming x x 37 19? 132044 12-09-21 DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 3a b 4a ILDING TOGETHER OF THE TRIANGLE s6-1 ax 2a Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax Statements, filed for the calendar year ending with or within the year covered by this return lf at least one is reporled on line 2a, did the organization file all required federal employment tax returns? Note: lf the sum of lines 1a and 2a is greater than 250, you may be required lo e-file. See instructions. Did the organization have unrelated business gross income of $1 ,000 or more during the year? lf "Yes," has it filed a Form 990.T for this year? lf "No" to line 3b, provide an explanation on Schedule O At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a ftnancial account in a foreign country (such as a bank account, securities account, or other financial account)? lf,,YeS,,,enterthenameoftheforeigncountry> See instructions for filing requirements for FinCEN Form 114, Repod of Foreign Bank and Financial Accounts (FBAR). Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? Did any taxable party notify the organization that it was or is a pany to a prohibited tax shelter transaction? lf "Yes" to line 5a or 5b, did the organization file Form 8886-T? Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? lf "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ' organizations that may receive deductible contributions under section 170(c). a Did the or0anization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provicled to the payor? b lf "Yes, " did the organization notify the donor of the value of the goods or services provided? c Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form B2B2? lf "Yes," indicate the number of Forms 8282 filed during the year 7d Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract? Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? lf the organization received a contribution of qualified intellectual property, did the organization frle Form BB99 as required? .. lf the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form i ogB-C? Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsorang organization have excess business holdings at any time during the year? Sponsoring organizations maintaining donor advised funds. Did the sponsoring organization make any taxable distributions under section 4966? 5a b c 6a d e I s h B a b 10 a b Did the sponsoring organization make a distribution to a donor, donor advisor, or related person? Section 501(cX7) organizations. Enter: lnitiation fees and capital contributions included on part Vlll, Iine 12 Gross receipts, included on Form 990, part Vlll, line 12, for public use of club facilities11 Section 501(c)(12) organizations. Enter: a Gross income from members or shareholders b Gross income from other sources. (Do not net amounts due or paid to other sources against amounts due or received from them.) 12a Section agaT@)(1) non-exempt charitable trusts. ls the organization filing Form 990 in lieu of Form 1041?b lf "Yes, " enter the amount of tax-exempt interest received or accrued during the year13 Section 501(c)(29) qualified nonprofit health insurance issuers. a ls the organization licensed to issue qualified health plans in more than one state? Note: See the instructions for additional information the organization must report on Schedule O.b Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans Enter the amount of reserves on hand Did the organization receive any payments for indoor tanning services during the lax year? lf "Yes," has it filed aFormT2O to report these payments? lf ,,No,,, provide an explanation on Schedule O ls the organization subject to the section 4960 tax on payment(s) of more than $1 ,O00,000 in remuneration or excess parachute payment(s) during the year? ............. lf "Yes," see the instructions and file Form 4720, Scheduie N. ls the organization an educational institution subject to the section 4g68 excise tax on net investment income? lf "Yes," complete Form 4720, Schedule O.'17 Section 501(c)(21) organizations. Did the trust, any disqualified person, or mine operator engage in any activjties that would result in the imposition of an excise tax under section 4951 ,4952 or 4953? c 14a b 15 16 x x 132005 12-0S-21 Form 990 (2021) L7 DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 1a1a ttrt Formee0(2021) REBUfLDING TOGETHER OF THE TRIANGLE 55-L955629 p"re.e ,No,,response to line 8a, 8b, or 10b below, describe the circumstances, processes, or changes on Schedule O. See instructions. if Schedule O contains a response or note Section A.and Enter the number of voting members of the governing body at ihe end of the tax year lf there are material differences in voting rights among members of the governing body, or il the governing body delegated broad authorityt0 an execulive committee or similar committee, explain on Schedule 0. Enterthe number of voting members included on line ia, above, who are independent .................. Did any oificer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors, trustees, or key employees to a management company or other person? Did the organization make any significant changes to jts governing documents since the prior Form 990 was filed? Did the organization become aware during the year of a significant diversion of the organization's assets? Did the organization have members or stockholders? Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? Are any governance decisions of the organization reserved to (or subject to approval by) members, stockhotders, or persons other than the governing body? Did the organization contemporaneously document the meetings held or written aclions undertaken during the year by lhe following: The governing body? ..... Each committee with authority to act on behalf of the governing body? Is there any officer, director, trustee, or key employee listed in Pad Vll, Section A, who cannot be reached at the Section x x x x x x 4 5 6 7a 8 a b I x No x10a b 11a b 12a b c 13 14 15 a b 16a b Did the organization have local chapters, branches, or affiliates? lf "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes? Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? Describe on Schedule O the process, if any, used by the organization to review this Form g90. Did the organization have a written conflict of interest policy? y',No,,,go to tine 1S Were officers, directors, 0r lrustees, and key employees required to clisclose annually interests that could give rise to conflicts? Did the organization regularly and consistently monitor and enforce compliance with the policy? 11"yeq ,, descrlbe on Schedule O how this was done Did the organization have a written whistleblower policy? Did the organization have a written document retention and destruction policy? Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision? The organization's CEO, Executive Director, or top management official Other officers or key employees of the organization lf "Yes" to line 15a or 15b, describe the process on Schedule o. See instructions. Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement wilh a taxabie entity during the year? lf "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization,s List the states with which a copy of this Form 990 is required to be filed )NONE Section 6104 requires an organization to make its Forms 1o23 (1024 or 1o24-A, if applicable), ggo, and 99GT (section 501 (c)(3)s onlyl ,*itunt" for public inspection. lndicate how you made these available. check all that apply. Describe on Schedule o whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year. 2oStatethename,address,andtelephonenumberofthepersonwhopossessestheorganization,SbookSandrecords> DAN SARGENT - 919_34L-5980 17 18 19 200 132006 12-09-21 AIR DR SUITE 2OO RISVILLE 27 560 por6 990 lzozty b 2 DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 Employees, and lndependent Contractors Check if Schedule O contains a line in this Pan Vll It Form990(2021)REBUILDrNGToGETHERoFTHETRIANGLE56-1955Ww]- 1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization,s tax year. o List all of the organization's current officers, directors, trustees (whether individuals or organizations), regardless of amount of compensation.Enter-0- in columns (D), (E), and (F) if no compensation was paid. o List all of the organization's current key employees, if any. See the instructions for definition of ,,key employee.,' . . ' List ihe organization's five c^urrent highes-t compensated employees (other than an officer, director, trustee, or key employee) who received report-able compensation (box 5 of Form w-2, Form 1099-MlSC, and/or box 1 oi Foim 1099 NEC) ol more than $loo,ooo riom the organizaiion a'nd inyielated organizations. o List all of the organization's former officers, key employees, and highest compensated employees who received more than $j 00,00o ofreportable compensation from the organization and any related organizations. o List all of the organization's former directors or trustees that received, in the capacity as a former director or trustee of the organization,more than $10,000 of reportable compensation from the organization and any related oiganiiations. See the instructions for the order in which to list the persons above. Check (A) Name and title (F) Estimated amount of other compensation from the organization and related organizations 11_595. (1) DAN SARGENT EXECUT]VE D]RECTOR (2\ KATY PATToN PRES IDENT (3) ANNE STODDARD VICE PRESIDENT (4) MATTHEW DUNCAN SECRETARY (5) DAN CROSLEY TREASURER (6) MIKE TRAINoR BOARD MEMBER (7 ) MICHAEL BYERS BOARD MEMBER (8 ) BRANDON },-IOOREFIELD BOARD MEMBER (9) SHELLY MCPHATTER BOARD MEMBER (10) MARCELLE THOMAS BOARD MEMBER 0. 0. 0. 0. 0. 0. 0. 0. 0. (B) Average hours per week (list any hours for related (c) Position (do not check more than one box, unless person is both an offjcer and a director/trustee) (D) Reportable compensation from the organization (w.2/1099.MtSC/ 1099-NEC) (E) Repodable compensation from related organizations (w-2l1099-MtSC/ 10e9"NEC) 105,656. 132007 't2-09-21 Form (2o21) DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 ]NG TOGETHER Section (A) Name and title c Total from continuation sheets to part Vll, Section A > IANGLE 55-1 (F) Estimated amount of other compensation from the organization and related organizations 11 s95. 595.2 Total number of individuals (including but not limited to those Iisted above) who received more than $10o,OOO of reponable Did the organization list any former officer, director, trustee, key employee, or highest compensated employee on For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $ 150,000? lf ,'yes,,' complete Schedule J for such individual Did any person listed on line I a receive or accrue compensation from any unrelated organization or individual for services Section B.Contractors 1 Complete this table for your five highest compensated independent contractors that received more than $1oo,0Oo of "o-pnn"rtioi-iJilforthe orqani (A) Name and business address BOER BROTHERS HEATING & COOLING530 NC HWY 54 WEST, CHAPEL HILL NC 275L6 234 270BLAKENEY TNC LLC2 BRUIN CT, GREENSBORO, NC 27405 L7B 527INTERGRITY ROOFING & RESTORATION LLC603 BUTLER DRTVE, GARNER, NC 27529 168 348 2 f otal number of independent contractors (including but not limited to those listed above) who recetved more than 0. L No x ; 11 (c) Compensation (B) Average hours per week (list any hours for related (c) Position (do not check more than one box, unless person is both an officer and a director/trustee) (D) Reportable compensation from the organization (w,2/1099.M1SC/ 1099,NEC) (E) Reponable compensation from related organizations (w-2l1099.M1SC/ 1099.NEC) 105,565. 105,565. REPAIR AND rorm 990 lzoz'l1 132oOA 12-09-21 5 DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 Formeeo(2021) REBUILDING TOGETHER OF THE TRIANGTE 55-1955629 pase9 Check if Schedule O contains a note to anV line in this Pad Vlll o c(! o ui 6 6trioF:,ll' €) o otr Lo -c o (D) Bevenue excluded from tax under sections 51? - 514 -3,565. L8,324. L4,759. rorm 990 1zozr1 1 a Federated campaigns b Membership dues c Fundraising events ..................... d Relatedorganizations e Government grants (contributions) f All other contribulions, gifts, grants, and similar amounts not included above g Noncash contributions included in lines 1a-if 2a b c d e t CONSULTING FEES All other program service revenue 3 lnvestment income (including dividends, interest, and 4lncomefrominVeStmentoftax.exemptbondproceeds> 6 a Gross rents b Less: rental expenses c Bental income or (loss) d Net rental income or 7 a Gross amount from sales of assets other than inventory b Less: cost or other basis and sales expenses .........c Gain or (loss) d Net gain or (loss) 8 a Gross income from fundraising events (not contributions reported on line 1c). See Part lV, line 1B b Less: direct expenses c Net income or (loss) from fundraising I a Gross income from gaming activities. See Part lV, line 19 c Net income or (loss) from gaming 10 a Gross sales of inventory, less returns b Less: cost of goods sold 24 .025. 11 a b c d SBA PPP LOAN FORGIVENE 132009 12-09-21 DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 Form BUILDING TOGETHER THE TRTANGLE 56-1 562 10 Section Do not include amounts repofted on lines 6b, 7b, Bb, 9b, and 10b of Part Vlll. 1 Grants and 0ther assistance to domestic organizations and domestic governments. See Part lV, line 21 2 Grants and other assistance to domestic individuals. See Part lV,line22 3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part lV, lines 15 and i6 ......... 4 Benefits paid to or for members 5 Compensation of current officers, directors, trustees, and key employees Compensation not included above to disqualified persons (as defined under section 4958(l)(1)) and persons described in section a95B(c)(3)(B) Other salaries and wages Pension plan accruals and contrjbutions (include section 401(k) and 403(b) employer contributjons) and 501 all columns. All other Check if Schedule ains a se or note to any line in this Part lX L7 589. 447 I 9 10 11 a b c d e t s 12 13 14 15 16 17 18 19 20 21 22 23 24 a b c d e Other employee benefits Payroll taxes Fees for services (nonemployees): Management Legal ............. Accounting Lobbying Professional fundraising services. See parl lV, line lT lnvestment management fees ........................ Other. (lf line 119 am0unt exceeds l0% of line 25, column (A), amount, list iine 119 expenses on Sch O.) Advertising and promotion Office expense lnformation technology Royalties Occupancy Travel Payments of travel or entertainment expenses for any federal, state, or local public officials ... Conferences, conventions, and meetings ...... lnterest Payments to affiliates Depreciation, depletion, and amortization lnsurance 0ther expenses. ltemize expenses not covered above. (List miscellaneous expenses 0n line 24e. lf line 24e amount exceeds 10% of line 25. column (A). amount, list line 24e expenses on Schedule 0.) CONTRACT LABORBUILM BUILDING SITE INCIDENTA DUES, LICENSES, & MEMBE All other expenses ]-67 . 984. 032. 944. t_1 94L. 726. L1,g 723, 0s4. 997 . 254 249. 779.Total Add lines 1 26 Joint costs. Complete this line only if the organization reported rn column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here Lt7,26L.82,083.17,589 357 ,7 Bg .255 ,203 5g,4Lg. 10,589. 38,030.27 ,001-. LL ,94L. 1,2 ,390 . 39,548 L9,824.1-1,101. 10,386. !9,527.L5 ,465. 1 , 021 ,297 1, ,021 ,291, 576,570.576,570. 57,55L.s7,551-. 24 ,092.23,583. 50,224.42,L57 . 2,377 ,643.2 ,Lss ,234 .L23 ,630 . 132010 12-09-21 (ASC 958-7 9B (2o21) DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 REBUILDI TOGETHER OF THE 55-1955529 11 o 0) =o .qJ ooo (! Eo t 5 tJ- !o o ooo 0)z O contains a any line in this Part X (B) End of year 77 ,L7g. 492 ,625 . 97,992. L09,696. 6,600. 784,092. 582. t46 537 . 36,2L9. 47 ,873. 447 ,873. 784,092. 132011 12-09-21 rorm 990 1zozt1 Savings and temporary cash investments Pledges and grants receivable, net Accounts recelvable, net Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35o% conirolled entity or family member of any of these persons Loans and other receivables from other disqualified persons (as defined under section 4958(fX1), and persons described in section 4958(c)(3)(B) Notes and loans receivable, net lnventories for sale or use Prepaid expenses and deferred charges Land, buildings, and equipment: cost or other basis. Complete Part Vl of Schedule D Less: accumulated depreciation lnvestments - other securities. See Parl lV, line 11 lnvestments- program-related. See parl lV, line 11 lntangible assets ............. Other assets. See Parl lV, line 11 Accounts payable and accrued expenses Deferred revenue Escrow or custodial account liability. Complete pan lV of Schedule D Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor. or 35% controlled entity or family member of any of these persons Secured mortgages and notes payable to unrelated third parties Unsecured notes and loans payable to unrelated third parties Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17.24). Complete part X of Schedule D Organizations that follow FASB ASC 9Sg, check here )> and complete lines 27, 28, 32, and 33. Net assets without donor restrictions Net assets with donor restrictions Organizations that do not follow FASB ASC g58, check here > E and complete lines 29 through 33. Capital stock or trust principal, or current funds Paid-in or capital surplus, or land, building, or equipment fund Retained earnings, endowment, accumulated income, or other funds Total net assets or fund balances DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 Formee0(2021) REBUIIJDING TOGETHER OF THE TRIANGLE 55-1955629 pase'12 if Schedule to any line in this 78L 755.1 2 3 4 5 6 7 8 9 10 Total revenue (must equal Part Vlll, cotumn (A), line 12) Total expenses (must equal Part lX, column (A), line 25) Revenue less expenses. Subtract line 2 from line 1 Net assets or fund balances at beginning of year (must equal part X, line 32, column (A)) Net unrealized gains (losses) on investments Donated servlces and use of facilities lnvestment expenses Prior period adjustments Other changes in net assets or fund balances (explain on Schedule O) Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, Financial Statements and Reporting if Schedule 1 Accounting method used to prepare the Form gg0: f-l casn lXl Accrual f_l oth", lf the organization changed its method of accounting from a prior year or checked "Other," explain on Schedule O. 2a Were the organization's financial statements compiled or reviewed by an independent accountant? lf "Yes," check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both: f_l Separate basis f-l Consolidated basis fl eoth consolidated and separate basis b were the organization's financial statements audited by an independent accountant? lf "Yes," check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both: I Xl Separate basis I Consolidated basis l-_-l eoth consolidated and separate basis c lf "Yes" to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its frnancial statements and selection of an independent accountant? lf the organization changed either its oversight process or selection process during the tax year, explain on Schedule O. 3a As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133? b lf "Yes, " did the organization undergo the required audit or audits? lf the organization did not undergo the required audit 377 643. 404 LL2. 43 7 6L. 447 873. 0. por.9901zozr) 132012 12-A9-21 DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 SCHEDULE A (Form 990) Depatment o, the Tresury lnternal Revenue Service Public Charity Status and Public Support Complete if the organization is a section 501(cXg) organization or a section gaT @)(11 nonexempt charitable trust. ) Attach to Form 990 or Form 990-EZ. An agricultural research organization described in section rzo(b)(r)(A)(ix) operated in conjunction with a land-grant college or university or a non-land'grant college of agriculture (see instructions). Enter the name, city, and state of the college or university: ONIB No. 1545-0047 2021 Go to www for instructions and the latest information. o, the organization Employer identification number ILDING OF THE -1955629 s must complete this See instructions. city, and state: 5flAnorganizationoperatedforthebenefitotu section 17O(bXlXAXiv). (Comptete parr It.) A federal, state, or local government or governmental unit described in section 17O(b)(f )(A)(v). An organization ihat normally receives a substantial part of its support from a governmental unlt or frorn the general public described in section 170(b)(t)(A)(vi). (Comptete part il.) A community trust described in section 170(bXlXAXvi). (Complete part lt.) 6f-l7E 8E s f_l 10 f-l An organization that normally receives (1 ) more than 33 1/3%o of its supporl from contributions, membership fees, and gross receipts from activities related to its exempt functions, subject to certain exceptions; and (2) no more than 33 1/3yoof its suppod from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1g75. See section 509(aX2). (Comptete part il1.).|, E An organization organized and operated exclusively to test for public safety. See section 509(a)(a).P f-l An organization organized and operated exclusively for the benefit of, to per-form the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 5o9(a)(2). See section 509(aX3). Check the box on -lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 1zt, and 12g.u f_] Type l. A supportlng organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete part lV, Sections A and B. b f] Type ll. A supporting organization supervised or controlled in connection with its suppofted organization(s), by having control or management of the suppoding organization vested in the same persons that control or manage the supported organization(s). you must complete part lV, Sections A and C. " f] Type lll functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete part lV, Sections A, D, and E_d f] Type lll non-functionally integrated. A supporting organization operated in connection with its supporled organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness - reguirement (see instructions). You must complete Part lV, Sections A and D, and part V.u I-_l CheckthisboxiftheorganizationreceivedawrlttendeterminationfromthelRsthatitisaTypet,Typell,Typeill functionally integrated, or Type lll non-functionally integrated supporting organization.f Enter the number of suppoded organizations Name of supported organization (vi) Amount of other support (see instructions) (described on lines 1,10 LHA For Paperwork Reduction Act Notice, see the lnstructions for Form 99o or 990-EZ . rlzo2.t 01-04-22 Schedule A (Form 99O) 2021 DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 (Complete only if you checked the box on line 5, 7, or B of part I fails to qualify under the tests listed below, please complete part or if the organization failed to qualify under Part lll. lf the organization ilr.) Calendar year (or fiscal year beginning in) ) 1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ...... 2 Tax revenues levied for the organ- ization's benefit and either paid to or expended on its behalf ........ . 3 The value of services or facilities furnished by a governmental unit to the organization without charge ... 4 Total. Add lines 1 through 3 . 5 The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2%o of the amount shown on line I1, column (0 from line 4. Calendar year (or fiscal year beginning in) > 7 Amounts from line 4 ... .. ....... 8 Gross income from interest, dividends, payments received on securities loans, rents, royalties, and income from similar sources ... 9 Net income from unreiated business activities, whether or not the business is regularly carried on 10 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part Vl.) 1 1 Total support. Add lines 7 through 10 12 Gross receipts from related activities, etc. (see instructions) 13 First 5 years. lf the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 5oi (c)(3) c. 14 Public support percentage 'f or 2021 (line 6, corumn (f), divided by rine 1 1 , corumn (D) ..... ....... ..15 Public support percentage from2OZO Schedule A, part ll, line 14 77 92330 . 7 92330 . Total 77 923 752. 100 00 00 00 >E >E >E 16a33 1/3%supporttest-2021' lftheorganizationclidnotchecktheboxonlinel3,andlinel4isg3 1/3yoormore,checkthisno*ano b33 1/3%supporttest-2020' lf theorganizationdidnotcheckaboxonlinel3orl6a,andlinel5is33 1/3%oormore,checkthisbox 17a10%-facts-and-circumstancestest-2O2'1. lf theorganizationdidnotcheckaboxonlinel3, 16a,or16b,andlinei4is jOyoormore, and if the organization meets the facts'and-circumstances test, check this box and stop here. Explain in part Vl how the orqanization meets the facts'and-circumstances test. The organization qualifies as a publicly supported organization b'lo%-facts-and-circumstancestest'2o2o. lttheorganizationdidnotcheckaboxonlinei3, 16a,i6b,or17a,andlinej5isi0%or more, and if the organization meets the facts'and-circumstances test, check this box and stop here. Explain in part Vl how the organization meets the facts'and-circumstances test. The organization qualifies as a publicly supported organization Schedule A (Form 99O) 2021 132022 01-04-22 DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 56-195562 (Complete only if you checked the box on line 1O of Pad I or if the organization failed to qualify under Part ll. lf the organization fails io Calendar year (or liscal year beginning in) > 1 Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ...... 2 Gross receipts from admissions, merchandise sold or services per. formed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose 3 Gross receipts from activities thai are not an unrelated trade or bus- iness under section 513 4 Tax revenues levied for the organ- ization's benefjt and either paid to or expended on its behalf 5 The value of services or facilities furnished by a governmental unit to the organization without charge ... 6 Total. Add lines 1 through 5 ... .. 7a Amounts included on lines 1,2, and 3 received from disqualified persons b Amounts included on lines 2 ancl 3 received lrom other than disqualified persons that exceed the greater of $5,000 or i% of the amount on line 13 for the year c Add lines 7a and 7b Calendar year (or liscal year beginning in) ) I Amounts from line 6 . . 10a Gross income from interest, dividends, payments received on securities loans, rents, royalties, and income from simiiar sources ... b Unrelated business laxable income (less section 51 1 taxes) from businesses acquired after June 30, l975 c Add lines 10a and 10b ,.. . . ..11 Net income from unrelated business activities not included on line iOb, whether or not the business is regularly carried on 12 Other income. Do not include gain or loss from the sale of capital assets (Explain in Part Vl.) 13 14 TOtal SUppoft. (Add tines s. 1oc, 1.1, and i2.) First 5 years. lf the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 50i (cX3) organization, '15 Public suppod percentage for 2021 (line B, column (f), divided by line 13, column (f)) f lnvestment income percentage for 2021 (line 1oc, column (f), divided by line 13, column (f)) lnvestment income percentage from 202O Schedule A, part lll, line 17 3g 1tg% support tests - 2021. lf the organization did not check the box on line ra ,rJ "" rs i" ,"r" ,n, J;;;d [,* 1, b ,o. more than 33 1/3%' check this box and stop here. The organization qualifies as a publicly supported organization >Eb33 1/3%supporttests-2o2o. lf theorganizationdidnotcheckaboxonlinel4orlinelga,andlinei6ismorethan 33 1/3%o,and 17 18 19a line 18 is not more than 33 1/3%o, check this box and stop here. The organization qualifies as a publicly supported organization E 132023 01 04-22 Schedule A (Form 990) 2021 DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 schedureA(Formeeo)2o21 REBUILDING TOGETHER OF THE TRfANGLE 55-1955fug (Complete only if you checked a box in line 12 on Part l. lf you checked box 12a, Part l, complete Sections A and B. lf you checked box 12b, Part l, complete Sections A and C. lf you checked box 12c, part l, complete Sections . lf vqu checked box 12d, Pad I and D, and A. AlI tza 'l Are all of the organization's supported organizations listed by name in the organization's governing documents? tf "No," describs in ParlYl how the suppofted organizations are designatecl. lf designated by class or purpose, describe the designation. tf historic and continuing relationship, exptain.2 Did the organization have any supporled organization that does not have an IRS determination of status under section 509(aX1) or (2)? y "Yes," exptainip Part Vl how the organization determined that the supported organization was described in section 509(a)(1) or (2). 3a Did the organization have a supporied organization described in section 50] (cX ), (5), or (6)? lf ,'yes," answer lines 3b and 3c below. b Did the organization confirm that each supported organization qualified under section 501 (c)( ), (5), or (6) and satisfied the public support tests under section 509(a)(2)? tf ,,yes,,, describe 11 part Vl when and how the organization made the determination. c Did the organization ensure that all support to such organizations was used exclusively for section i 7O(c)(2[B) purposes? tf "Yes," explain in ParlYl what controls the organization put in place to ensuresuch use.4a Was any supported organization not organized in the United States ("foreign supported organizalion")? 11 "Yes," and if you checked box 12a or 12b in parr t, answer lines 4b and 4c berow.b Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? tf "Yes," describe rn Part Vl how the organization had such control and discretion despite being controlled or supentised by or in connection with its supported organizations.c Did the organization suppod any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? 1S "yes,,, exptain 11.1 part Vl what controts the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes. 5a Did the organization add, substitute, or remove any supponed organizations during the tax year? lf ',yes,, answer lines 5b and 5c below (if applicabb). Atso, provide detait in part Vl, inctucling (i) the names and EtN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).b Type I or Type ll only' Was any added or substituted supported organization pad of a class already designated in the organization,s organizing document? c Substitutions only. Was the substitution the result of an event beyond the organization,s control?6 Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supporled organizations, (ii) individuals that are part of the charjtable class benefited by one or more of its supponed organizations, or (iii) other supporting organizations that also suppod or benefit one or more of the firing organization's supported organizations? rf "yes,', provide detait in Part Vl. 7 Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contribtrtor (as defined in section a95s(c)(3)(C)), a family member of a substantial contributor, or a3}%ocontrolled entity with regard to a substantial contributor? lf "yes," complete parl I of Schedule L (Form g90). 8 Did the organization make a loan to a disquallfied person (as defined in section 4958) not described on line l? If "Yes," complete Part I of Schedute L (Form gg0). 9a Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? 1y "yes," provide detait in part Vl. b Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? lf ,,yes,,, provide detail in part Vl.c Did a disqualified person (as defined on line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? lf ,,yes,,, provide detail in part Vl.'t0a Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type ll supporting organizations, and all Type lll nonJunctionally integrated supporting organrzations)? tf "yes," answer line lOb below.b Did the organization have any excess business holdings in the tax year? (Jse schedule c, Form 4720, to 132024 01 04-21 Schedule A (Form 99O)2021 DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 REBUTLDTNG ETHER OF THE TRIANGLE 11 Has the organization accepted a glft or contribution from any of the following persons? a A person who directly or indirectly controls, either alone or together with persons described on lines 11b and .1 1c below, the governing body of a suppoded organization? b A family member of a person described on line 11a above? c 435%o controlled entityof a person described on line 11a or 11b above? 11 ,,yes,,to line 11a, 11b, or 11c, provide Section 1 a b c 2 a I Supporting Did the governing body, members of the governing body, officers acting in their official capacity, or membership of one or more supported organizations have the power to regularly appoint or elect at ieast a majority of the organization's officers, directors, or trustees at all times during the tax year? lf "No,, describe in parlvl how the supported organization(s) effectively operated, supervised, orcontrolled the organization's activities. lf the organization had more than one supported organization, describe how the powers to appoint and/or remove officers, directors, or trustees were allocated among the suppofted organizations and what conditions or restrictions, if any, applied to such powers during the tax year. Did the organization operate for the benefit of any supported organization other than the supponed organization(s) that operated, supervised, or controlled the supporting organization? lf "yes," explain in ParlYl fisvv pT6viding such benefit carried out the purposes of the suppofted organization(s) that operated, C. Type Were a majority of the organization's directors or trustees during the tax year also a ma.lority of the directors or trustees of each of the organization's supported organization(s)? ff ,No," describe 111 part vl how control or management of the supporting organization was vested in the same persons that controlted or managed Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization's tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization's governing documents in effect on the date of notification, to the extent not previously provided? Were any of the organization's officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? tf ,'No,', explain in parlyl how the organization maintained a close and continuous working relationship with the supported organization(s). By reason of the relationship described on line 2, above, did the organization's suppofted organizations have a signiftcant voice in the organization's investment policies and in directing the use of the organization,s income or assets at all times during the tax year? lf "yes,,, describe rn part Vl the role the organization,s lll Func Organ Did substantially all of the organization's activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? 11 ,yss," then in part Vl identify those supported organizations and explain how these activities directty fufthered their exemptpurposeg how the organization u/as responslve to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities. Did the activities described on line 2a, above, constitute activities that, but for the organization,s involvement, one or more of the organization's supported organization(s) would have been engaged in? lf ,yes,,, explain in Part Vl 16s reasons for the organization's position that its suppotled organization(s) woutd have engaged in these activities but for the organization's involvement. Parent of Supported Organizations. Answer lines 3a and 3b below. Did the organization have the power to regularly appoint or elect a majority of the officers, djrectors, or trustees of each of the supported organizations? lf "yes,, or ,,No,, provide details in part Vl. Did the organization exercise a substantial degree of direction over the policies, programs, and activities of each AII 55-L95552 132025 01-04,22 Schedule A (Form 99O) 2021 DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 Check here if the organization satisfied the lntegral Part Test as a qualifying trust on Nov. 20, 1970 ( explain rn Part Vl). See instructions. All other Tvpe lll Section A -,Adjusted Net lncome shod-term Podion of operating expenses paid or incurred for production or collection of gross income or for management, conservatjon, or held for B Section B - Minimum Asset Amount 1 Aggregate fair market value of all non-exempt-use assets (see assets held for securities 1a, 1b, and 1 Discount claimed for blockage or other factors Part Iine 1d. Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see Section C - Distributable Amount 7 Sections A (B) Current Year (optional) (B) Current Year (optional) Current Year 1 Adiusted net income for Section 0.85 of line 1 Section 4 in b Distributable Amount. Subtract line 5 from line 4, unless subject to Check here if the current year is the organization's first as a non'functionally integrated Type lll supporling organization (see Schedufe A (Form 99O) 2021 132026 A1-04-22 DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 Sec REBUTLDING TOGETHER OF THE TR LE orting anlz ons ts paid to izations to Amounts paid to perform activity that directly furthers exempt purposes of supportecl in excess of i act Administrative id to sh do s paid to t-use assets Qualified nor Part distr Part See in Total distributions. Add lines 1 h6 Distributlons to attentive supported organizations to which the organization is responsive Part Vl). See instructions. I Distribu amount tor 2021 from Section line 55-195s62 Current Y (iii) Distributable Amount lor 2O21 1 2 I Section E - Distribution Allocations (see instructions) ributable amount 1 from Section C, line 6 Underdistributions, if any, for years prior Io 2O2l (reason able cause requlred - exolain rn Part Vl). See ins distribut il any,to2021 From 201 From 2017 From 201 B From 201 From2020 Total of lines 3a t ions of 1 distributable r from 2016 n ied instruct Bemainder 'act lines from line 3f Distributions tor 2021 from Section D, line 7 to 2021 distributable any. Subtract lines 39 and 4a from line 2. For resujt greater than zero Part Vl. See Remaining underdistributions for 2021. Subtract lines 3h and 4b from line 1 . For result greater than zero, explain in Part 7 Excess distributions carryover to 2022. Add lines 3i 4c. Breakdown of Excess from 201 Exces 2019 Excess from 2020 Schedule A (Form g9}l2021 132027 01-04-22 m DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 SchedureA(FormeeO)2021 REBUILDfNG TOGETHER OF THE TRIANGLE 56-1955629 paoes I Han Vl I Supplemental lnfOrmatiOn. provide the explanations required by part ll, line i0; part It, line 17a or 17b; pan ilt, line 12; Paft lV, Section A, lines 1,2,3b,3c,4b,4c,5a,6, 9a,9b,9c, 11a, 11b, and 11c, Part lV, Section B, lines 1 and2; Part lV, Section C, line 1; Pad lV, Section D, lines 2 and 3; Part lV, Section E, lines 1c, 2a,2b,3a, and 3b; Part V, line 1; Part V, Section B, Iine 1e; Parl V, Section D, lines 5, 6, and B; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any adclitional informatlon. (See instructions.) 132028 01-04-22 Schedule A (Form 990) 2O21 DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 Schedule B (Form 990) Department of the Treasury lnternal Bevenue Service Name of the organization Organization type (check one): Filers of: Form 990 or 990-EZ Form 990-PF Schedule of Contributors ) Attach to Form 990 or Form 990-pF, ) Go to www.irs.gov/Form99O for the latest information. EBUILDI OF THE Section: fXl sor (cX 3 ) lenter number) organization 4947(a)(1) nonexempt charitable trust not treated as a private foundation 527 political organization 501 (c)(3) exempt private foundation f_l +O+l1uyl) nonexempt charitable trust treated as a private foundation f--l sOt 1";1s1 taxabte private foundation OMB No. 1545-0047 2021 Employer identification number 955629 fl E E check if your organization is covered by the General Rule or a special Bule, Note: Only a section 501(c)(7), (B), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions. General Rule f-] rot an organization filing Form 990, 990-EZ, or 990'PF that received, dunng the year, contributions totaling $s,oog or more (in money or property) from any one contributor. Complete Parts I and ll. See instructions for determining a contributor,s total contributions. Special Rules For an organization described in section 501(c)(3) filing Form g90 or 990-EZ that met the 33 i/3%osupport test of the regulations under sections509(aX1)and 170(b)(1)(A)(vi), that checked ScheduleA(Form 990), Part ll, tine 13, 16a, or 16b, and that received from anyone contributor, during the year, total contributions of the greater of ( 1) g5,OOO; or (2) 2yo of the amount on (i) Form 990, part Vlll, line t h; or (ii) Form 99O.EZ,line 1. Complete parts I and ll. For an organization described in section 501(c)(7), (B), or (10) filing Form 990 or 990.E2 that received from any one contributor, during the year, total contributions of more than $i,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete parls I (entering "N/A" in column (b) instead of the contributor name and address), ll, and lll. f_] ror an organization described in section 501 (cX7), (B), or (1 o) filing Form 990 or 990-EZ that received from any one contributor, during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $i,000. lf this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc.,purpose Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year > $ caution: An organization that isn't covered by the General Bule and/or the Special Rules doesn,t file schedule B (Form gg0), but it must answer "No" on Part lV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ or on its Form 99O,pF, part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990). E E 123451 11-11-21 Schedule B (Form 99O) (2021)LHA For Paperwork Reduction Act Notice, see the instructions for Form ggo, 990-Ez, or 99o-pF. DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 Schedule B Name of organization ING TOGETHER THE TR]ANGLE Employer identification number 6-L955629 tFEE-Il Contributors (see instructions). Use duplicate copies of part I if additionat space is needed. (a) No. (b) Name, address, and ZIP + 4 (c) Total contributions (d) of contribution L NATIONAL 999 N. CAPITOL STREET NE, SU]TE 701 WASHINGTON, DC 2OOO2 99 000. Person EPayroll t] Noncash E (Complete Part ll for noncash contributions.) (a) No. (b) Name, address, and ZIP + 4 (c) Total contributions (d) of contribution 2 CHATHAM COUNTY COUNCIL ON AGTNG 365 NC-87 PITTSBORO NC 27 3L2 251,986. Person E Payroll E Noncash E (Complete Part ll for noncash contributions.) (a) No, (b) Name, address, and ZIP + 4 (c) Total contributions (d) of contribution 3 TRTANGLE .] COUNCTL OF GOVERNMENTS 4307 EMPEROR BLVD DURHAM, NC 27703 608 302. Person Payroll Noncash EEE (Complete Part ll for noncash contributions.) (a) No, (b) Name, address, and ZIP + 4 (c) Total contributions (d) of contribution 4 TOWN OF CARY 316 N. ACADEMY ST CARY NC 275L3 400 909. Person EPayrott E Noncash E (Complete Part llfor noncash contributions.) (a) No, 5 (b) Name, address, and ZIP + 4 (c) Total contributions (d) of contribution DUKE HHF 4428 LOUISBURG RD STE 101. RALEIGH, NC 27516 74 01,7 . Person EPayroll t_] Noncash t] (Complete Part ll for noncash contributions.) (a) No. 6 (b) Name, address, and ZIP + 4 (c) Total contributions (d) of contribution CHATHAM HTF 355 NC-87 PITTSBORO, NC 273L2 52 800. Person Payroll Noncash EEE (Complete Parl llfor noncash contributions.) 123452 11-11 21 Schedule B (Form 99O) (2021) DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 Schedule B (Form Name of organization REBUILD OF THE TRIANGLE Employer identification number s6-195s629 tF tI Contributors (see instruciions). Use duplicate copies of part I if additionat space is needed. (a) No. (b) Name, address, and ZIP + 4 (c) Total contributions (d) of contribution 7 DURHAM SSCF 101 CITY HALL PLAZA -ANNEX DURHAM, NC 2770]. $ 58,l-69. EEEPayroll Noncash (Complete Parl ll for noncash contributions.) (a) No, (b) Name, address, and ZIP + 4 (c) Total contributions (d) of contribution B USDA RURAL DEVLOPMENT RURAL HOUSING SERVICE 1400 INDEPENDENCE AVENUE sw RM 501-4 WASHINGTON DC 202s0 62 502. Person E Payroll t] Noncash t] (Complete Part ll for noncash contributions.) (a) No. (b) Name, ?ddress, and ZIP + 4 (c) Total contributions (d) of contribution 9 (a) No. MOEN INC 25300 AL MOEN DRTVE NORTH OLMSTED oH 44070 L26 503. Person Payroll Noncash tlEE (Complete Part ll for noncash contributions.) (b) Name, address, and ZIP + 4 (c) Total contributions (d) of contribution Person EPayroll t] Noncash E (Complete Part ll for noncash contributions.) (a) No. (b) Name, address, and ZIP + 4 (c) Total contributions (d) of contribution Person f] Payroll E Noncash t] (Complete Part ll for noncash contributions.) (a) No. (b) Name, address, and ZIP + 4 (c) Total contributions (d) Person f] Payroll t] Noncash E (Complete Part ll for noncash contributions.) Schedule B (Form 99O) (2021) of 123452 11-11-21 DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 Schedule B (Form Name of organization REBUILD TOGETHER OF THE TRIANGLE Employer identification number 56-L955629 Fartlil Noncash Property (see instructions). Use dupticate copies of Part il if additionat space is needed. (a) No, from Part I (b) Description of noncash property given (c) FMV (or estimate) (See instructions.) (d) Date received 9 BUILDTNG SUPPLIES $L26 503.09/30/2L (a) No. from Part I (b) Description of noncash property given (c) FMV (or estimate) (See instructions.) (d) Date received $ (a) No. from Part I (b) Description of noncash property given (c) FMV (or estimate) (See instructions.) (d) Date received $ (a) No. from Part I (b) Description of noncash property given (c) FMV (or estimate) (See instructions.) (d) Date received $ (a) No. from Part I (b) Description of noncash property given (c) FMV (or estimate) (See instructions.) (d) Date received $ (a) No. from Part I (b) Descriptlon of noncash property given (c) FMV (or estimate) (See instructions.) (d) Date received $ 123453 11-11-21 Schedule B (Form 99O) (2021) DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 Schedule B (Form Name of organization LD]NG Employer identification number s6-19ss6 (d) Description of how gift is held THE TRI of Part lll if additional is needed. (e) Transfer of gift (d) Description of how gift is hetd (e) Transfer of gift (d) Description of how gift is hetd (e) Transfer of gift (d) Description of how gift is held (c) Use of gift (c) Use of gift (c) Use of gift (c) Use of gift (e) Transfer of gift Schedule B (Form 99O) (2021) more than 123454 1 1-1 1-21 DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 SCHEDULE D (Form 990) Department of the Treasury lnternal Name of the organization Employer identification number ILDING THE TR 56-19s or Complete if the organization answered "Yes" on Form 990, parl lV, line 6. (b) Funds and other accounts Total number at end of year Aggregate value of contributions to (during year) Aggregate value of grants from (during year) Aggregate value at end of year 5 Did the organization inform all donors and donor advlsors in writing that the assets held ln donor advised funds are the organization's property, subject to the organization's exclusive legal control? .. f -l y". f-] ruo6 Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring ar,V, line 7. 1Purpose(s)ofconSerVationeaSementSheldbytheorganization(check"rr. f.l Preservation of land for public use (for example, recreation or education) fl pru."rvation of a historically impodant land areaf_l Protection of natural habitat f-l Preservation of open space f_l Preservation of a certified historic structure a b c d Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a day of the tax year. Total number of conservation easements Total acreage restrlcted by conservation easements Number of conservation easements on a certified historic structure included in (a) Number of conservation easements included in (c) acquired afler 7/2s/o6, and not on a historic structure listed in the National Register Number of conservation easements year> -- modified, transferred, released, extinguished, or terminated by the organization during the tax Number of states where propeny subject to conservation easement is located ) Does the organization have a written policy regarding the periodic monitoring, lnspection, handling of violations, and enforcement of the conservation easements it holds? Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year 7 Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year>$ _ Does each conservation easement reporled on line 2(d) above satisfy the requirements of section 17o(hX4XBXD ln Part Xlll, describe how the organization reports conservation easements in its revenue and expense statement and balance sheet, and include, if applicable, the text of the footnote to the organization's financial statements that describes the ll ruo Supplemental Financial Statements ) Complete if the organization answered ',Yes,, on Form g9O, Part lV, line 6, 7, 8, 9, 10, 1 1a, 1 1b, 1 1c, 1 1d, 1 1e, 1 1f, 12a, or 12b. ) Attach to Form gg0. 2021 1 2 3 4 4 5 Held at the End of the Tax Year answered "Yes" on Form gg0, part IV, line B. 1a lf the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public seruice, provide in Part XIll the text of the footnote to its financial statements that describes these items. b lf the organization elected, as permitted under FASB ASC 958, to repod in its revenue statement and balance sheet works of ad, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these ttems: (i) Revenue included on Form 990, part Vlll, line 1 (ii) Assets included in Form 990, Part X >$>$ lf the organization received or held works of art, historical treasures, or other the following amounts required to be reported under FASB ASC 958 relating a Revenue included on Form 990, pan Vlll, line 1 similar assets for financial gain, provide to these items: >$ LHA For Paperwork Reduction Act Notice, see the lnstructions for Form g9o. 132051 10-2A-21 Schedule D (Form 99O)2021 DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 TOGETHER OF THE or other records, check any of the following that make significant use of its d E Loan or exchange program " f-l oth"t I Using the organization's acquisition, accession, and collection items (check all that apply): u E Public exhibition b E Scholarly research " f-l Preservation for future generations 4 Provide a description of the organization's collections and explain how they further the organization's exempt purpose in part Xlll.5 During the year, did the organization solicit or receive donations of art, historical treasures, or other similar assets to be sold to raise funds rather than to be maintained as oart of the orq"nirdig!s!9,l!eg!9!?:.........___... rganizationanswered,,Yes,,onFormgg0,PartlV,lineg,or reported an amount on Form 990, Part X, line 21. 1a ls the organization an agent, trustee, custodian or other intermediary for contributions or other assets not inaluded on Form 990, Part X? . ... ........ b lf "Yes," explain the arrangement in part Xlll and complete the following table: Amount Beginning balance Additions during the year Djstributions during the year Ending balance Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? "Yes. " if the answered "Yes" on Form Part lV, line 1O- Four years back Beginning of year balance Contributions Net investment earnings, gains, and losses Grants or scholarships Other expenditures for facilities and programs Administrative expenses End of year balance Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as: Board designated or quasi.endowment )> % Permanent endowment ) Term endowment ) The percentages on lines 2a,2b, and 2c should equal .100%. 3a Are there endowment funds not in the possession of the organization that are held and administered for the organization by: (i) Unrelatedorganizations (ii) Relatedorganizations b lf "Yes" on line 3a(ii), are the related organizations listed as required on Schedule R? [l ye"f_-] ruo c d e f 2a 'la b c d e % % t s 2 a b c answered "Yes" on Form 990, part lV, line i 1a. See Form gg0, parl X, line 10. Description of property 1a b c d Leasehold improvements (d) Book value 1_09EquipmentL32 ,413.22,7L7 . Schedule D (Form 990) 2021 132452 10-28-21 Land Buildings DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 TOGETHER ilrveslrnen[5 - LJtner Decunlles. Complete if the organization answered "Yes" on Form g90, Part lV, line 11b. See Form 990, part X, line 12. (a) DeSCription Of SecUrity 0r Category (inctudins name of security)(c) Method of valuation: Cost or market value (1) Financial derivatives (2) Closely held equity interests (3) Other Complete if the answered "Yes" on Form 990, Part lV, line l1c. See Form 990, pad X, line 13. (a) Description of investment (c) Method of valuation: Cost or end.of.year market value answered "Yes" on Form 990, Part lV, line i1d. See Form 990, part X, line 15. (a) Description (b) Book value Complete if the organization answered "Yes" on Form 990, Part lV, line 11e or 11f. See Form 9go, partX, line25. (a) Description of liability (b) Book value ,...'.'.,,.''.......'....'...'.'...............-...-., Z l Liability for uncertain tax positions. In Part Xlll, provide the text of the footnote to the organization's financial statements that repods the Schedule D (Form 99O)2021 132053 10-28-21 DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 SchedureD(Formeeo)2021 REBUfLDING TOGETHER OF THE TRIANGLE 56-1955629 p*"q_ 1 2 a b c d e if the organization answered "Yes" on Form 990, Part lV, line i2a. Total revenue, gains, and other suppon per audited financial statements Amounts included on line 1 but not on Form 990, part Vlll, line 12: 2,787 456. Net unrealized gains (losses) on investments Donated services and use of facillties Recoveries of prior year grants Other (Describe in Part Xlll.) Add lines 2a through 2d 5 701 Subtract line 2e from line 1 2,78L 755 Amounts included on Form 990, Part Vlll, line 12, but not on line l: Investment expenses not included on Form 990, parl Vlll, line 7b Other (Describe in Part Xlll.) Add lines 4a and 4b 78L,75per if the answered "Yes" on Form 990, Part lV, line 12a. Total expenses and losses per audited financial statements 2 ,383 ,344. Amounts included on line 1 but not on Form 990, part lX, line 25: Donated services and use of facilities Prior year adjustments Other losses Other (Describe in Part Xlll.) Add lines 2a through 2d 5 7 0L. Subtract line 2e from line 1 2 ,377 643. Amounts included on Form 990, Part lX, Iine 25, but not on line 1: lnvestment expenses not included on Form 990, part Vlll, Iine 7b Other (Describe in Part Xlll.) Add lines 4a and 4b Provide the descriptions required for Part ll, lines 3, 5, and 9; Part Ill, lines 1a and 4; part IV, lines 1b and 2b; part V, line 4; part X, line 2; Part Xl, lines 2d and 4b; and Part Xll, lines 2d and 4b. Also complete this pad to provide any additional information. a b c 1 2 a b c d e 3 4 a b c 77 PART XT LINE 2D _ OTHER ADJUSTMENTS: FUNDRAISER EVENTS EXPENSES 70L. FUNDRAISER EVENTS EXPENSES 7 0L. 132054 10-2A-21 Schedule D (Form 99O)2021 DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 SCHEDULE G (Form 990) Depiltment of the Treasury lnternal Revenue Service Name organization supplemental lnformation Regarding Fundraising or Gaming Activities complete if the organization answered "Yes" on Form 990, Part lV, line 17, 18, or 19, or if the organization entered more than 915,000 on Form 990-EZ, line 6a. ) Attach to Form 990 or Form 990-EZ. the latest information. OMB No. 1545-0047 for 2021 Employer identification number REBU]LD TRTANGLE I Se-r95562 Fundraising Activities.Complete if the organization answered "Yes" on Form 990, Part lV, line 17. Form 990-EZ filers are not 1 a b c d 2a required to this pad. lndicate whether the organization raised funds through any of the following activities. Check all that apply.f l vait solicitations f -l lnternet and email solicitations fl Phon" solicitations fl ln-pur.on solicitations Did the organization have a written or oral agreement with any individual (including officers, directors, trustees, or key employees listed in Form 990, Part Vll) or entlty in connection with professional fundraising services? f_-l yu" f.'l ruob lf "Yes,"listthel0highestpaidindividualsorentities(fundraisers) pursuanttoagreementsunderwhichthefundraiseristobe compensated at least $5,000 by the organization. u f-l Soti"itution of non-government grants t f-l Solicitation of government grants g f_-] Special fundraising events (i) Name and address of individual or entity (fundraiser) (vi) Amount paid to (or retained by) organization Total 3 List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration (v) Amount paid to (or retained by) fundraiser listed in col. (i) or LHA For Paperwork Beduction Act Notice, see the lnstructions for Form ggo or 99o-EZ. 132081 1A-21-21 Schedule G (Form 9SO)2O2i DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 scheduleG(Formeso)2021 REBUILDING TOGETHER OF THE TRIANCTE 56-1955629 p"s"2 ian $15,ooo of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000 9, or reported more than I Enter the state(s) in which the organization conducts gaming activities: alstheorganizationlicensedtoconductgamingactiVitieSineachofthesestates? b lf "No," explain: ,0, b lf "Yes," explain: 'l Gross receipts (a) Event #'l JHUCK_N_CLUC ( (b) Event #2 (c) Other events NONE (d) Total events (add col. (a) through col. (c))(event iype)(event type)(total number) 24 ,025 .24 .02s 2 3 Less: Contributions ............. Gross income (line 1 minus line 2)24 ,025 .o2\ i 0).=o 5,70L. 9 in column (d) re 3. column (d) ........ 5 ,7 01. 5 - 701 . Complete if the organization answered ,,yes,, on Form g90, parl IV, line $15,000 on Form 990.E2, line 6a. 132042 10 21-21 Schedule G (Form 99O)2021 (d) Total gaming (add (a) through col. (c)) Food and beverages Entedainment Other direct expenses ..... (b) Pull tabs/instant bingo/progressive bingo 7DireCteXpenSeSummary.Addlines2through5incolumn(d)> DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 SChEdUIEG(FOTM99O)2021 REBUIIJDING TOGETHER OF THE TRIANGLE 55_1955529 PAqEs 12 ls the organization a grantor, beneficiary or trustee of a trust, or a member of a partnership or other entity formed fl y"r E ruo 13 lndicate the percentage of gaming activity conducted in: a The organization's facility 14 Enter the name and address of the person who prepares the organization's gaming/special events books and records: Name ) Address )> 15a Does the organization have a contract with a third pady from whom the organization receives gaming revenue? f-l y"" [l fto b If "Yes," enter the amount of gaming revenue received by the organization )> g and the amount of gaming revenue retained by the third party > $ c lf "Yes," enter name and address of the third parly: Name ) Address ) '16 Gaming manager information: Name ) Gaming manager compensation Description of services provided f-l Director/officer f l Employee 17 Mandatorydistributions: fl lndependent contractor a ls the organization required under state law to make charitable distributions from the gaming proceeds to b Enter the amount of distributions required under state law to be distributed to other exempt organizations or spent in the '15b, 15c, 16, and 17b, as applicable. Also provide any additional information. See instructions. 1320A3 10-21-21 Schedule G (Form 990) 2021 DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 132084 11 1B-21 Schedule G (Form 99O) DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 !r SCHEDULE M (Form 990) Oepartment of the Treasury lnternal Revenue Service Noncash Contributions Gomplete if the organizations answered ,,Yes,,on Form ggo, part lV, lines 2g or S0. Attach to Form 990. Go to www for instructions and the latest information. Name of the organization THE TRT Ad - Works of art Ar1 - Historical treasures Ad - Fractional interests Books and publications Clothing and household goods Cars and other vehicles Boats and planes lntellectual property Securities - Publicly traded Securities- Closely held stock Securities- Partnership, LLC, , trust interests Securities' Miscellaneous Qualified conservation contribution Historic structures Qualified conservation contribution - Other Real estate - Residential Real estate. Commercial Real estate - Other Collectibles Food inventory Drugs and medical supplies Taxidermy Historical artifacts Scientific specimens Archeological artifacts 29 Number of Forms 8283 received by the organization during the tax year for contributions for which the organization completed Form 8283, part V, Donee Acknowledgement 30a During the year, did the organization receive by contribution any propedy reported in parl I, lines 1 through 28, that it must hold for at least three years from the date of the initial contribution, and which isn,t required to be used for exempt purposes for the entire holding period? b lf "Yes," describe the arrangement in part jl. 31 Does the organization have a gift acceptance policy that requires the review of any nonstandard contributions? 32a Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash contributions? ....... b lf "Yes," describe in Part ll. 33 lf the organization didn't report an amount in column (c) for a type of property for which column (a) is checked, LHA For Paperwork Reduction Act Notice, see the rnstructions for Form 99o. OMB No. 1545-0047 2021 Employer identification number 6-29 (d) Method of determining noncash contribution amounts 1 2 3 4 5 6 7 I I 10 11 12 13 14 15 16 't7 18 19 20 21 22 23 24 25 26 27 x x x Form 990, Part Vlll, line 1 237 ,478. 132141 11-17-21 Schedule M (Form 99O) 2021 ) ) Open to Public lnspection, DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 is reporting in Part l, column (b), the number of contributions, te nrrne, of items received, or a cornbination of both. Also completethis pad for any additional information. 132142 11-17-21 Schedule M (Form 99O)2021 DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 SCHEDULE O (Form 990) Supplemental Information to Form 990 or 990-EZ Complete to provide information for responses to specific questions on Form 990 or 990-EZ or to provide any additional information. ) Attach to Form 990 or Form 990-EZ. 2021 Department of the Treasury Name of the organization Employer identification number REBUILDT OF THE 55-19s562 FORM 990, PART I, LINE 1, DESCRIPTION OF ORGANIZATION MISSION: WITH DISABILITIES, AND FAMTLES WITH CHILDREN _ LIVE IN SAFE HEALTHY HOMES. FORM 990, PART VI SECTfON B, LTNE ]-1B: MANAGEMENT AND THE TREASURER REVTEWS THE 990 PRIOR TO FTI,ING. FORM 990, PART VI, SECTION B, LTNE L2CZ THE ORGANIZATION IS CAREFUL NOT TO ENGAGE IN BUSINESS TRANSACTIONS WITH COMPANTES IN WHICH BOARD MEMBERS AND STAFF HAVE MATERIAL INTERESTS. THE ORGANIZATTON USED SALARY DATA FROM THE NC CENTER FOR NON_PROFITS AND FORM 990, PART VI, SECTTON B, LINE 15A: OTHER SOURCES TO ENSURE THAT COMPENSATTON WAS FORM 990, PART VI SECTION C, LTNE 19: THE ORGANIZATTON'S FORM 990 AND GOVERNING DOCUMENT ARE AVATLABLE TO THE PUBLIC UPON LHA For Paperwork Reduction Act Notice, see the lnstructions for Form 99O or 99O-EZ. 132211 11-11-21 Schedufe O (Form 99012021 DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 NoN ooo) E olt tr .9 to oo o o; o a ! I9; (g E'= o_ c;oo E olr o oco o:,! th E o ooo do oz o co o !ld0r+G.j !o-}TLFo: CL(E-o.6 8S NoooN Uo io Er(,zH <AdB Or trl ETH a) F] trl r'1& FIu Jo E{HA4 o @ n @n I N4 I U H o( tsl F E]o Er o Ho!lH Do F]d zc tlJ O!E!No'- ^-L6oG Ox n.^ EE -(do6 ib IE I8l*t; lE ls l-E I3 t;lf lel8li IBl.sIt ls ls IE ls li IH IElo IHl.Nlcldls,lolol-trl#t'; o E. 5o E 6 .NE6 g,o o E(,Xillld*E*rE#oo)E56s, oE E? E€ E'.NCC'6' tr)T'! 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Eo +Jo F o 6 Elio>lLx b.gOoloEoo,GC tiF.: EbOc 6ENin $Boo BI s{E6 Eg 6pEoGEo(EiENE'Eco0, E)!, I EI YGX6 '- vP^r o a5:o - c -Yra'=EF - oiioE oSu=o&-- rl I\o lr} N DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 NoN o d)o E oII tr -gatoEoo trlD}f4 rc 0) o -c cf tr CU (,) VC E o q)tc o !oT c) frH ,< .o (d .Nc(d o) gE d E]iq E{ o FfHp rq (gT o o E(!z ,3t ff; o 6E .of r $ Xo; ^^ Y'c!2 06.o ts ii(dir N!rdi'=-ikE o 60 A!! 6t6 0-o9o olo UUA(U(!!Po-o CCP9 bEChoou!9s k .o_O:Fro-= -=ooiEE O xlx XIX XIXIX Co Cd .Nc(d C,) o o) (U o) I =aoo o E 0)o'6 o o) C'f 6 .Ca a c .o d .Nc(u o) o o 6-o) -c..c B 0 0)oa(! oE o U; e o) .tr'6 E {.,co E.g fuo ui .o) =oG o c,)c (g -c@ 6;vgE-.o6#Efik-N ri s, d,6b C-oX#n(!i! o;i oo oo (UdEE.o .oooooo) o).c .c.2 .9(uN !! lf, oo .s .g 2{.o0)-o-oEEooEE oo aaoooo--ooao oo oq)ooCC(s(trEEooTEoo)0- o- : a s6 o(dENii '-_Naco.)(d!(,)uoE 1)Eof!(triPE ^o oa ooaaoaCU6 oo !!oo oo fn'LLoq)EEo_o'5 '5u(,oo ui u;oo =Eoo(!6 ooo0)oa(UNoo -JJ a CoEd .Ncdo) o 0) (d o) -trE a ooa Cd 0)(,)c(dcoxtu a co (! .N C(u o) o 0) (n -o) Eo a ooa(! o (!)o(! -co f,o @ o (tr .N (d o) o !o (Up o o ooo(\, o c,-6 U) C')or.v-Eco Lo (E .Nc(u o) o !o (g6 Eo o!co! :>o .o (E .N C(d o) o !o 6 -oo()o c(u (!lo, (U -9 o oc(uoJ Q) ac .o G ,Nc(u O) o o (! q) o o o o o)o C Cd (! f,o) c Go o oc(0oJ ! i I : a co Ncdo) o o (n 0) Eo co r=f coo (! .= CL(no o c(n o.) J+o o a c (d Nc 0) (! o o co f c o o o o o c (,) L(, c.. l aE(so .C ! 0) .9. oco.F (!l N,-: c!lDLio i ol(Ei 6: 9lqj E: o;o:c:o: c:,; o>r 6o ax SFFFq,F =u€b oEI#+ctsOoL a>k: .=o ouio)o o); uoc- =:= .N 0iccl6=p- OCoSc'" t":-aE9oo>! x-(E= O=!U o.9ca)'io:toocc oi f rC C).coa .a ! o o =j 0 (g o_ .c o .9 ,o ..! c 0) c (U = 0) ,E OJ 0) u Eo a, oz ldI c"Jt-lot;l3t-lsIoICl=-l>Irl6lo-t-lo6o) E otL co @ol ! 0) c) =oC(g c .o (! .Nc(E Po oE =o oo EoO ,ntroji(! .N Gg) o !o s 0) CC ; o o o(!o o F rJItlI(EItri DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 NoN od,o E olr trg fE 0) oa z trJ !c(g a= 60cvLO Ets!o Cg oi E(!z l^td) l6lc)ILlalalo lo t; l0lalal(, lgl*-l-olo lslaldlo t;IEt> IElp lbt;lolo lq lc lEIElo t; lolf lE 4lotlo9IEElN (gI'E o l(!!l9',bloE196li olc 2lo,=IE CllE lE,3 YoI+ fa ETE0)(!0)oco! a6(!u)oP9q.EbaE'a= dE 8,9 ,F ;l - ol € Elc cl €91 PEIafl o olF glo olr cl 0., Hlp =t F el l5 ls I5 EIH HI E nl*ol 6IE Hl 5 Erl ci EI Eol 9HIE Hl fi HIE "l E-l .E Hl $El -EbtEtTT E flE DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 s6-195562 Provide additional information for responses to questions on Schedule R. See instructions. 132165 11-17-21 Schedule R (Form 99O)2021 DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 .",. 8879-TE Depa(ment of lhe Treasury lnternal Revenue Service IRS e-file Siqnature Authorizationfor a Tax Exempt Entity For calendar year 2021, or fiscal year beginning ONIB No. 1545-0047 ,2021, and ending ) Do not send to the lRS, Keep for your records. Go io 2021 ormB879TE lor the latest information. of Iiler EIN or SSN s6-1 95s629REBUILDING TOGETHER OF THE TRIANGLE Name and title of officer or person subiect to tax DAN SARGENT DIRE 1a Form gg0 check here ......... > U b2a Form990-EZ checkhere ... >E b3a Form 1120-POL check frere ) l--l b4a Form990-PF checkhere ... >E b5a Form3363checkhere ......>E b 6a Form 990-T check here ...... > E b7a Form4T?0 check here ...... > f] b8a Form5227 checkhere ...... >n b9a Form 5330 check here ...... > f] b Total revenue, if any (Form 990, Part Vlll, column (A), line 12)h 2,78L,755. Total revenue, if any (Form 990-EZ, line 9) Tax due (Form 5330, Part ll, line i9) Under penalties of perjury, I declare that I am an officer of the above entity or I am a person subject to tax with respect to (name of entity), (ElN)-'_---- and that I have examined a copy of the ::f,Li1r"":-l?Xf#X':il: -L,"flfi}Ig-.*31!g.^i!9^.P1?T?!l!r l?9r to the best or my knowredge and betier, they are true, correct, and Checktheboxforthereturn.fo.rwhichyoUareusingthisFormBB79-TEandentertheapp|icableamount,it, ::'ll"t::P^l].:."Tf^"1:.: 1",,,::._::9,::]:: f:j 3lfll"Jlg'Il ?nt?l whore doilars onry. rr yo, crrecx trre nox on [ne 1a, 2a,3a,4a, 5a,6a,7a, Ba, ea,or 1oa below, and the amount on that line for the return being filed with this form was blink,'then leave line ;;6;;, il,fi, ;i, ;;, ;;, 6;, ;; ;3t:whichever is applicable, blank (do not enter'o). But, if you entered -o- on the return, then enter-0. on the applicable Iine beiow.' Do not complete morethan one line in Part l. Total tax (Form 1 120.POL, tine 22) ........ Tax based on investment income (Form 990-pF, paft V, line 5) Balance due (Form 8868, line 3c) . .... ... Total tax Total tax FMV of WOOTEN & HAYWOOD LLP 2b 3b 4b 5b 6b 7b 8b 9b complete. I rurther declare that tne an{ou"niin p;nl;bli;e is ih" ;;;;i:hil;ffi;,;;i ;i'i##;Ltii.","i;h:'i"J;'."Jiifr :frffi?;'"intermediate service provider, transmitter, or electronic,return originator 1fnol io-seno tne'ri:turn toiiie iils'ano to receive from it',E rnb 1u; unacknowledqementof receiptorreasonfoirejectionof thetransmis.ion,'lulLhdfoasonforSnygg[yinproc]ssingthereturnorrefund,and (c)thedate Bl,li{j J,i,l?;lfflJ'i"1?l?l,l*l:?,:1:"1**:;l:::ly_::f:{q::igt l".-Fil;it;iAs;nii6;;irrt;$';6;tronic runds withdrawar (direct debit) auKlrowreogemenr oT recelpt or reason tor reiection of the transmission, (b) the reason for any d9l3y in processing tne return-or iljtr"O, aiO' iiof any refund.' lf appJicable, I authorize the u:s. Treasury.and its oeiignlt5d Financiar ngeni t6 i":it,"rt" li erlttronic funds withdrawat (direct de fig?"1",*,1?l,Xi[?ilX*llHif: 3::^",,l1tjlgi:*:.J,,:rlil1.tfp"'_lion-'ott**e Er;?iTetiqi'iiilj#",litqes owed on this return, and therinancial institution to debit the entry to this acCouni il;;;;i;;p;fi;;i,iffi""i;#?#i:'#ii.'6:ir".,::';,yHfir""[Trui,nl'"i llb[Sottlr'&", ""3ji'-,13i"? ij,rf:..S:]ifl::ll^:l? l?ff:,"f:l',::"^ll^g:11 i3!9 t,th"iir;il; rf;i; iiiTii,iiiliiji.i""i"al;i#;;3"t.li"ni1i t " erectronicrater tnan 2 business days prior to the payment (settlement) datepayment of taxes to receive confidential ihformaiion necessarv tcPdyrrrer rt ur taxes ro recelve conTloentlal lnlormatlon necessary to answer inquiries and resolve issues related to the payment- I havJ selected apersonal identification number (PlN) as my signature for the el'ectronii retur,linJ, if applicable, the consent to electronic funds withdrawal. PIN: check one box IXI tauthorize only KOONCE ER0 firm name to enter my PIN 54820 Enler five numbers, but do nol enter all zeros as my signature on the lax year 2o21 electronically filed return. lf I have indicated within this return that a copy of the return is being filedwith a state agency(ies) regulating charities as pad of the IRS Fed/State program, I also authorize the aforementioned ERO to enter my plN on the return's disclosure consent screen. f l ns an officer or person subject to tax with respect to the entity, I will enter my PIN as my signature on the tax year 2o2l electronicaily filedreturn lf I have indicated within plsJqyrf\t a copy of the return is being filed with a state agency(ies) regutating charities as part of theIRS Fed/state program, r wilr ev(er ryffi ont tn" rq,urt's discrosure consent screen .- 6- lda:. ERO's EFIN/PlN. Enter your six.digit electronicvfiling identification number (EFIN) followed by your five.digit self,selected plN 5562525482L Do not enter all zeros I certify that the above numeric entry is my PlN, which is my signature on the 2021 electronically filed return indicated above. I confirm that I amsubmittingthisreturninaccordancewiththerequirementsof Pub.4l63,Modernizede.File(MeF)lnformationforAuthorizedlRs 6-;/sprovidersforBusiness Returns. ER0's signature )Date ) MustRetainttris rffi Do Not Submit This Form to the tRS Untess Requested To Do SoLHAForPrivacyactandPaperworkReductionActNotice,seeinstruction"'-@ 102521 01-11-22 PY-- : DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 Applicant Organization's Budget Actual Total for Previous Year Estimated Total for Current Year Projected Total for Next Year Percent Change 61,597$ 55,000$ 65,000$ 18% 130,502$ 175,000$ 180,000$ 3% 779,524$ 975,000$ 1,300,000$ 33% -$ -$ -$ 0 -$ -$ -$ 0 24,160.00$ -$ -$ 0 561,500.00$ 85,000.00$ 225,000.00$ 1.65$ 374,162.04$ 615,000.00$ 725,000.00$ 0.18$ Private Foundation Grants 378,006.36$ 515,000.00$ 575,000.00$ 0.12$ Other Revenue: Corporate Sponsor / In-Kind 481,571$ 380,000$ 400,000$ 0.05$ 2,791,023$ 2,800,000$ 3,470,000$ 24% 541,055$ 810,380$ 925,000$ 14% 64,215$ 157,050$ 160,000$ 2% 1,726,341$ 1,687,570$ 2,220,000$ 32% 5,257$ 13,500$ 15,000$ 11% 50,042$ 131,500$ 150,000$ 14% 2,386,910$ 2,800,000$ 3,470,000$ 24% 404,113$ -$ -$ 0SURPLUS/(DEFICIT) FOR PERIOD: Other Government Grants Triangle United Way State Government Federal Government (CDBG/HOME/etc.) Compensation Rent & Utilities Other Expenses: Fundraising, Insurance, Admin Total Agency Expenses Supplies & Equipment Travel & Training (Most recent complete calendar year or fiscal year) ORGANIZATION REVENUE Private Donations Rebuilding Together of the Triangle, Inc. Ending Date: 12/31/2022Starting date: 1/1/2021 ORGANIZATION NAME: AGENCY EXPENSES Total Organization Revenue Local Government Grants (Please list separately): Funding covering - Wake, Orange, Chatham, Carrboro, Durham Generated Revenue (fees, sales, etc) FY 2018-19 Agency Budget DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 Proposed Project Budget Use for all projects Actual Total for Previous Year Estimated Total for Current Year Projected Total for Next Year Percent Change -$ -$ -$ 0 -$ -$ -$ 0 -$ -$ 150,000$ 0 -$ -$ -$ 0 -$ -$ -$ 0 -$ -$ -$ 0 -$ -$ -$ 0 -$ -$ -$ 0 -$ -$ -$ 0 Private Foundation Grants -$ -$ -$ 0 Other Revenue: please briefly explain here -$ -$ -$ 0 -$ -$ 150,000$ 0 -$ -$ 30,000$ 0 -$ -$ -$ 0 -$ -$ 40,000$ 0 -$ -$ -$ 0 -$ -$ 80,000$ 0 -$ -$ 150,000$ 0 -$ -$ -$ 0 PROJECT REVENUE PROJECT NAME:Supplemental Weatherization for Low-Income Orange County Homeowners Use only if project is ongoing Private Donations Project Generated Revenue: Local Government Grants (Please list separately): Orange County Community Climate Action Grant Other Government Grants Triangle United Way State Government Travel & Training Other Expenses: Skilled Contract Labor Federal Government (CDBG/HOME/etc.) Supplies & Equipment Total Project Revenue PROJECT EXPENSES Compensation Rent & Utilities SURPLUS/(DEFICIT) FOR PERIOD: Total Project Expenses FY 2018-19 Program Budget DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 Rebuilding Together of the Triangle Board of Directors Name Physical/Mailing Address Phone number Email address Company Term Expires Shelley McPhatter, Chair 600 N Duke St, Durham, NC 27701 (919) 761- 0511 smcphatter@bridgepointnc.com BridgePoint General Contracting 2023 Matthew Duncan, Secretary 3737 Glenwood Ave Suite 450, Raleigh, NC 27707 (919) 743- 7329 Matthew.duncan@sas.com SAS Institute 2022 Mike Trainor, Treasurer 103 Milky Way Dr., Apex, NC 27502 (919) 645- 8607 mtrainor7473@gmail.com Servicing Solutions 2023 Anne Stoddard 3700 Glenwood Ave, Raleigh, NC 27607 (919) 614- 3214 astoddard@grubbventures.com Grubb Ventures 2022 Tyler Grimes 3600 Glenwood Ave Suite 300, Raleigh, NC 27607 (919 810- 6200 tgrimes15@gmail.com McGriff 2022 Marcelle Thomas 429 Foster Street, Durham, NC 27701 (919) 815- 4411 marcelle@urbandurham.com Urban Durham Realty 2022 Lauren Joyce 1500 Sunday Drive, Suite 300 Raleigh, North Carolina, 27607 (919) 232- 5929 ljoyce@hpg.com Hughes Pittman & Gupton, LLP 2024 Greg McNamara 4801 Glenwood Ave Suite 310, Raleigh, NC 27612 (919) 851- 9880 greg@accurogroup.com Accuro Group 2024 DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 3/12/2023 Arthur J.Gallagher Risk Management Services,LLC 595 Market Street Suite 2100 San Francisco CA 94105 Darby Hughes 415-546-9300 415-536-8499 Darby_Hughes@ajg.com License#:0D69293 Philadelphia Indemnity Insurance Company 18058 REBUTOG-92 Tokio Marine Specialty Ins Co 23850RebuildingTogether,Inc.(Affiliates) Rebuilding Together of the Triangle 999 N.Capitol St.,NE,Suite 701 Washington DC 20002 1428031055 A X 1,000,000 X 100,000 5,000 1,000,000 2,000,000 X X Stop Gap Liab Y PHPK2524743 3/15/2023 3/15/2024 2,000,000 STP GAP/ND OH WA WY 1,000,000 A 1,000,000 X X X PHPK2524743 3/15/2023 3/15/2024 A X X 10,000,000PHUB8535423/15/2023 3/15/2024 10,000,000 X 10,000 B B Contractors Pollution/Prof Liab Commercial Crime (Fidelity)PPK2524494 PSD1780869 3/15/2023 3/15/2023 3/15/2024 3/15/2024 Limits :$1,000,000 Limit $25,000 $50,000 Orange County Housing and Community Development are included as additional insured as required by written contract. Orange County Housing and Community Development 300 W Tryon Street Hillsborough NC 27278 DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12 PHPK2524743 DocuSign Envelope ID: 3B3ED7CA-61F5-4E47-87CD-95256B532A12