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HomeMy WebLinkAbout2023-515-E-DEAPR-Piedmont Wildlife Center-Outside Agency FundingOrange County Outside Agency Performance Agreement Revised 06/23—County Manager Version Page 1 of 10 OUTSIDE AGENCY PERFORMANCE AGREEMENT THIS AGREEMENT, made and entered into the first day of July 2023, (“Effective Date”) by and between the County of Orange, a political subdivision of the State of North Carolina, Post Office Box 8181, Hillsborough, North Carolina, 27278, ("County") and Piedmont Wildlife Center, a not-for-profit corporation, located at 364 Leigh Farm Road, Durham, North Carolina 27707 (“Provider”). WITNESSETH: WHEREAS, it is in the interests of the County that said program be assisted by the County and thereby enhance its availability to residents of the County, and said program addresses an important community human services need, as identified by the Board of Commissioners. NOW, THEREFORE, in consideration of the above and the mutual covenants and conditions hereafter set forth, the County and Provider agree as follows: 1.Term of the Agreement. The term of this Agreement shall be a program year beginning July 1, 2023 to June 30, 2024. 2.Scope of Services. a.Provider will provide services, as outlined in the attached Outside Agency Funding Application and any amendments or revision thereto which is attached as Exhibit “A” and incorporated by reference, to the residents of Orange County. The Scope of Services and the Program Budget may be different from the original application based on County appropriation; however, any revisions or amendments to this Agreement must be approved in writing by the County and attached to this Agreement as Exhibit B. b.The Provider shall be solely responsible for the means, methods, techniques, sequence, safety program and procedures necessary to properly and fully complete the work set forth in the Scope of Services. 3.Funding. a.The County agrees to appropriate for the provision of services described in Exhibit A, Scope of Services and more particularly described in the Revised Program Budget, the maximum sum of $12,000. 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 four equal installments in the amount of $3,000. The first payment is contingent upon receipt of the agency’s performance agreement; the remaining payments are contingent upon receipt of the request for reimbursement and related supporting documentation. d.The County’s obligation to make the quarterly payments is contingent upon receipt of Progress Reports, which show satisfactory progress toward completion of performance measures and an accounting of expenditures as detailed in the attached Scope of Services. DocuSign Envelope ID: 59AE45FB-98E0-4087-8250-10D08A4AD3AD Orange County Outside Agency Performance Agreement Page 2 of 10 Rev.06/23 e. Once Provider has satisfied its obligations as provided in (d) payment will be made 21 days after receipt of the Progress Report and Request for Reimbursement or 21 days after due date of Progress Report whichever is later. f. The County is not obligated to provide any other support to Provider in this or in succeeding fiscal years. 4. Agency Reporting. a. Provider will provide Orange County a Progress Report that includes a fiscal report and updates on performance measures as outlined in the Scope of Services. Progress Report dates are: July 1 – December 31; January 1 – March 31 and April 1 - June 30. Reports are due on January 8, April 8 and July 8 of the program fiscal year. b. Provider agrees to allow the County to inspect its financial books and records, which document costs of those services, upon reasonable notice during normal working hours. 5. Termination. a. Termination for Cause. In the event of any of the circumstances set forth below (hereinafter referred to as “default”), the County may immediately terminate this Agreement, in whole or in part, and from time to time. Notice of termination must be in writing, state the reason or reasons for the termination, and specify the effective date of the termination: i. In the event that Provider shall cease to exist as an organization or shall enter bankruptcy proceedings, be declared insolvent, or liquidate all or substantially all of its assets, or significantly reduce its services or accessibility to Orange County residents during the term of this Agreement; or ii. In the event that Provider shall fail to render a satisfactory accounting as provided section 4 above, the County may terminate this Agreement and Provider shall return all payments already made to it by the County for services which have not been provided or for which no satisfactory accounting has been rendered; or iii. In the event of any fraudulent representation by the Provider in an invoice or other verification required to obtain payment under this Agreement or other dishonesty on a material matter relating to the performance of services under this Agreement. iv. Nonperformance, incomplete service or performance, or failure to satisfactorily perform any part of the work identified in the Scope of Services or to comply with any provision of this Agreement, as determined by the County in its sole discretion. v. Failure to adhere to the terms of applicable county, state or federal laws, regulations, or stated public policy. b. In the event of default by the Provider, the county may elect to terminate this Agreement, in whole or in part and/or require the Provider to repay the funds within ten (10) business days from written notice of default. The County may (but shall not be required to) grant the Provider an opportunity to cure the default without termination of this Agreement. This clause shall not be interpreted to limit the County’s remedies in law or in equity. c. Notwithstanding the foregoing, either party may terminate the agreement at any time without penalty; provided that written notice of such termination is furnished to the other party at DocuSign Envelope ID: 59AE45FB-98E0-4087-8250-10D08A4AD3AD Orange County Outside Agency Performance Agreement Page 3 of 10 Rev.06/23 least 30 days prior to termination. In the event of such termination, any payment due shall be prorated to the date of termination and any unused funds shall be returned to the County within 10 days of termination. d. Any termination of this Agreement for default under this section that is later deemed to be unjustified shall be deemed a termination for convenience. e. Waiver. The payment of any sums by the County under this Agreement or the failure of the County to require compliance by the Provider with any provisions of this Agreement or the waiver by the County of any breach of this Agreement shall not constitute a waiver of any claim for damages by the County for any breach of this Agreement or a waiver of any other required compliance with this Agreement. 6. Responsibilities of the County. Cooperation and Coordination. The County has designated (Ardra Webster) to act as the County's representative with respect to the Project who shall have the authority to render decisions within guidelines established by the County Manager or the County Board of Commissioners and who shall be available during working hours as often as may be reasonably required to render decisions and to furnish information. 7. Insurance. a. General Requirements. The Provider shall purchase and maintain, during the period of performance of this Agreement, insurance: i. Worker’s Compensation. For protection from claims under workers' or workmen's compensation acts; ii. Cyber Liability. For protection from claims resulting from data breach, virus, and cyberattack; iii. Comprehensive General Liability Insurance covering claims arising out of or relating to bodily injury, including bodily injury, sickness, disease or death of any of the Consultant's employees or any other person and to real and personal property including loss of use resulting thereof; iv. Comprehensive Automobile Liability Insurance, including hired and non-owned vehicles, if any, covering personal injury or death, and property damage; and v. Professional Liability Insurance, covering personal injury, bodily injury and property damage and claims arising out of or related to the performance under this Agreement by the Consultant or his agents, consultants and employees. vi. Sexual Misconduct. Sexual Abuse/Molestation Insurance is required when Provider works directly one-on-one with children, elderly or other at-risk populations. b. Limits of Coverage: Minimum limits of insurance coverage shall be as follows: INSURANCE DESCRIPTION MINIMUM REQUIRED COVERAGE  Worker's Compensation Limits for Coverage A ‐ DocuSign Envelope ID: 59AE45FB-98E0-4087-8250-10D08A4AD3AD Orange County Outside Agency Performance Agreement Page 4 of 10 Rev.06/23 Statutory State NC, for each employee Limits for Coverage B ‐ Employers Liability of: $1 million Each Occurrence $1,000,000 BID limit  Cyber Liability $1,000,000 Each Occurrence; $2,000,000 Aggregate *Only required for agencies transmitting personal identifiable information that is disseminated electronically.  Commercial General $1,000,000 Each Occurrence Liability $2,000,000 Aggregate  Automobile Liability $1,000,000 Each Occurrence *Only required for agencies doing travel as part of the agreement with the County.  Professional Liability $1,000,000 Each Occurrence $2,000,000 Aggregate  Sexual Misconduct $1,000,000 Each Occurrence $2,000,000 Aggregate *Only required for agencies doing direct work with minors (under the age of 18). c. All insurance policies (with the exception of Worker's Compensation and Professional Liability) required under this Agreement shall name the County as an additional insured party and as a certificate holder. For more information see the Orange County Risk Transfer Policy and Orange County Minimum Insurance Coverage Requirements, (each document is incorporated herein by reference and may be viewed at http://www.orangecountync.gov/departments/purchasing_division/contracts.php.) Evidence of such insurance and all correspondence shall be sent to: Orange County Risk Manager Post Office Box 8181 Hillsborough, NC 27278 d. Nothing in this section is intended to affect or abrogate the County’s sovereign immunity defenses. 8. General Provisions. a. Governing Law. This Agreement and the duties, responsibilities, obligations and rights of respective parties hereunder shall be governed by the laws of the State of North Carolina. By executing this Agreement Provider affirms that Provider and any subcontractors of Provider are and shall remain in compliance with Article 2 of Chapter 64 of the North Carolina General Statutes. By executing this Agreement Provider certifies that Provider has not been identified, and has not utilized the services of any agent or subcontractor identified, on the list created by the State Treasurer pursuant to G.S. 147-86.58. By executing this Agreement Provider certifies that Provider has not been identified, and has not utilized the services of DocuSign Envelope ID: 59AE45FB-98E0-4087-8250-10D08A4AD3AD Orange County Outside Agency Performance Agreement Page 5 of 10 Rev.06/23 any agent or subcontractor identified, on the list created by the State Treasurer pursuant to G.S. 147-86.81. b.Non-Discrimination. Provider agrees as part of consideration of the granting of funds by Orange County the parties hereto for themselves, their agents, officials, employees and servants agree not to discriminate in any manner of these basis of race, color, gender, national origin, age, handicap, religion, sexual orientation, familial status or veterans status with reference to any activities carried out by the grantee, no matter how remote. The parties hereto further agree in all respects to conform to the provision and intent of Orange County Civil Rights Ordinance, as amended and the Orange County Non-discrimination Policy, which is incorporated herein by reference and can be viewed at http://www.orangecountync.gov/departments/purchasing_division/contracts.php. The County may enforce this provision by an action for specific performance, injunctive relief, or other remedy as by law provided; this provision shall be binding on the grantees, the successors and assigns of the parties hereto with reference to the above subject manner. c.Dispute Resolution. Any and all suits or actions to enforce, interpret or seek damages with respect to any provision of, or the performance or non-performance of, this Agreement shall be brought in the General Court of Justice of North Carolina sitting in Orange County, North Carolina. It is agreed by the parties that no other court shall have jurisdiction or venue with respect to such suits or actions. Binding arbitration may not be initiated by either Party, however, the Parties may agree to nonbinding mediation of any dispute prior to the bringing of such suit or action. d.Living Wage. Orange County is committed to providing its employees with a living wage and encourages agencies if funds to pursue the same goal. The Orange County Living Wage Policy, which is incorporated herein by reference, can be viewed at: http://www.orangecountync.gov/departments/purchasing_division/contracts.php. The County’s living wage is $15.85 per hour. To the extent possible, Orange County recommends that Provider provide a living wage to its employees. e.Relationship of the Parties. Provider is an independent contractor of the County. Provider represents that they have or will secure, at his own expense, all personnel required in performing the services under this Agreement. Such personnel shall not be employees or have any contractual relationship with the County. All personnel engaged in work under this Agreement shall be fully qualified and shall be authorized and permitted under federal, state and local law to perform such services. f.Compliance with all Laws. The Provider, at its sole expense, shall comply with all laws, ordinances, orders and regulations of the federal, state or local governments, as well as their respective departments, commissions, boards, and officers, which are in effect at the time of execution of this Agreement or are adopted at any time following execution of this agreement. g.Subcontract. The County and Provider deem the services provided under this Agreement to be personal in nature and Provider may not subcontract any rights or duties under this Agreement to any other party without prior written consent from the County. h.Assignment. The Provider shall not assign this Agreement, including the rights to payment, to any other party without the prior written consent of the County. i.Indemnification. Provider agrees to defend, indemnify, and hold harmless the County, for all loss, liability, claims or expense (including reasonable attorney's fees) arising from bodily DocuSign Envelope ID: 59AE45FB-98E0-4087-8250-10D08A4AD3AD Page 6 of 10 injury, including death or property damage, to any person or persons caused in whole or in part by the negligence or willful misconduct of the Provider, except to the extent same are caused by the negligence or willful misconduct of the County. It is the intent of this section to require Provider to indemnify the County to the extent permitted under North Carolina law. Nothing in this section is intended to affect or abrogate the County’s sovereign immunity defenses. j.Non-Appropriation. This Agreement is subject to the availability of funds to purchase the specified services and may be terminated at any time if such funds become unavailable. k.Severability. All clauses found herein shall act independently of each other. If a clause is found to be illegal or unenforceable, it shall have no effect on the other provisions of this Agreement. It is understood by the parties hereto that if any part, term or provision of this Agreement is by the Courts held to be illegal or in conflict with any laws of the State of North Carolina or the United States, the validity of the remaining portions or provisions shall not be affected, and the rights and obligations of the parties shall be construed and enforced as if the Agreement did not contain the particular part, term or provision held to be invalid. l.Entire Agreement. This Agreement represents the entire and integrated agreement between the County and the Provider and supersedes all prior negotiations, representations or agreements, either written or oral. This Agreement may be amended only by written instrument signed by both parties. Modifications may be evidenced by facsimile signatures. m.Notices. Any notice required by this Agreement shall be in writing and delivered by certified or registered mail, return receipt requested to the following: Orange County Attention: Ardra Webster P.O. Box 8181 Hillsborough, NC 27278 Provider’s Name Piedmont Wildlife Center Attention: Karen McCall Address: 364 Leigh Farm Road Durham, NC 27707 Email:admin@piedmontwildlifecenter.org Email:awebster@orangecountync.gov n.Signatures. This Agreement together with any amendments or modifications may be executed electronically. All electronic signatures affixed hereto evidence the intent of the Parties to comply with Article 11A and Article 40 of North Carolina General Statute Chapter 66. IN WITNESS WHEREOF, the Orange County and the Provider have signed this Agreement, effective on the last date this Agreement is signed by both parties as indicated by the dates set forth under signatures below. For and on behalf of the Provider _______________________ Date _____________________________ Karen McCall, Executive Director For and on behalf of Orange County Government _______________________________ Orange County Outside Agency Performance Agreement Rev.06/23 ________________________ DocuSign Envelope ID: 59AE45FB-98E0-4087-8250-10D08A4AD3AD 9/18/2023 9/26/2023 Orange County Outside Agency Performance Agreement Page 7 of 10 Rev.06/23 Bonnie Hammersley, County Manager Date DocuSign Envelope ID: 59AE45FB-98E0-4087-8250-10D08A4AD3AD Orange County Outside Agency Performance Agreement Page 8 of 10 Rev.06/23 ORANGE COUNTY—DEPARTMENT USE ONLY ______________________________________________________________________________ Party/Vendor Name: Piedmont Wildlife Center Party/Vendor Contact Person: Karen McCall Contact Phone: 919- 489-0900 Party/Vendor Address: 364 Leigh Farm Road City Durham State: NC Zip: 27707 Department: DEAPR Amount: $12,000 Purpose: Outside Agency Funding Budget Code(s): 10290050 719032 Vendor # 51232 (N/A if new vendor) Vendor is a BOCC consultant? Yes No Contract Type: (Check one) New Renewal Amendment Effective Date Approved by Board Yes No Agenda Date: June 20, 2023 This agreement is approved as to technical form and content and I as Department Director affirmatively state work on this project has not been initiated prior to execution of the agreement: Department Director’s Signature ________________________________________ Date: ________ Agreements for emergency services or repair are not subject to the above affirmation. If services related to this agreement have already begun or been completed please briefly describe the nature of the emergency condition that was addressed: Information Technologies (Applicable only to hardware/software purchases or related services) This agreement has been reviewed and is approved as to information technology content and specifications: Office of the Chief Information Officer___________________________________ Date: ________ Risk Management This agreement is approved for sufficiency of insurance standards, specifications, and requirements: Office of the Risk Management Officer___________________________________ Date: _________ Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officer ____________________________________ Date: _________ Legal Services This agreement is approved as to legal form and sufficiency: Office of the County Attorney __________________________________________Date: ________ Clerk to the Board Received for record retention: All Docusign contracts must be copied to the Clerk upon completion: occlerkdocs@orangecountync.gov The following signature block is for hard copies only and is not required for Docusign contracts: Office of the Clerk to the Board __________________________________________Date:_________ DocuSign Envelope ID: 59AE45FB-98E0-4087-8250-10D08A4AD3AD 9/18/2023 9/25/2023 9/26/2023 9/26/2023 COVER PAGE Applicant Contact Information Piedmont Wildlife Center 364 Leigh Farm Road, Durham, NC 27707 364 Leigh Farm Road, Durham, NC 27707 https://www.piedmontwildlifecenter.org/ Executive Director: Karen McCall Telephone Number: 919-489-0900 E-Mail: admin@piedmontwildlifecenter.org Tax ID Number: 47-0890261 Funding Request Please list all Fiscal Year 2024 Human Services (HS) funding requested for all programs and the proposed use of funds (please list program name only) Program Carrbor o - HS Chapel Hill - HS Orange County- HS Total Earthkeepers Afterschool Program - Personnel 2,800 11,685 14,485 Earthkeepers Afterschool Program Travel and Supplies 200 315 515 Totals 3,000 12,000 15,000 DocuSign Envelope ID: 59AE45FB-98E0-4087-8250-10D08A4AD3AD Briefly explain your proposed use of funds: As part of our mission to connect people and nature, Piedmont Wildlife Center offers afterschool programs, camps, and other educational programming for children ages 5-17 in Orange and Durham Counties. Through our outdoor programs, students connect with nature, learn about the local environment, hone awareness skills, and build a desire to protect our environment. They also develop valuable mental, emotional, and interpersonal skills, which in turn improve their academic performance and general well-being. Indeed, studies show that when children spend time outside, it improves their ability to learn, reduces stress and anxiety, makes students more engaged and interested, develops self-discipline, and improves leadership aptitude. (https://greatergood.berkeley.edu/article/item/six_ways_nature_helps_children_learn ). program. This is an expanded afterschool program performed on-site at Carrboro Elementary, Orange Middle, Gravely Middle, and A. L. Stanback Middle School. If the full grant amount is awarded, we plan to replicate the successes of Carrboro Elementary with an elementary school in Orange County. All students enrolled in afterschool at Carrboro Elementary and Orange County middle schools will participate in the Earthkeepers Program free of charge once a week. In 2022-23, we ran programs in Orange County for 6 weeks in the fall and 9 -day camp program on January 23. This gave us a great opportunity to connect with students who would not normally sign up for a program at Piedmont Wildlife Center, getting them outside and helping them learn how we are all connected and part of the natural world. We will continue this program in a similar timeframe for 2023-24. Funds from this grant will go to support staff salaries and supplies so we are able to operate the programs at each school for all students in afterschool free of charge. DocuSign Envelope ID: 59AE45FB-98E0-4087-8250-10D08A4AD3AD DocuSign Envelope ID: 59AE45FB-98E0-4087-8250-10D08A4AD3AD DocuSign Envelope ID: 59AE45FB-98E0-4087-8250-10D08A4AD3AD AGENCY INFORMATION Please provide the following information about your agency: Date of Incorporation (Month/Year):12/2002 (no more than a few sentences): Our mission is to encourage conservation and inspire people to build lifelong connections with nature through immersive outdoor education, citizen science, and wildlife stewardship. carrying out similar projects and evidence of successful record of meeting proposed budgets and timetables (no more than 100 words). We have been running our afterschool program for 8 years at CHCCS and Durham Public Schools. At Carrboro Elementary school, we have worked within our budget, sent timely program agendas to the school: carried out teacher trainings and submitted sign in lists for continuing education credit and followed the timeframe laid out in our proposals. Parents reported on surveys how their children share their experience and knowledge, and send their kids to camp. Positive survey responses, the excitement students showed when we arrived at the school, and teachers reported using the activities in our absence, are signs of our success. Living Wage: Does this agency pay permanent employees a minimum living wage?(Yes / No)No If yes, is this agency an Orange County Living Wage Certified Employer? No If no, please briefly explain. Due to financial decisions made prior to the pandemic, and then freezing salaries during the pandemic, salaries were adjusted as best as possible, and we had a group health plan. Our criteria to offer an employer plan changed and those who needed health insurance had to go back through the marketplace. Currently, the board is evaluating adjusting the current budget so we can pay a living wage without health insurance to our permanent full-time staff. We are incrementally raising wages with the goal of eventually providing a living wage. Schedule of Positions: # of FTE Full-Time Paid Positions: _8__ # of FTE Part-Time Paid Positions: _1_ * 1 Part time staff that works all year round. * 41 Part time staff that work seasonal. DocuSign Envelope ID: 59AE45FB-98E0-4087-8250-10D08A4AD3AD Race & Equity Consistent with our commitment to equity and inclusion, the Towns of Chapel Hill and Carrboro and Orange County Government are taking steps together to center racial equity in the Human Services Funding Program. We are requesting basic 5. How has your organization incorporated racial equity goals into your organizational goals? Our goal as an organization is for our staff, board, and participants to more comparably reflect the diversity of the community where we are located. In order to achieve this goal, we are actively working to remove barriers to the accessibility of Piedmont Wildlife We have changed our scholarship process, removing a tax document requirement that may have caused privacy concerns and adding a letter of recommendation instead; offer afterschool programs on-site and provided bus transportation to other schools; and we are advertising our open staff positions where candidates of all backgrounds are more likely to see them. In addition, our board is developing a Diversity, Equity, and Inclusion committee, and both board members and full time staff are participating in Diversity, Equity, and Inclusion workshops. Please describe how you have involved the intended beneficiaries of the proposed project in the planning and design process (in 100 words or less). In order to design an afterschool program that will provide the greatest impact on our participants, we collaborated with the Afterschool teachers of the three Orange County and what activities they have enjoyed in the past, allowing us to tailor our programming Afterschool programming assisted in the selection of which schools would most benefit schedules. 7. Please fill in your agency demographics in the table below: Agency Demographics Staff Board Gender Men 4 4 Women 40 3 Nonbinary/Genderqueer 8 0 Self-Describe 2 0 Total 55 7 Race and Ethnicity Black or African-American 2 2 American Indian or Alaska Native 0 Asian Indian 0 White 40 4 Native Hawaiian or Other Pacific Islander 0 DocuSign Envelope ID: 59AE45FB-98E0-4087-8250-10D08A4AD3AD Chinese 1 1 Japanese 0 Vietnamese 0 Filipino 2 Korean 0 Multiracial 11 Total 55 7 Of the above, how many Hispanic, Latino or Spanish origin 5 0 Of the above, how many non-Hispanic, Latino or Spanish origin 50 7 Total 55 7 8. Please describe any activities your organization is doing to address racial equity. a. % of staff that have attended racial equity training: 63 i. Two of our full-time staff participated in a non-profit conference focused on DEI in November 2022 with the intent of sharing what was learned with the rest of the full time staff. We have started to do so by incorporating cultural sharing into our staff meetings each month, and will continue this practice into training for seasonal staff. ii. Three of our full-time staff participated in other DEI trainings earlier in 2022. One of this same staff will partake in an online course in February 2023 on Justice, Equity, Diversity, and Inclusion in Environmental Education and work with seasonal staff to integrate the lessons learned into summer staff training. b. % of board that have attended racial equity training: 88 i. We had a DEI training for our board in November 2022. The training focused on recognizing cultural diversity and shaping ourselves toward Acceptance, Adaptation, and Integration through open conversations. We are working to schedule another training and form a DEI committee. ii. In addition, at least two board members will attend the BoardLead Nonprofit Learning Series in February 2023, a four-part training series that will focus on best practices in good governance and how to practice diversity, equity, and inclusion. c. Any additional activities: DocuSign Envelope ID: 59AE45FB-98E0-4087-8250-10D08A4AD3AD PROGRAM INFORMATION *Please submit for each program if applying for funding for more than one program. 9. Program Name: Earthkeepers Afterschool Program Program Primary Contact and Title: Katie Zimmerman, Education Programs Coordinator Telephone Number:919-489-0900 E-Mail: katiez@piedmontwildlifecenter.org 10.Please briefly describe the proposed program, including an explanation of how it aligns with the Town of , and Orange County BOCC Goals and Priorities, and the target population to benefit from the program. (250 words or less) a high quality of life and lifelong learning that champions diversity, education at all levels, libraries, parks, recreation, and animal welfare. Through our programs, children ages 5-14 and from all walks of life learn naturalist skills that improve their awareness, creativity, and problem-solving abilities. Both they and their teachers are encouraged to ask questions to heighten their curiosity, challenge their observations, and keep them wondering. Students develop a relationship with what sparks their interest, motivating them to preserve and protect our environment, continue learning and use these skills in the classroom. In FY 22-23, we brought our program to Carrboro Elementary School with both an afterschool program and 3 programs on their teacher work days. In addition, we ran our program at 3 middle schools in Orange County. In FY 23- programs at an elementary school in Orange County as well as continue the programs at the existing schools. Our projected numbers are based on similar attendance at the Orange County elementary school as what we have previously experienced at Carrboro Elementary. 11. Target Population:Please complete the table below with numbers (not percentages) of individuals served and projected to be served. DocuSign Envelope ID: 59AE45FB-98E0-4087-8250-10D08A4AD3AD Program Target Population Demographics Projecte d 2021- 2022 Actual 2021- 2022 Project ed 2022- 2023 Projected 2023- 2024 Gender Men 92 10 106 144 Women 99 10 87 112 Nonbinary/Genderqueer 2 0 1 0 Self-Describe 0 0 0 0 Total 193 20 194 256 Race and Ethnicity Black or African-American 20 2 5 39 American Indian or Alaska Native 0 0 0 0 Asian Indian 9 1 1 6 White 104 17 66 182 Native Hawaiian or Other Pacific Islander 0 0 0 0 Chinese 0 0 1 0 Japanese Vietnamese Filipino Korean Some other race 60 0 121 29 Total 193 20 194 256 Of the above, how many Hispanic, Latino or Spanish origin 60 3 18 30 Of the above, how many non-Hispanic, Latino or Spanish origin 133 17 176 226 Total 193 20 0 256 Age 0-5 years 55 5 18 55 6-18 years 138 15 176 201 19-50 years 0 0 0 51+ years 0 0 0 Total 193 20 194 256 Geographic Location Town of Chapel Hill 7 0 9 0 Town of Carrboro 100 20 73 89 Orange County (Outside of Chapel Hill/Carrboro) 28 0 71 167 Outside of Orange County 58 0 41 0 Total 193 20 194 256 Income Low-income (80% of the Area Median Income and Below) ** ** ** DocuSign Envelope ID: 59AE45FB-98E0-4087-8250-10D08A4AD3AD Please see income table in the attachments Total 0 0 0 0 **We do not have this data except when people apply for scholarships, and then it is destroyed upon scholarship approval. We provided the program free to Carrboro afterschool students last year, but worked through the aftercare manager at the school, and do not have access to and do not have access to County based on percent of students on Free or Reduced Lunch. 12. Cost Per Individual This cost per individual must reflect the total program budget divided by the total number of program individuals in this application. Actual 2021- 2022 Projected 2022- 2023 Projected 2023- 2024 Total Cost of Program $1,401.73 $12,732 $17,641.34 Total # of Individuals 87 194 256 Cost Per Individual $16.11 $65.63 $68.91 13. Performance Indicators For Chapel Hill and Carrboro applicants: Please complete the following chart with information about the Strategic Objective, Intermediate Result, and the Agency Performance Indicator for each program for which you are applying for funding. Please select one strategic objective per program.If you would like to provide additional information on how your program aligns with additional strategic objectives, please include that information in Question 10 Program Description. See the Results Framework in the Attachments section as a reference. Program Name: Strategic Objective (please choose one from the Results Framework) Children improve their educational outcomes Residents Increase their livelihood security Residents improve their health outcomes Intermediate Result (please choose one from the Results Framework) Children demonstrate new grade-level-appropriate skills. DocuSign Envelope ID: 59AE45FB-98E0-4087-8250-10D08A4AD3AD RESULTS Actual 2021-2022 Projected 2022-2023 Projected 2023-2024 Performance Indicators (Please choose at least one performance indicator to report on from the Results Framework and add additional performance indicators that you would like to report to the Towns. Please insert additional rows as needed, listing one per row). % and # of program participants will increase their awareness and observation skills. This will be observed by counselors asking questions, and watching who successfully demonstrates their skills during activities. Counselors will record the # of students and % at the end of the activities. 20 students successfully demonstrated awareness and observation skills. In lieu of doing our original plan of afterschool programming, Jaydee Moore, the Afterschool Director, was understaffed and unable to take on coordinating our program to include training Afterschool teachers. Instead, she asked us to support her for her teacher workdays at Carrboro Elementary. We were able to support Jaydee Carrboro Elementary on February 15th, March 25th, and April 15th. 40% and the equivalent 28 students will successfully demonstrate awareness and observation skills. 50% and the equivalent 35 students will successfully demonstrate awareness and observation skills. Afterschool teachers will be trained on nature mentoring and receive 2 hours of continuing education credit. Teachers will be able to incorporate activities assisting us, or leading them on In lieu of doing our original plan of afterschool programming, Jaydee Moore, the Afterschool Director, was understaffed and unable to take on coordinating our program to include training Afterschool teachers. Instead, she 90% of teachers will receive training and continuing education credit. They will be able to assist and lead activities taught during the training. 100% of teachers will receive training and continuing education credit. They will be able to assist and lead activities taught during the training. DocuSign Envelope ID: 59AE45FB-98E0-4087-8250-10D08A4AD3AD their own, continuing connection with nature. asked us to support her for her teacher workdays at Carrboro Elementary. We were able to support Jaydee Carrboro Elementary on February 15th, March 25th, and April 15th. DocuSign Envelope ID: 59AE45FB-98E0-4087-8250-10D08A4AD3AD DocuSign Envelope ID: 59AE45FB-98E0-4087-8250-10D08A4AD3AD DocuSign Envelope ID: 59AE45FB-98E0-4087-8250-10D08A4AD3AD Orange County Outside Agency Performance Agreement Page 10 of 10 Rev.06/23 ATTACHMENT “A” Orange County Certifications – FY 2023-2024 Outside Agency Performance Agreement Chief Contact, Administrators, Chief Executive Officer and Chief Financial Officer I certify that I have provided a list of the chief contact, administrators, chief executive officer and chief financial officer for my agency with this Agreement and that I will keep it current to the County of Orange. The list should be in writing with the name, title, residential address; phone and email address and if possible, fax number. Officers and Board of Directors I certify that I have provided a current list of the Officers and Board of Directors with this Agreement and that we will continue to update the list as changes occur. The list should be in writing, with the name, physical address, mailing address and if possible, phone, fax and email address. Budget Submission I certify that I have provided a budget for the period to be covered by funding Orange County, and that any substantive changes made to this budget have been in advance authorized in writing by Orange County. Annual Financial Review I certify that I have provided a copy of the latest annual Financial Review for our agency and the budget adopted by the agency for the fiscal years encompassing this Agreement. If not, please explain on a separate sheet of paper. Alignment with Organization’s Mission I certify that the programs and services for which this funding is requested align with the mission of the organization. Intended Purpose I certify that the funds provided to the agency under the terms of this Agreement will be used for a public purpose and shall only be used for the purposes intended and any money not used for those purposes will be promptly returned to Orange County. Certified by: _______________________ Title: __________________________ Date: ___________ (Provider’s Signature) DocuSign Envelope ID: 59AE45FB-98E0-4087-8250-10D08A4AD3AD Executive Director 9/18/2023 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 8/29/2023 High &Rubish Insurance PO Box 3040 Chapel Hill NC 27515-3040 Laura Pope 919-913-1144 919-913-1155 Laura@highandrubish.com License#:1000008811 Cincinnati Surplus Lines 13037 PIEDWIL-01 Progressive Southeastern 38784PiedmontWildlifeCenterInc. 364 Leigh Farm Rd. Durham NC 27707 1019053104 A X 1,000,000 X 100,000 5,000 1,000,000 2,000,000 X Y CSU0174091 9/1/2023 9/1/2024 2,000,000 Sexual Molestation 1,000,000 A B 1,000,000CSU0174091 970023072 9/1/2023 5/23/2023 9/1/2024 5/23/2024 A 1,000,000CSU01740959/1/2023 9/1/2024 A Cyber Coverage CSU0174096 9/1/2023 9/1/2024 Each Occurence 50,000 Orange County,its officers,agents and employees are listed as additional insured with respect to the General Liability policy. Orange County 300 West Tryon Street PO Box 8181 Hillsborough NC 27278 DocuSign Envelope ID: 59AE45FB-98E0-4087-8250-10D08A4AD3AD DocuSign Envelope ID: 59AE45FB-98E0-4087-8250-10D08A4AD3AD