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2024-170-E-AMS-Habitat for Humanity-Supplemental Weatherization to Home Repair
COMMUNITY CLIMATE ACTION GRANT PERFORMANCE AGREEMENT THIS AGREEMENT, made and entered into the eleventh day of March, 2024, (“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 Habitat for Humanity a legal entity corporation, located at 88 Vilcom Center Drive, Suite L110, Chapel Hill, NC 27514(“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 two years beginning March 11, 2024 to March 11, 2026. 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 $55,000. 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 See Exhibit C to be paid as follows: See 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 and 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 alternative payment schedule, which if approved, will be attached to this Agreement as Exhibit C, Alterative Payment Schedule. Should an Alternative Payment schedule be approved, the DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E Provider will still be required to submit quarterly Progress Reports for the duration of the Term of the Agreement. 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 Exhibits B and C. e. 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. 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 Exhibit B, Revised Scope of Services. . Progress Report dates are: January 1-March 31, April 1-June 30, July 1-September 30, and October 1-December 31. Reports are due on April 15, July 15, October 15, and January 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. 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 in 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. DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E 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 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 (Amy Eckberg) 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. 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 claims arising out of or related to the performance under this Agreement by the Consultant or his agents, consultants and employees. v. 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: DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E INSURANCE DESCRIPTION MINIMUM REQUIRED COVERAGE • Worker's Compensation Limits for Coverage A - Statutory State NC & Coverage B - Employers Liability $500,000 each accident, disease policy limit and disease each employee • Commercial General $1,000,000 Each Occurrence Liability $2,000,000 Aggregate • Automobile Liability $500,000 Combined Single Limit • Professional Liability $1,000,000 Each Occurrence $2,000,000 Aggregate • Sexual Misconduct $1,000,000 Each Occurrence $2,000,000 Aggregate c. All insurance policies (with the exception of Worker's Compensation and Professional Liability) required under this Agreement shall name the County as an additional insured party and as a certificate holder. For more information see the Orange County Risk Transfer Policy and Orange County Minimum Insurance Coverage Requirements, (each document is incorporated herein by reference and may be viewed at http://www.orangecountync.gov/departments/purchasing_division/contracts.php.) Evidence of such insurance and all correspondence shall be sent to: Orange County Risk Manager Post Office Box 8181 Hillsborough, NC 27278 d. Nothing in this section is intended to affect or abrogate the County’s sovereign immunity defenses. 8. General Provisions. a. Governing Law. This Agreement and the duties, responsibilities, obligations and rights of respective parties hereunder shall be governed by the laws of the State of North Carolina. By executing this Agreement Provider affirms that Provider and any subcontractors of Provider are and shall remain in compliance with Article 2 of Chapter 64 of the North Carolina General Statutes. By executing this Agreement Provider certifies that Provider has not been identified, and has not utilized the services of any agent or subcontractor identified, on the list created by the State Treasurer pursuant to G.S. 147-86.58. By executing this Agreement Provider certifies that Provider has not been identified, and has not utilized the services of any agent or subcontractor identified, on the list created by the State Treasurer pursuant to G.S. 147-86.81. b. Non-Discrimination. Provider agrees as part of consideration of the granting of funds by Orange County the parties hereto for themselves, their agents, officials, employees and servants agree not to discriminate in any manner of these basis of race, color, gender, national origin, age, handicap, religion, sexual orientation, familial status or veterans status with reference to any activities carried out by the grantee, no matter how remote. The parties hereto further agree in all respects to conform to the provision and intent of Orange County Civil Rights Ordinance, as amended and the Orange County Non-discrimination Policy, which is incorporated herein by reference and can be viewed at http://www.orangecountync.gov/departments/purchasing_division/contracts.php. The County may enforce this provision by an action for specific performance, injunctive relief, or other remedy as by law provided; this provision shall be binding on the grantees, the successors and assigns of the parties hereto with reference to the above subject manner. DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E 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 $16.60 per hour. To the extent possible, Orange County recommends that Provider provide a living wage to its employees. e. Relationship of the Parties. Provider is an independent contractor of the County. Provider represents that they have or will secure, at his own expense, all personnel required in performing the services under this Agreement. Such personnel shall not be employees or have any contractual relationship with the County. All personnel engaged in work under this Agreement shall be fully qualified and shall be authorized and permitted under federal, state and local law to perform such services. f. Compliance with all Laws. The Provider, at its sole expense, shall comply with all laws, ordinances, orders and regulations of the federal, state or local governments, as well as their respective departments, commissions, boards, and officers, which are in effect at the time of execution of this Agreement or are adopted at any time following execution of this agreement. g. Subcontract. The County and Provider deem the services provided under this Agreement to be personal in nature and Provider may not subcontract any rights or duties under this Agreement to any other party without prior written consent from the County. h. Assignment. The Provider shall not assign this Agreement, including the rights to payment, to any other party without the prior written consent of the County. i. Indemnification. Provider agrees to defend, indemnify, and hold harmless the County, for all loss, liability, claims or expense (including reasonable attorney's fees) arising from bodily injury, including death or property damage, to any person or persons caused in whole or in part by the negligence or willful misconduct of the Provider, except to the extent same are caused by the negligence or willful misconduct of the County. It is the intent of this section to require Provider to indemnify the County to the extent permitted under North Carolina law. Nothing in this section is intended to affect or abrogate the County’s sovereign immunity defenses. j. Non-Appropriation. This Agreement is subject to the availability of funds to purchase the specified services and may be terminated at any time if such funds become unavailable. k. Severability. All clauses found herein shall act independently of each other. If a clause is found to be illegal or unenforceable, it shall have no effect on the other provisions of this Agreement. It is understood by the parties hereto that if any part, term or provision of this Agreement is by the Courts held to be illegal or in conflict with any laws of the State of North Carolina or the United States, the validity of the remaining portions or provisions shall not 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. DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E l. Entire Agreement. This Agreement represents the entire and integrated agreement between the County and the Provider and supersedes all prior negotiations, representations or agreements, either written or oral. This Agreement may be amended only by written instrument signed by both parties. Modifications may be evidenced by facsimile signatures. m. Notices. Any notice required by this Agreement shall be in writing and delivered by certified or registered mail, return receipt requested to the following: Orange County Provider’s Name: Habitat for Humanity Attention: Amy Eckberg Attention: Alice Jacoby P.O. Box 8181 Address: 88 Vilcom Center Drive Hillsborough, NC 27278 Suite L110, Chapel Hill, NC 27514 Email:aeckberg@orangecountync.gov Email: ajacoby@orangehabitat.org n. Signatures. This Agreement together with any amendments or modifications may be executed electronically. All electronic signatures affixed hereto evidence the intent of the Parties to comply with Article 11A and Article 40 of North Carolina General Statute Chapter 66. IN WITNESS WHEREOF, the Orange County and the Provider have signed this Agreement, effective on the last date this Agreement is signed by both parties as indicated by the dates set forth under signatures below. For and on behalf of the Provider _____________________________ _______________________ , Date For and on behalf of Orange County Government _______________________________ ________________________ Bonnie Hammersley, County Manager Date DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E 3/14/2024 VP of Policy and Advocacy 3/19/2024 ORANGE COUNTY—INTERNAL USE ONLY ______________________________________________________________________________ Finance Information Vendor Name: Habitat for Humanity Vendor Contact Person: Alice Jacoby Phone: 919-932-7077 Address: 88 Vilcom Center Drive, Suite L110, City Chapel Hill State: NC Zip: 27514 Department: County Manager Amount: $55,000 Purpose: Supplemental Weatherization to Home Repair Projects Budget Code(s): 61370035-803086-30052 Vendor # 15086 Vendor Status with NCSOS: Vendor is a BOCC consultant: Yes X No Contract Details Contract Type: New Amendment (Original Contract: ) (Most Recent Amendment ) Effective Date 3/11/24 End Date 3/11/26 Notice Date (Notice Purpose ) Award X Approved by Board (Agenda Date: 12/12/23); Made or Administered by Signature Authority - BOCC Express Delegation (Agenda Date: ) - Policy 9.4: Under $5,000; Service Under $90,000; Construction Under $250,000 - Budget Policy Section XV (Capital Improvement Project: ) Bidding Informal Bidding ($30k-$90k); Formal RFP ($90k+); Other (<$30k); Exception(# ) Department Affirmation X 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. Services related to this agreement have already begun or been completed. Description of the nature of the emergency condition that was addressed: Department Director’s Signature ________________________________________ Date: ________ Information Technologies This agreement has been reviewed and is approved as to information technology content and specifications: Office of the Chief Information Officer___________________________________ Date: ________ Inapplicable because no hardware/software purchases or related service 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 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: Received for record retention: Office of the Clerk to the Board __________________________________________Date:_________ DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E 3/14/2024 3/18/2024 3/19/2024 3/19/2024 Exhibit A Community Climate Action Grant Program Application FY23-24 Board of County Commissioners Agenda 12-12-23 DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E Exhibit B Community Climate Action Grant Program’s Revised Scope of Services and Program Budget No Revisions DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E Climate Action Grant Program Revised 1/24 Page 10 of 10 Exhibit C Community Climate Action Grant Program’s Alternative Payment Schedule FY24 Q3 $0 FY24 Q4 $10,000 FY25 Q1 $15,000 FY25 Q2 $15,000 FY25 Q3 $15,000 DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E Habitat for Humanity Orange County Community Climate Action Grant Program Performance Agreement Page 11 of 10 Rev.1/24 ATTACHMENT “A” Orange County Certifications – FY 2023-2024 Community Climate Action Grant 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: DBE8454E-5CDD-4377-A739-3C0016853D4E 3/14/2024VP of Policy and Advocacy P a g e 1 o f 18 Orange County Community Climate Action Grant - Application 2023-24 SUBMISSION CHECKLIST Primary Applicant Organization: Habitat for Humanity, Orange County, N.C., Inc. Project Name: Supplemental Weatherization to Home Repair Projects Section Subsection Cover Page Applicant and Collaborator/Partner Contact Information Funding Request Summary Signed Application Cover Page Disclosure 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) Project Information Project Name Project Description and Climate Plan Alignment Collaborator Information (if applicable) Criteria-Specific Sections 1-7 Attachments (A description of these items is available on page 13: “Description of Required Attachments.” Please contact us if it will not be possible to provide any of these required attachments at the time of application: aeckberg@orangecountync.gov Applicant Organization’s Annual Budget and Proposed Project Budget (Use template provided) Applicable Financial Records to prove eligibility: IRS Federal Form 990 or Applicant Organization’s Tax Returns from 2022 Applicable Financial Records to prove eligibility of collaborator/partner (if they are receiving project funds): IRS Federal Form 990 or Tax Returns from 2022 List of members of organization’s Governing Board (if Board exists) Certificate of Insurance DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E P a g e 2 o f 18 COVER PAGE Applicant Organization’s Contact Information Organization’s Legal Name: Habitat for Humanity, Orange County, N.C., Inc. Physical Address: 88 Vilcom Center Drive, Suite L110, Chapel Hill, NC 27514 Mailing Address: 88 Vilcom Center Drive, Suite L110, Chapel Hill, NC 27514 Web Address: www.orangehabitat.org Telephone Number: (919) 932-7077 E-Mail: ajacoby@orangehabitat.org Tax ID Number: 58-1603427 Funding Request Summary Please list all Fiscal Year 23-24 Community Climate Action Grant funding requested for the project you are proposing and the proposed use of funds (please list project name only). Applicants will be asked to provide more details on their proposed project budget in the Budget Worksheets attachment. Project Equipment Operations Personnel Total Supplemental Weatherization to Home Repair Projects $0 $55,000 $0 $55,000 Briefly explain your proposed use of funds (2-4 sentences): To the best of my knowledge and belief all information and data in this application is true and current. Signature: August 18, 2023 Applicant’s Authorized Signatory Date Habitat for Humanity of Orange County proposes to use $55,000 in Orange County Climate Action Grant Funds to provide supplemental weatherization services on five homes being repaired through the organization’s Home Preservation program in the coming year. Habitat’s Home Preservation program serves Orange County residents who own their homes but are unable to afford necessary repairs due to low or fixed incomes. Of this amount, $50,000 will go towards the direct cost of the weatherization projects, including materials, subcontractor labor, and direct construction staff labor. The remaining $5,000 is a 10% overhead charge for support staff and other costs to administer the program. DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E P a g e 3 o f 18 DISCLOSURE OF POTENTIAL CONFLICTS 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/partners or members of their immediate families, or their business associates: YES NO a) Employees of or closely related to employees of Orange County? b) Members of or closely related to members of the governing bodies of Orange County? c) Current beneficiaries of the program for which funds are being requested? d) Paid providers of goods or services to the program or having other financial interest in the program? If you have answered YES to any question or know of any other potential conflict of interest regarding your application, please provide a full explanation here: n/a 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 on the basis of race, color, gender, national origin, age, handicap, religion, sexual orientation, gender identity/expression, familial status or veteran status with reference to any activities carried out by the grantee, no matter how remote. The parties hereto further agree in all respects to conform to the provision and intent of Orange County Civil Rights Ordinance, as amended and the Orange County Anti-Discrimination Policy. This provision is enforced by action for specific performance, injunctive relief, or other remedy as by law provided; this provision shall be binding on the grantees, the successors and assigns of the parties hereto with reference to the above subject manner. To the best of my knowledge and belief all of the above information is true and current. I acknowledge and understand that the existence of a potential conflict of interest does not necessarily make the program ineligible for funding, but the existence of an undisclosed conflict may result in the termination of any grant awarded. Signature: August 18, 2023 Applicant’s Authorized Signatory Date DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E P.O. Box 8181 * Hillsborough, North Carolina 27278 Telephone: 919 245-2626 Applicant Organization & Collaborator Information Please provide the following information about the primary applicant organization: Contact Information for Primary Contact, Chief Executive Officer / Executive Director, and Chief Financial Officer Primary Contact Name Alice Jacoby Title Vice President of Policy & Advocacy Preferred phone number (919) 932-7077 ext. 216 Email address ajacoby@orangehabitat.org Fax number (if applicable) (919) 932-7079 Chief Executive Officer / Executive Director Name Jennifer Player Title President & CEO Preferred phone number (919) 932-7077 ext. 215 Email address jplayer@orangehabitat.org Fax number (if applicable) (919) 932-7079 Chief Financial Officer Name Grace Johnston Title Vice President of Finance & Administration Preferred phone number (919) 932-7077 ext. 219 Email address gjohnston@orangehabitat.org Fax number (if applicable) (919) 932-7079 1. Date of Incorporation (Month/Year): April 1984 2. Applicant organization’s Purpose/Mission (2-4 sentences): Seeking to put God’s love into action, Habitat for Humanity of Orange County brings people together to build homes, communities, and hope. Our vision is an Orange County where everyone has a decent place to live. Since its founding in 1984, Habitat has built more than 330 new homes and repaired more than 240 owner-occupied homes in Orange County. Habitat has a successful history of leveraging funds from local government to create and preserve affordable homeownership in Orange County. DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E P a g e 5 o f 18 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 sentences): In 2020-2021, Habitat successfully used funds from the Climate Action Fund to incorporate more weatherization projects into its Home Preservation program. Through these efforts, Habitat leveraged over $50,000 in Climate Action Funds to replace or repair 4 HVAC systems, add insulation to attics and crawl spaces, and replace windows. This was in addition to the critical repairs that Habitat went into the house to address, which include things like failing roofs or repairs to structural framing. In years without this special funding available, Habitat would have been unable to complete these weatherization projects due to budget limitations on the amount of funds that can be allocated per house. 4. Living Wage: Does this organization pay permanent employees a minimum living wage? (Yes / No) Yes If yes, is this organization an Orange County Living Wage Certified Employer? (Yes / No) If no, please briefly explain. Yes 5. Schedule of Positions: a. Number of Full-Time Paid Positions: 26 b. Number of Part-Time Paid Positions: 1 c. Number of volunteers: 155 per month Average hours worked per volunteer per month 15 hours per volunteer per month on average. Approximately 27,900 hours total annually. Most volunteers complete one 4-hour shift per year. We also have a core crew who volunteer 8 hours at least once a week, and folks who fall everywhere in between. Please note this is new home construction volunteers only. Collaborators: Please provide the following information about all significant collaborators and partners whether or not they will be receiving grant funding for this project. Feel free to copy and paste Questions “a” through ”e” as needed if you have more than one significant collaborator/partner: a. Date of Incorporation (Month/Year): b. Applicant organization’s Purpose/Mission (2-4 sentences): DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E P a g e 6 o f 18 c. 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 sentences): d. Living Wage: Does this organization pay permanent employees a minimum living wage? (Yes / No) If yes, is this organization an Orange County Living Wage Certified Employer? (Yes / No) If no, please briefly explain. e. Schedule of Positions: a. Number of Full-Time Paid Positions: b. Number of Part-Time Paid Positions: c. Number of volunteers: Average hours worked per volunteer per month Project Information *Please submit for each project if applying for funding for more than one project. 6. Project Name: Supplemental Weatherization to Home Repair Projects DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E P a g e 7 o f 18 7. Please briefly describe the proposed project and the target population to benefit from the program. How many people will benefit? (100-300 words) Habitat for Humanity’s Home Preservation program serves Orange County homeowners earning between 0% and 80% AMI. In the past year, average AMI served was 35%, with a total household income of about $26,000. Most homeowners we serve through this program live alone. We estimate this funding will serve 6-7 people across 5 households. Habitat serves the entire county, from the downtowns of Chapel Hill, Carrboro, and Hillsborough, to more rural stretches such as Cedar Grove, Efland, and White Cross. The Home Preservation program traditionally focuses on critical repairs like leaking roofs, collapsing floors, or aging-in-place modifications. Often during the course of these repairs, weatherization needs are discovered, including broken or inefficient windows, attics with little to no insulation, leaky and humid crawl spaces, and fuel, gas- powered, or otherwise inefficient HVAC systems. In 2020-2021 when the Climate Action Fund was started, funds were granted for weatherization projects. These funds enabled Habitat to complete weatherization projects on six homes that were beyond the scope of repairs Habitat would have otherwise been able to provide. We intend to use these funds to increase the energy efficiency of homes through projects such as repair or replacement of aging HVAC systems, repair or replacement of drafty windows, and the addition of insulation in crawl spaces and attics. Of the repair applications that Habitat receives, about half are for these types of weatherization projects. Increasing the energy efficiency of these aging homes can immediately create savings for Orange County homeowners while reducing the demand on the power grid, or removing gas and oil furnaces. Please note that these funds will not be used for the installation of electric water heaters, as we are aware that another organization already has existing grant funding approved for this specific purpose, which Habitat is able to access when needed. This proposal aims to expand Habitat’s direct ability to provide other types of weatherization work that are currently in high demand. 8. Please choose the best description for the type of project: ☐ Infrastructure/Clean Tech: New ☒ Infrastructure/Clean Tech: Repair ☒ Infrastructure/Clean Tech: Replacement ☐ Communication/Education ☐ Natural Systems Management/Restoration ☐ Circular Economy/Waste reduction ☐ Analysis/Plan ☐ Other (Please describe): 9. Please choose the primary climate change mitigation focus for this project (select all that apply): ☒ Energy Efficiency ☐ Renewable Energy ☒ Beneficial Electrification DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E P a g e 8 o f 18 ☐ Carbon Sequestration ☐ Other (Please describe): 10. Has your organization or have your collaborators/partners completed projects of this type in the past? If so, what funds were used? ☒ Yes ☐ No Funding used (Please describe): Orange County Climate Action Funds, Private Donations 11. If this project is not selected for funding in this round, what other funding might be used to support it within the next 5 years? ☐ Other capital or operational funds ☐ None. This is a unique opportunity. ☒ Unknown (please describe): Whenever possible, Habitat seeks to complete these types of projects on the houses in the Home Preservation program. However, the scope of work demanding attention is frequently so extensive that resources cannot be allocated to these projects unless they are specifically reserved for that work. The cost of these repairs can range from $500 for a small window replacement to $10,000 or more for major HVAC work. Habitat will cover these repairs when possible, but if it is in addition to a $10,000+ roof or structural repair, it becomes difficult to add that scope to our repair. 12. 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: ☒ Carrboro: https://townofcarrboro.org/928/Community-Climate- Action-Plan ☒ Chapel Hill: https://www.sustainchapelhill.org/featured/2020/2/18/climate- action-and-response-plan ☒ Orange County: In progress, please instead show alignment with the Orange County BOCC Goals and Priorities. Residential and commercial buildings are the largest source of emissions in Carrboro. The Town’s plan proposes an 80% challenge: to reduce emissions attributed to Carrboro buildings by 80% by 2030. Identified implementation opportunities include reduced electricity and gas use from more efficient building envelopes, appliances, HVAC systems, and lighting; healthier buildings; older buildings brought up to code; and utility cost savings for building owners/occupants. The plan also prioritizes environmental justice and climate equity, ensuring that lower- income households can also take part in the benefits of these efforts. This project helps achieve these goals specifically by reducing the emissions of homes owned by lower-income residents. The proposed project fulfills multiple goals under the Chapel Hill Climate Action and Response Plan. Most directly, this weatherization proposal promotes Energy Upgrades for existing buildings and facilities, thereby promoting climate action and DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E P a g e 9 o f 18 climate equity. Small scale repairs like these also utilize local job forces and encourage the subcontractors Habitat routinely works with to learn and promote weatherization repairs to the broader community. This project directly addresses Orange County Board of Commissioner goals and priorities. Specifically, this project helps protect the natural environment by reducing CO2 emissions and repairing the aging stock of homes in Orange County. By preserving these aging homes, as opposed to building new ones, the County keeps materials out of the landfill and protects generational homes for low-income residents. Collaborators and Partners In some projects, collaborators and partners provide essential capacity and connections. If collaborators or partners are an essential part of your project whether or not they are receiving grant funds, please use this section to provide more details. If 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 partnerships/collaborations that add the most value to the success of the proposed project: n/a Criterion 1 - Social Justice and Racial Equity 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 geographic 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: Habitat’s Home Preservation program has four basic requirements for eligibility. Qualified applicants must live in Orange County, own their own home, owe no back taxes, and have an annual income below 80% of the area median income. Of the most recent group of applicants for program, one in four (24%) are considered extremely low income, earning below 30% AMI. This is less than $19,100 annually for a single-person household. The average annual income of the whole group was $24,500. Elderly individuals were also highly served by the Home Preservation program. Last year, the average age served was 68. Further, 37% had a disability present in the home and four were veterans. About 70% of families served have a female head of household. More than 90% of Home Preservation repair recipients are Black. Many are members of foundational Black families of Orange County, who have lived in this area for generations. Many are living in homes that were built by their parents or grandparents, which they are now in danger of having to give up to due rising home values and property taxes. This can result DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E P a g e 10 o f 18 in decades of deferred maintenance, creating a living situation that is urgently unsafe. Habitat’s Home Preservation program offers a low-cost option for homeowners who cannot afford critical repairs to their homes through traditional means. Program participants pay between $50 and $450 total for the work they receive, depending on their income level. In addition to its work building new affordable homes, Habitat considers this work to preserve the affordable housing stock that already exists in our County to be essential and urgent. Once these properties are sold and often redeveloped, they will likely never be affordable again. According to the most recent U.S. Census, Orange County’s population identifies as: 76.7% White, 11.9% African American, 8.8% Hispanic and 7.9% Asian. In Orange County, 67% of white households in Orange County are homebuyers while less than half (44%) of Black households own their home. Homeownership is a critical tool for building wealth. Due to a legacy of systemic racism and discriminatory housing practices, Black Americans continue to face significant barriers to homeownership. The racial gap in homeownership is a primary driver of the wealth gap between Black and white households. The median net wealth of white families is 10 times greater than that of Black families ($171,000 vs. $17,600). As a result, Black parents have dramatically less wealth, assets, and economic security to pass on to their children, driving economic, educational, and housing disparities for the next generation. For this reason, it is incredibly important that Black families are not priced out of the homes they already own, and have affordable options to repair and improve their homes when needed. 15. Please describe any ways in which low‐income or marginalized communities/households were engaged in the creation of this project proposal: Habitat began completing exterior repairs for Orange County homeowners in 2010. In 2016, the program was expanded to include more extensive work and interior work in direct response to community demand. The pilot for this expansion took place in the Northside neighborhood in partnership with the Jackson Center. Over the years, Habitat has regularly adjusted the program in response to what we are seeing on applications for assistance. It is Habitat’s experience that many homeowners who apply for critical repairs also request weatherization work. Of the 427 open applications in the Orange County Home Preservation Coalition database, 115 include HVAC repairs or replacements and 136 include thermal and moisture repairs, which includes insulation and windows. These numbers clearly demonstrate that low-income households are in need of these services. DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E P a g e 11 o f 18 16. 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 communities/households: As with any construction work, extensive home repairs can be disruptive to the routines of the homeowners. Habitat hopes by supplementing our regular scope of repairs with weatherization work, we can minimize this disruption by reducing the need for additional repairs in the future. Once complete, these repairs also often have a great impact on a homeowner’s day to day comfort and quality of life in their home. 17. Are the impacted residents already aware of the potential positive and negative impacts of your project and the steps you are taking? If not, please describe your plan to engage with them and how you will act based on their input: If there are any potential negative impacts of a project, Habitat ensures that homeowners are aware of these before beginning any work on the home. Habitat works with the homeowner to find a mutually agreeable resolution. If a resolution cannot be reached, the project does not move forward. Habitat seeks to educate homeowners on the positive impacts of the repairs as well. Particularly with HVACs, education is required to explain the benefits to homeowners who may have lived their entire lives with either gas or fuel source heating. 18. During and after the project, what will your continued engagement with the community be? Building trust and relationships in all communities where we work is central to Habitat’s mission. We continue to engage with residents and community organizations throughout each project and beyond. Many homeowners who have received services also recommend the Home Preservation program to their neighbors in the community. 19. Please describe any other aspect of your project that is relevant to Social Justice and Racial Equity: Climate justice and racial justice are linked. The National Center for Environmental Assessment found that in the U.S., Black people are exposed to approximately 1.5 times more particulate matter than white people, and Hispanic populations 1.2 times more. People living in poverty have approximately 1.3 times more exposure than people living above the poverty line, with significant health implications. According to the National Weatherization Assistance Program Evaluation in 2016, for older single-family homes, weatherization reduces low-income households’ total energy costs by 12.4% within the first year. This is substantial given that low-income households have higher energy burdens, spending three times the share of their annual income (7.2%) on energy costs as compared with other households (2.3%) (American Council for Energy Efficient Economy, 2014). By partnering with local homeowners to provide weatherization, energy efficiency will improve, utility costs will be reduced, and Orange County homeowners will receive upgrades that they likely would not have had access to otherwise. Criterion 2 - Emissions Reduced DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E P a g e 12 o f 18 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: According to the Department of Energy, on average, weatherization measures reduce carbon dioxide emissions by one metric ton per weatherized home per year, or one-third the average emissions of an automobile. This project will provide weatherization assistance to five households, thus reducing greenhouse gas emissions by an estimated five metric tons each year. Because the specific projects that will be completed have not yet been identified, it is difficult to provide a more precise estimate at this time. 21. For how many years will this emissions reduction take place as a result of your project? Please consider the expected lifetime of the technology/program/impact etc. We estimate that this level of emissions reduction will continue for 15-20 years following project completion. The expected life of a properly maintained new HVAC system is about 15 years. Effects of other weatherization repairs such as insulation or properly sealed windows are expected to last an average of 20 years. 22. Please describe the location of the emissions reduction. Where would fossil fuels have been burned if not for your project? For projects creating electricity usage reductions, it can be difficult to determine the location of the power produced. Please feel free to state “Grid-tied electricity reduction” The primary benefit of weatherization is a reduction of a home’s energy demand, typically leading to a reduction of grid- tied electricity. In addition, replacement of natural gas or fuel furnace systems reduces greenhouse gases in the home, leading to a cleaner environment for both the people living in the home and the community as a whole. Emissions reduction will take place in homes that are selected for weatherization projects across Orange County. Projects may take place in any jurisdiction within the County, both urban and rural. Projects are typically conducted on older single-family homes, which have often been in the owner’s family for decades. 23. Please describe any other aspect of your project that is relevant to the amount of emissions that it will reduce or avoid. Habitat’s Home Preservation program routinely performs repairs that extend the lifespan of homes in Orange County. This prevents the demolition of existing affordable homes, reducing materials in our local landfills. Maintaining the existing stock of affordable homes in our community also decreases the need to build new homes with additional materials consumption and emissions output. 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. If the proposed project is new, please write N/A in the first column of the table below, and just fill out the second column. Please note that our program budget spreadsheet reflects the total budget for the Home Preservation program, with this weatherization project work incorporated. The table below reflects only the weatherization project specifically. We intend that this funding would fully cover the costs incurred to complete weatherization work on five homes in Orange County in the coming year. DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E P a g e 13 o f 18 Actual Annual Project Costs (If your proposed project expands or accelerates an ongoing effort) Projected Project Costs Total Cost of Project $55,000 Unit of Impact: Total # of tons of greenhouse gases reduced 75 tons Cost Per Ton of GHG’s Reduced $733 Unit of Impact: Total # of individuals served/benefitted 7 Cost Per Individual Served/Benefitted $7,857 (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: According to the Department of Energy, weatherization repairs save homeowners an average of $350 annually in utility expenses. For 5 families over the course of 15 years, this is a savings of $26,250. Repairs also lead to health benefits when mold, mildew, and other contaminants are eliminated. CO2 emissions can lead to increased hospitalizations, muscle aches, headaches, and in situations where people have preexisting conditions such as chronic obstructive pulmonary disease, a significantly higher likelihood of early death. Increasing the healthy environment of one’s home will enable residents of Orange County to have a better overall quality of life, including reduced medical expenses. In 2022, the Department of Energy calculated the total health and household-related benefit from weatherization is $14,148 per home. Weatherization also generates $2.78 in non-energy benefits for every $1 invested in weatherization assistance. 25. Does your project accelerate or expand on existing programs that already show positive impact? In 2020-2021, Habitat utilized Climate Action Funds to increase its weatherization work as part of the Home Preservation program. That year, we were able to repair broken HVACs, increase insulation, create healthier crawl spaces, and replace damaged windows for six homes. In 2021, this work led to the reduction of CO2 emissions by 4 tons per year. 26. Does your project also take advantage of other funding sources? The Home Preservation program takes advantage of many funding sources, including Community Development Block Grant Funds from the Town of Chapel Hill, Carrboro Town Funds, and private fundraising from companies and individuals in Orange County. 27. Would your proposed project help you to take advantage of funding from other sources besides this grant in the future? By creating the infrastructure within our organization and then identifying and building relationships with subcontractors who can complete weatherization projects, Habitat will continue this important work in the future. Habitat will continue to seek additional funds for weatherization projects from Orange County and the Towns of Chapel Hill, Hillsborough, and Carrboro. Demand for these services is continuing to grow as the cost of repairs and materials continue to rise. A 2021 study DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E P a g e 14 o f 18 from Harvard University’s Joint Center for Housing Studies revealed that homeowners who earn less than $32,000 a year spent on average 20 percent of their incomes on improvements and home maintenance. This percentage was twice the share of income for other homeowners. 28. Please describe any other aspect of your project that is relevant to the efficient use of grant funds: Funds received for these weatherization projects will be added to Home Preservation projects that Habitat will already be working on. These funds will enable weatherization repairs on a larger scale than would have been possible otherwise, thus leading to a greater overall impact in the quality of life for the homeowner and their family. Because weatherization projects will apply to homes already being repaired, additional mobilization costs are low, as is any added disruption for the homeowner. Criterion 4 - Capacity of Applicant 29. Please describe any projects that you have completed successfully in the past which are similar to the project you are proposing: The Home Preservation Program has successfully completed 247 repairs in Orange County. Last year, we performed repairs on 19 homes, with 32 more projects planned for the current fiscal year. Many of these homes have included weatherization components. 30. If 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: n/a 31. Please describe any other relevant expertise or capacity to carry out the project in your application: For 39 years, Habitat has served the residents of Orange County by building and repairing affordable homes. Our vision is a community where everyone has a decent place to live. Habitat implements this vision through a commitment to high-quality, cost-effective, and community-centered building practices. We are proud of our track record serving residents and hope that it inspires confidence in Habitat’s ability to maximize an investment from the Orange County Climate Action Grant to bring the benefits of renewable energy to low-income homeowners. Criterion 5 - Local Economic Development 32. How many Orange County residents are employed by your organization? Half of our full-time staff, 13 Habitat employees currently live in Orange County. DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E P a g e 15 o f 18 33. What percent of project materials will be purchased from sources within Orange County or North Carolina? All vendors and subcontractors for this project are located in the Triangle, with the majority being located in Orange County. Materials will be purchased from Orange County vendors when possible, such as Rice’s Glass for window replacements. 34. Please describe any other aspect of your project that is relevant to local economic development. Habitat’s Repair Team has increased from one employee to four employees within the past year. This work is in high demand in Orange County and our staff and Board are invested in growing this program to help meet that need. Habitat employs local tradespeople to complete jobs that our staff cannot otherwise complete such as HVAC replacements and insulation. The budget for this program has continued to increase each year, indicating an increase in direct spending on materials and subcontracted labor in our local economy. We seek out small and minority-owned businesses and look for partners who share our values. Our work supports businesses that are investing in more energy efficient products. Criterion 6 - Amount and Duration of Engagement 35. Please describe how you will engage with and/or educate project participants. Homeowners will receive education about proper usage and maintenance of all updated components of their home. According to information in a 2018 study by Yan Zhang, homeowner behavior heavily influences a house’s energy performance and can result in up to 25% variation in energy use. Potential savings from increased home energy efficiency could go unrealized because of the way homeowners interact with the features of their homes. This education on usage and maintenance will extend the life of the weatherization improvements and enable the homeowner to maintain lower utility bills. 36. How will you measure the success of that engagement or educational effort? Because of the scale of these projects and the typical demographic being served, it would be unnecessarily burdensome to the homeowner to conduct quantitative measurement such as requesting that they send copies of utility bills. Success is measured more qualitatively through assessing the level of homeowner engagement with the education being provided. 37. Please describe any other aspect of your project that is relevant to the amount, or quality, or length of engagement and/or education that your project will produce. Homeowners may call Habitat later if the outcome of their project does not meet their expectations. If homeowners are not seeing the results they expected, Habitat will work with them to discover the issue and how it can be addressed, whether it is an issue with the system or a change in behavior that needs to be made. Criterion 7 - Time to Complete DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E P a g e 16 o f 18 38. How much time will your project require to demonstrate the positive impacts you describe? Impact will be seen immediately upon completion of each weatherization project. Homeowners’ electric and fuel consumption, along with their utility bills, will begin to decrease right away. Grid-tied electricity usage will also drop as soon as weatherization projects are complete. All projects will be completed by the end of 2024. Submission Guidance Applications are to be submitted as email attachments to Orange County Sustainability Programs Manager, Amy Eckberg at aeckberg@orangecountync.gov. Please also CC the lead staff member supporting the Commission of the Environment, Wesley Poole at wpoole@orangecountync.gov. The Application Submittal Deadline for the Fiscal Year 23-24 round of the Community Climate Action Grant is Friday, August 18, 2023 at 5pm. 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, aeckberg@orangecountync.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 same 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 here. Please submit the budget in PDF form as well as in the original editable Excel format. b) IRS Federal Form 990 or 2022 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 information about each board of director’s member: name, telephone number, and address, of each member and the list must identify the principal officers of the governing body, and length of term. Please feel free to use the template provided in Table 2 of the appendix or your own format. DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E P a g e 17 o f 18 d) Certificate of Liability Insurance A copy of the applicant organization’s current certificate, from the organization’s insurance carrier. Table 1 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 certificate holder and provide coverage for the duration of the funding period (two years, beginning as early as October 1, 2023). If proof of insurance can only be written for one year, an update will be required for all ongoing projects. Renewal certificates must be sent to the jurisdiction 30 days prior to any expiration date, cancellation or modification of any stipulated insurance coverage. NOTE: Upon request, insurance requirements may be reviewed on a case by case basis by the County. Please contact the staff identified on the Submission Requirements on Page 15 if you 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 INSURANCE ORANGE COUNTY3 Worker's Compensation1 Limits for Coverage A - Statutory State NC, for each employee Limits for Coverage B - Employers Liability of: $500,000 each accident, $500,000 Bodily Injury by Disease (BID) for each employee $500,000 for BID limit Commercial General Liability $1 million Each Occurrence $2 million Aggregate Automobile Liability $1 million Each Occurrence Professional Liability $1 million Each Occurrence $2 million Aggregate Sexual Abuse & Molestation $1 million Each Occurrence $2 million Aggregate Cyber Liability $1 million Each Occurrence $2 million Aggregate Environmental/Pollution Liability (Required if demolition, use of hazardous material or environmentally sensitive) $1 million Each Occurrence DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E P a g e 18 o f 18 ▪ Visit the NC Industrial Commission’s website for more information regarding Coverage A. Also, note that if an agency uses subcontractors, it must require subcontractors to have workmen’s compensation insurance. ▪ Please visit Orange County’s Risk Management page for more information about the County’s Minimum Insurance Requirements. Table 2 - Contact Information for Board of Directors and Officers of the Board Name (also title and term length if Officer) Physical address Mailing address Phone number Email address Fax number (if applicable) DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E Name/ Position Term Address Phone number Email address Betsy Blackwell (Chair)2020-2023 604 E Franklin St, Chapel Hill, NC 27514 (704) 816-9446 watwell@aol.com Cathy Bryson 2020-2023 7923 Morrow Mill Rd, Chapel Hill, NC 27516 (310) 592-2382 bryson.cathy@gmail.com Andy Buchanan 2022-2025 400 Westwood Dr, Chapel Hill, NC 27516 (703) 307-7681 andybuck2002@yahoo.com Doug Call 2021-2024 139 S Fields Cir, Chapel Hill, NC 27516 (919) 240-4524 dwc@douglascall.com Sharon Davis 2022-2025 107 Bel Arbor Ln, Carrboro, NC 27510 (919) 967-2078 shardvs@yahoo.com Zac Hedrick 2021-2024 1510 Highbranch Way, Hillsborough, NC 27278 (336) 870-1143 zachedrick@hotmail.com Kelly Holcombe 2021-2024 1400 Gray Bluff Trl, Chapel Hill, NC 27517 (231) 590-8985 kholcombe11@gmail.com Darlene Laws 2021-2024 2525 Gemena Rd, Chapel Hill, NC 27516 (919) 932-1591 mslaws@hotmail.com Emil Malizia 2021-2024 105 Dartmouth Ct, Chapel Hill, NC 27516 (919) 259-1439 malizia@email.unc.edu Jim McNeely 2021-2024 3626 Shrewsbury St, Durham, NC 27707 (919) 596-1242 jmcneely@certapro.com Anna Millar (Secretary)2021-2024 1011 Bayberry Dr, Chapel Hill, NC 27517 (919) 451-1311 annamillar4@gmail.com Cami Schupp (Past Chair)2022-2023 1526 E Franklin St Ste 202, Chapel Hill, NC 27514 (919) 741-0877 cami@ams-lawyer.com Joan Sierfert Rose 2022-2025 1713 Audubon Rd, Chapel Hill, NC 27514 (919) 633-7052 joansrose@gmail.com John Stanley 2022-2025 4303 Peachway Dr, Durham, NC 27705 (919) 259-4961 stanleyj@lenovo.com Annetta Streater 2022-2025 11 Heather Ct, Chapel Hill, NC 27517 (919) 918-2037 astreater@gmail.com Ree Ree Wei 2022-2025 104 Gracie Cir, Chapel Hill, NC 27516 (919) 296-0475 hsarwei3@gmail.com Anna Wu (First Vice-Chair)2022-2025 921 Monmouth Ave, Durham, NC 27701 (919) 929-1984 wutruskey@gmail.com Michael Zuber (Treasurer)2022-2025 511 Fayetteville St Apt 2216, Raleigh, NC 27601 (980) 522-2702 michaelalanzuber@gmail.com DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E PUBLIC DISCLOSURE COPY DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E Check if self-employed OMB No. 1545-0047 Department of the TreasuryInternal Revenue Service Check ifapplicable: Addresschange Namechange Initialreturn Finalreturn/termin-ated Gross receipts $ Amendedreturn Applica-tionpending Are all subordinates included? 132001 12-09-21 Beginning of Current Year Paid Preparer Use Only Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations) | Do not enter social security numbers on this form as it may be made public.Open to Public Inspection| Go to www.irs.gov/Form990 for instructions and the latest information. A For the 2021 calendar year, or tax year beginning and ending B C D Employer identification number E G H(a) H(b) H(c) F Yes No Yes No I J K Website: | L M 1 2 3 4 5 6 7 3 4 5 6 7a 7b a bActivities & GovernancePrior Year Current Year 8 9 10 11 12 13 14 15 16 17 18 19Revenuea bExpenses End of Year 20 21 22 Sign Here Yes No For Paperwork Reduction Act Notice, see the separate instructions. (or P.O. box if mail is not delivered to street address) Room/suite )501(c)(3) 501(c) ((insert no.) 4947(a)(1) or 527 |Corporation Trust Association Other Form of organization:Year of formation:State of legal domicile: | |Net Assets orFund BalancesUnder penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge. Signature of officer Date Type or print name and title Date PTINPrint/Type preparer's name Preparer's signature Firm's name Firm's EIN Firm's address Phone no. Form Name of organization Doing business as Number and street Telephone number City or town, state or province, country, and ZIP or foreign postal code Is this a group return for subordinates?Name and address of principal officer:~~ If "No," attach a list. See instructions Group exemption number | Tax-exempt status: Briefly describe the organization's mission or most significant activities: Check this box if the organization discontinued its operations or disposed of more than 25% of its net assets. Number of voting members of the governing body (Part VI, line 1a) Number of independent voting members of the governing body (Part VI, line 1b) Total number of individuals employed in calendar year 2021 (Part V, line 2a) ~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~ Total number of volunteers (estimate if necessary) Total unrelated business revenue from Part VIII, column (C), line 12 Net unrelated business taxable income from Form 990-T, Part I, line 11 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~ Contributions and grants (Part VIII, line 1h) ~~~~~~~~~~~~~~~~~~~~~ Program service revenue (Part VIII, line 2g) ~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~Investment income (Part VIII, column (A), lines 3, 4, and 7d) Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)~~~~~~~~ Total revenue - add lines 8 through 11 (must equal Part VIII, column (A), line 12) Grants and similar amounts paid (Part IX, column (A), lines 1-3) Benefits paid to or for members (Part IX, column (A), line 4) Salaries, other compensation, employee benefits (Part IX, column (A), lines 5-10) ~~~~~~~~~~~ ~~~~~~~~~~~~~ ~~~ Professional fundraising fees (Part IX, column (A), line 11e) Total fundraising expenses (Part IX, column (D), line 25) ~~~~~~~~~~~~~~ Other expenses (Part IX, column (A), lines 11a-11d, 11f-24e) Total expenses. Add lines 13-17 (must equal Part IX, column (A), line 25) Revenue less expenses. Subtract line 18 from line 12 ~~~~~~~~~~~~~ ~~~~~~~ Total assets (Part X, line 16) Total liabilities (Part X, line 26) Net assets or fund balances. Subtract line 21 from line 20 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~ May the IRS discuss this return with the preparer shown above? See instructions LHA Form (2021) Part I Summary Signature BlockPart II 990 Return of Organization Exempt From Income Tax990 2021 § == 999 ** PUBLIC DISCLOSURE COPY ** JUL 1, 2021 JUN 30, 2022 HABITAT FOR HUMANITY, ORANGE COUNTY NC, INC. 58-1603427 919-932-707788 VILCOM CENTER DRIVE L110 12,032,449. CHAPEL HILL, NC 27514 XJENNIFER PLAYER WWW.ORANGEHABITAT.ORG X 1984 NC HABITAT FOR HUMANITY OF ORANGE 17 17 38 1641 0. 0. 10,143,612. 1,814,223. 10,393. 6,688. 8,810,630. 11,974,916. 75,000. 0. 1,712,278. 47,746. 573,906. 2,642,439. 4,945,671. 4,477,463. 3,864,959. 7,497,453. 18,236,653. 26,519,199. 4,785,128. 5,570,221. 13,451,525. 20,948,978. GRACE JOHNSTON, VP OF FINANCE & ADMINISTRATION P00748038AMANDA ADAMS 88-2730877CHERRY BEKAERT ADVISORY LLC 3800 GLENWOOD AVE, SUITE 200 RALEIGH, NC 27612 919-782-1040 X SAME AS C ABOVE COUNTY BUILDS AND SELLS HOMES WITH AFFORDABLE MORTGAGES. X 5,453,826. 3,346,202. 8,980. 1,622. 60,000. 0. 1,403,489. 43,635. 3,438,547. 5/15/2023 DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E Code:Expenses $including grants of $Revenue $ Code:Expenses $including grants of $Revenue $ Code:Expenses $including grants of $Revenue $ Expenses $including grants of $Revenue $ 132002 12-09-21 1 2 3 4 Yes No Yes No 4a 4b 4c 4d 4e Form 990 (2021)Page Check if Schedule O contains a response or note to any line in this Part III Briefly describe the organization's mission: Did the organization undertake any significant program services during the year which were not listed on the prior Form 990 or 990-EZ? If "Yes," describe these new services on Schedule O. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization cease conducting, or make significant changes in how it conducts, any program services? If "Yes," describe these changes on Schedule O. ~~~~~~ Describe the organization's program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported. () ()() () ()() () ()() Other program services (Describe on Schedule O.) ()() Total program service expenses | Form (2021) 2 Statement of Program Service AccomplishmentsPart III 990 SEEKING TO PUT GOD'S LOVE INTO ACTION, HABITAT FOR HUMANITY BRINGS X X PEOPLE TOGETHER TO BUILD HOMES, COMMUNITIES, AND HOPE TO REALIZE OUR 3,187,229.75,000.1,518,137. SAFE AND AFFORDABLE HOMES IN PARTNERSHIP WITH US. HABITAT HOUSES ARE NC, INC.58-1603427 HABITAT FOR HUMANITY, ORANGE COUNTY VISION OF A WORLD WHERE EVERYONE HAS A DECENT PLACE TO LIVE. HABITAT FOR HUMANITY OF ORANGE COUNTY ADHERES TO A STRICT NON-PROSELYTIZING HOMEOWNERSHIP PROGRAM: FAMILIES IN NEED OF A DECENT PLACE TO LIVE BUILD MODESTLY SIZED. THEY ARE LARGE ENOUGH FOR THE HOMEOWNER FAMILY'S NEEDS, BUT SMALL ENOUGH TO KEEP CONSTRUCTION AND MAINTENANCE COSTS AFFORDABLE. BY USING THE LABOR OF VOLUNTEERS AND PROSPECTIVE HOMEOWNERS, EMPLOYING EFFICIENT BUILDING METHODS, KEEPING HOUSE SIZES MODEST, USING DONATED 378,176.16,877. HOME PRESERVATION PROGRAM: OUR HOME PRESERVATION PROGRAM IS AN OUTREACH CONSTRUCTION MATERIALS AND APPLIANCES, AND ISSUING NO-PROFIT LOANS, HABITAT MAKES ITS HOUSES AFFORDABLE FOR LOW-INCOME FAMILIES TO PURCHASE. AFFORDABLE HOMEOWNERSHIP HELPS CREATE THE CONDITIONS THAT FREE FAMILIES FROM INSTABILITY, STRESS, AND FEAR AND ENCOURAGE SELF-RELIANCE AND CONFIDENCE. STUDIES SHOW THAT STRONG AND STABLE HOUSEHOLDS ARE FOUNDATIONAL TO CHILD DEVELOPMENT AND GROWTH. WHEN A INITIATIVE THAT SEEKS TO PROVIDE A WIDE RANGE OF OPPORTUNITIES FOR LOW- TO MODERATE-INCOME HOMEOWNERS, INCLUDING VETERANS AND SENIORS, WHO ARE STRUGGLING TO MAINTAIN THEIR HOMES BECAUSE OF AGE, DISABILITY, OR FAMILY CIRCUMSTANCES. WE PARTNER WITH FAMILIES TO HELP THEM RECLAIM 279,209. THE HABITAT FOR HUMANITY RESTORE IS A NON-PROFIT HOME IMPROVEMENT STORE THEIR HOMES WITH PRIDE AND DIGNITY. THE PROGRAM ALLOWS FAMILIES TO STAY IN THEIR HOME AND AVOID THE UNCERTAINTY, TRAUMA, AND EXPENSE OF MOVING. PROJECTS CONSIST OF INTERIOR AND/OR EXTERIOR REPAIRS INTENDED TO ALLEVIATE CRITICAL HEALTH, LIFE, AND SAFETY ISSUES OR CODE VIOLATIONS. VOLUNTEER TEAMS WORK ALONG WITH SUBCONTRACTORS UNDER THE DIRECTION OF HABITAT FOR HUMANITY OF ORANGE COUNTY STAFF MEMBERS TO COMPLETE THE REPAIRS. SINCE THE INCEPTION OF THE HOME PRESERVATION PROGRAM, HABITAT AND DONATION CENTER THAT SELLS NEW AND GENTLY USED FURNITURE, HOME ACCESSORIES, BUILDING MATERIALS, AND APPLIANCES TO THE PUBLIC AT A FRACTION OF THE RETAIL PRICE. THE LOCAL HABITAT FOR HUMANITY RESTORES ARE PROUDLY OPERATED BY THE WAKE HABITAT FOR HUMANITY AFFILIATE VIA AN AGREEMENT WITH WAKE, ORANGE, AND DURHAM HABITAT AFFILIATES, WHO SHARE 3,565,405. PROCEEDS OF ALL TRIANGLE NC RESTORES BASED ON DONATIONS BY COUNTY. PROCEEDS ARE USED TO BUILD HOMES, COMMUNITY, AND HOPE LOCALLY AND AROUND THE WORLD. X SEE SCHEDULE O FOR CONTINUATION(S) DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E 132003 12-09-21 Yes No 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 1 2 3 4 5 6 7 8 9 10 Section 501(c)(3) organizations. a b c d e f a b 11a 11b 11c 11d 11e 11f 12a 12b 13 14a 14b 15 16 17 18 19 20a 20b 21 a b 20 21 a b If "Yes," complete Schedule A Schedule B, Schedule of Contributors If "Yes," complete Schedule C, Part I If "Yes," complete Schedule C, Part II If "Yes," complete Schedule C, Part III If "Yes," complete Schedule D, Part I If "Yes," complete Schedule D, Part II If "Yes," complete Schedule D, Part III If "Yes," complete Schedule D, Part IV If "Yes," complete Schedule D, Part V If "Yes," complete Schedule D, Part VI If "Yes," complete Schedule D, Part VII If "Yes," complete Schedule D, Part VIII If "Yes," complete Schedule D, Part IX If "Yes," complete Schedule D, Part X If "Yes," complete Schedule D, Part X If "Yes," complete Schedule D, Parts XI and XII If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional If "Yes," complete Schedule E If "Yes," complete Schedule F, Parts I and IV If "Yes," complete Schedule F, Parts II and IV If "Yes," complete Schedule F, Parts III and IV If "Yes," complete Schedule G, Part I. If "Yes," complete Schedule G, Part II If "Yes," complete Schedule G, Part III If "Yes," complete Schedule H If "Yes," complete Schedule I, Parts I and II Form 990 (2021)Page Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Is the organization required to complete ? See instructions Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? ~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? Is 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. 98-19? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~ 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? Did the organization receive or hold a conservation easement, including easements to preserve open space, the environment, historic land areas, or historic structures? Did the organization maintain collections of works of art, historical treasures, or other similar assets? ~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization report an amount in Part X, line 21, for escrow or custodial account liability, serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? Did the organization, directly or through a related organization, hold assets in donor-restricted endowments or in quasi endowments? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ If the organization's answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X, as applicable. Did the organization report an amount for land, buildings, and equipment in Part X, line 10? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization report an amount for investments - other securities in Part X, line 12, that is 5% or more of its total assets reported in Part X, line 16? Did the organization report an amount for investments - program related in Part X, line 13, that is 5% or more of its total assets reported in Part X, line 16? ~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization report an amount for other assets in Part X, line 15, that is 5% or more of its total assets reported in Part X, line 16? Did the organization report an amount for other liabilities in Part X, line 25? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~ 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)? Did the organization obtain separate, independent audited financial statements for the tax year? ~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Was the organization included in consolidated, independent audited financial statements for the tax year? ~~~~~ Is the organization a school described in section 170(b)(1)(A)(ii)? 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 $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? See instructions ~~~~~~~~~~~~~~~~~~~~ Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization operate one or more hospital facilities? ~~~~~~~~~~~~~~~~~ If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return?~~~~~~~~~~ Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? ~~~~~~~~~~~~~~ Form (2021) 3 Part IV Checklist of Required Schedules 990 X X X X X X X X X X X X X X X X X X X X X X HABITAT FOR HUMANITY, ORANGE COUNTY X X X X X X NC, INC.58-1603427 DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E 132004 12-09-21 Yes No 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 22 23 24a 24b 24c 24d 25a 25b 26 27 28a 28b 28c 29 30 31 32 33 34 35a 35b 36 37 38 a b c d a b Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. a b c a b Section 501(c)(3) organizations. Note: Yes No 1 a b c 1a 1b 1c (continued) If "Yes," complete Schedule I, Parts I and III If "Yes," complete Schedule J If "Yes," answer lines 24b through 24d and complete Schedule K. If "No," go to line 25a If "Yes," complete Schedule L, Part I If "Yes," complete Schedule L, Part I If "Yes," complete Schedule L, Part II If "Yes," complete Schedule L, Part III If "Yes," complete Schedule L, Part IV If "Yes," complete Schedule L, Part IV If "Yes," complete Schedule L, Part IV If "Yes," complete Schedule M If "Yes," complete Schedule M If "Yes," complete Schedule N, Part I If "Yes," complete Schedule N, Part II If "Yes," complete Schedule R, Part I If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1 If "Yes," complete Schedule R, Part V, line 2 If "Yes," complete Schedule R, Part V, line 2 If "Yes," complete Schedule R, Part VI Form 990 (2021)Page 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? ~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization answer "Yes" to Part VII, 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? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 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? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 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? ~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~ Did the organization engage in an excess benefit transaction with a disqualified person during the year? Is 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 990-EZ? ~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization report any amount on Part 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% controlled entity or family member of any of these persons?~~~~~~~~~~~~~ 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 to a 35% controlled entity (including an employee thereof) or family member of any of these persons? ~~~ Was the organization a party to a business transaction with one of the following parties (see the Schedule L, Part IV, instructions for applicable filing thresholds, conditions, and exceptions): A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ A family member of any individual described in line 28a? A 35% controlled entity of one or more individuals and/or organizations described in line 28a or 28b? ~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization receive more than $25,000 in non-cash contributions? Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? ~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization liquidate, terminate, or dissolve and cease operations? Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? ~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? Was the organization related to any tax-exempt or taxable entity? ~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization have a controlled entity within the meaning of section 512(b)(13)? If "Yes" to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? ~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~ Did the organization make any transfers to an exempt non-charitable related organization? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? ~~~~~~~~ Did the organization complete Schedule O and provide explanations on Schedule O for Part VI, lines 11b and 19? All Form 990 filers are required to complete Schedule O Check if Schedule O contains a response or note to any line in this Part V Enter the number reported in box 3 of Form 1096. Enter -0- if not applicable ~~~~~~~~~~~ Enter the number of Forms W-2G included on line 1a. Enter -0- if not applicable ~~~~~~~~~~ Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? Form (2021) 4 Part IV Checklist of Required Schedules Part V Statements Regarding Other IRS Filings and Tax Compliance 990 X X X X X X X X X X X X NC, INC.58-1603427 HABITAT FOR HUMANITY, ORANGE COUNTY 46 0 X X X X X X X X X DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E 132005 12-09-21 Yes No 2 3 4 5 6 7 a b 2a Note: 2b 3a 3b 4a 5a 5b 5c 6a 6b 7a 7b 7c 7e 7f 7g 7h 8 9a 9b a b a b a b c a b Organizations that may receive deductible contributions under section 170(c). a b c d e f g h 7d 8 9 10 11 12 13 14 15 16 17 Sponsoring organizations maintaining donor advised funds. Sponsoring organizations maintaining donor advised funds. a b Section 501(c)(7) organizations. a b 10a 10b Section 501(c)(12) organizations. a b 11a 11b a b Section 4947(a)(1) non-exempt charitable trusts. 12a 12b Section 501(c)(29) qualified nonprofit health insurance issuers. Note: a b c a b 13a 13b 13c 14a 14b 15 16 17 Section 501(c)(21) organizations. ~~~~~~~~~~~~~~ (continued) e-file. If "No" to line 3b, provide an explanation on Schedule O If "No," provide an explanation on Schedule O Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? Form (2021) Form 990 (2021)Page 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 ~~~~~~~~~~ If at least one is reported on line 2a, did the organization file all required federal employment tax returns? If the sum of lines 1a and 2a is greater than 250, you may be required to See instructions. ~~~~~~~~~~ ~~~~~~~~~~~ Did the organization have unrelated business gross income of $1,000 or more during the year? If "Yes," has it filed a Form 990-T for this year? ~~~~~~~~~~~~~~ ~~~~~~~~~~ At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?~~~~~~~ If "Yes," enter the name of the foreign country See instructions for filing requirements for FinCEN Form 114, Report 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 party to a prohibited tax shelter transaction? ~~~~~~~~~~~~ ~~~~~~~~~ If "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? If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ If "Yes," did the organization notify the donor of the value of the goods or services provided? Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? ~~~~~~~~~~~~~~~ If "Yes," indicate the number of Forms 8282 filed during the year 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? If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ~ Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year?~~~~~~~~~~~~~~~~~~~ Did the sponsoring organization make any taxable distributions under section 4966? Did the sponsoring organization make a distribution to a donor, donor advisor, or related person? ~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~ Enter: Initiation fees and capital contributions included on Part VIII, line 12 Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities ~~~~~~~~~~~~~~~ ~~~~~~ Enter: Gross income from members or shareholders Gross income from other sources. (Do not net amounts due or paid to other sources against amounts due or received from them.) ~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Is the organization filing Form 990 in lieu of Form 1041? If "Yes," enter the amount of tax-exempt interest received or accrued during the year Is the organization licensed to issue qualified health plans in more than one state? See the instructions for additional information the organization must report on Schedule O. ~~~~~~~~~~~~~~~~~~~~~ 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 tax year? If "Yes," has it filed a Form 720 to report these payments? ~~~~~~~~~~~~~~~~ ~~~~~~~~~ Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? If "Yes," see the instructions and file Form 4720, Schedule N. Is the organization an educational institution subject to the section 4968 excise tax on net investment income? If "Yes," complete Form 4720, Schedule O. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~ Did the trust, any disqualified person, or mine operator engage in any activities that would result in the imposition of an excise tax under section 4951, 4952 or 4953? If "Yes," complete Form 6069. 5 Part V Statements Regarding Other IRS Filings and Tax Compliance 990 J X X X X X X X X X X X X X 38 NC, INC.58-1603427 HABITAT FOR HUMANITY, ORANGE COUNTY X DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E 132006 12-09-21 Yes No 1a 1b 1 2 3 4 5 6 7 8 9 a b 2 3 4 5 6 7a 7b 8a 8b 9 a b a b Yes No 10 11 a b 10a 10b 11a 12a 12b 12c 13 14 15a 15b 16a 16b a b 12a b c 13 14 15 a b 16a b 17 18 19 20 For each "Yes" response to lines 2 through 7b below, and for a "No" response to line 8a, 8b, or 10b below, describe the circumstances, processes, or changes on Schedule O. See instructions. If "Yes," provide the names and addresses on Schedule O (This Section B requests information about policies not required by the Internal Revenue Code.) If "No," go to line 13 If "Yes," describe on Schedule O how this was done (explain on Schedule O) If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain on Schedule O. Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following: Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? Form (2021) Form 990 (2021)Page Check if Schedule O contains a response or note to any line in this Part VI Enter the number of voting members of the governing body at the end of the tax year Enter the number of voting members included on line 1a, above, who are independent ~~~~~~ ~~~~~~ Did any officer, 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 its 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, stockholders, or persons other than the governing body? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 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 Part VII, Section A, who cannot be reached at the organization's mailing address? Did the organization have local chapters, branches, or affiliates? If "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 990. Did the organization have a written conflict of interest policy? ~~~~~~~~~~~~~~~~~~~~~ ~~~~~~ Did the organization regularly and consistently monitor and enforce compliance with the policy? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 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 If "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 with a taxable entity during the year?~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ If "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 exempt status with respect to such arrangements? List the states with which a copy of this Form 990 is required to be filed Section 6104 requires an organization to make its Forms 1023 (1024 or 1024-A, if applicable), 990, and 990-T (section 501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply. Own website Another's website Upon request Other 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. State the name, address, and telephone number of the person who possesses the organization's books and records | 6 Part VI Governance, Management, and Disclosure. Section A. Governing Body and Management Section B. Policies Section C. Disclosure 990 J 17 17 X X X X X X X X X X X X X X X X X X X X X GRACE JOHNSTON - 919-932-7077 88 VILCOM CENTER DRIVE #L110, CHAPEL HILL, NC 27514 X X NC, INC.58-1603427 HABITAT FOR HUMANITY, ORANGE COUNTY X NC X DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E Individual trustee or directorInstitutional trusteeOfficerKey employeeHighest compensatedemployeeFormer(do not check more than one box, unless person is both an officer and a director/trustee) 132007 12-09-21 current Section A.Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees 1a current current former former directors or trustees (A)(B)(C)(D)(E)(F) able compensation (box 5 of Form W-2, Form 1099-MISC, and/or box 1 of Form 1099-NEC) of more than $100,000 from the organization and any related organizations. Form 990 (2021)Page Check if Schedule O contains a response or note to any line in this Part VII 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. ¥ List all of the organization's 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. ¥ List all of the organization's key employees, if any. See the instructions for definition of "key employee." ¥ List the organization's five highest compensated employees (other than an officer, director, trustee, or key employee) who received report- ¥ List all of the organization's officers, key employees, and highest compensated employees who received more than $100,000 of reportable compensation from the organization and any related organizations. ¥ List all of the organization's 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 organizations. See the instructions for the order in which to list the persons above. Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee. PositionName and title Average hours per week (list any hours for related organizations below line) Reportable compensation from the organization (W-2/1099-MISC/ 1099-NEC) Reportable compensation from related organizations (W-2/1099-MISC/ 1099-NEC) Estimated amount of other compensation from the organization and related organizations Form (2021) 7 Part VII Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors 990 (1) JENNIFER PLAYER PRESIDENT & CEO (2) RANDY MCNEILL (3) CAMI SCHUPP (4) BETSY BLACKWELL (5) ANNA WU (6) CATHY BRYSON (7) MICHAEL ZUBER (8) ELAM HALL (9) DOUG CALL (10) SHARON DAVIS (11) SUE HARVIN (12) ZAC HEDRICK (13) KELLY HOLCOMBE (14) SHANNON KENNEDY (15) DARLENE LAWS (16) TAYLOR LUDLAM (17) EMIL MALIZIA VICE PRESIDENT OF FINANCE CHAIR 1ST VICE CHAIR 2ND VICE CHAIR SECRETARY TREASURER PAST CHAIR DIRECTOR DIRECTOR DIRECTOR (TERM 10/21) DIRECTOR DIRECTOR DIRECTOR DIRECTOR DIRECTOR DIRECTOR 40.00 32.00 2.00 2.00 2.00 2.00 2.00 2.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 X X X X X X X X X X X X X X X X X X X X X X 90,834. 60,182. 0. 0. 0. 0. 0. 0. 0. 0. 0. 0. 0. 0. 0. 0. 0. 0. 0. 0. 0. 0. 0. 0. 0. 0. 0. 0. 0. 0. 0. 0. 0. 0. 14,384. 12,448. 0. 0. 0. 0. 0. 0. 0. 0. 0. 0. 0. 0. 0. 0. 0. NC, INC.58-1603427 HABITAT FOR HUMANITY, ORANGE COUNTY 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E FormerIndividual trustee or directorInstitutional trusteeOfficerHighest compensatedemployeeKey employee(do not check more than one box, unless person is both an officer and a director/trustee) 132008 12-09-21 Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (B)(C)(A)(D)(E)(F) 1 b c d Subtotal Total from continuation sheets to Part VII, Section A Total (add lines 1b and 1c) 2 Yes No 3 4 5 former 3 4 5 Section B. Independent Contractors 1 (A)(B)(C) 2 (continued) If "Yes," complete Schedule J for such individual If "Yes," complete Schedule J for such individual If "Yes," complete Schedule J for such person Page Form 990 (2021) PositionAverage hours per week (list any hours for related organizations below line) Name and title Reportable compensation from the organization (W-2/1099-MISC/ 1099-NEC) Reportable compensation from related organizations (W-2/1099-MISC/ 1099-NEC) Estimated amount of other compensation from the organization and related organizations ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~| ~~~~~~~~~~| | Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization | Did the organization list any officer, director, trustee, key employee, or highest compensated employee on line 1a? ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 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? ~~~~~~~~~~~~~ Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization's tax year. Name and business address Description of services Compensation Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization | Form (2021) 8 Part VII 990 (18) JIM MCNEELY DIRECTOR 1.00 X 0.0.0. (19) ANNA MILLAR DIRECTOR 1.00 X 0.0.0. (20) SUKI NEWTON DIRECTOR (TERM 10/21) 1.00 X 0.0.0. (21) HASSAN PINTO DIRECTOR 1.00 X 0.0.0. 151,016.0.26,832. 0.0.0. 0.00 0.00 0.00 0.00 2432 HOLLY BROOK DR, BURLINGTON , NC 27217 0 1 151,016.0.26,832. NC, INC. X X X 58-1603427 OWENS PLUMBING HABITAT FOR HUMANITY, ORANGE COUNTY PLUMBING 100,465. DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E Noncash contributions included in lines 1a-1f 132009 12-09-21 Business Code Business Code Total revenue. (A)(B)(C)(D) 1 a b c d e f 1 1 1 1 1 1 1 a b c d e f ggContributions, Gifts, Grantsand Other Similar Amountsh Total. a b c d e f g 2 Program ServiceRevenueTotal. 3 4 5 6 a b c d 6a 6b 6c 7 a 7a 7b 7c b c d a b c 8 8a 8b 9 a b c 9a 9b 10 a b c 10a 10bOther Revenue11 a b c d eMiscellaneousRevenue Total. 12 Revenue excluded from tax undersections 512 - 514 All other contributions, gifts, grants, and similar amounts not included above Gross amount from sales of assets other than inventory cost or other basis and sales expenses Gross income from fundraising events See instructions Form (2021) Page Form 990 (2021) Check if Schedule O contains a response or note to any line in this Part VIII Total revenue Related or exempt function revenue Unrelated business revenue Federated campaigns Membership dues ~~~~~ ~~~~~~~ Fundraising events Related organizations ~~~~~~~ ~~~~~ Government grants (contributions) ~ $ Add lines 1a-1f | All other program service revenue ~~~~~ Add lines 2a-2f | Investment income (including dividends, interest, and other similar amounts) Income from investment of tax-exempt bond proceeds ~~~~~~~~~~~~~~~~~| | Royalties | (i) Real (ii) Personal Gross rents Less: rental expenses Rental income or (loss) Net rental income or (loss) ~~~~~ ~ | (i) Securities (ii) Other Less: Gain or (loss) ~~~ ~~~~~ Net gain or (loss)| (not including $of contributions reported on line 1c). See Part IV, line 18 ~~~~~~~~~~~~ Less: direct expenses ~~~~~~~~~ Net income or (loss) from fundraising events | Gross income from gaming activities. See Part IV, line 19 ~~~~~~~~~~~~ Less: direct expenses Net income or (loss) from gaming activities ~~~~~~~~ | Gross sales of inventory, less returns and allowances ~~~~~~~~~~~~ Less: cost of goods sold Net income or (loss) from sales of inventory ~~~~~~~ | All other revenue ~~~~~~~~~~~~~ Add lines 11a-11d | | 9 Part VIII Statement of Revenue 990 288,839. 1,598,222. 983,479. 8,256,551. 10,143,612. 238,995. 1,814,223. 447,463. 279,209. 84,328. NC, INC. 19,744. 11,974,916.1,814,223.0.17,081. 58-1603427 HABITAT FOR HUMANITY, ORANGE COUNTY HOME SALES 900099 983,479. MORTGAGE DISC. AMORT.900099 447,463. RESTORE NET SALES 900099 11,080.11,080. 10,450. 1,171. 9,279. 9,279.9,279. 279,209. DISC. ON NOTES PAYABLE 900099 5,116. 5,803. -687. -687.-687. 47,968. 50,559. -2,591.-2,591. 288,839. 84,328. 900099 19,744. DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E Check here if following SOP 98-2 (ASC 958-720) 132010 12-09-21 Total functional expenses. Joint costs. (A)(B)(C)(D) 1 2 3 4 5 6 7 8 9 10 11 a b c d e f g 12 13 14 15 16 17 18 19 20 21 22 23 24 a b c d e 25 26 Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A). Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 Compensation not included above to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) Professional fundraising services. See Part IV, line 17 (If line 11g amount exceeds 10% of line 25, column (A), amount, list line 11g expenses on Sch O.) Other expenses. Itemize expenses not covered above. (List miscellaneous expenses on line 24e. Ifline 24e amount exceeds 10% of line 25, column (A),amount, list line 24e expenses on Schedule O.) Add lines 1 through 24e Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Form 990 (2021)Page Check if Schedule O contains a response or note to any line in this Part IX Total expenses Program serviceexpenses Management andgeneral expenses Fundraisingexpenses ~ Grants and other assistance to domestic individuals. See Part IV, line 22 ~~~~~~~ Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16 ~~~ Benefits paid to or for members ~~~~~~~ Compensation of current officers, directors, trustees, and key employees ~~~~~~~~ ~~~ Other salaries and wages ~~~~~~~~~~ Other employee benefits ~~~~~~~~~~ Payroll taxes ~~~~~~~~~~~~~~~~ Fees for services (nonemployees): Management Legal Accounting Lobbying ~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~ Investment management fees Other. ~~~~~~~~ Advertising and promotion Office expenses Information technology Royalties ~~~~~~~~~ ~~~~~~~~~~~~~~~ ~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~ Occupancy ~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~Travel Payments of travel or entertainment expenses for any federal, state, or local public officials ~ Conferences, conventions, and meetings ~~ Interest Payments to affiliates ~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~ Depreciation, depletion, and amortization Insurance ~~ ~~~~~~~~~~~~~~~~~ All other expenses | Form (2021) Do not include amounts reported on lines 6b, 7b, 8b, 9b, and 10b of Part VIII. 10 Statement of Functional ExpensesPart IX 990 75,000. 209,380. 1,201,101. 21,948. 178,666. 101,183. 1,590. 26,075. 47,746. 42,089. 71,401. 83,075. 36,916. 84,247. 10,763. 5,157. 27,972. 60,326. 50,182. 1,028,032. 408,539. 224,991. 35,883. 445,201. 4,477,463. 75,000. 41,528.126,324.41,528. 844,727.85,990.270,384. 17,114.4,834. 134,791.9,329.34,546. 70,071.11,996.19,116. 1,590. 26,075. 47,746. 41,159.930. 51,439.7,678.12,284. 63,346.7,379.12,350. 23,755.3,060.10,101. 52,587.13,572.18,088. 4,301.791.5,671. 2,924.437.1,796. 27,972. 17,250.813.42,263. 45,371.4,811. 1,028,032. 408,539. 224,991. 35,883. 353,035.38,967.53,199. 3,565,405.338,152.573,906. CONSTRUCTION COSTS INT. AMORT. MORT. REC. INT. AMORT. NOTE PAY. HOMEOWNER SUPPORT NC, INC.58-1603427 HABITAT FOR HUMANITY, ORANGE COUNTY DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E 132011 12-09-21 (A)(B) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 1 2 3 4 5 6 7 8 9 10c 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 a b 10a 10bAssets Total assets. LiabilitiesTotal liabilities. Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33. 27 28 Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33. 29 30 31 32 33Net Assets or Fund Balances Form 990 (2021)Page Check if Schedule O contains a response or note to any line in this Part X Beginning of year End of year Cash - non-interest-bearing Savings and temporary cash investments Pledges and grants receivable, net ~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~ Accounts receivable, net ~~~~~~~~~~~~~~~~~~~~~~~~~~ Loans and other receivables from 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 ~~~~~~~~~ Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B)~~ Notes and loans receivable, net Inventories for sale or use Prepaid expenses and deferred charges ~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~ Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D Less: accumulated depreciation ~~~ ~~~~~~ Investments - publicly traded securities Investments - other securities. See Part IV, line 11 Investments - program-related. See Part IV, line 11 Intangible assets ~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~ ~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Other assets. See Part IV, line 11 ~~~~~~~~~~~~~~~~~~~~~~ Add lines 1 through 15 (must equal line 33) Accounts payable and accrued expenses Grants payable Deferred revenue ~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Tax-exempt bond liabilities Escrow or custodial account liability. Complete Part IV 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 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Add lines 17 through 25 | Net assets without donor restrictions Net assets with donor restrictions ~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~ | 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 ~~~~~~~~~~~~~~~~~~~~~~ Total liabilities and net assets/fund balances Form (2021) 11 Balance SheetPart X 990 63,288.38,329. 488,832.244,593. 1,104,813.953,259. 6,948,070.6,619,853. 292,184. 239,361.48,092.52,823. 62,379. 5,899,068.9,336,418. 18,236,653.26,519,199. 3,684,490.9,273,924. 135,571. 223,869.1,004,119. 42,713.30,033. 2,307,812.2,254,354. 2,148,355.2,146,144. 4,785,128.5,570,221. X 12,334,801.20,833,547. 1,116,724.115,431. 13,451,525.20,948,978. 18,236,653.26,519,199. 58-1603427NC, INC. HABITAT FOR HUMANITY, ORANGE COUNTY DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E 132012 12-09-21 1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10 Yes No 1 2 3 a b c 2a 2b 2c a b 3a 3b Form 990 (2021)Page Check if Schedule O contains a response or note to any line in this Part XI Total revenue (must equal Part VIII, column (A), line 12) Total expenses (must equal Part IX, 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 services and use of facilities Investment 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, column (B)) ~~~~~~~~~~~~~~~~~~ Check if Schedule O contains a response or note to any line in this Part XII Accounting method used to prepare the Form 990:Cash Accrual Other If the organization changed its method of accounting from a prior year or checked "Other," explain on Schedule O. Were the organization's financial statements compiled or reviewed by an independent accountant?~~~~~~~~~~~~ If "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: Separate basis Consolidated basis Both consolidated and separate basis Were the organization's financial statements audited by an independent accountant?~~~~~~~~~~~~~~~~~~~ If "Yes," check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both: Separate basis Consolidated basis Both consolidated and separate basis If "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 financial statements and selection of an independent accountant?~~~~~~~~~~~~~~~ If the organization changed either its oversight process or selection process during the tax year, explain on Schedule O. 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?~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why on Schedule O and describe any steps taken to undergo such audits Form (2021) 12 Part XI Reconciliation of Net Assets Part XII Financial Statements and Reporting 990 X NC, INC.58-1603427 HABITAT FOR HUMANITY, ORANGE COUNTY 11,974,916. 4,477,463. 7,497,453. 13,451,525. 0. 20,948,978. X X X X X DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E (iv) Is the organization listedin your governing document? OMB No. 1545-0047 Department of the Treasury Internal Revenue Service 132021 01-04-22 (i)(iii)(v)(vi)(ii) Name of supported organization Type of organization (described on lines 1-10 above (see instructions)) Amount of monetary support (see instructions) Amount of other support (see instructions) EIN (Form 990)Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust. | Attach to Form 990 or Form 990-EZ. | Go to www.irs.gov/Form990 for instructions and the latest information. Open to Public Inspection Name of the organization Employer identification number 1 2 3 4 5 6 7 8 9 10 11 12 section 170(b)(1)(A)(i). section 170(b)(1)(A)(ii). section 170(b)(1)(A)(iii). section 170(b)(1)(A)(iii). section 170(b)(1)(A)(iv). section 170(b)(1)(A)(v). section 170(b)(1)(A)(vi). section 170(b)(1)(A)(vi). section 170(b)(1)(A)(ix) section 509(a)(2). section 509(a)(4). section 509(a)(1)section 509(a)(2)section 509(a)(3). a b c d e f g Type I. You must complete Part IV, Sections A and B. Type II. You must complete Part IV, Sections A and C. Type III functionally integrated. You must complete Part IV, Sections A, D, and E. Type III non-functionally integrated. You must complete Part IV, Sections A and D, and Part V. Yes No Total For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.Schedule A (Form 990) 2021 (All organizations must complete this part.) See instructions. The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.) A church, convention of churches, or association of churches described in A school described in (Attach Schedule E (Form 990).) A hospital or a cooperative hospital service organization described in A medical research organization operated in conjunction with a hospital described in Enter the hospital's name, city, and state: An organization operated for the benefit of a college or university owned or operated by a governmental unit described in (Complete Part II.) A federal, state, or local government or governmental unit described in An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in (Complete Part II.) A community trust described in (Complete Part II.) An agricultural research organization described in 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: An organization that normally receives (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions, subject to certain exceptions; and (2) no more than 33 1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See (Complete Part III.) An organization organized and operated exclusively to test for public safety. See An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in or . See Check the box on lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g. A supporting 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. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization. Enter the number of supported organizations ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Provide the following information about the supported organization(s). LHA SCHEDULE A Part I Reason for Public Charity Status. Public Charity Status and Public Support 2021 X HABITAT FOR HUMANITY, ORANGE COUNTY 58-1603427NC, INC. DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E Subtract line 5 from line 4. 132022 01-04-22 Calendar year (or fiscal year beginning in) Calendar year (or fiscal year beginning in) | 2 (a) (b) (c) (d) (e) (f) 1 2 3 4 5 Total. 6 Public support. (a) (b) (c) (d) (e) (f) 7 8 9 10 11 12 13 Total support. 12 First 5 years. stop here 14 15 14 15 16 17 18 a b a b 33 1/3% support test - 2021. stop here. 33 1/3% support test - 2020. stop here. 10% -facts-and-circumstances test - 2021. stop here. 10% -facts-and-circumstances test - 2020. stop here. Private foundation. Schedule A (Form 990) 2021 | Add lines 7 through 10 Schedule A (Form 990) 2021 Page (Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.) 2017 2018 2019 2020 2021 Total Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.")~~ Tax revenues levied for the organ- ization's benefit and either paid to or expended on its behalf ~~~~ The value of services or facilities furnished by a governmental unit to the organization without charge ~ Add lines 1 through 3 ~~~ The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)~~~~~~~~~~~~ 2017 2018 2019 2020 2021 Total Amounts from line 4 ~~~~~~~ Gross income from interest, dividends, payments received on securities loans, rents, royalties, and income from similar sources ~ Net income from unrelated business activities, whether or not the business is regularly carried on ~ Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)~~~~ Gross receipts from related activities, etc. (see instructions)~~~~~~~~~~~~~~~~~~~~~~~ If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and | ~~~~~~~~~~~~Public support percentage for 2021 (line 6, column (f), divided by line 11, column (f)) Public support percentage from 2020 Schedule A, Part II, line 14 % %~~~~~~~~~~~~~~~~~~~~~ If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box and The organization qualifies as a publicly supported organization ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~| If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this box and The organization qualifies as a publicly supported organization ~~~~~~~~~~~~~~~~~~~~~~~~~~~~| If the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10% or more, and if the organization meets the facts-and-circumstances test, check this box and Explain in Part VI how the organization meets the facts-and-circumstances test. The organization qualifies as a publicly supported organization ~~~~~~~~~~~~~~~| If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 10% or more, and if the organization meets the facts-and-circumstances test, check this box and Explain in Part VI how the organization meets the facts-and-circumstances test. The organization qualifies as a publicly supported organization ~~~~~~~~| If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see instructions | Part II Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) Section A. Public Support Section B. Total Support Section C. Computation of Public Support Percentage 1394475. 1394475. 1769440. 1769440. 2407254.5453826.10143612.21168607. 2407254.5453826.10143612.21168607. 5039697. 16128910. 1394475.1769440.2407254.5453826.10143612.21168607. 50,143.46,964.53,816.32,388.21,530.204,841. 21373448. 15,781,429. 75.46 88.88 X NC, INC.58-1603427 HABITAT FOR HUMANITY, ORANGE COUNTY DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E (Subtract line 7c from line 6.) Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year (Add lines 9, 10c, 11, and 12.) 132023 01-04-22 Calendar year (or fiscal year beginning in) | Calendar year (or fiscal year beginning in) | Total support. 3 (a) (b) (c) (d) (e) (f) 1 2 3 4 5 6 7 Total. a b c 8 Public support. (a) (b) (c) (d) (e) (f) 9 10 a b c 11 12 13 14 First 5 years. stop here 15 16 15 16 17 18 19 20 2021 2020 17 18 a b 33 1/3% support tests - 2021. stop here. 33 1/3% support tests - 2020. stop here. Private foundation. Schedule A (Form 990) 2021 Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975 Schedule A (Form 990) 2021 Page (Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.) 2017 2018 2019 2020 2021 Total Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.")~~ 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 Gross receipts from activities that are not an unrelated trade or bus- iness under section 513 ~~~~~ Tax revenues levied for the organ- ization's benefit and either paid to or expended on its behalf ~~~~ The value of services or facilities furnished by a governmental unit to the organization without charge ~ ~~~ Add lines 1 through 5 Amounts included on lines 1, 2, and 3 received from disqualified persons ~~~~~~ Add lines 7a and 7b ~~~~~~~ 2017 2018 2019 2020 2021 Total Amounts from line 6 ~~~~~~~ Gross income from interest, dividends, payments received on securities loans, rents, royalties, and income from similar sources ~ ~~~~ Add lines 10a and 10b ~~~~~~ Net income from unrelated businessactivities not included on line 10b, whether or not the business is regularly carried on ~~~~~~~ Other income. Do not include gainor loss from the sale of capital assets (Explain in Part VI.)~~~~ If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and | Public support percentage for 2021 (line 8, column (f), divided by line 13, column (f)) Public support percentage from 2020 Schedule A, Part III, line 15 ~~~~~~~~~~~% % Investment income percentage for (line 10c, column (f), divided by line 13, column (f)) Investment income percentage from Schedule A, Part III, line 17 ~~~~~~~~% %~~~~~~~~~~~~~~~~~~ If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and The organization qualifies as a publicly supported organization ~~~~~~~~~~| If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3%, and line 18 is not more than 33 1/3%, check this box and The organization qualifies as a publicly supported organization ~~~~| If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions | Part III Support Schedule for Organizations Described in Section 509(a)(2) Section A. Public Support Section B. Total Support Section C. Computation of Public Support Percentage Section D. Computation of Investment Income Percentage NC, INC.58-1603427 HABITAT FOR HUMANITY, ORANGE COUNTY DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E 132024 01-04-21 4 Yes No 1 2 3 4 5 6 7 8 9 10 Part VI 1 2 3a 3b 3c 4a 4b 4c 5a 5b 5c 6 7 8 9a 9b 9c 10a 10b Part VI a b c a b c a b c a b c a b Part VI Part VI Part VI Part VI Part VI, Type I or Type II only. Substitutions only. Part VI. Part VI. Part VI. Part VI. Schedule A (Form 990) 2021 If "No," describe in how the supported organizations are designated. If designated by class or purpose, describe the designation. If historic and continuing relationship, explain. If "Yes," explain in how the organization determined that the supported organization was described in section 509(a)(1) or (2). If "Yes," answer lines 3b and 3c below. If "Yes," describe in when and how the organization made the determination. If "Yes," explain in what controls the organization put in place to ensure such use. If "Yes," and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below. If "Yes," describe in how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations. If "Yes," explain in what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes. If "Yes," answer lines 5b and 5c below (if applicable). Also, provide detail in including (i) the names and EIN 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). If "Yes," provide detail in If "Yes," complete Part I of Schedule L (Form 990). If "Yes," complete Part I of Schedule L (Form 990). If "Yes," provide detail in If "Yes," provide detail in If "Yes," provide detail in If "Yes," answer line 10b below. (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings.) Schedule A (Form 990) 2021 Page (Complete only if you checked a box in line 12 on Part I. If you checked box 12a, Part I, complete Sections A and B. If you checked box 12b, Part I, complete Sections A and C. If you checked box 12c, Part I, complete Sections A, D, and E. If you checked box 12d, Part I, complete Sections A and D, and complete Part V.) Are all of the organization's supported organizations listed by name in the organization's governing documents? Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? Was any supported organization not organized in the United States ("foreign supported organization")? Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? Did the organization add, substitute, or remove any supported organizations during the tax year? Was any added or substituted supported organization part of a class already designated in the organization's organizing document? Was the substitution the result of an event beyond the organization's control? Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization's supported organizations? Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (as defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? 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))? 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? 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? Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? Did the organization have any excess business holdings in the tax year? Part IV Supporting Organizations Section A. All Supporting Organizations NC, INC.58-1603427 HABITAT FOR HUMANITY, ORANGE COUNTY DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E 132025 01-04-22 5 Yes No 11 a b c 11a 11b 11cPart VI. Yes No 1 2 Part VI 1 2 Part VI Yes No 1 Part VI 1 Yes No 1 2 3 1 2 3 Part VI Part VI 1 2 3 (see instructions). a b c line 2 line 3 Part VI Answer lines 2a and 2b below.Yes No a b a b Part VI identify those supported organizations and explain 2a 2b 3a 3b Part VI Answer lines 3a and 3b below. Part VI. Part VI Schedule A (Form 990) 2021 If "Yes" to line 11a, 11b, or 11c, provide detail in If "No," describe in how the supported organization(s) effectively operated, supervised, or controlled the organization's activities. If 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 supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year. If "Yes," explain in how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised, or controlled the supporting organization. If "No," describe in how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s). If "No," explain in how the organization maintained a close and continuous working relationship with the supported organization(s). If "Yes," describe in the role the organization's supported organizations played in this regard. Check the box next to the method that the organization used to satisfy the Integral Part Test during the year Complete below. Complete below. Describe in how you supported a governmental entity (see instructions). If "Yes," then in how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities. If "Yes," explain in the reasons for the organization's position that its supported organization(s) would have engaged in these activities but for the organization's involvement. If "Yes" or "No" provide details in If "Yes," describe in the role played by the organization in this regard. Schedule A (Form 990) 2021 Page Has the organization accepted a gift or contribution from any of the following persons? A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization? A family member of a person described on line 11a above? A 35% controlled entity of a person described on line 11a or 11b above? 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 least a majority of the organization's officers, directors, or trustees at all times during the tax year? Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? Were a majority of the organization's directors or trustees during the tax year also a majority of the directors or trustees of each of the organization's supported organization(s)? 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? By reason of the relationship described on line 2, above, did the organization's supported organizations have a significant 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? The organization satisfied the Activities Test. The organization is the parent of each of its supported organizations. The organization supported a governmental entity. Activities Test. 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? 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? Parent of Supported Organizations. Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Did the organization exercise a substantial degree of direction over the policies, programs, and activities of each of its supported organizations? (continued)Part IV Supporting Organizations Section B. Type I Supporting Organizations Section C. Type II Supporting Organizations Section D. All Type III Supporting Organizations Section E. Type III Functionally Integrated Supporting Organizations NC, INC.58-1603427 HABITAT FOR HUMANITY, ORANGE COUNTY DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E 132026 01-04-22 6 1 Part VI See instructions. Section A - Adjusted Net Income 1 2 3 4 5 6 7 8 1 2 3 4 5 6 7 8Adjusted Net Income Section B - Minimum Asset Amount 1 2 3 4 5 6 7 8 a b c d e 1a 1b 1c 1d 2 3 4 5 6 7 8 Total Discount Part VI Minimum Asset Amount Section C - Distributable Amount 1 2 3 4 5 6 7 1 2 3 4 5 6 Distributable Amount. Schedule A (Form 990) 2021 explain in explain in detail in Schedule A (Form 990) 2021 Page Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (). All other Type III non-functionally integrated supporting organizations must complete Sections A through E. (B) Current Year (optional)(A) Prior Year Net short-term capital gain Recoveries of prior-year distributions Other gross income (see instructions) Add lines 1 through 3. Depreciation and depletion Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) Other expenses (see instructions) (subtract lines 5, 6, and 7 from line 4) (B) Current Year (optional)(A) Prior Year Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): Average monthly value of securities Average monthly cash balances Fair market value of other non-exempt-use assets (add lines 1a, 1b, and 1c) claimed for blockage or other factors ( ): Acquisition indebtedness applicable to non-exempt-use assets Subtract line 2 from line 1d. Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions). Net value of non-exempt-use assets (subtract line 4 from line 3) Multiply line 5 by 0.035. Recoveries of prior-year distributions (add line 7 to line 6) Current Year Adjusted net income for prior year (from Section A, line 8, column A) Enter 0.85 of line 1. Minimum asset amount for prior year (from Section B, line 8, column A) Enter greater of line 2 or line 3. Income tax imposed in prior year Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions). Check here if the current year is the organization's first as a non-functionally integrated Type III supporting organization (see instructions). Part V Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations NC, INC.58-1603427 HABITAT FOR HUMANITY, ORANGE COUNTY DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E 132027 01-04-22 7 Section D - Distributions Current Year 1 2 3 4 5 6 7 8 9 10 1 2 3 4 5 6 7 8 9 10 Part VI Part VI Total annual distributions. Part VI (i) Excess Distributions (ii) Underdistributions Pre-2021 (iii) Distributable Amount for 2021Section E - Distribution Allocations 1 2 3 4 5 6 7 8 Part VI a b c d e f g h i j Total a b c Part VI. Part VI Excess distributions carryover to 2022. a b c d e Schedule A (Form 990) 2021 provide details in describe in provide details in explain in explain in explain in Schedule A (Form 990) 2021 Page Amounts paid to supported organizations to accomplish exempt purposes Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity Administrative expenses paid to accomplish exempt purposes of supported organizations Amounts paid to acquire exempt-use assets Qualified set-aside amounts (prior IRS approval required - ) Other distributions ( ). See instructions. Add lines 1 through 6. Distributions to attentive supported organizations to which the organization is responsive ( ). See instructions. Distributable amount for 2021 from Section C, line 6 Line 8 amount divided by line 9 amount (see instructions) Distributable amount for 2021 from Section C, line 6 Underdistributions, if any, for years prior to 2021 (reason- able cause required - ). See instructions. Excess distributions carryover, if any, to 2021 From 2016 From 2017 From 2018 From 2019 From 2020 of lines 3a through 3e Applied to underdistributions of prior years Applied to 2021 distributable amount Carryover from 2016 not applied (see instructions) Remainder. Subtract lines 3g, 3h, and 3i from line 3f. Distributions for 2021 from Section D, line 7:$ Applied to underdistributions of prior years Applied to 2021 distributable amount Remainder. Subtract lines 4a and 4b from line 4. Remaining underdistributions for years prior to 2021, if any. Subtract lines 3g and 4a from line 2. For result greater than zero, See instructions. Remaining underdistributions for 2021. Subtract lines 3h and 4b from line 1. For result greater than zero, . See instructions. Add lines 3j and 4c. Breakdown of line 7: Excess from 2017 Excess from 2018 Excess from 2019 Excess from 2020 Excess from 2021 (continued) Part V Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations NC, INC.58-1603427 HABITAT FOR HUMANITY, ORANGE COUNTY DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E 132028 01-04-22 8 Schedule A (Form 990) 2021 Schedule A (Form 990) 2021 Page Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a, and 3b; Part V, line 1; Part V, Section B, line 1e; Part V, Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions.) Part VI Supplemental Information. NC, INC.58-1603427 HABITAT FOR HUMANITY, ORANGE COUNTY DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E Department of the Treasury Internal Revenue Service 123451 11-11-21 For Paperwork Reduction Act Notice, see the instructions for Form 990, 990-EZ, or 990-PF.Schedule B (Form 990) (2021) OMB No. 1545-0047 (Form 990)| Attach to Form 990 or Form 990-PF. | Go to www.irs.gov/Form990 for the latest information. Employer identification number Organization type Filers of:Section: not General Rule Special Rule. Note: General Rule Special Rules (1) (2) General Rule Caution: must exclusively exclusively nonexclusively Name of the organization (check one): Form 990 or 990-EZ 501(c)() (enter number) organization 4947(a)(1) nonexempt charitable trust treated as a private foundation 527 political organization Form 990-PF 501(c)(3) exempt private foundation 4947(a)(1) nonexempt charitable trust treated as a private foundation 501(c)(3) taxable private foundation Check if your organization is covered by the or a Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions. For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions. For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33 1/3% support test of the regulations under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of $5,000; or 2% of the amount on (i) Form 990, Part VIII, line 1h; or (ii) Form 990-EZ, line 1. Complete Parts I and II. For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor, during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I (entering "N/A" in column (b) instead of the contributor name and address), II, and III. For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor, during the year, contributions for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an religious, charitable, etc., purpose. Don't complete any of the parts unless the applies to this organization because it received religious, charitable, etc., contributions totaling $5,000 or more during the year ~~~~~~~~~~~~~~~|$ An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990), but it answer "No" on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ or on its Form 990-PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990). LHA Schedule B Schedule of Contributors 2021 NC, INC.58-1603427 X 3 X ** PUBLIC DISCLOSURE COPY ** HABITAT FOR HUMANITY, ORANGE COUNTY DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E 123452 11-11-21 Schedule B (Form 990) (2021) Employer identification number (a) No. (b) Name, address, and ZIP + 4 (c) Total contributions (d) Type of contribution Person Payroll Noncash (a) No. (b) Name, address, and ZIP + 4 (c) Total contributions (d) Type of contribution Person Payroll Noncash (a) No. (b) Name, address, and ZIP + 4 (c) Total contributions (d) Type of contribution Person Payroll Noncash (a) No. (b) Name, address, and ZIP + 4 (c) Total contributions (d) Type of contribution Person Payroll Noncash (a) No. (b) Name, address, and ZIP + 4 (c) Total contributions (d) Type of contribution Person Payroll Noncash (a) No. (b) Name, address, and ZIP + 4 (c) Total contributions (d) Type of contribution Person Payroll Noncash Schedule B (Form 990) (2021)Page Name of organization (see instructions). Use duplicate copies of Part I if additional space is needed. $ (Complete Part II for noncash contributions.) $ (Complete Part II for noncash contributions.) $ (Complete Part II for noncash contributions.) $ (Complete Part II for noncash contributions.) $ (Complete Part II for noncash contributions.) $ (Complete Part II for noncash contributions.) 2 Part I Contributors 1 X 5,000,000. 2 X 500,000. 3 X 1,405,692. HABITAT FOR HUMANITY, ORANGE COUNTY NC, INC.58-1603427 DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E 123453 11-11-21 Schedule B (Form 990) (2021) Employer identification number (a) No. from Part I (c) FMV (or estimate)(b) Description of noncash property given (d) Date received (a) No. from Part I (c) FMV (or estimate)(b) Description of noncash property given (d) Date received (a) No. from Part I (c) FMV (or estimate)(b) Description of noncash property given (d) Date received (a) No. from Part I (c) FMV (or estimate)(b) Description of noncash property given (d) Date received (a) No. from Part I (c) FMV (or estimate)(b) Description of noncash property given (d) Date received (a) No. from Part I (c) FMV (or estimate)(b) Description of noncash property given (d) Date received Schedule B (Form 990) (2021)Page Name of organization (see instructions). Use duplicate copies of Part II if additional space is needed. (See instructions.) $ (See instructions.) $ (See instructions.) $ (See instructions.) $ (See instructions.) $ (See instructions.) $ 3 Part II Noncash Property HABITAT FOR HUMANITY, ORANGE COUNTY NC, INC.58-1603427 DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E (Enter this info. once.)completing Part III, enter the total of exclusively religious,charitable, etc., contributions of for the year. 123454 11-11-21 Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor.(a)(e) and $1,000 or less Schedule B (Form 990) (2021) Complete columns through the following line entry. For organizations Employer identification number (a) No.fromPart I (b) Purpose of gift (c) Use of gift (d) Description of how gift is held (e) Transfer of gift Transferee's name, address, and ZIP + 4 Relationship of transferor to transferee (a) No.fromPart I (b) Purpose of gift (c) Use of gift (d) Description of how gift is held (e) Transfer of gift Transferee's name, address, and ZIP + 4 Relationship of transferor to transferee (a) No.fromPart I (b) Purpose of gift (c) Use of gift (d) Description of how gift is held (e) Transfer of gift Transferee's name, address, and ZIP + 4 Relationship of transferor to transferee (a) No.fromPart I (b) Purpose of gift (c) Use of gift (d) Description of how gift is held (e) Transfer of gift Transferee's name, address, and ZIP + 4 Relationship of transferor to transferee Schedule B (Form 990) (2021)Page Name of organization | $ Use duplicate copies of Part III if additional space is needed. 4 Part III HABITAT FOR HUMANITY, ORANGE COUNTY NC, INC.58-1603427 DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E Department of the Treasury Internal Revenue Service 132051 10-28-21 OMB No. 1545-0047 Held at the End of the Tax Year | Complete if the organization answered "Yes" on Form 990,Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b. | Attach to Form 990.|Go to www.irs.gov/Form990 for instructions and the latest information. (Form 990) Open to PublicInspection Name of the organization Employer identification number (a) (b) 1 2 3 4 5 6 Yes No Yes No 1 2 3 4 5 6 7 8 9 a b c d 2a 2b 2c 2d Yes No Yes No 1 2 a b (i) (ii) a b For Paperwork Reduction Act Notice, see the Instructions for Form 990.Schedule D (Form 990) 2021 Complete if the organization answered "Yes" on Form 990, Part IV, line 6. Donor advised funds 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 ~~~~~~~~~~~~~~~ ~~~~ ~~~~~~ ~~~~~~~~~~~~~ Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization's property, subject to the organization's exclusive legal control?~~~~~~~~~~~~~~~~~~ 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 impermissible private benefit? Complete if the organization answered "Yes" on Form 990, Part IV, line 7. Purpose(s) of conservation easements held by the organization (check all that apply). Preservation of land for public use (for example, recreation or education) Protection of natural habitat Preservation of open space Preservation of a historically important land area Preservation of a certified historic structure Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year. Total number of conservation easements Total acreage restricted by conservation easements ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~ Number of conservation easements on a certified historic structure included in (a) Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the tax year | Number of states where property subject to conservation easement is located | Does the organization have a written policy regarding the periodic monitoring, inspection, 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 | Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year |$ Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)?~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ In Part XIII, 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 organization's accounting for conservation easements. Complete if the organization answered "Yes" on Form 990, Part IV, line 8. If 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 service, provide in Part XIII the text of the footnote to its financial statements that describes these items. If the organization elected, as permitted under FASB ASC 958, 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 service, provide the following amounts relating to these items: Revenue included on Form 990, Part VIII, line 1 Assets included in Form 990, Part X ~~~~~~~~~~~~~~~~~~~~~~~~~~~~|$ $~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~| If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the following amounts required to be reported under FASB ASC 958 relating to these items: Revenue included on Form 990, Part VIII, line 1 Assets included in Form 990, Part X ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~|$ $| LHA Part I Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Part II Conservation Easements. Part III Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets. SCHEDULE D Supplemental Financial Statements 2021 HABITAT FOR HUMANITY, ORANGE COUNTY NC, INC.58-1603427 DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E 132052 10-28-21 3 4 5 a b c d e Yes No 1 2 a b c d e f a b Yes No 1c 1d 1e 1f Yes No (a) (b) (c) (d) (e) 1 2 3 4 a b c d e f g a b c a b Yes No (i) (ii) 3a(i) 3a(ii) 3b (a) (b) (c) (d) 1a b c d e Total. Schedule D (Form 990) 2021 (continued) (Column (d) must equal Form 990, Part X, column (B), line 10c.) Two years back Three years back Four years back Schedule D (Form 990) 2021 Page Using the organization's acquisition, accession, and other records, check any of the following that make significant use of its collection items (check all that apply): Public exhibition Scholarly research Preservation for future generations Loan or exchange program Other Provide a description of the organization's collections and explain how they further the organization's exempt purpose in Part XIII. 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 part of the organization's collection? Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21. Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not included on Form 990, Part X? If "Yes," explain the arrangement in Part XIII and complete the following table: ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Amount Beginning balance Additions during the year Distributions during the year Ending balance ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided on Part XIII ~~~~~ Complete if the organization answered "Yes" on Form 990, Part IV, line 10. Current year Prior year 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%. |% |% |% Are there endowment funds not in the possession of the organization that are held and administered for the organization by: Unrelated organizations Related organizations ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ If "Yes" on line 3a(ii), are the related organizations listed as required on Schedule R? Describe in Part XIII the intended uses of the organization's endowment funds. ~~~~~~~~~~~~~~~~~~~~ Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10. Description of property Cost or other basis (investment) Cost or other basis (other) Accumulated depreciation Book value Land Buildings Leasehold improvements ~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~ Equipment Other ~~~~~~~~~~~~~~~~~ Add lines 1a through 1e. | 2 Part III Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets Part IV Escrow and Custodial Arrangements. Part V Endowment Funds. Part VI Land, Buildings, and Equipment. X X 15,000. 120,380. 156,804. 15,000. 98,687. 125,674. 0. 21,693. 31,130. 52,823. NC, INC.58-1603427 HABITAT FOR HUMANITY, ORANGE COUNTY X DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E (including name of security) 132053 10-28-21 Total. Total. (a) (b) (c) (1) (2) (3) (a) (b) (c) (1) (2) (3) (4) (5) (6) (7) (8) (9) (a) (b) (1) (2) (3) (4) (5) (6) (7) (8) (9) Total. (a) (b) 1. Total. 2. Schedule D (Form 990) 2021 (Column (b) must equal Form 990, Part X, col. (B) line 15.) (Column (b) must equal Form 990, Part X, col. (B) line 25.) Description of security or category (Col. (b) must equal Form 990, Part X, col. (B) line 12.) | (Col. (b) must equal Form 990, Part X, col. (B) line 13.) | Schedule D (Form 990) 2021 Page Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12. Book value Method of valuation: Cost or end-of-year market value Financial derivatives Closely held equity interests Other ~~~~~~~~~~~~~~~ ~~~~~~~~~~~ (A) (B) (C) (D) (E) (F) (G) (H) Complete if the organization answered "Yes" on Form 990, Part IV, line 11c. See Form 990, Part X, line 13. Description of investment Book value Method of valuation: Cost or end-of-year market value Complete if the organization answered "Yes" on Form 990, Part IV, line 11d. See Form 990, Part X, line 15. Description Book value | Complete if the organization answered "Yes" on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25. Description of liability Book value (1) (2) (3) (4) (5) (6) (7) (8) (9) Federal income taxes | Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FASB ASC 740. Check here if the text of the footnote has been provided in Part XIII 3 Part VII Investments - Other Securities. Part VIII Investments - Program Related. Part IX Other Assets. Part X Other Liabilities. NC, INC. NON-INTEREST BEARING MORTGAGES RECEIVABLE NMTC JOINT VENTURE DEPOSITS- RENT SECURITY LAND HELD FOR HOMESITES HOMES UNDER CONSTRUCTION HOMES HELD FOR SALE DUE TO JOINT VENTURE DEFERRED RENT 58-1603427 5,414,349. 1,205,504. 6,619,853. 137,461. 7,464,223. 1,267,629. 467,105. 9,336,418. 2,133,922. 12,222. 2,146,144. HABITAT FOR HUMANITY, ORANGE COUNTY END-OF-YEAR MARKET VALUE END-OF-YEAR MARKET VALUE X DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E 132054 10-28-21 1 2 3 4 5 1 a b c d e 2a 2b 2c 2d 2a 2d 2e 32e 1 a b c 4a 4b 4a 4b 3 4c. 4c 5 1 2 3 4 5 1 a b c d e 2a 2b 2c 2d 2a 2d 2e 1 2e 3 a b c 4a 4b 4a 4b 3 4c. 4c 5 Schedule D (Form 990) 2021 (This must equal Form 990, Part I, line 12.) (This must equal Form 990, Part I, line 18.) Schedule D (Form 990) 2021 Page Complete if the organization answered "Yes" on Form 990, Part IV, line 12a. Total revenue, gains, and other support per audited financial statements Amounts included on line 1 but not on Form 990, Part VIII, line 12: ~~~~~~~~~~~~~~~~~~~ Net unrealized gains (losses) on investments Donated services and use of facilities Recoveries of prior year grants Other (Describe in Part XIII.) ~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~ Add lines through ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Subtract line from line ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Amounts included on Form 990, Part VIII, line 12, but not on line 1: Investment expenses not included on Form 990, Part VIII, line 7b Other (Describe in Part XIII.) ~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~ Add lines and Total revenue. Add lines and ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Complete if the organization answered "Yes" on Form 990, Part IV, line 12a. Total expenses and losses per audited financial statements Amounts included on line 1 but not on Form 990, Part IX, line 25: ~~~~~~~~~~~~~~~~~~~~~~~~~~ Donated services and use of facilities Prior year adjustments Other losses Other (Describe in Part XIII.) ~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~ Add lines through Subtract line from line ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Amounts included on Form 990, Part IX, line 25, but not on line 1: Investment expenses not included on Form 990, Part VIII, line 7b Other (Describe in Part XIII.) ~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~ Add lines and Total expenses. Add lines and ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part IV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information. 4 Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Part XIII Supplemental Information. THE ORGANIZATION IS HOLDING FUNDS IN ESCROW FOR THE FUTURE SALE OF FINISHED LOTS TO MARKET-RATE BUILDER PARTNERS; ON BEHALF OF FIVE HOMEOWNERS' ASSOCIATIONS FOR WHICH IT MANAGES BANK ACCOUNTS; AND ON BEHALF OF ONE HOMEOWNER IN BANKRUPTCY. PART X, LINE 2: INCOME TAX STATUS - THE ORGANIZATION IS EXEMPT FROM FEDERAL AND STATE 12,038,566. 11,920. 11,920. 12,026,646. -51,730. -51,730. 11,974,916. 4,541,113. 11,920. 51,730. 63,650. 4,477,463. 0. 4,477,463. PART IV, LINE 2B: NC, INC.58-1603427 HABITAT FOR HUMANITY, ORANGE COUNTY INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND THE APPLICABLE STATE TAX STATUTES. IN ADDITION, THE ORGANIZATION QUALIFIES FOR THE CHARITABLE CONTRIBUTION DEDUCTION UNDER SECTION 170(B)(1)(A) AND HAS BEEN QUALIFIED AS AN ORGANIZATION THAT IS NOT A PRIVATE FOUNDATION UNDER DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E 132055 10-28-21 5 Schedule D (Form 990) 2021 (continued) Schedule D (Form 990) 2021 Page Part XIII Supplemental Information SECTION 509(A)(2) OF THE INTERNAL REVENUE CODE. MANAGEMENT HAS EVALUATED THE EFFECT OF THE GUIDANCE PROVIDED BY GAAP ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. MANAGEMENT BELIEVES THAT THE ORGANIZATION CONTINUES TO SATISFY THE REQUIREMENTS OF A TAX-EXEMPT ORGANIZATION AT JUNE 30, 2022. PART XI, LINE 4B - OTHER ADJUSTMENTS: DIRECT FUNDRAISING EVENT EXPENSES -50,559. RENTAL EXPENSES -1,171. TOTAL TO SCHEDULE D, PART XI, LINE 4B -51,730. PART XII, LINE 2D - OTHER ADJUSTMENTS: DIRECT FUNDRAISING EVENT EXPENSES 50,559. RENTAL EXPENSES 1,171. TOTAL TO SCHEDULE D, PART XII, LINE 2D 51,730. NC, INC.58-1603427 HABITAT FOR HUMANITY, ORANGE COUNTY DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E Department of the Treasury Internal Revenue Service Didfundraiserhave custodyor control ofcontributions? 132081 10-21-21 Go to OMB No. 1545-0047 Complete if the organization answered "Yes" on Form 990, Part IV, line 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. Open to Public Inspection | Attach to Form 990 or Form 990-EZ. | www.irs.gov/Form990 for instructions and the latest information. Employer identification number 1 a b c d a b e f g 2 Yes No (i) (ii) (iii) (iv) (v) (i) (vi) Yes No Total 3 For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.Schedule G (Form 990) 2021 Name of the organization Complete if the organization answered "Yes" on Form 990, Part IV, line 17. Form 990-EZ filers are not required to complete this part. Indicate whether the organization raised funds through any of the following activities. Check all that apply. Mail solicitations Internet and email solicitations Phone solicitations In-person solicitations Solicitation of non-government grants Solicitation of government grants Special fundraising events Did the organization have a written or oral agreement with any individual (including officers, directors, trustees, or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services? If "Yes," list the 10 highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is to be compensated at least $5,000 by the organization. Name and address of individual or entity (fundraiser)Activity Gross receipts from activity Amount paidto (or retained by)fundraiserlisted in col. Amount paidto (or retained by)organization | List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing. LHA Supplemental Information Regarding Fundraising or Gaming ActivitiesSCHEDULE G (Form 990) Part I Fundraising Activities. 2021 HABITAT FOR HUMANITY, ORANGE COUNTY 58-1603427 X X X X X X X X NC MOSS & ROSS - 4102 WESTFIELD X 1,768,149.47,746.1,720,403. 47,746.1,768,149.DRIVE, DURHAM, NC 27705 1,720,403. NC, INC. FUNDRAISING CONSULTING DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E 132082 10-21-21 2 (d) (a) (c) (a) (b) (c) 1 2 3 4 5 6 7 8 9 10 11 (a) (b) (c) (d) (a) (c) 1 2 3 4 5 6 7 8 Yes Yes Yes No No No 9 10 a b Yes No a b Yes No Schedule G (Form 990) 2021 Pull tabs/instant bingo/progressive bingo Schedule G (Form 990) 2021 Page Complete if the organization answered "Yes" on Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000. Total events (add col. through col. )RevenueEvent #1 Event #2 Other events (event type)(event type)(total number) Gross receipts Less: Contributions ~~~~~~~~~~~~~~ ~~~~~~~~~~~ Gross income (line 1 minus line 2)Direct Expenses Cash prizes Noncash prizes ~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~ Rent/facility costs ~~~~~~~~~~~~ Food and beverages Entertainment ~~~~~~~~~~ ~~~~~~~~~~~~~~ Other direct expenses ~~~~~~~~~~ Direct expense summary. Add lines 4 through 9 in column (d) Net income summary. Subtract line 10 from line 3, column (d) ~~~~~~~~~~~~~~~~~~~~~~~~| | Complete if the organization answered "Yes" on Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.RevenueBingo Other gaming Total gaming (add col. through col. )Direct ExpensesGross revenue Cash prizes Noncash prizes ~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~ Rent/facility costs Other direct expenses ~~~~~~~~~~~~ %%% Volunteer labor ~~~~~~~~~~~~~ Direct expense summary. Add lines 2 through 5 in column (d) Net gaming income summary. Subtract line 7 from line 1, column (d) ~~~~~~~~~~~~~~~~~~~~~~~~| | Enter the state(s) in which the organization conducts gaming activities: Is the organization licensed to conduct gaming activities in each of these states? If "No," explain: ~~~~~~~~~~~~~~~~~~~~ Were any of the organization's gaming licenses revoked, suspended, or terminated during the tax year? If "Yes," explain: ~~~~~~~~~ Part II Fundraising Events. Part III Gaming. 172,727. 172,727. 357. 10,883. 164,080. 116,112. 47,968. 690. 30,342. 336,807. 288,839. 47,968. 1,047. 41,225. 50,559. -2,591. HOUSE PARTY TABLE DINNER FARM TO NC, INC.58-1603427 HABITAT FOR HUMANITY, ORANGE COUNTY NONE 550. 2,608. 1,425. 3,704.6,312. 1,975. DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E 132083 10-21-21 3 11 12 13 14 15 Yes No Yes No a b 13a 13b Yes Noa b c 16 17 a b Yes No Schedule G (Form 990) 2021 Schedule G (Form 990) 2021 Page Does the organization conduct gaming activities with nonmembers? Is the organization a grantor, beneficiary or trustee of a trust, or a member of a partnership or other entity formed to administer charitable gaming? ~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Indicate the percentage of gaming activity conducted in: The organization's facility An outside facility ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~% %~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Enter the name and address of the person who prepares the organization's gaming/special events books and records: Name | Address | Does the organization have a contract with a third party from whom the organization receives gaming revenue? If "Yes," enter the amount of gaming revenue received by the organization | ~~~~~~ $and the amount of gaming revenue retained by the third party | $ If "Yes," enter name and address of the third party: Name | Address | Gaming manager information: Name | Gaming manager compensation | Description of services provided | $ Director/officer Employee Independent contractor Mandatory distributions: Is the organization required under state law to make charitable distributions from the gaming proceeds to retain the state gaming license?~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Enter the amount of distributions required under state law to be distributed to other exempt organizations or spent in the organization's own exempt activities during the tax year |$ Provide the explanations required by Part I, line 2b, columns (iii) and (v); and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also provide any additional information. See instructions. Part IV Supplemental Information. NC, INC.58-1603427 HABITAT FOR HUMANITY, ORANGE COUNTY DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E 132084 11-18-21 4 Schedule G (Form 990) (continued) Schedule G (Form 990)Page Part IV Supplemental Information NC, INC.58-1603427 HABITAT FOR HUMANITY, ORANGE COUNTY DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E OMB No. 1545-0047 Department of the Treasury Internal Revenue Service 132101 10-26-21 SCHEDULE I (Form 990) Complete if the organization answered "Yes" on Form 990, Part IV, line 21 or 22. | Attach to Form 990. | Go to www.irs.gov/Form990 for the latest information. Open to Public Inspection Employer identification number Part I General Information on Grants and Assistance 1 2 Yes No Part II Grants and Other Assistance to Domestic Organizations and Domestic Governments. (f) 1 (a) (b) (c) (d) (e) (g) (h) 2 3 For Paperwork Reduction Act Notice, see the Instructions for Form 990.Schedule I (Form 990) 2021 Name of the organization Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and the selection criteria used to award the grants or assistance?~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed. Method ofvaluation (book, FMV, appraisal,other) Name and address of organization or government EIN IRC section (if applicable) Amount of cash grant Amount of noncash assistance Description of noncash assistance Purpose of grant or assistance Enter total number of section 501(c)(3) and government organizations listed in the line 1 table Enter total number of other organizations listed in the line 1 table ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~| | LHA Grants and Other Assistance to Organizations, Governments, and Individuals in the United States 2021 HABITAT FOR HUMANITY, ORANGE COUNTY NC, INC. HABITAT FOR HUMANITY INTERNATIONAL ASSISTANCE WITH HOUSING 91-1914868 501(C)(3)75,000.0.PROGRAMS 1. 0. X 322 W LAMAR STREET 58-1603427 AMERICUS, GA 31709 DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E 132102 10-26-21 2 Grants and Other Assistance to Domestic Individuals. Part III (e) (a) (b) (c) (d) (f) Part IV Supplemental Information. Schedule I (Form 990) 2021 Schedule I (Form 990) 2021 Page Complete if the organization answered "Yes" on Form 990, Part IV, line 22. Part III can be duplicated if additional space is needed. Method of valuation(book, FMV, appraisal, other)Type of grant or assistance Number of recipients Amount of cash grant Amount of non- cash assistance Description of noncash assistance Provide the information required in Part I, line 2; Part III, column (b); and any other additional information. PART I, LINE 2: THE ORGANIZATION MAKES TITHE CONTRIBUTIONS TO HABITAT FOR HUMANITY INTERNATIONAL TO PROVIDE FUNDING TO INTERNATIONAL AFFILIATES. THE TITHE IS DIRECTED TO HONDURAS AND MYANMAR. HABITAT FOR HUMANITY INTERNATIONAL ENSURES THAT EACH AFFILIATE PROVIDES REPORTING AND ACCOUNTABILITY TO REMAIN AN AFFILIATE IN GOOD STANDING. IN ADDITION, PERIODIC REPORTS ARE RECEIVED THAT DETAIL THE ACTIVITIES AND THE USE OF FUNDS BY EACH INTERNATIONAL PARTNER. HABITAT FOR HUMANITY, ORANGE COUNTY NC, INC.58-1603427 DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E OMB No. 1545-0047 Department of the Treasury Internal Revenue Service 132141 11-17-21 Open to Public Inspection Complete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30. Attach to Form 990. Go to www.irs.gov/Form990 for instructions and the latest information. Employer identification number (a)(b)(c)(d) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 29 Yes No 30 31 32 33 a b 30a 31 32a a b For Paperwork Reduction Act Notice, see the Instructions for Form 990.Schedule M (Form 990) 2021 Name of the organization Check if applicable Number of contributions or items contributed Noncash contribution amounts reported on Form 990, Part VIII, line 1g Method of determining noncash contribution amounts Art - Works of art Art - Historical treasures Art - Fractional interests ~~~~~~~~~~~~~ ~~~~~~~~~ ~~~~~~~~~~ Books and publications Clothing and household goods ~~~~~~~~~~ ~~~~~~ Cars and other vehicles Boats and planes Intellectual property ~~~~~~~~~~ ~~~~~~~~~~~~~ ~~~~~~~~~~~ Securities - Publicly traded Securities - Closely held stock ~~~~~~~~ ~~~~~~~ Securities - Partnership, LLC, or 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 ~~~~~~~~~~~~ ~~~~~~~~~~~ ~~~~~~~~~~ Other () Other () Other () Other () 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 ~~~~ During the year, did the organization receive by contribution any property reported in Part 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?~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ If "Yes," describe the arrangement in Part II. Does the organization have a gift acceptance policy that requires the review of any nonstandard contributions?~~~~~~ Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash contributions?~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ If "Yes," describe in Part II. If the organization didn't report an amount in column (c) for a type of property for which column (a) is checked, describe in Part II. LHA SCHEDULE M (Form 990) Part I Types of Property Noncash Contributions 2021J J J J J J J HABITAT FOR HUMANITY, ORANGE COUNTY 58-1603427 197,649. 41,346. 10 20 FMV MARKET COST X XCONSTRUCTION X X X 0 NC, INC. DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E 132142 11-17-21 2 Schedule M (Form 990) 2021 Schedule M (Form 990) 2021 Page Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information. Part II Supplemental Information. SCHEDULE M, LINE 32B: THE ORGANIZATION USES WELLS FARGO INVESTMENT ADVISORS TO RECEIVE AND IMMEDIATELY SELL ALL SECURITIES RECEIVED AS A CONTRIBUTION. HABITAT FOR HUMANITY, ORANGE COUNTY NC, INC.58-1603427 DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E OMB No. 1545-0047 Department of the Treasury Internal Revenue Service 132211 11-11-21 Complete to provide information for responses to specific questions onForm 990 or 990-EZ or to provide any additional information. | Attach to Form 990 or Form 990-EZ.| Go to www.irs.gov/Form990 for the latest information. Open to Public Inspection Employer identification number For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.Schedule O (Form 990) 2021 Name of the organization LHA (Form 990) SCHEDULE O Supplemental Information to Form 990 or 990-EZ 2021 FORM 990, PART III, LINE 1, DESCRIPTION OF ORGANIZATION MISSION: POLICY AND WILL NOT OFFER ASSISTANCE ON THE EXPRESSED OR IMPLIED CONDITION THAT PEOPLE MUST ADHERE TO OR CONVERT TO A PARTICULAR FAITH OR LISTEN AND RESPOND TO MESSAGING DESIGNED TO INDUCE CONVERSION TO A PARTICULAR FAITH. FORM 990, PART III, LINE 4A, PROGRAM SERVICE ACCOMPLISHMENTS: HOME FOSTERS - INSTEAD OF HINDERS - HEALTH AND SAFETY, FAMILIES CAN FLOURISH. OWNING AN AFFORDABLE HOME ALSO ALLOWS HOMEOWNERS TO LIFT UP THEIR ENTIRE FAMILY BY SAVING FOR THEIR FUTURES AND INVESTING IN EDUCATIONAL OPPORTUNITIES, BOLSTERING JOB OPPORTUNITIES AND CAREER GROWTH. DURING FISCAL YEAR 2022, HABITAT FOR HUMANITY OF ORANGE COUNTY SERVED MORE THAN 50 PEOPLE THROUGH ITS LONG-TERM HOMEOWNERSHIP PROGRAM. FORM 990, PART III, LINE 4B, PROGRAM SERVICE ACCOMPLISHMENTS: FOR HUMANITY OF ORANGE COUNTY HAS PARTNERED WITH 230 LOCAL HOMEOWNERS, WITH 23 HOMEOWNERS SERVED DURING FY22. FORM 990, PART VI, SECTION B, LINE 11B: THE ORGANIZATION PROVIDES A COMPLETE COPY OF THE FORM 990 TO ALL MEMBERS OF THE BOARD OF DIRECTORS FOR THEIR REVIEW PRIOR TO FILING THE 990. FORM 990, PART VI, SECTION B, LINE 12C: WHEN ANY SUCH CONFLICT OF INTEREST CONCERNING A BOARD MEMBER IS RELEVANT TO A MATTER REQUIRING BOARD ACTION, THE INTERESTED BOARD MEMBER SHALL CALL IT TO THE ATTENTION OF THE BOARD PRESIDENT, AND THE INTERESTED NC, INC.58-1603427 HABITAT FOR HUMANITY, ORANGE COUNTY DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E 132212 11-11-21 2 Employer identification number Schedule O (Form 990) 2021 Schedule O (Form 990) 2021 Page Name of the organization MEMBER SHALL NOT ACT OR VOTE ON THE MATTER. THE MINUTES OF THE MEETING SHALL REFLECT THAT THE CONFLICT OF INTEREST WAS DISCLOSED AND THAT THE INTERESTED PERSON DID NOT VOTE. FORM 990, PART VI, SECTION B, LINE 15: THE PRESIDENT/CEO'S SALARY IS REVIEWED ANNUALLY BY THE INDEPENDENT EXECUTIVE COMMITTEE. INCREASES ARE BASED ON MERIT AND AN ANNUAL SALARY SURVEY PROVIDED BY HABITAT INTERNATIONAL. THE TOTAL SALARY INCREASE FOR ALL STAFF FOR EACH FISCAL YEAR IS APPROVED BY THE BOARD PRIOR TO THE START OF EACH FISCAL YEAR (MAY), AND ALL SALARY INCREASES, EXCLUDING THE EXECUTIVE COMMITTEE'S-APPROVED PRESIDENT/CEO SALARY, FOR THE FISCAL YEAR ARE INTERNALLY DISCUSSED BY DEPARTMENT HEADS, APPROVED BY THE VP-FINANCE AND PRESIDENT/CEO, AND ARE WITHIN THE BUDGETED TOTAL. ALL INCREASES ARE BASED ON MERIT, AND AN ANNUAL SALARY SURVEY FROM HABITAT INTERNATIONAL AND/OR SALARY INFORMATION FROM AN EXTERNAL SOURCE OR SOURCES. FORM 990, PART VI, SECTION C, LINE 19: GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS, FORM 990 AND 1023 ARE AVAILABLE TO THE PUBLIC UPON REQUEST. NC, INC.58-1603427 HABITAT FOR HUMANITY, ORANGE COUNTY DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E Applicant Organization's Budget Actual Total for Previous Year (FY22) Estimated Total for Current Year (FY23) Projected Total for Next Year (FY24) Percent Change 1,530,575$ 1,800,206$ 2,000,000$ 11% 279,209$ 306,974$ 250,000$ -19% 43,487$ 63,250$ 94,250$ 49% 76,133$ 80,000$ 95,000$ 19% 84,134$ 143,091$ 75,000$ -48% 158,000$ 545,000$ 712,500$ 31% 75,000$ 524,933$ 167,241$ -68% Federal Home Loan Bank 5,000$ 97,500$ 37,500$ -62% Chapel Hill CDBG 12,718$ 6,208$ 10,000$ 61% Private Foundation Grants 175,000$ 60,000$ 75,000$ 25% Other Revenue: primarily home sales 1,013,084$ 2,605,612$ 3,548,384$ 0.36$ 3,452,340$ 6,232,774$ 7,064,875$ 13% 1,706,768$ 2,032,875$ 2,550,514$ 25% 102,104$ 101,438$ 108,627$ 7% 55,676$ 97,417$ 57,380$ -41% 30,983$ 33,736$ 35,400$ 5% 2,455,774$ 2,917,848$ 3,824,379$ 31% 4,351,305$ 5,183,314$ 6,576,300$ 27% (898,965)$ 1,049,460$ 488,575$ -53% AGENCY EXPENSES Total Organization Revenue (Most recent complete calendar year or fiscal year) ORGANIZATION REVENUE Private Donations Habitat for Humanity, Orange County, N.C., Inc. Ending Date: 06/30/2023 Local Government Grants (Please list separately): Orange County Climate Action Orange County Outside Agency Starting date: 07/01/2022 Generated Revenue (fees, sales, etc) - ReStore ORGANIZATION NAME: Other Expenses: primarily construction costs Total Agency Expenses Supplies & Equipment Travel & Training SURPLUS/(DEFICIT) FOR PERIOD: Other Government Grants Triangle United Way NCHFA Orange County HOME Funds Compensation Rent & Utilities FY 2018-19 Agency Budget DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E Proposed Project Budget Use for all projects Actual Total for Previous Year (FY22) Estimated Total for Current Year (FY23) Projected Total for Next Year (FY24) Percent Change 175,000$ 70,000$ 230,000$ 229% 5,387$ 6,170$ 5,000$ -19% 3,487$ 8,250$ 55,000$ 567% 76,133$ 80,000$ 95,000$ 19% -$ 5,000$ 5,000$ 0% -$ -$ -$ 0 -$ -$ -$ 0 12,718$ 6,208$ 10,000$ 61% Private Foundation Grants -$ -$ -$ 0 Other Revenue: general operating revenue 41,272$ 317,960$ 144,665$ -55% 313,997$ 493,588$ 544,665$ 10% 156,332$ 181,513$ 200,000$ 10% 116,709$ 247,694$ 273,622$ 10% 40,956$ 64,381$ 71,043$ 10% 313,997$ 493,588$ 544,665$ 10% -$ -$ -$ 0 This grant will fund a subset of projects completed under Habitat's Home Preservation repair program. SURPLUS/(DEFICIT) FOR PERIOD: Total Project Expenses Chapel Hill CDBG Overhead - 15% Total Project Revenue PROJECT EXPENSES Materials & subcontracted labor Salaries & benefits - repair team Other Government Grants Triangle United Way State Government Orange County Outside Agency Carrboro AHSRF Private Donations - restricted Project Generated Revenue: homeowner payments Local Government Grants (Please list separately): Orange County Climate Action PROJECT REVENUE PROJECT NAME:Habitat Home Preservation Repair Program Use only if project is ongoing FY 2018-19 Program Budget DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E ORANGE COUNTY BOARD OF COMMISSIONERS ACTION AGENDA ITEM ABSTRACT Meeting Date:December 12, 2023 Action Agenda Item No.6-b SUBJECT: Community Climate Action Grant (CCAG) – FY 2023-24 Project Selection for General Applicants and Schools DEPARTMENT: County Manager ATTACHMENT(S): 1) CCAG 2023-24 Project Descriptions, Scoring, and Comments for General Applicants and Schools 2) CCAG Project Status Summary Including Estimated GHG Reductions INFORMATION CONTACT: Amy Eckberg, (919) 245-2626 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 2023-24 Orange County Community Climate Action Grant Program; and 2) Approve funding for the recommended Community Climate Action Grant projects for FY 2023-24 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 help 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 Newly adopted Climate Action Plan (November 2023) For the 2023-24 funding cycle, $564,085 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 soliciting 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 ($282,042.50) to be awarded to projects submitted by either of Orange County's two public school districts. The remaining half ($282,042.50) was to be made available to all other eligible general applicants in this round. 1 DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E The Community Climate Action grant program received eleven (11) applications in this round from a variety of general applicants representing non-profit and public organizations whose total requests added up to $614,540. Two (2) projects totaling $557,959 were submitted from the Chapel Hill Carrboro City Schools and Orange County Schools districts. 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 2023, each of these Commissions voted to forward their final scoring 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: General Applications: Name Project Name Description Amount Requested Recommended Funding level Rank Total Score out of 26 Points Habitat for Humanity Supplemental Weatherization Habitat’s Home Preservation program support. $55,000 $55,000 1 21 Urban Sustainability Solutions Growing More than Rain Gardens Create a Green Infrastructure Workforce Development Apprenticeship Program $69,156 $69,156 2 21 Town of Chapel Hill LED Lighting Upgrades LED Lighting Upgrade for Hargraves Community Center Basketball Court $95,000 $0 3 20 Hillsborough United Church of Christ Solar Panel Project Rooftop Solar Installation $10,000 $10,000 4 20 Binkley Baptist Church Let There Be (clean energy) Light! Install 50 solar panels $49,046 $49,036 5 18 EMPOWERment Rooftop solar on PEACH apartments Rooftop solar installation $134,562 $61,623 6 18 Club Nova Big Impact Small Footprint Support Installation of garden, greenhouse, terrace. $37,227 $37,227 7 17 Eco‐Institute at Sanctuary Farm Community Garden Cooperative Expand Community Garden Cooperative and create a new Training Program $50,800 $0 8 17 The Arts Center Haven for Outdoor Eco‐Classroom Solar Powered Shelter with 16 places to charge up, explore, create, and learn. $41,729 $0 9 17 St. Thomas More Catholic Church EV Charging Station EV Charging Station Installation $22,030 $0 10 16 Triangle ECycling The e is for Equity. Discount eBike with Voucher Pilot Program $50,000.00 $0 11 13 2 DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E School Applications: Name Project Description Amount Requested Recommended Funding Level Rank Total Score out of 26 Points Chapel Hill Carrboro City Schools LED Lights LED Campus Lighting Changeover $270,000 $94,014 1 17 Orange County Schools Solar 54 Panel Solar Pedestal with Battery Storage $287,959 $188,029 2 11 * All projects were placed in rank order by CFE and HRC voting. Attachment 2 provides a status summary including estimates of GHG emissions avoided annually from projects that have been approved by the Community Climate Action Grant program to date. FINANCIAL IMPACT: The Community Climate Action Grant Tax funding of $564,085 in FY 2023- 24, 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 the 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 distribution 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 and 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 energy; 2) reduce resource consumption; 3) increase the use of recycled and renewable resources; and 4) minimize waste stream impacts on the environment. 3 DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E 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 natural resources both inside and outside of the County. RECOMMENDATION(S): The Manager recommends that the Board: 1) Receive the grant project funding recommendations from the Human Relations Commission and the Commission for the Environment for the FY 2023-24 Orange County Community Climate Action Grant Program; and 2) Approve funding for the recommended Community Climate Action Grant projects for FY 2023-24. 4 DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E P.O. Box 8181 * Hillsborough, North Carolina 27278 Telephone: (919)245‐2625 Attachment 1 Date: December 12, 2023 To: Board of Orange County Commissioners From: Amy Eckberg, Sustainability Programs Manager RE: Orange County Community Climate Action Grant ‐ Project Descriptions, Scoring, and Comments for General and School Applicants For the 2023‐24 funding cycle of the Orange County Community Climate Action Grant program, $564,085 in funding was budgeted to support climate action projects that benefit Orange County residents both socially and financially. For this grant cycle, the Board of Orange County Commissioners reserved half of the total funding for this grant program ($282,042.50) to be awarded to projects submitted by either of Orange County’s two public school districts. The remaining half ($282,042.50) was to be made available to all other eligible “general” applicants. Based on feedback received from the Board, a concerted effort to publicize the grant opportunity was made this year. A UNC‐Chapel Hill Eco Studio intern helped support our community engagement efforts through phone calls, flyer distribution and “door to door” canvassing of local businesses, churches, and community groups. A special info graphic announcing the grant was distributed via social media, Orange County TV screens, website, and weekly happenings email. A targeted mass email went out to community groups, churches, nonprofits and small businesses announcing the grant opportunity. As a result of all these outreach efforts, we received the most grant applications ever received since the inception of the grant and many new applicants! The Community Climate Action grant program received 11 “general” applications in this round from a variety of nonprofit and public organizations whose total requests add up to almost $615,000. In addition, both school districts submitted applications totaling almost $558,000. Following the scoring and eligibility guidelines of the Board of Orange County Commissioners (BOCC), the applications were reviewed and scored by the Commission for the Environment (CFE) and the Human Relations Commission (HRC). The BOCC asked the Human Relations Commission to score the applications on the Social Justice and Racial Equity criterion, as this pertains to their expertise and because the racial representation of the CFE as a whole does not reflect the racial diversity of Orange County. The following is a rank‐order summary table of the combined project scoring and recommendations. A full table showing the scores for each project on each of the 7 scoring elements is included in the Appendix. 5 DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E General Applications: Name Project Name Description Amount Requested Recommended Funding level Rank Total Score out of 26 Points Habitat for Humanity Supplemental Weatherization Habitat’s Home Preservation program support. $55,000 $55,000 1 21 Urban Sustainability Solutions Growing More than Rain Gardens Create a Green Infrastructure Workforce Development Apprenticeship Program $69,156 $69,156 2 21 Town of Chapel Hill LED Lighting Upgrades LED Lighting Upgrade for Hargraves Community Center Basketball Court $95,000 $0 3 20 Hillsborough United Church of Christ Solar Panel Project Rooftop Solar Installation $10,000 $10,000 4 20 Binkley Baptist Church Let There Be (clean energy) Light! Install 50 solar panels $49,046 $49,036 5 18 EMPOWERment Rooftop solar on PEACH apartments Rooftop solar installation $134,562 $61,623 6 18 Club Nova Big Impact Small Footprint Support Installation of garden, greenhouse, terrace. $37,227 $37,227 7 17 Eco‐Institute at Sanctuary Farm Community Garden Cooperative Expand Community Garden Cooperative and create a new Training Program $50,800 $0 8 17 The Arts Center Haven for Outdoor Eco‐Classroom Solar Powered Shelter with 16 places to charge up, explore, create, and learn. $41,729 $0 9 17 St. Thomas More Catholic Church EV Charging Station EV Charging Station Installation $22,030 $0 10 16 Triangle ECycling The e is for Equity. Discount eBike with Voucher Pilot Program $50,000.00 $0 11 13 School Applications: Name Project Description Amount Requested Recommended Funding Level Rank Total Score out of 26 Points Chapel Hill Carrboro City Schools LED Lights LED Campus Lighting Changeover $270,000 $94,014 1 17 Orange County Schools Solar 54 Panel Solar Pedestal with Battery Storage $287,959 $188,029 2 11 Below is a set of expanded details for each proposed project, in rank order per HRC and CFE scoring. The quoted text was pulled directly from various sections of the submitted applications. Also summarized below are the comments from the HRC and the CFE, along with scores and funding recommendations. #1 Ranked Project – Habitat for Humanity Applicant (Collaborators): Habitat for Humanity Funding Requested: $55,000 Recommended Funding Level: $55,000 Total Score (Out of 26 pts): 21 6 DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E Project Description: Habitat for Humanity of Orange County proposes to use $55,000 in Orange County Climate Action Grant Funds to provide supplemental weatherization services on five homes being repaired through the organization’s Home Preservation program in the coming year. Habitat’s Home Preservation program serves Orange County residents who own their homes but are unable to afford necessary repairs due to low or fixed incomes. Of this amount, $50,000 will go towards the direct cost of the weatherization projects, including materials, subcontractor labor, and direct construction staff labor. The remaining $5,000 is a 10% overhead charge for support staff and other costs to administer the program. Project Benefits: Funds will increase the energy efficiency of homes through projects such as repair or replacement of aging HVAC systems, repair or replacement of drafty windows, and the addition of insulation in crawl spaces and attics. Of the repair applications that Habitat receives, about half are for these types of weatherization projects. Increasing the energy efficiency of aging homes can immediately create savings for Orange County homeowners while reducing the demand on the power grid or removing gas and oil furnaces. Habitat considers this work to preserve the affordable housing stock that already exists in our County to be essential and urgent. Once these properties are sold and often redeveloped, they will likely never be affordable again. Reviewer Comments: We are pleased to continue supporting this community leader in their efforts to provide energy efficiency services for low‐income residents in Orange County. Grant Dollars Requested Per Metric Ton of Greenhouse Gas Emissions Reduced During Project Lifetime: $733 #2 Ranked Project – Urban Sustainability Solutions Applicant (Collaborators): Burts Bees Foundation, NC DEQ/EPA, Carrboro Stormwater/Public Works, Triangle Community Foundation Funding Requested: $69,156 Recommended Funding Level: $69,156 Total Score (Out of 26 pts): 21 Project Description: Urban Sustainability Solutions is requesting grant funding to create a Green Infrastructure Workforce Development Apprenticeship Program for underserved youth and to fund 40% of the installation cost of Green Infrastructure on single family residences that are in neighborhoods that the North Carolina Department of Environmental Quality’s Environmental Justice Program has designated as underserved and low income. Project Benefits: Students will obtain after‐school green‐jobs training by job shadowing with environmental contractors who will be installing rain gardens, rain‐harvesting cisterns, riparian buffers, and other sustainable stormwater “best management practices” (BMP’s) on underserved/low‐income properties suffering from flooding and erosion issues in Orange County. The curriculum specifically targets students who have not performed at grade level in math and sciences. Based on direct past experience this hands‐on curriculum leads to improved student performance in traditional STEM curricula and improves environmental literacy and stewardship. Reviewer Comments: We are pleased to support this project as it builds on work previously started in neighboring Durham County. Additionally, we are excited to receive an application that is focused on nature‐ based climate solutions that engage young people in our community. Grant Dollars Requested Per Metric Ton of Greenhouse Gas Emissions Reduced During Project Lifetime: $191 #3 Ranked Project – Town of Chapel Hill Applicant (Collaborators): The Hargraves Community Center Funding Requested: $95,000 Recommended Funding Level: $0 Total Score (Out of 26 pts): 20 7 DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E Project Description: The requested funds will be used to purchase and install new LED light fixtures to replace the existing, less efficient metal halide fixtures at the Hargraves Community Center outdoor basketball court. Hargraves Community Center is located in Chapel Hill’s largest historically black neighborhood and is part of the NC Civil Rights Trail. In addition to the emissions reductions, this retrofit would enhance safety, improve neighborhood relations, and minimize maintenance and energy costs. Project Benefits: This proposed upgrade would provide both better lighting and better quality of life. Carbon emissions will be reduced through improved energy efficiency, and this new lighting system will significantly reduce spill light and glare while also allowing the lights to be consistently turned off each night by 11 pm. This has biodiversity benefits (especially for migrating birds in spring and fall) and would benefit neighbors by reducing light spillage, glare, and noise after 11 pm. Reviewer Comments: This initiative is supported, however funding was not recommended this year as there were many community applicants that had not received funding from the CCAG program in the past. This project’s benefits included lighting areas that are not currently lit and reduced energy consumption due to timers which also reduced nighttime light pollution. We encourage Chapel Hill to continue to pursue this effort. Grant Dollars Requested Per Metric Ton of Greenhouse Gas Emissions Reduced During Project Lifetime: $956 #4 Ranked Project – Hillsborough United Church of Christ Applicant (Collaborators): N/A Funding Requested: $10,000 Recommended Funding Level: $10,000 Total Score (Out of 25 pts): 20 Project Description: The project is to add solar panels to provide green energy for our building. This project is part of a long‐term vision to dramatically reduce our carbon footprint and to live out part of our calling and mission to care for creation. As a smaller faith community, we have wanted to move toward solar but the costs have made it prohibitive for a congregation of our size. With the passage of the Inflation Reduction Act and the inclusion of faith communities for the federal rebate, it began to be a real possibility. Project Benefits: This project indirectly benefits the wider community by reducing the use of fossil fuels that contribute to global warming. The project over its lifetime will have the equivalent impact of planting 4,987 trees, creating nearly 160 new acres of forest land and will have the same impact of not driving fossil fueled cars for 481,470 miles. These benefits directly help Hillsborough but also our world as we all move to do our part to reduce the harmful impacts of climate change. We hope at the completion of this project we can share with other congregations our success and that solar is a real possibility for them as well. Reviewer Comments: We are pleased that this project utilized funding from additional sources beyond the CCAG furthering their larger sustainability efforts and that there is intentional community focus on awareness of renewable impacts. We are also happy to support an organization in the northern portion of Orange County. Grant Dollars Requested Per Metric Ton of Greenhouse Gas Emissions Reduced During Project Lifetime: $126 #5 Ranked Project – Binkley Baptist Church Applicant (Collaborators): N/A Funding Requested: $49,036 Recommended Funding Level: $49,036 Total Score (Out of 26 pts): 18 Project Description: With this grant we wish to install 46 solar panels (18.86 DC Net‐metered) with an annual production of 23,905 kWh/year to reduce Binkley’s energy‐generated carbon emissions by more than 32,500 lbs/year. By doing so, Binkley will demonstrate its continuing commitment to do all we can as a 8 DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E multiracial/multiethnic congregation to care for the Earth and reduce the impacts of climate change which are felt most acutely by poor and marginalized people. Project Benefits: This project will directly benefit the multiracial/multiethnic congregation, the preschool, and day care program for low‐income families, and the many community users of the church, such as AA, Al anon groups and others. In total, approximately 500 people/week will benefit from the ‘clean energy’ generated by the added panels. In addition, our Earth Ministry team is active in all of the towns within Orange County providing education and outreach for the community, our congregation and user groups about the positives of solar energy for the climate, and other topics such as waste‐diversion, global climate change, and environmental issues. Reviewer Comments: We are excited to support a community organization that is also leveraging the Solarize the Triangle program for additional cost savings. We love the community outreach portion of this application and believe their engagement with the broader community has great potential to reach individuals outside of the direct Binkley Baptist community to educate and inform the community about climate change, programs such as Solarize the Triangle and promoting sustainable practices. Grant Dollars Requested Per Metric Ton of Greenhouse Gas Emissions Reduced During Project Lifetime: $122 #6 Ranked Project – EMPOWER‐ment Applicant (Collaborators): SolarEquity Funding Requested: $134,562 Recommended Funding Level: $61,623 Total Score (Out of 26 pts): 18 Project Description: The funds provided by Orange County's Community Climate Action Grant Program will go directly towards installing rooftop solar on EmPOWERment's PEACH Apartments located in Chapel Hill. The funds will cover 18.1% of operations, 100% of equipment, and 100% of personnel costs. Project Benefits: EmPOWERment Inc. (EI) is building an apartment building. As a partner, SolarEquity will install rooftop solar on the PEACH Apartments, a rental complex for ten low‐income and very low‐income families. Installing rooftop solar will mitigate carbon emissions while decreasing the target population’s energy burden. Reviewer Comments: We are excited about this project and recognize that EMPOWERment is in the early stages of construction with opportunity to seek additional funds through the next CCAG round of funding and/or other outlets to support the remaining funding need. We feel strongly that the final outcome of this project should emphasize any savings received going directly to the tenants of the PEACH apartments through reduced utility expense. Grant Dollars Requested Per Metric Ton of Greenhouse Gas Emissions Reduced During Project Lifetime: $106 #7 Ranked Project – Club Nova Applicant (Collaborators): Carrboro Farmers’ Market, NC Botanical Garden Funding Requested: $37,227 Recommended Funding Level: $37,227 Total Score (Out of 26 pts): 17 Project Description: Club Nova will use funds for completing plans for our garden, greenhouse, and terrace to grow our own vegetables and herbs; purchasing materials for these areas including accessible raised beds and planters, purchasing an energy efficient stackable washer and dryer that utilizes less water and sanitizes reusable items such as dish clothes, cloth napkins, and towels. 9 DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E Project Benefits: Club Nova works with individuals living with serious mental illness. We anticipate at least 100 members will directly benefit from our project. Our project includes minimizing the greenhouse gas emissions and minimizing our carbon footprint through accelerating and expanding the following: Plant based diet, food waste reduction plan, composting, growing our own vegetables and herbs, increasing local purchasing, recycling, utilizing reusable products/items (i.e. cloth napkins and limiting one time use items), and capturing and reusing rainwater. Our members will benefit from a healthier, sustainable diet and from being part of a larger focus to make a significant, positive impact on climate change. Reviewer Comments: We are pleased to support an organization that supports an underserved population within our County. We also love that this population will have a voice in the voting and execution of this project. Grant Dollars Requested Per Metric Ton of Greenhouse Gas Emissions Reduced During Project Lifetime: $116 #8 Ranked Project – Eco‐Institute at Sanctuary Farm Applicant (Collaborators): N/A Funding Requested: $50,800 Recommended Funding Level: $0 Total Score (Out of 26 pts): 17 Project Description: Funds will be used to expand the existing Community Garden Cooperative and to create a new Community Garden Training Program by providing scholarships for residents from low‐income households and/or marginalized communities. Funds will also be used to hire Orange County Farmers and Gardeners as guest teachers. Project Benefits: Participants learn to grow organic food while engaging in intergenerational conversations about climate resilience. Climate resilient gardening includes practices like increasing native plant diversity, composting household food waste, improving soil health, growing heat tolerant vegetable crops, and using stormwater management practices. Participants are invited to bring their household compost, which serves as fertilizer for the garden. We share in the labor and share in the harvest. Participants go home with a basket full of fresh, healthy garden produce each week. This reduces their dependence on the industrial food system. Reviewer Comments: Recommended not funding due to limited public benefit and uncertainty due to community being served. Suggest that the organization seek other philanthropic funding sources. Grant Dollars Requested Per Metric Ton of Greenhouse Gas Emissions Reduced During Project Lifetime: $not estimated #9 Ranked Project – The ArtsCenter Applicant (Collaborators): N/A Funding Requested: $41,729 Recommended Funding Level: $0 Total Score (Out of 26 pts): 17 Project Description: At our new home, we have an enclosed garden space that we will turn into an Outdoor Eco‐ Classroom. This outdoor learning center will educate patrons of all ages on our rooftop solar system as well as other eco‐ friendly projects they can incorporate into their lives from outdoor hydroponics to garden art created using recycled materials. The learning center of this classroom will be Haven, a solar powered shelter in the sun with 16 places to charge up, explore, create and learn. Haven is made by the NC based company, Spotlight Solar. The structure was designed in Raleigh and is manufactured in Sanford, NC. Project Benefits: This project will help us educate the community about our solar project made possible through previous funding The ArtsCenter received last year through the Orange County Community Climate Action Grant Program. This shelter will offer our community a solar workspace, a solar classroom and a solar charging station 10 DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E for up to 16 devices. By adding signage to Haven with QR codes that link to our website, we can share how both Haven and our full rooftop solar system are positively impacting our community. By amplifying our commitment to green design and initiatives, Haven will become the focal point of our Outdoor Eco‐Classroom. Our youth will learn creative ways they can incorporate ecofriendly life choices into their day‐to‐day routines. Making our commitment to the environment more visible, individuals and businesses alike will be inspired to adopt similar initiatives, specifically solar. Reviewer Comments: This project did not offer a significant amount of GHG reduction for the expenditure and therefore we did not recommend funding. We would like to encourage the ArtsCenter to continue to apply for funding for impactful projects that are highly visible to the community and that provide educational opportunities. Grant Dollars Requested Per Metric Ton of Greenhouse Gas Emissions Reduced During Project Lifetime: $1,354 #10 Ranked Project – St Thomas More Catholic Church Applicant (Collaborators): N/A Funding Requested: $22,030 Recommended Funding Level: $0 Total Score (Out of 26 pts): 16 Project Description: Installation of an EV charging Station in the church/parish center area that would be freely accessible to visitors on campus. Equipment costs are for parts and equipment. Personnel costs are for installation and project associated labor. Project Benefits: The station will be located in the parking area of the building where most meetings and activities happen making it accessible to any visitor on campus with an EV. EV chargers offset fossil fuels that would be burned by internal combustion engines in fuel engine vehicles. The EV charger station would be tied to the solar array to be installed on the building roof later this year, therefore offsetting electric grid electricity generated by fossil fuel plants in NC. Reviewer Comments: In the future, this grant would be more likely to receive recommendation for funding if the project were expanded to offer benefits to those beyond the St. Thomas More community due to the nature of the time it takes to complete a full charge. Grant Dollars Requested Per Metric Ton of Greenhouse Gas Emissions Reduced During Project Lifetime: $225 #11 Ranked Project – Triangle ECycling Applicant (Collaborators): Bike Walk NC, Carolina Tarwheels, City of Raleigh, Chapel Hill Cycling, Bicycle Alliance of Chapel Hill Funding Requested: $50,000 Recommended Funding Level: $0 Total Score (Out of 26 pts): 13 Project Description: To purchase 25‐30 electronic bikes and sell them to Orange County residents at below market prices. Half of the bikes will be sold to qualified low‐income residents using a discount voucher program to promote social justice and racial equity. This pilot program will raise awareness of ebikes as a healthy, environmentally friendly way of reducing car trips and commuting, including accessing public transportation for work and school. It will be the first step in making Orange County a leader in the national ebike voucher movement.” Project Benefits: The people who purchase the ebikes will benefit most directly. Indirectly the community will benefit from reduced GHG emissions. This is a small pilot program but OC residents will benefit from the increased use of ebikes as they are proven to replace cars for short “around town” trips and provide a way to commute from 11 DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E home and work for public transportation riders. The positive impact on air quality and traffic congestion are benefits that can be shared by all. Reviewer Comments: Recommend not funding at this time. We support the idea and would love to see this concept considered further in future grant cycles with additional information on the specific logistics of this proposal further described. Grant Dollars Requested Per Metric Ton of Greenhouse Gas Emissions Reduced During Project Lifetime: $791 #1 Ranked School Project – Chapel Hill Carrboro City Schools Applicant (Collaborators): Funding Requested: $270,000 Recommended Funding Level: $94,014 Total Score (Out of 26 pts): 17 Project Description: Funds will be used to accelerate LED campus lighting changeovers on school district’s campuses – specifically, to fund 50% or more of the cost to complete this work at Carrboro High School. Project Benefits: To provide the latest lighting technology to reduce energy usage while providing superior lighting for students, staff and campus visitors. Over 500 students and 100 staff will benefit each day. There is an on‐going benefit of eliminating lighting maintenance which is very significant. The project accelerates and expands the LED campus lighting project. Reviewer Comments: These funds may be spent over the next 2 years and although we cannot fully fund either project, we are in full support of these projects. The allocation of school funds is split 1/3 CHCCS and 2/3 OCS due to the fact that OCS has not been able to apply for and receive funding over the past two grant cycles. Since the creation of the Community Climate Action Grant, CHCCS has received $525,075 more than OCS. Grant Dollars Requested Per Metric Ton of Greenhouse Gas Emissions Reduced During Project Lifetime: $93 #2 Ranked School Project – Orange County Schools Applicant (Collaborators): Funding Requested: $287,959 Recommended Funding Level: $188,029 Total Score (Out of 26 pts): 11 Project Description: To add a second 54‐panel solar pedestal and battery bank storage which can generate power for four EV chargers, stadium lights at Orange Middle School and irrigation pumps for athletic fields at Orange High School while creating a battery bank of storage sufficient to sell energy back to Duke Energy. Project Benefits: Solar power reduces operating expenses of the schools and provides opportunity for overall budget cost reductions, while also generating revenue to offset utility expenses. Off the grid energy production creates resiliency and opportunities for educating about solar power within the schools. Reviewer Comments: These funds may be spent over the next 2 years and although we cannot fully fund either project, we are in full support of these projects. The allocation of school funds is split 1/3 CHCCS and 2/3 OCS due to the fact that OCS has not been able to apply for and receive funding over the past two grant cycles. Since the creation of the Community Climate Action Grant, CHCCS has received $525,075 more than OCS. Grant Dollars Requested Per Metric Ton of Greenhouse Gas Emissions Reduced During Project Lifetime: $340 12 DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E Appendix: Full Scoring Table: General Applications: Name Project Funding Requested Social Justice Racial Equity GHG Emissions Reduced Efficient Use of Funds Capacity of Applicant Local Economic Develop‐ ment Amount Duration of Engage‐ ment Time to Complete Total Score out of 26 Points Final Rank Out of 6 points Out of 4 points Out of 4 points Out of 3 points Out of 3 points Out of 3 points Out of 3 points Habitat for Humanity Supplemental Weatherization $55,000.00 4 3 4 3 3 2 2 21 1 Urban Sustainability Solutions Growing More than Rain Gardens $69,156.00 6 2 3 3 2 3 2 21 2 Town of Chapel Hill LED Lighting Upgrades $95,000.00 4 3 4 3 2 2 2 20 3 Hillsborough United Church of Christ Solar Panel Project $10,000.00 3 4 4 3 2 2 2 20 4 Binkley Baptist Church Let There Be (Clean Energy) Light! $49,036.02 4 3 3 3 1 2 2 18 5 EMPOWERment Rooftop Solar on PEACH Apartments $134,562.00 5 3 3 2 2 1 2 18 6 Club Nova Big Impact Small Footprint $37,227.38 5 1 2 3 2 2 2 17 7 Eco‐Institute at Sanctuary Farm Community Garden Cooperative $50,800.00 6 1 1 3 2 2 2 17 8 The Arts Center Haven for Outdoor Eco‐Classroom $41,729.00 4 2 2 3 2 2 2 17 9 St. Thomas More Catholic Church EV Charging Station $22,030.00 2 3 3 3 1 2 2 16 10 Triangle ECycling The e is for Equity $50,000.00 3 2 2 2 1 1 2 13 11 School Applications: Chapel Hill Carrboro City Schools LED Lights $270,000 3 3 3 3 1 2 2 17 1 Orange County Schools Solar Panel $287,959 1 2 2 2 1 1 2 11 2 13 DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E Attachment 2 ‐ Community Climate Action Grant Project Status * 54 Panel bi‐facial solar pedestal and two EV chargers; ** Chapel Hill and East Chapel Hill High School and Morris Grove and Northside Elementary receiving solar (installation August 2024) Fiscal Year Project Organization Award Amount Estimated Annual GHG Reduction metric tons CO2e Project Status 19‐20 Solar for Schools* Orange County Schools$150,000 82In progress19‐20 Solar for Schools** Chapel Hill Carrboro City Schools $150,000 194In progress19‐20 Supplemental Weatherization Orange County$150,000 22 In progress19‐20 LED Light Campaign* Orange County$19,272 10.5 COMPLETED 20‐21 Tree Planting Program Town of Chapel Hill$40,000 533lbsPlanting trees now20‐21 Electric Vehicle Charging Station Town of Chapel Hill$18,500 6COMPLETED20‐21 Cedar Falls Park LED Light Conversion Town of Chapel Hill$128,057 9 COMPLETED20‐21 Cane Creek Reservoir 352.4 kW Solar OWASA$75,000 119 COMPLETED20‐21 Water heater replacements NAACP$122,100 26 In progress20‐21 Solar Panels on Affordable Habitat Homes Habitat for Humanity of Orange County $95,000 43 COMPLETED 21‐22 Low Income HVAC Replacement Rebuilding Together of the Triangle $113,000 34 In progress21‐22 Neighborhood Energy Resiliency ProjectNC Sustainable Energy Association $90,000 10 In progress21‐22 Food Waste Monitor Eno River Farmer’s Market$4,000 37COMPLETED21‐22 Food Waste Monitor Town of Carrboro$3,765 44 In progress21‐22 Bike Rack and EV Charging Station The ArtsCenter$17,000 6COMPLETED21‐22 203 Project Solar Array and Green RoofTown of Carrboro$40,567 See FY 22‐23In progress21‐22 Solar for Schools Chapel Hill Carrboro City Schools $250,00 See FY 19‐20In progress 22‐23 Habitat Rooftop Solar Habitat for Humanity$100,000 70In progress22‐23 Weatherization Rebuilding Together of the Triangle $25,00026 In progress22‐23 Food Waste Monitors Eno River Farmers’ Market$4,500 37 In progress22‐23 203 Solar Project Town of Carrboro$40,575 23In progress22‐23 Fleet Electrification Project Town of Chapel Hill$50,000 33 In progress22‐23 Solar Roof The ArtsCenter$55,000 28 COMPLETED22‐23 Emission Reductions Through HVAC Replacements Chapel Hill Carrboro City Schools $275,075 80 In progress 14DocuSign Envelope ID: DBE8454E-5CDD-4377-A739-3C0016853D4E 03/04/2024 Summit Insurance Group Inc. PO Box 2485 Huntersville, NC 28070-2485 License #: 7638156 Nicole R. Talbert (704)659-2141 (704)659-2148 nicole@sumins.com 00008390-3307269 54 Habitat For Humanity of Orange County, NC, Inc. 88 Vilcom Center Dr. Ste L110 Chapel Hill, NC 27514 Builders Mutual Insurance Company 10844 A CPP 0058155 10 04/01/2023 04/01/2024X X X 1,000,000 100,000 5,000 1,000,000 2,000,000 2,000,000 Builders Premier Insurance Company 13036 B PCA 0009233 10 04/01/2023 04/01/2024 X 1,000,000 Builders Mutual Insurance Company 10844 A MUB 0001005 06 04/01/2023 04/01/2024XX X 10,000 5,000,000 5,000,000 Builders Premier Insurance Company 10844 13036 C PWC 1011231 10 04/01/2023 04/01/2024 X 1,000,000 1,000,000 1,000,000 WellFleet Insurance Company D MP0000822133 04/01/2023 04/01/2024Volunteer/Accident Limit $250,000 Travelers Cas & Surety Co Of America 19038 E 107048172 04/01/2022 04/01/2025Directors & Officers Limit $1,000,000 Certificate holder includes: Orange County, its officers, agents and employees Additional insured status applies to the certificate holder under General Liability when required by written contract. Orange County 300 West Tryon Street P.O. Box 8181 Hillsborough, NC 27278 (NRT) Printed by NRT on 03/04/2024 at 11:51AM ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? 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THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved. 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