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2024-670-E-Criminal Justice Dept-Oxford House-Outside Agency
Orange County Outside Agency Performance Agreement Revised 06/23—County Manager Version Page 1 of 10 OUTSIDE AGENCY PERFORMANCE AGREEMENT THIS AGREEMENT, made and entered into the first day of July 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 Oxford House, Inc., a not-for-profit corporation, located at 1010 Wayne Ave., Suite 300, Silver Spring, Maryland and, North Carolina 20910 (“Provider”). WITNESSETH: WHEREAS, it is in the interests of the County that said program be assisted by the County and thereby enhance its availability to residents of the County, and said program addresses an important community human services need, as identified by the Board of Commissioners. NOW, THEREFORE, in consideration of the above and the mutual covenants and conditions hereafter set forth, the County and Provider agree as follows: 1. Term of the Agreement. The term of this Agreement shall be a program year beginning July 1, 2024 to June 30, 2025. 2. Scope of Services. a. Provider will provide services, as outlined in the attached Outside Agency Funding Application and any amendments or revision thereto which is attached as Exhibit “A” and incorporated by reference, to the residents of Orange County. The Scope of Services and the Program Budget may be different from the original application based on County appropriation; however, any revisions or amendments to this Agreement must be approved in writing by the County and attached to this Agreement as Exhibit B. b. The Provider shall be solely responsible for the means, methods, techniques, sequence, safety program and procedures necessary to properly and fully complete the work set forth in the Scope of Services. 3. Funding. a. The County agrees to appropriate for the provision of services described in Exhibit A, Scope of Services and more particularly described in the Revised Program Budget, the maximum sum of $9,000. b. All funds appropriated shall be used for purposes described in Exhibit A. Any funds not used for the purposes stated shall be returned to the County. Any changes in the use of funds must be authorized in writing by the County prior to any expenditure of the funds by the Provider. If the funds are expended not in accordance with the Scope of Services, at the discretion of the County the Provider may be required to repay the funds to the County. c. The Provider shall be paid in four equal installments in the amount of $2,250. The first payment is contingent upon receipt of the agency’s performance agreement; the remaining payments are contingent upon receipt of the request for reimbursement and related supporting documentation. d. The County’s obligation to make the quarterly payments is contingent upon receipt of Progress Reports, which show satisfactory progress toward completion of performance measures and an accounting of expenditures as detailed in the attached Scope of Services. Docusign Envelope ID: 9ADEFAD5-C106-45CE-909F-ED02DFA16A16 Orange County Outside Agency Performance Agreement Page 2 of 12 Rev.06/24 e. Once Provider has satisfied its obligations as provided in (d) payment will be made 21 days after receipt of the Progress Report and Request for Reimbursement or 21 days after due date of Progress Report whichever is later. f. The County is not obligated to provide any other support to Provider in this or in succeeding fiscal years. 4. Agency Reporting. a. Provider will provide Orange County a Progress Report that includes a fiscal report and updates on performance measures as outlined in the Scope of Services. Progress Report dates are: July 1 – December 31; January 1 – March 31 and April 1 - June 30. Reports are due on January 7, April 7 and July 7 of the program fiscal year. b. Provider agrees to allow the County to inspect its financial books and records, which document costs of those services, upon reasonable notice during normal working hours. 5. Termination. a. Termination for Cause. In the event of any of the circumstances set forth below (hereinafter referred to as “default”), the County may immediately terminate this Agreement, in whole or in part, and from time to time. Notice of termination must be in writing, state the reason or reasons for the termination, and specify the effective date of the termination: i. In the event that Provider shall cease to exist as an organization or shall enter bankruptcy proceedings, be declared insolvent, or liquidate all or substantially all of its assets, or significantly reduce its services or accessibility to Orange County residents during the term of this Agreement; or ii. In the event that Provider shall fail to render a satisfactory accounting as provided section 4 above, the County may terminate this Agreement and Provider shall return all payments already made to it by the County for services which have not been provided or for which no satisfactory accounting has been rendered; or iii. In the event of any fraudulent representation by the Provider in an invoice or other verification required to obtain payment under this Agreement or other dishonesty on a material matter relating to the performance of services under this Agreement. iv. Nonperformance, incomplete service or performance, or failure to satisfactorily perform any part of the work identified in the Scope of Services or to comply with any provision of this Agreement, as determined by the County in its sole discretion. v. Failure to adhere to the terms of applicable county, state or federal laws, regulations, or stated public policy. b. In the event of default by the Provider, the county may elect to terminate this Agreement, in whole or in part and/or require the Provider to repay the funds within ten (10) business days from written notice of default. The County may (but shall not be required to) grant the Provider an opportunity to cure the default without termination of this Agreement. This clause shall not be interpreted to limit the County’s remedies in law or in equity. c. Notwithstanding the foregoing, either party may terminate the agreement at any time without penalty; provided that written notice of such termination is furnished to the other party at Docusign Envelope ID: 9ADEFAD5-C106-45CE-909F-ED02DFA16A16 Orange County Outside Agency Performance Agreement Page 3 of 12 Rev.06/24 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 (Caitlin Fenhagen) to act as the County's representative with respect to the Project who shall have the authority to render decisions within guidelines established by the County Manager or the County Board of Commissioners and who shall be available during working hours as often as may be reasonably required to render decisions and to furnish information. 7. Insurance. a. General Requirements. The Provider shall purchase and maintain, during the period of performance of this Agreement, insurance: i. Worker’s Compensation. For protection from claims under workers' or workmen's compensation acts; ii. Cyber Liability. For protection from claims resulting from data breach, virus, and cyberattack; iii. Comprehensive General Liability Insurance covering claims arising out of or relating to bodily injury, including bodily injury, sickness, disease or death of any of the Consultant's employees or any other person and to real and personal property including loss of use resulting thereof; iv. Comprehensive Automobile Liability Insurance, including hired and non-owned vehicles, if any, covering personal injury or death, and property damage; and v. Professional Liability Insurance, covering personal injury, bodily injury and property damage and claims arising out of or related to the performance under this Agreement by the Consultant or his agents, consultants and employees. vi. Sexual Misconduct. Sexual Abuse/Molestation Insurance is required when Provider works directly one-on-one with children, elderly or other at-risk populations. b. Limits of Coverage: Minimum limits of insurance coverage shall be as follows: INSURANCE DESCRIPTION MINIMUM REQUIRED COVERAGE Worker's Compensation Limits for Coverage A ‐ Docusign Envelope ID: 9ADEFAD5-C106-45CE-909F-ED02DFA16A16 Orange County Outside Agency Performance Agreement Page 4 of 12 Rev.06/24 Statutory State NC, for each employee Limits for Coverage B ‐ Employers Liability of: $1 million Each Occurrence $1,000,000 BID limit Cyber Liability $1,000,000 Each Occurrence; $2,000,000 Aggregate *Only required for agencies transmitting personal identifiable information that is disseminated electronically. Commercial General $1,000,000 Each Occurrence Liability $2,000,000 Aggregate Automobile Liability $1,000,000 Each Occurrence *Only required for agencies doing travel as part of the agreement with the County. Professional Liability $1,000,000 Each Occurrence $2,000,000 Aggregate Sexual Misconduct $1,000,000 Each Occurrence $2,000,000 Aggregate *Only required for agencies doing direct work with minors (under the age of 18). c. All insurance policies (with the exception of Worker's Compensation and Professional Liability) required under this Agreement shall name the County as an additional insured party and as a certificate holder. For more information see the Orange County Risk Transfer Policy and Orange County Minimum Insurance Coverage Requirements, (each document is incorporated herein by reference and may be viewed at http://www.orangecountync.gov/departments/purchasing_division/contracts.php.) Evidence of such insurance and all correspondence shall be sent to: Orange County Risk Manager Post Office Box 8181 Hillsborough, NC 27278 d. Nothing in this section is intended to affect or abrogate the County’s sovereign immunity defenses. 8. General Provisions. a. Governing Law. This Agreement and the duties, responsibilities, obligations and rights of respective parties hereunder shall be governed by the laws of the State of North Carolina. By executing this Agreement Provider affirms that Provider and any subcontractors of Provider are and shall remain in compliance with Article 2 of Chapter 64 of the North Carolina General Statutes. By executing this Agreement Provider certifies that Provider has not been identified, and has not utilized the services of any agent or subcontractor identified, on the list created by the State Treasurer pursuant to G.S. 147-86.58. By executing this Agreement Provider certifies that Provider has not been identified, and has not utilized the services of Docusign Envelope ID: 9ADEFAD5-C106-45CE-909F-ED02DFA16A16 Orange County Outside Agency Performance Agreement Page 5 of 12 Rev.06/24 any agent or subcontractor identified, on the list created by the State Treasurer pursuant to G.S. 147-86.81. b. Non-Discrimination. Provider agrees as part of consideration of the granting of funds by Orange County the parties hereto for themselves, their agents, officials, employees and servants agree not to discriminate in any manner of these basis of race, color, gender, national origin, age, handicap, religion, sexual orientation, familial status or veterans status with reference to any activities carried out by the grantee, no matter how remote. The parties hereto further agree in all respects to conform to the provision and intent of Orange County Civil Rights Ordinance, as amended and the Orange County Non-discrimination Policy, which is incorporated herein by reference and can be viewed at http://www.orangecountync.gov/departments/purchasing_division/contracts.php. The County may enforce this provision by an action for specific performance, injunctive relief, or other remedy as by law provided; this provision shall be binding on the grantees, the successors and assigns of the parties hereto with reference to the above subject manner. c. Dispute Resolution. Any and all suits or actions to enforce, interpret or seek damages with respect to any provision of, or the performance or non-performance of, this Agreement shall be brought in the General Court of Justice of North Carolina sitting in Orange County, North Carolina. It is agreed by the parties that no other court shall have jurisdiction or venue with respect to such suits or actions. Binding arbitration may not be initiated by either Party, however, the Parties may agree to nonbinding mediation of any dispute prior to the bringing of such suit or action. d. Living Wage. Orange County is committed to providing its employees with a living wage and encourages agencies if funds to pursue the same goal. The Orange County Living Wage Policy, which is incorporated herein by reference, can be viewed at: http://www.orangecountync.gov/departments/purchasing_division/contracts.php. The County’s living wage is $17.65 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. There are no third party beneficiaries of this Agreement and nothing in this Agreement, express or implied, is intended to confer on any person other than the parties hereto (and their respective successors, heirs and permitted assigns), any rights, remedies, or obligations. 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. Docusign Envelope ID: 9ADEFAD5-C106-45CE-909F-ED02DFA16A16 Orange County Outside Agency Performance Agreement Page 6 of 12 Rev.06/24 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. 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 Oxford House, Inc Attention: Caitlin Fenhagen Attention: Kathleen Gibson P.O. Box 8181 Address: 1010 Wayne Ave., Suite 300, Silver Spring, MD 27514 Hillsborough, NC 27278 kathleen.gibson@oxfordhouse.org Email:cfenhagen@orangecountync.gov Email: 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 _____________________________ _______________________ Kathleen Gibson, Executive Director Date Docusign Envelope ID: 9ADEFAD5-C106-45CE-909F-ED02DFA16A16 10/31/2024 Orange County Outside Agency Performance Agreement Page 7 of 12 Rev.06/24 For and on behalf of Orange County Government _______________________________ ________________________ Travis Myren, County Manager Date Docusign Envelope ID: 9ADEFAD5-C106-45CE-909F-ED02DFA16A16 11/5/2024 Orange County Outside Agency Performance Agreement Page 8 of 12 Rev.06/24 ORANGE COUNTY—INTERNAL USE ONLY ______________________________________________________________________________ Finance Information Vendor Name: Oxford House, Inc Vendor Contact Person: Kathleen Gibson Phone: 919-395-8206 Address: 1010 Wayne Ave., Suite 300 City Silver Spring State: MD Zip: 20910 Department: CJRD Amount: $9,000 Purpose: Outside Agency Budget Code(s): 10290050-719104 Vendor # 68268 Vendor Status with NCSOS: Vendor is a BOCC consultant: Yes No Contract Details Contract Type: New Amendment (Original Contract: ) (Most Recent Amendment ) Effective Date 7/1/24 End Date 6/30/25 Notice Date (Notice Purpose ) Award Approved by Board (Agenda Date: June 2024); Made or Administered by Signature Authority - BOCC Express Delegation (Agenda Date: June 2024) - 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 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. This agreement is approved as to technical form and content. 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 services 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: 9ADEFAD5-C106-45CE-909F-ED02DFA16A16 11/1/2024 11/4/2024 11/4/2024 11/4/2024 Orange County Outside Agency Performance Agreement Page 9 of 12 Rev.06/24 Docusign Envelope ID: 9ADEFAD5-C106-45CE-909F-ED02DFA16A16 Orange County Outside Agency Performance Agreement Page 10 of 12 Rev.06/24 Exhibit A Insert Provider’s Outside Agency Application (located on the T:drive/Outside Agencies FY24-25 folder) Docusign Envelope ID: 9ADEFAD5-C106-45CE-909F-ED02DFA16A16 Orange County Outside Agency Performance Agreement Page 11 of 12 Rev.06/24 Exhibit B Insert Provider’s Revised Scope of Services and Program Budget Docusign Envelope ID: 9ADEFAD5-C106-45CE-909F-ED02DFA16A16 Orange County Outside Agency Performance Agreement Page 12 of 12 Rev.06/24 ATTACHMENT “A” Orange County Certifications – FY 2024-2025 Outside Agency Performance Agreement Chief Contact, Administrators, Chief Executive Officer and Chief Financial Officer I certify that I have provided a list of the chief contact, administrators, chief executive officer and chief financial officer for my agency with this Agreement and that I will keep it current to the County of Orange. The list should be in writing with the name, title, residential address; phone and email address and if possible, fax number. Officers and Board of Directors I certify that I have provided a current list of the Officers and Board of Directors with this Agreement and that we will continue to update the list as changes occur. The list should be in writing, with the name, physical address, mailing address and if possible, phone, fax and email address. Budget Submission I certify that I have provided a budget for the period to be covered by funding Orange County, and that any substantive changes made to this budget have been in advance authorized in writing by Orange County. Annual Financial Review I certify that I have provided a copy of the latest annual Financial Review for our agency and the budget adopted by the agency for the fiscal years encompassing this Agreement. If not, please explain on a separate sheet of paper. Alignment with Organization’s Mission I certify that the programs and services for which this funding is requested align with the mission of the organization. Intended Purpose I certify that the funds provided to the agency under the terms of this Agreement will be used for a public purpose and shall only be used for the purposes intended and any money not used for those purposes will be promptly returned to Orange County. Certified by: _______________________ Title: __________________________ Date: ___________ (Provider’s Signature) Docusign Envelope ID: 9ADEFAD5-C106-45CE-909F-ED02DFA16A16 CEO 10/31/2024 Orange County Outside Agency Performance Agreement Page 13 of 12 Rev.06/24 FOR INFORMATION ONLY ATTACHMENT “B” As mentioned in Sections 3- Funding and Section 4- Agency Reporting of the performance agreement, the following two forms will be required before quarterly reimbursements can be made. They are included below for informational purposes. Forms are available online at https://www.orangecountync.gov/736/Contracts-Reporting Quarterly Expense Report Docusign Envelope ID: 9ADEFAD5-C106-45CE-909F-ED02DFA16A16 Orange County Outside Agency Performance Agreement Page 14 of 12 Rev.06/24 Quarterly Outcomes Form Docusign Envelope ID: 9ADEFAD5-C106-45CE-909F-ED02DFA16A16 1/30/24, 2:45 PM HSOA-24-40 https://chapelhillnc.workflow.opengov.com/#/explore/records/63250/react-form-details/63250 1/20 Town of Chapel Hill, NC 1/30/2024 HSOA-24-40 Human Services/Outside Agencies Funding Application Fiscal Year 2025 Status: Active Submitted On: 1/12/2024 Applicant Paula Harrington 919-616-3020 paula.harrington@oxfordhouse.org 4100 FIVE OAKS DR UNIT 18 DURHAM, NC 27707-5246 Agency Information Agency's Legal Name Oxford House, Inc. Agency's Mailing Address (Street, City, State & Zip Code) 1010 Wayne Avenue, Suite 300, Silver Spring, Maryland 20910 Agency's Physical Address (Street, City, State & Zip Code) 1010 Wayne Avenue, Suite 300, Silver Spring, Maryland 20910 Agency’s Web Address www.oxfordhouse.org, www.oxfordhousenc.org Tax ID: **-***2231 Date of Incorporation (Month/Year) October/1987 Executive Director Name Kathleen Gibson E-Mail Address kathleen.gibson@oxfordhouse.org Telephone Number 919-395-8206 Docusign Envelope ID: 9ADEFAD5-C106-45CE-909F-ED02DFA16A16 1/30/24, 2:45 PM HSOA-24-40 https://chapelhillnc.workflow.opengov.com/#/explore/records/63250/react-form-details/63250 2/20 Agency's Purpose/Mission Statement brief description of your organization’s past achievements Wages and Positions The mission of Oxford House, Inc. is to foster the development of Oxford Houses to provide those recovering from substance use disorder (SUD) the opportunity to live in an environment designed to support recovery without the recurrence of use. The NIAAA (National Institute on Alcohol Abuse and Alcoholism) and NIDA (National Institute on Drug Abuse) have conducted separate research studies that confirm the effectiveness of the Oxford House model in helping residents maintain sobriety without relapsing into substance use. The Oxford House model has met the criteria to be included in SAMSHA's (Substance Abuse and Mental Health Services Administration) National Registry of Evidenced-Based Programs and Practices (NREPP), which is a significant recognition for individuals who have consistently demonstrated the benefits of living in an Oxford House for over 49 years. This recognition highlights the increased likelihood of achieving long-term sobriety for those residing in an Oxford House. Furthermore, the U.S. Surgeon General has identified Oxford House as a valuable tool in addressing the serious issue of addiction in the country. Oxford House has a long- standing history of collaboration with the Orange County community and partnerships with NCDHHS, UNC, and Freedom House since 1991, saving thousands of lives and restoring countless families. The approach of providing affordable and effective care, including stable housing and support, is evident through the presence of 25 houses with 210 beds in the county. Additionally, establishing the first Collegiate Oxford House in 2016, which has now become a model adopted nationwide, has been successfully maintained for over seven years. Due to this remarkable success, the Oxford House Model™ was included in the Federal Registry of Evidence-based Programs in 2011. Docusign Envelope ID: 9ADEFAD5-C106-45CE-909F-ED02DFA16A16 1/30/24, 2:45 PM HSOA-24-40 https://chapelhillnc.workflow.opengov.com/#/explore/records/63250/react-form-details/63250 3/20 Does the agency pay permanent employees a living wage? Yes Is the agency an Orange County Living Wage Certified Employer? Yes Award Programs Check one or more of the following application types. Human Services Awards (Chapel Hill, Carrboro, and Orange County) Small Awards (Chapel Hill & Carrboro Applicants Only) Community Impact Awards (Chapel Hill Applicants Only) Agency Demographics Please ensure that each subsection listed below adds up to the total number of staff and board members listed here. Number of Part-Time Paid Positions 7 Number of Full-Time Paid Positions 265 Staff Members Total Number of Staff 272 Staff Members - Sex Docusign Envelope ID: 9ADEFAD5-C106-45CE-909F-ED02DFA16A16 1/30/24, 2:45 PM HSOA-24-40 https://chapelhillnc.workflow.opengov.com/#/explore/records/63250/react-form-details/63250 4/20 Number of Male Staff 146 Number of Female Staff 124 Number of Nonbinary Staff 2 Number of Staff who prefer not to answer 0 Staff Members - Race and Ethnicity Number of American Indian or Alaska Native Staff 4 Number of Asian Staff 1 Number of Black or African American Staff 20 Number of Native Hawaiian or Other Pacific Islander Staff 1 Number of White Staff 211 Number of Staff of more than one race 11 Number of staff who prefer not to answer 5 Number of Staff who identify as a race/ethnicity not listed 19 Total Number of Staff who identify as Hispanic or Latino 19 Total Number of Staff who do not identify as Hispanic or Latino 253 Board Members Docusign Envelope ID: 9ADEFAD5-C106-45CE-909F-ED02DFA16A16 1/30/24, 2:45 PM HSOA-24-40 https://chapelhillnc.workflow.opengov.com/#/explore/records/63250/react-form-details/63250 5/20 Total Number of Board of Members 12 Board Members - Sex Number of Male Board Members 10 Number of Female Board Members 2 Number of Nonbinary Board Members 0 Number of Board Members who prefer not to answer 0 Board Members - Race and Ethnicity Number of American Indian or Alaska Native Board Members 0 Number of Asian Board Members 0 Number of Black or African American Board Members 3 Number of Native Hawaiian or Other Pacific Islander Board Members 0 Number of White Board Members 9 Number of Board Members of more than one race 0 Number of Board Members who prefer not to answer 0 Number of Board Members who identify as a race/ethnicity not listed 0 Docusign Envelope ID: 9ADEFAD5-C106-45CE-909F-ED02DFA16A16 1/30/24, 2:45 PM HSOA-24-40 https://chapelhillnc.workflow.opengov.com/#/explore/records/63250/react-form-details/63250 6/20 Total Number of Board Members who identify as Hispanic or Latino 0 Total Number of Board Members who do not identify as Hispanic or Latino 12 Race & Equity Consistent with our commitment to equity and inclusion, the Towns of Chapel Hill and Carrboro and Orange County Government are taking steps together to center racial equity in the Human Services Funding Program. We are requesting basic information about your organization’s racial equity work. Describe how the agency incorporates racial equity into its goals. (150 word limit) Oxford House, Inc. (OHI) partnered with C4 Innovations to expand its commitment to racial equity in the field of recovery. The training program aimed to ensure equitable access to recovery support for marginalized communities such as Black, Indigenous, and Latinx groups. OHI's leadership received guidance on interacting with national recovery leaders and addressing deep-seated structures perpetuating racial inequities in substance use disorder treatment and recovery. They worked together to develop innovative strategies to make recovery support accessible, equitable, and effective, benefiting both Oxford House residents and the broader community. Continuing staff training remains a top priority, offering employees growth opportunities and contributing to an inclusive and effective recovery framework. The aim is to bring about lasting, population-wide changes that guarantee equal access to housing, services, opportunities, and overall well-being, regardless of race. Docusign Envelope ID: 9ADEFAD5-C106-45CE-909F-ED02DFA16A16 1/30/24, 2:45 PM HSOA-24-40 https://chapelhillnc.workflow.opengov.com/#/explore/records/63250/react-form-details/63250 7/20 Describe how the intended beneficiaries of the proposed project(s) were involved in the planning and design process. (150 word limit) Percent (%) of Staff who attended racial equity trainings. 100 Percent (%) of Board Members who attended racial equity trainings. 80 Describe other racial equity related activities. Program Funding Request Please list all of the current Fiscal Year Human Services (HS) funding requested for all programs and the proposed use of funds. Program Name Oxford House Financial Assistance Town of Carrboro 9000 Town of Chapel Hill 9000 Orange County 9000 Oxford House is democratically organized from the grassroots up, residents in each house elect officers, participate in chapters [mutually supportive groups of six to twelve individual houses], conduct workshops, and organize state associations. On a voluntary basis, the individual house members help run the structure of Oxford House. The OxfordHouse World Council serves as the primary advisory group to the Oxford House organization. Locally, each Chapter discusses monthly any needs in the local community and how best to meet those needs. In NC Outreach, attend these meetings and offer guidance and support. The staff attends annual staff training, Clifton Strengths training, and Recovery Coaching classes, which allow the staff to learn more about others and themselves, helping them to grow personally and be more supportive of the low-barrier underserved residents that we house and serve. Docusign Envelope ID: 9ADEFAD5-C106-45CE-909F-ED02DFA16A16 1/30/24, 2:45 PM HSOA-24-40 https://chapelhillnc.workflow.opengov.com/#/explore/records/63250/react-form-details/63250 8/20 Total Short description of proposed use of funds. Please list all of the current Fiscal Year Human Services (HS) funding requested for all programs and the proposed use of funds. Program Name Oxford House Peer Advocate Program Town of Carrboro – Town of Chapel Hill 33000 Orange County – Total Short description of proposed use of funds. 27000 Oxford House addresses the factors that influence the ability of individuals to lead healthy lives, including healthcare, housing, transportation, and employment by helping them with affordable housing and paying the first month's equal expense shared. Residents will then feel safe and have the hope that their lives will and can change because of the support provided by Oxford House. Oxford Houses are Peer-run, Self-sustaining, substance free housing. 33000 An Oxford House Peer Advocate is a person who is in recovery and has lived or now lives in an Oxford House who will be able to mentor the new resident. This person has learned life strategies, how to be a self-advocate, and how to live independently and has acquired the skills to help others do the same. Docusign Envelope ID: 9ADEFAD5-C106-45CE-909F-ED02DFA16A16 1/30/24, 2:45 PM HSOA-24-40 https://chapelhillnc.workflow.opengov.com/#/explore/records/63250/react-form-details/63250 9/20 Funding Totals Carrboro Chapel Hill Orange County Total Program Information Program Name Oxford House Financial Assistance Program Primay Contact's Name Paula Harrington Primary Contact's Phone Number 919-616-3020 Primary Contact's Email Address paula.harrington@oxfordhouse.org 9000 42000 9000 60000 Docusign Envelope ID: 9ADEFAD5-C106-45CE-909F-ED02DFA16A16 1/30/24, 2:45 PM HSOA-24-40 https://chapelhillnc.workflow.opengov.com/#/explore/records/63250/react-form-details/63250 10/20 Describe the proposed program and the target population to benefit from the program. Please also explain how the program aligns with the Town of Chapel Hill and Carrboro's Human Services Program Results Framework and/or Orange County's BOCC Goals and Priorities (250 words or less). Target Population The program target population demographics table is included as an attachement on the application cover page. Please download the excel spreadsheet and fill out the demographic data in the table and then upload it with your application. Provide one copy per program that you are requesting funding for. Oxford House, Inc. will address the need to provide affordable housing and access to various supportive services for citizens recovering from substance use disorder in Orange County. The ability to obtain and sustain safe, affordable housing is one of the most significant barriers facing persons in the early stages of recovery. Substance Abuse and Mental Health Services Administration's (SAMHSA's) includes ten (10) guiding principles that support individuals in their recovery from substance use disorder (SUD). There is a basic principle that states that “recovery is holistic” and involves several social determinants of health that affect well-being of the citizen. Oxford House addresses these factors that influence the ability of individuals to lead healthy lives, including healthcare, housing, transportation and employment. Individuals recovering from substance abuse must not only seek affordable housing, such as Oxford House, find the means to pay entry costs but then also navigate their own way through the mental health, substance abuse,and other supportive services provider network. Docusign Envelope ID: 9ADEFAD5-C106-45CE-909F-ED02DFA16A16 1/30/24, 2:45 PM HSOA-24-40 https://chapelhillnc.workflow.opengov.com/#/explore/records/63250/react-form-details/63250 11/20 Program Cost This cost per individual must reflect the total program budget divided by the total number of program individuals in this application. Actual Cost 2022-2023 Total Program Cost (Actual 2022-2023) 15000 Total Number of Individuals (Actual 2022-2023) 25 Cost Per Individual (Actual 2022-2023) 600 Projected Cost 2023-2024 Total Program Cost (2023-2024) 21000 Total Number of Individuals (Projected 2023- 2024) 35 Cost Per Individual (Projected 2023-2024) 600 Projected Cost 2024-2025 Total Program Cost (Projected 2024-2025) 27000 Total Number of Individuals (Projected 2024- 2025) 45 Cost Per Individual (Projected 2024-2025) 600 Docusign Envelope ID: 9ADEFAD5-C106-45CE-909F-ED02DFA16A16 1/30/24, 2:45 PM HSOA-24-40 https://chapelhillnc.workflow.opengov.com/#/explore/records/63250/react-form-details/63250 12/20 Performance Indicators/Program Goals Strategic Objective* 2. Residents increase their livelihood security Intermediate Result* 2.1 Residents access the most appropriate social safety new services If applying to Orange County, please select the funding area that best aligns with your program. Housing Based on the strategic objective, intermediate result, and/or funding area selected above, what are the performance indicators/program goals related to this program? Actual Outcomes 2022-2023 Projected Outcomes 2023-2024 Projected Outcomes 2024-2025 Goal 1: Residents will remain housed while in early recovery. Goal 2: Decreased substance use Goal 3: Reduced occurrence of return to use Goal 1: Actual Outcomes 24 residents Goal 2: Actual Outcomes 20 residents Goal 3: Actual Outcomes 20 residents Goal 1: Actual Outcomes 35 residents Goal 2: Actual Outcomes 35 residents Goal 3: Actual Outcomes 35 residents Goal 1; Actual Outcomes 45 residents Goal 2:Actual Outcomes 45 residents Goal 3: Actual Outcomes 45 residents Docusign Envelope ID: 9ADEFAD5-C106-45CE-909F-ED02DFA16A16 1/30/24, 2:45 PM HSOA-24-40 https://chapelhillnc.workflow.opengov.com/#/explore/records/63250/react-form-details/63250 13/20 Program Name Oxford House Peer Advocate Primay Contact's Name Paula Harrington Primary Contact's Phone Number 919-616-3020 Primary Contact's Email Address paula.harrington@oxfordhouse.org Docusign Envelope ID: 9ADEFAD5-C106-45CE-909F-ED02DFA16A16 1/30/24, 2:45 PM HSOA-24-40 https://chapelhillnc.workflow.opengov.com/#/explore/records/63250/react-form-details/63250 14/20 Describe the proposed program and the target population to benefit from the program. Please also explain how the program aligns with the Town of Chapel Hill and Carrboro's Human Services Program Results Framework and/or Orange County's BOCC Goals and Priorities (250 words or less). Under the umbrella of OHI, the Oxford House (OH) program strongly aligns with all of Chapel Hill and Carrboro’s and Orange Counties' priorities and goals by continuing to fill the gaps in the substance use disorder services continuum by establishing and maintaining self-run, self-supported peer-operated recovery homes and providing supportive services. The OH model of care continues to provide quality recovery housing assistance which provides opportunities for recovering citizens the ability to live together in a disciplined environment tomaintain recovery without the return to use. This level of care includes providing a safe and affordable, drug-free living situation to recovering individuals with the support of other peers in recovery, staff, and other supports and services in the community. It is well established that individuals in active substance use face significant health and safety risks as well as the individuals leaving treatment because of the substantial risk of resuming a lifestyle that promotes a return to use with old acquaintances and no support from the community. Peer Advocates will assist individuals becoming self-sufficient by helping them acquire life skills in a supportive peer environment. This effort assists Orange County in meeting its mission to partner with the community in responding to public health, behavioral health, and economic and social needs. To help meet this need, we will help individuals seeking substance abuse services obtain residency in the County OH and supportive access services in the County; OH would like to recruit 3 addiitonal Peer Advocates. Docusign Envelope ID: 9ADEFAD5-C106-45CE-909F-ED02DFA16A16 1/30/24, 2:45 PM HSOA-24-40 https://chapelhillnc.workflow.opengov.com/#/explore/records/63250/react-form-details/63250 15/20 Target Population The program target population demographics table is included as an attachement on the application cover page. Please download the excel spreadsheet and fill out the demographic data in the table and then upload it with your application. Provide one copy per program that you are requesting funding for. Program Cost This cost per individual must reflect the total program budget divided by the total number of program individuals in this application. Actual Cost 2022-2023 Total Program Cost (Actual 2022-2023) 0 Total Number of Individuals (Actual 2022-2023) 0 Cost Per Individual (Actual 2022-2023) 0 Projected Cost 2023-2024 Total Program Cost (2023-2024) 21000 Total Number of Individuals (Projected 2023- 2024) 35 Cost Per Individual (Projected 2023-2024) 600 Projected Cost 2024-2025 Docusign Envelope ID: 9ADEFAD5-C106-45CE-909F-ED02DFA16A16 1/30/24, 2:45 PM HSOA-24-40 https://chapelhillnc.workflow.opengov.com/#/explore/records/63250/react-form-details/63250 16/20 Total Program Cost (Projected 2024-2025) 33000 Total Number of Individuals (Projected 2024- 2025) 55 Cost Per Individual (Projected 2024-2025) 600 Performance Indicators/Program Goals Strategic Objective* 2. Residents increase their livelihood security Intermediate Result* 2.1 Residents access the most appropriate social safety new services If applying to Orange County, please select the funding area that best aligns with your program. Housing Based on the strategic objective, intermediate result, and/or funding area selected above, what are the performance indicators/program goals related to this program? Actual Outcomes 2022-2023 Projected Outcomes 2023-2024 Projected Outcomes 2024-2025 Docusign Envelope ID: 9ADEFAD5-C106-45CE-909F-ED02DFA16A16 1/30/24, 2:45 PM HSOA-24-40 https://chapelhillnc.workflow.opengov.com/#/explore/records/63250/react-form-details/63250 17/20 Community Impact Award Please describe the impact the proposed programs will have on the target population. Please include specific quantitative and qualitative data in your response. What methods/tools will your organization use to evaluate the proposed program’s effectiveness? Please include specific examples, such as a logic model. The County reported that in 2022, 16.9% of the population lived with severe housing problems. OHI provides affordable housing and access to supportive services for individuals recovering. The ability to obtain and sustain safe, affordable housing is one of the most significant barriers facing persons starting their recovery journey. OHI targets economically disadvantaged adults and does not discriminate on the basis of race, color, religion, or national and ethnic origin, ensuring that special populations such as Latinos and persons with dual diagnoses will have culturally competent access to the Oxford Houses and the services of an Oxford House Peer Advocate. Oxford House is a national network of Peer-run, Self-sustaining, substance-free housing and is cited by SAMHSA as a best practice in sober living. A study by DePaul University found that staying at least one year in an Oxford House offers a greater than 80% chance of long-term recovery, leading to the recovery capital needed for self-efficacy. Persons finding recovery from substance use disorder experience a ripple effect that allows the community at large to benefit from that recovery through a reduction in domestic violence, child abuse, neglect, poverty, homelessness, hunger, absence of healthcare, unemployment, criminal activity, and chemically impaired driving related to substance use disorder. OHI shall submit data on all outcomes listed as required. Docusign Envelope ID: 9ADEFAD5-C106-45CE-909F-ED02DFA16A16 1/30/24, 2:45 PM HSOA-24-40 https://chapelhillnc.workflow.opengov.com/#/explore/records/63250/react-form-details/63250 18/20 Please briefly describe how your proposed programs aligns with evidence-based approaches to addressing human service need(s). Please describe one to three key partnerships/collaborations that add the most value to the success of the proposed programs. If you are not awarded a Community Impact Award, what would your agency’s funding request be? Oxford House is a national network of peer-run, self-sustaining, substance-free housing SAMHSA recommends for sober living. A DePaul University study found that a one-year stay in an Oxford House increases the chance of long-term recovery by over 80%, providing the necessary recovery capital for self-efficacy. This ripple effect benefits the community, reducing domestic violence, child abuse, poverty, homelessness, hunger, healthcare gaps, unemployment, criminal activity, and substance-related accidents. Notably, only 7% of those needing primary treatment receive it, making Oxford House a crucial alternative that effectively breaks the cycle of relapse for individuals seeking recovery from substance use disorders. Drug courts, parole officials, and family treatment courts send clients to Oxford House as an effective vehicle for establishing long-term recovery without relapse or recidivism. Over 75% of Oxford House residents have experienced incarceration and have succeeded in recovery at Oxford House. Freedom House is committed to recovery support for men and women who have substance use disorders and mental disabilities. Many Oxford House residents' journey started with detoxification at Freedom House, or transition from the halfway houses, followed by recovery in an Oxford House combined with continued outpatient services at Freedom House. Community Empowerment Fund, Interfaith Council, and the Lantern program provide Oxford House residents with person-centered support, financial education, and asset- building tools. If not awarded the Community Impact Award, we would like to continue to develop and explore different avenues to fund newly recovering individuals coming into Oxford House. We are requesting $33,000.00 and further support its Peer Advocate Program. Docusign Envelope ID: 9ADEFAD5-C106-45CE-909F-ED02DFA16A16 1/30/24, 2:45 PM HSOA-24-40 https://chapelhillnc.workflow.opengov.com/#/explore/records/63250/react-form-details/63250 19/20 Applicant Statement Disclosure of Conflicts of Interest Are any board members or agency employees, including their immediate relatives and business associates, current beneficiaries of the proposed program for which funds are being requested? No Are any board members or agency employees, including their immediate relatives and business associates, members of or related to members of the governing bodies of Chapel Hill, Carrboro, or Orange County? No Are any board members or agency employees, including their immediate relatives and business associates, paid providers of goods or services to or have other financial interest in the proposed program? No Are any board members or employees, including their immediate relatives and business associates, related to employees of that Town of Chapel Hill, Town of Carrboro, or Orange County? No If the answer to any of the above is yes, please provide an explanation. Non-discrimination Clause Provider agrees as part of consideration of the granting of funds by funding agencies to the parties hereto for themselves, their agents, officials, employees and servants agree not to discriminate in any manner of these basis of race, color, gender, national origin, age, handicap, religion, sexual orientation, gender identity/expression, familial status or veterans status with reference to any activities carried out by the grantee, no matter how remote. The parties hereto further agree in all respects to conform to the provision and intent of Orange County Civil Rights Ordinance, as amended, and the Orange County Anti-discrimination Policy. This provision is enforced by action for specific performance, injunctive relief, or other remedy as by law provided; this provision shall be binding on the grantees, the successors and assigns of the parties hereto with reference to the above subject manner. Docusign Envelope ID: 9ADEFAD5-C106-45CE-909F-ED02DFA16A16 1/30/24, 2:45 PM HSOA-24-40 https://chapelhillnc.workflow.opengov.com/#/explore/records/63250/react-form-details/63250 20/20 Applicant Statement 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. Name of Person Submitting the Application Paula Harrington Agency Role of Person Submitting the Application Special Projects Coordinator Agency Representative Signature Paula Harrington Jan 10, 2024 By submitting this application, the agency representative noted above affirms they are either the Executive Director, or, if someone other than the Executive Director is submitting this application, they affirm the Executive Director has reviewed the application for accuracy and approved it for submittal. Approval Details Approved Amount – Docusign Envelope ID: 9ADEFAD5-C106-45CE-909F-ED02DFA16A16 Certified by: _______________________ Title: Chief Executive Officer Date:10/24/2024 (Provider’s Signature) EXHIBIT “B” Scope of Services – FY 2024-25 Outside Agency Performance Agreement Agency Name: Oxford House, Inc. Program Name: Oxford House Resident Financial Assistance Funding Award: $9000.00 Outline how the agency will spend Orange County’s funding award. Program Services Outline the critical services (activities) the agency will employ to attain the Anticipated Outcomes below, by June 30, 2025. •Assist new residents with up to one month of EES (Equal Expense Shared) of up to $600.00 • • Anticipated Outcomes The Anticipated Results column must include quantifiable results in the form of number of persons/units served within Orange County, only (all Towns and municipalities). If you use percentages, you must also provide the total number of participants within that measure’s description or for an earlier performance measure. Performance Measures Anticipated Results These funds will assist 15 new residents in Oxford Houses in Orange County, NC 15 Expense Description Amount Financial Assistance Program (Provision of financial assistance for members) $9000.00 Docusign Envelope ID: 9ADEFAD5-C106-45CE-909F-ED02DFA16A16 ANY PROPRIETOR/PARTNER/EXECUTIVEOFFICER/MEMBER EXCLUDED? INSR ADDL SUBRLTR INSD WVD PRODUCER CONTACTNAME: FAXPHONE(A/C, No):(A/C, No, Ext): E-MAILADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY) (MM/DD/YYYY) AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATIONAND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE EACH OCCURRENCE $ DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence) MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRO-POLICY LOC PRODUCTS - COMP/OP AGGJECT OTHER: $ COMBINED SINGLE LIMIT $(Ea accident) ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED BODILY INJURY (Per accident) $AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $AUTOS ONLY AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE CLAIMS-MADE AGGREGATE $ DED RETENTION $ PER OTH-STATUTE ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.L. DISEASE - POLICY LIMITDESCRIPTION OF OPERATIONS below INSURER(S) AFFORDING COVERAGE NAIC # COMMERCIAL GENERAL LIABILITY Y / N N / A (Mandatory in NH) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer 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.ACORD 25 (2016/03) CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) $ $ $ $ $ The ACORD name and logo are registered marks of ACORD 10/24/2024 (410) 685-4625 (410) 685-3071 29580 Oxford House, Inc 1010 Wayne Ave, Ste 300 Silver Spring, MD 20910 10166 A 1,000,000 X HHS 8530942 11/18/2023 12/31/2024 500,000 20,000 1,000,000 3,000,000 3,000,000 1,000,000A HHS 8530942 11/18/2023 12/31/2024 3,000,000A HHS 8530942 11/18/2023 12/31/2024 3,000,000 0 B AF WCP 100089169 04 1/15/2024 1/15/2025 1,000,000 1,000,000 1,000,000 A Crime HHS 8530942 11/18/2023 250,000 A Professional Liab. HHS 8530942 11/18/2023 12/31/2024 $1M OCC/$3M AGG. Orange County North Carolina is included as additional insured as respects to the General Liability portion of coverage for work performed by the named insured if required to be in a written executed contract with the named insured per the policy terms and conditions. 30 days’ notice of cancellation will be provided to the certificate holder in the event of cancellation or non-renewal, or 10 days’ notice in the event of cancellation for non-payment of premium. Orange County North Carolina 300 West Tyron Street P.O Box 8181 Hillsborough, NC 27278 OXFOHOU-01 KWENGLER Maury, Donnelly & Parr, Inc.24 Commerce St. Baltimore, MD 21202 Berkley Regional Insurance Company Accident Fund Insurance Company of America X 12/31/2024 X X X X X X X X Docusign Envelope ID: 9ADEFAD5-C106-45CE-909F-ED02DFA16A16 FORM NUMBER: EFFECTIVE DATE: The ACORD name and logo are registered marks of ACORD ADDITIONAL REMARKS ADDITIONAL REMARKS SCHEDULE FORM TITLE: Page of THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, ACORD 101 (2008/01) AGENCY CUSTOMER ID: LOC #: AGENCY NAMED INSURED POLICY NUMBER CARRIER NAIC CODE © 2008 ACORD CORPORATION. All rights reserved. Maury, Donnelly & Parr, Inc. OXFOHOU-01 SEE PAGE 1 1 SEE PAGE 1 ACORD 25 Certificate of Liability Insurance 1 SEE P 1 Oxford House, Inc1010 Wayne Ave, Ste 300Silver Spring, MD 20910 SEE PAGE 1 KWENGLER 1 Additional Coverages: Sexual Abuse and Molestation Policy # HHS 8530942 Effective Date: 11/18/23-12/31/24 Carrier: Berkley Regional Insurance Company General Aggregate: $3,000,000 Each Claim Limit: $1,000,000 Docusign Envelope ID: 9ADEFAD5-C106-45CE-909F-ED02DFA16A16