HomeMy WebLinkAbout2024-775-E-Social Svc-Grow Your World-outside agency awardOrange 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 Grow Your World, a not-for-profit corporation, located
at 901 West Main Street, Carrboro, North Carolina 27510 (“Provider”).
WITNESSETH:
WHEREAS, it is in the interests of the County that said program be assisted by the County and thereby
enhance its availability to residents of the County, and said program addresses an important community
human services need, as identified by the Board of Commissioners.
NOW, THEREFORE, in consideration of the above and the mutual covenants and conditions hereafter set
forth, the County and Provider agree as follows:
1.Term of the Agreement. The term of this Agreement shall be a program year beginning July 1,
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 $2,500.
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 $625. 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.
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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
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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 (Sharron Hinton) 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 ‐
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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
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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.
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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 Grow Your World
Attention: Lindsey Shewmaker Attention: Sophie Suberman
P.O. Box 8181 Address: 901 West Main Street
Hillsborough, NC 27278 Carrboro NC 27510
Email:lshewmaker@orangecountync.gov Email:
sophie@growyourworld.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
_____________________________ _______________________
Sophie Suberman, Co-Executive Director Date
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For and on behalf of Orange County Government
_______________________________ ________________________
Travis Myren, County Manager Date
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ORANGE COUNTY—INTERNAL USE ONLY
______________________________________________________________________________
Finance Information
Vendor Name: Grow Your World Vendor Contact Person: Sophie Suberman Phone: 919-525-1374 Address: 901
West Main Street City Carrboro State: NC Zip: 27510 Department: Social Services Amount: 2,500 Purpose:
outside agency award Budget Code(s): 10290050-719113 Vendor # 67337
Vendor Status with NCSOS: Current-Active 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: 6/18/24); 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
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:_________
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12/13/2024
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Town of Chapel Hill, NC 1/30/2024
HSOA-24-57
Human Services/Outside Agencies
Funding Application Fiscal Year 2025
Status: Active
Submitted On: 1/12/2024
Applicant
Courtnei McWilliams
919-649-5040
courtnei@growyourworld.org
901 W Main St
Carrboro, NC 27510
Agency Information
Agency's Legal Name
Grow Your World
Agency's Mailing Address (Street, City, State & Zip
Code)
901 W Main St, Carrboro,NC 27510
Agency's Physical Address (Street, City, State & Zip
Code)
901 W Main St, Carrboro, NC 27510
Agency’s Web Address
www.growyourworld.org
Tax ID:
**-***5124
Date of Incorporation (Month/Year)
02/2019
Executive Director Name
Sophie Suberman and Soteria
Shepperson
E-Mail Address
sophie@growyourworld.org
Telephone Number
919-525-1374
Exhibit A
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Agency's Purpose/Mission Statement
brief description of your organization’s past achievements
Wages and Positions
Does the agency pay permanent employees a
living wage?
Yes
Is the agency an Orange County Living Wage
Certified Employer?
No
If the agency is not an Orange County Living Wage Certified Employer, please explain.
Grow Your World is a youth-focused organization that promotes community
development and broadens opportunities. We strive to bridge the gap between
different generations and backgrounds,advocating for diversity and inclusivity. Our
initiatives are built upon abundance,community, and empowerment. We acknowledge
the untapped potential within each individual and aim to nurture an environment
where young people can flourish and discover new possibilities. By integrating social-
emotional practices,we support participants in forming a positive self-image. We
emphasize the importance of developmental relationships, considering them vital for
personal and societal growth. Our primary objective is to empower youths,providing
them with the necessary tools for positive societal change. We firmly believe that by
fostering these young minds,we are contributing to a brighter future and a better
world.At Grow Your World,we facilitate connections among community members
through multigenerational and inclusive relationships, creating enrichment
opportunities for all.
In our 2022-2023 fiscal year, we had 96 youth participants; filled 194 youth program
slots; 115 college aged students received hands-on job training, equity training, and
leadership experiences; 31 organization collaborations; 2500+ one-on-one
mentorship hours.
Employees are being paid a living wage, but we are not an Orange County Living Wage
Certified Employer as we are a newer organization as well as only have three full time
employees.
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Number of Nonbinary Staff
5
Number of Staff who prefer not to answer
0
Staff Members - Race and Ethnicity
Number of American Indian or Alaska Native Staff
–
Number of Asian Staff
2
Number of Black or African American Staff
8
Number of Native Hawaiian or Other Pacific Islander
Staff
–
Number of White Staff
12
Number of Staff of more than one race
2
Number of staff who prefer not to answer
–
Number of Staff who identify as a race/ethnicity not
listed
–
Total Number of Staff who identify as Hispanic or
Latino
6
Total Number of Staff who do not identify as
Hispanic or Latino
24
Board Members
Total Number of Board of Members
3
Board Members - Sex
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Number of Male Board Members
0
Number of Female Board Members
1
Number of Nonbinary Board Members
1
Number of Board Members who prefer not to answer
–
Board Members - Race and Ethnicity
Number of American Indian or Alaska Native Board
Members
–
Number of Asian Board Members
1
Number of Black or African American Board
Members
0
Number of Native Hawaiian or Other Pacific Islander
Board Members
–
Number of White Board Members
1
Number of Board Members of more than one race
1
Number of Board Members who prefer not to answer
–
Number of Board Members who identify as a
race/ethnicity not listed
0
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
2
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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)
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.
100
Describe other racial equity related activities.
We will continue to build identity-empowering curriculum and anti-racism within our
culture and programming and extend training to other organizations and youth
service providers on how to embed anti-racism and identity-empowerment through
relationships, as we've been doing. We believe our strategies for connecting with
youth and countering inequitable systems through relationships and access to
meaningful opportunities and resources could not only impact youth across North
Carolina, but also youth in other states.
Program was designed with the expressed needs of the participants and continues to
evolve based on their needs.
All staff receive racial equity training as part of their onboarding and ongoing support
to ensure youth-centered programming that supports their positive racial and identity
development. Youth are also paired with mentor-tutors based on their race,
background, interests and lived experiences.
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Program Information
Program Name
Tutoring After 6
Primay Contact's Name
Sophie Suberman
Primary Contact's Phone Number
9195251374
Primary Contact's Email Address
sophie@growyourworld.org
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.
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
Tutoring After 6pm serves Spanish and English speaking families who, due to
location, lack of transportation and cost of services, are unable to access quality
tutoring services for their youth. Tutoring After 6pm ensures access,
programming and wraparound supports for families enrolled in our program. We
also provide inclusive opportunities for low income college students living in
Orange County.
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Total Program Cost (Actual 2022-2023)
42250
Total Number of Individuals (Actual 2022-2023)
179
Cost Per Individual (Actual 2022-2023)
236.03
Projected Cost 2023-2024
Total Program Cost (2023-2024)
74000
Total Number of Individuals (Projected 2023-
2024)
250
Cost Per Individual (Projected 2023-2024)
293
Projected Cost 2024-2025
Total Program Cost (Projected 2024-2025)
96500
Total Number of Individuals (Projected 2024-
2025)
325
Cost Per Individual (Projected 2024-2025)
296.92
Performance Indicators/Program Goals
Strategic Objective*
1.Children improve their education
outcomes
Intermediate Result*
1.2 Children demonstrate new grade-
level-appropriate skills
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If applying to Orange County, please select the
funding area that best aligns with your program.
Youth Services
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
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.
75% (113) of students enrolled improve their grades,75% (113) of students
enrolled improve their academic confidence,and 33% (113) of students enrolled
improve their mental health and emotional wellbeing
76.9%of students improved their grades in the tutored subject(s),76.9%of
students increased their confidence in academic potential and school success,
38.9%of students improved their mental health and emotional wellbeing
75% (113) of students enrolled improve their grades,75% (113) of students
enrolled improve their academic confidence,and 33% (113) of students enrolled
improve their mental health and emotional wellbeing
75% (113) of students enrolled improve their grades,75% (113) of students
enrolled improve their academic confidence,and 33% (113) of students enrolled
improve their mental health and emotional wellbeing
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What methods/tools will your organization use to evaluate the proposed program’s effectiveness? Please
include specific examples, such as a logic model.
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?
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?
Yes
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
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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.
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
Courtnei McWilliams
Agency Role of Person Submitting the Application
Program Manager
Agency Representative Signature
Courtnei P McWilliams
Jan 12,2024
If this grant is awarded,part of the funds will be allocated to staff salaries.
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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
–
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EXHIBIT “B”
Scope of Services – FY 2024-25
Outside Agency Performance Agreement
Agency Name: Grow Your World
Program Name: Tutoring After 6pm
Funding Award: $2,500
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.
•Provide one-on-one mentorship to 2nd-12th grade students across Orange County
•Provide social-emotional life skills lessons to 2nd-12th grade students across Orange County
•Provide one-on-one tutoring to 2nd-12th grade students across Orange County
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.
Expense Description Amount
Mentor-Tutor Salaries (Payroll)$2,500
Performance Measures Anticipated
Results
Provide over 300 one-on-one mentoring and tutoring hours to 2nd-12th grade Orange Co. youth 300
Provide 75 college students studying in Orange County with hands-on work experience.75
80% of Parents & Guardians report youth improved grades (20 respondents)80%
75% of Parents & Guardians reported youth increased confidence (20 respondents)75%
75% of college students studying in Orange County report increased sense of belonging and
connection in Orange County. (65 respondents)
75%
75% of college students studying in Orange County report increased sense of impact on local
community. (65 respondents)
75%
Certified by: _______________________ Title: __________________________ Date: ____________
(Provider’s Signature)
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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)
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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
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Orange County Outside Agency Performance Agreement Page 14 of 12
Rev.06/24
Quarterly Outcomes Form
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Coverage Form(s)/Part(s) and Endorsement(s) made a part of this policy at time of issue:
See Form EOD (01/95)
LIMITS OF INSURANCE
Each Occurrence Limit $1,000,000
Personal & Advertising Injury Limit (Any One Person/Organization)$1,000,000
Medical Expense (Any One Person)$5,000
Damages To Premises Rented To You (Any One Premises)$100,000
Products/Completed Operations Aggregate Limit Included
General Aggregate Limit $2,000,000
Hired and Non-owned Auto Each Occurrence Included
Hired and Non-owned Auto Aggregate Included
Professional E&O Liability Each Incident $1,000,000
Professional E&O Liability Aggregate $2,000,000
Abuse And Molestation Each Claim $100,000
Abuse And Molestation Aggregate $200,000
LIABILITY DEDUCTIBLE $0
LOCATIONS OF ALL PREMISES YOU OWN, RENT OR OCCUPY
Location Address Territory
1 901 W Main Street, Carrboro, NC 27510 002
2 437 Dimmocks Mill Road, Suite 27, Studio 7, Hillsborough, NC 27278 002
3 706 Gilbert Street, Durham, NC 27701 002
PREMIUM COMPUTATION
Rate Advance Premium
Loc Classification Code No. Premium Basis Pr/Co All Other Pr/Co All Other
1 Professional Liability - Social Services - Not-for-Profit 72990 Flat Included 165.000 Included $165
1 Youth Community Centers - Not-for-Profit 41668 1,000 Per 1,000 Total
Area
Included 68.873 Included $69
1 Abuse and Molestation Liability - Social Services 41799 Flat Included 0.000 Included Included
1 Non-Owned & Hired Automobile Liability - Social
Services
90099 5 Flat Included 313.240 Included $313
1 Blanket Additional Insured - Non-Profit Package 49950 1 Flat Included 100.000 Included $100
1 Buildings or Premises - bank or office - mercantile or
manufacturing (lessor's risk only) - Not-For-Profit only
61216 500 Per 1,000 Total
Area
Included 17.742 Included $9
2 Youth Community Centers - Not-for-Profit 41668 180 Per 1,000 Total
Area
Included 68.873 Included $12
3 Youth Community Centers - Not-for-Profit 41668 2,000 Per 1,000 Total
Area
Included 68.873 Included $138
MINIMUM PREMIUM FOR GENERAL LIABILITY COVERAGE PART:$735
TOTAL PREMIUM FOR GENERAL LIABILITY COVERAGE PART:
(This Premium may be subject to adjustment.)
$806
MP - minimum premium
NPP1597181D
COMMERCIAL GENERAL LIABILITY COVERAGE PART DECLARATIONS
Effective Date: 08/01/2024
12:01 STANDARD TIME
Policy No.
Copyright, ISO Commercial Risk Services, Inc., 1983, 1984, 1988
Includes copyrighted material of ISO Commercial Risk Services, Inc., with its permission.
THESE DECLARATIONS ARE PART OF THE POLICY DECLARATIONS CONTAINING THE NAME OF THE INSURED AND THE POLICY PERIOD.
CL150 (10/03)Page 1 Of 1
Docusign Envelope ID: 3F291284-28EA-4C38-99B9-60DFE2A69BE8
ITEM I. PARENT ORGANIZATION AND PRINCIPAL ADDRESS
GROW YOUR WORLD
161 PEACHTREE CENTER AVE NE
UNIT 1923
ATLANTA, GA 30303
ITEM II. POLICY PERIOD: (MM/DD/YYYY) From:08/01/2024 To:08/01/2025
$475
ITEM III. LIMITS OF LIABILITY
ITEM IV. RETENTION:
ITEM V. PREMIUM:
$1,000,000
$1,000,000
$0
EACH CLAIM
IN THE AGGREGATE
EACH CLAIM
RETROACTIVE DATE:Full Prior Acts
a. Non Profit Directors & Officers
b. Non Profit Directors & Officers
Non Profit Directors and Officers Liability Coverage Part
ITEM III. LIMITS OF LIABILITY
ITEM IV. RETENTION:
ITEM V. PREMIUM:
$1,000,000
$1,000,000
$0
$179
EACH CLAIM
IN THE AGGREGATE
EACH CLAIM
Employment Practices Liability Coverage Part
RETROACTIVE DATE:Full Prior Acts
a. Employment Practices
b. Employment Practices
PRIOR OR PENDING LITIGATION 08/01/2020
PRIOR OR PENDING LITIGATION 08/01/2020
THIS IS A CLAIMS MADE POLICY COVERAGE FORM AND UNLESS OTHERWISE PROVIDED HEREIN, THE
COVERAGE OF THIS FORM IS LIMITED TO LIABILITY FOR CLAIMS FIRST MADE DURING THE POLICY
PERIOD, OR THE EXTENSION PERIOD, IF APPLICABLE. DEFENSE COSTS SHALL BE APPLIED AGAINST
THE RETENTION.
NON PROFIT MANAGEMENT LIABILITY COVERAGE PART DECLARATIONS
Effective Date:08/01/2024
12:01 AM STANDARD TIME
No.Effective Date:NPP1597181D
PLEASE READ YOUR POLICY CAREFULLY.
DO-150 (02/09)Page 1 Of 2
THESE DECLARATIONS ARE PART OF THE POLICY DECLARATIONS CONTAINING THE NAME OF THE INSURED AND THE POLICY PERIOD.
Docusign Envelope ID: 3F291284-28EA-4C38-99B9-60DFE2A69BE8
Technology Insurance Company, Inc.
A Stock Insurance Company
WORKERS COMPENSATION WC 99 00 01 B
AND EMPLOYERS LIABILITY 1 of 5
INSURANCE POLICY INFORMATION PAGE
Ncci Code: 39071
1. Insured:
Grow Your World
901 W Main St
Carrboro, NC 27510
Other workplaces not shown above:
None
Producer:
Business Insurers of the Carolinas, LLC
P. O. Box 2536
Chapel Hill, NC 27515
Policy Number: TWC4513657
Individual Partnership
Corporation X Other
Federal Tax ID:
Risk Id:
Renewal of: New
2. The policy period is from 10/25/2024 to 10/25/2025 12:01 a.m. at the insured's mailing address.
3. A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of
the states listed here: North Carolina
B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in item 3.A.
The limits of our liability under Part Two are:
State Bodily Injury by Accident Bodily Injury by Disease Bodily Injury by Disease
$1,000,000 each accident $1,000,000 policy limit $1,000,000 each employee
C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here:
All states except ND, OH, WA, WY and State(s) Designated in Item 3.A
D. This policy includes these endorsements and schedules: See Extension of Information Page
4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating
Plans. All information required below is subject to verification and change by audit.
See Extension of Information Page
TOTAL ESTIMATED ANNUAL PREMIUM 866
STATE ASSESSMENT 0
TOTAL ESTIMATED COST 866
Minimum Premium 278
Deposit Premium 866
Issue Date: 10/25/2024 Countersigned by:
Authorized Representative
Docusign Envelope ID: 3F291284-28EA-4C38-99B9-60DFE2A69BE8