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2025-219-E-County Mgr-Town of Chapel Hill-EV Garbage Truck
Docusign Envelope ID: E196FFB6-481D-48D1-A670-07B90011COBE NORTH CAROLINA CONTRACT AMENDMENT ORANGE COUNTY THIS CONTRACT AMENDMENT ("Amendment") is made and entered into this 23rd day of May, 2025 by and between ORANGE COUNTY(hereinafter referred to as "County") and Town of Chapel Hill (hereinafter referred to as "Provider"). WITNESSETH: THAT WHEREAS, the County and Provider entered into a contract dated June 1, 2023, (hereinafter the "Original Agreement"), for the provision of services for EV Garbage Truck; and WHEREAS, the County and Provider desire to amend the Original Agreement while keeping in effect all terms and conditions of the Original Agreement not inconsistent with the terms and conditions set forth below. NOW THEREFORE, for and in consideration of the mutual covenants and agreements made herein, the parties agree to amend the Original Agreement as follows: I. In order to ensure the completion of the Services identified in the term of the Original Agreement is amended to reflect an end date by which all Services shall be completed of September 30,2025. 2. Exhibit_N/A to the Original Agreement is amended by adding the following tasks and services to the Services to be provided by the Consultant: 3. Article —N/A—, Section N/A_ is amended to reflect a maximum payable not-to-exceed amount of N/A 4. Except for the changes made herein,the Original Agreement shall remain in full force and effect to the extent it is not inconsistent with this Amendment. In the event there is a conflict between the terms of the Original Agreement and the terms of this Amendment,this Amendment shall control. IN TESTIMONY WHEREOF, this Amendment has been executed by the parties hereto, as of the date first above written. 0�2ASNCdF COUNTY IDV�R Q1ravis ravus 4tifAA, 5/27/2025 Lty, 5/23/2025 ° yren " Loryn Clark County Manager Deputy Town Manager Revised 01/24 Docusign Envelope ID: E196FFB6-481D-48D1-A670-07B90011COBE ORANGE COUNTY—INTERNAL USE ONLY Finance Information Vendor Name: Town of Chapel Hill Vendor Contact Person: Brennan Bouma Phone: 919-969-5011 Address:405 Martin Luther King Jr.Blvd._ City Chapel Hill State:NC Zip: 27514 Department: County Manager Amount: $50,000 Purpose: EV Garbage Truck Budget Code(s): 61370035-803078-30052 Vendor# 64 Vendor Status with NCSOS: Vendor is a BOCC consultant: ❑Yes ®No Contract Details Contract Type: ❑New ®Amendment(Original Contract: 6/1/23)(Most Recent Amendment ) Effective Date 6/1/23 End Date 9/30/25 Notice Date (Notice Purpose ) Award ®Approved by Board(Agenda Date: 1/17/23); ❑ Made or Administered by Signature Authority - ❑ BOCC Express Delegation(Agenda Date: - Policy 9.4: ❑Under$5,000; ❑ Service Under$90,000; ❑ Construction Under$250,000 - ❑ Budget Policy Section XV(Capital Improvement Project: Bidding ❑ Informal Bidding($30k-$90k); ❑ Formal RFP($90k+); ❑ Other(<$30k); ❑Exception(#____) Department Affirmation ® 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 "PRISPgOR.y condition that was addressed: A-9, 5/23/2025 Department Director's Signature €5 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 sufficienc TM*g ice standards,specifications,and requirements: M.t, ssa, fit/�t,�.v 5/27/2025 Office of the Risk Management Officer 8E49481B36F64E1... Date: Financial Services Initial This instrument has been pre-audited in th ffi`"illied by the Local Government Budget and Fiscal Control Act: C� Q019 t"05,00, 5/27/2025 Office of the Chief Financial Officer Date: Legal Services This agreement is approved as to lega 07TRINN"sMciency: ,9mt L l�c,mv, 5/27/2025 Office of the County Attorney 4C5F3CDDFOB94F6... 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: Revised 01/24 Docusign Envelope ID: E196FFB6-481D-48D1-A670-07B90011COBE COMMUNITY CLIMATE ACTION GRANT PERFORMANCE AGREEMENT THIS AGREEMENT, made and entered into the first day of June, 2023, ("Effective Date") by and between the County of Orange, a political subdivision of the State of North Carolina, Post Office Box 8181, Hillsborough, North Carolina, 27278, ("County") and Town of Chapel Hill, a legal entity corporation, located at 405 Martin Luther King Jr. Blvd, Chapel Hill, NC 27514 ("Provider"). WITNESSETH: WHEREAS, it is in the interests of the County that said program be assisted by the County and thereby enhance its availability to residents of the County, and said program addresses an important community human services need, as identified by the Board of Commissioners. NOW, THEREFORE, in consideration of the above and the mutual covenants and conditions hereafter set forth, the County and Provider agree as follows: 1. Term of the Agreement. The term of this Agreement shall be two years beginning June 1, 2023 to June 1, 2025. 2. Scope of Services. a. Provider will provide services, as outlined in the attached Community Climate Action Grant Program Application and any amendments or revision thereto which is attached as Exhibit "A" and incorporated by reference, to the residents of Orange County. The Scope of Services and the Program Budget may be different from the original application based on County appropriation; however, any revisions or amendments to this Agreement must be approved in writing by the County and attached to this Agreement as Exhibit B. b. The Provider shall be solely responsible for the means, methods, techniques, sequence, safety program and procedures necessary to properly and fully complete the work set forth in the Scope of Services. 3. Funding. a. The County agrees to appropriate for the provision of services described in Exhibit A. the Community Climate Action Grant Program Performance Application, Exhibit B, the Revised, Scope of Services and more particularly described in the Revised Program Budget, the maximum sum of$50,000. b. All funds appropriated shall be used for purposes described in Exhibit A. Any funds not used for the purposes stated shall be returned to the County. Any changes in the use of funds must be authorized in writing by the County prior to any expenditure of the funds by the Provider. If the funds are expended not in accordance with the Scope of Services, at the discretion of the County the Provider may be required to repay the funds to the County. c. The Provider shall be paid in installments in the amount of See Exhibit C to be paid as follows: See Exhibit C. The first payment is contingent upon receipt of the agency's performance agreement; the remaining payments are contingent upon receipt of the request for reimbursement and related supporting documentation and performance outlined in the Revised Scope of Services and Project Budget in Exhibit B. If the project described in Exhibit A requires funds to be provided on a different or more accelerated schedule, the Provider may request an alternative payment schedule, which if approved, will be attached to this Agreement as Exhibit C, Alterative Payment Schedule. Should an Alternative Payment Docusign Envelope ID: E196FFB6-481D-48D1-A670-07B90011COBE schedule be approved, the Provider will still be required to submit quarterly Progress Reports for the duration of the Term of the Agreement. d. The County's obligation to make the quarterly payments is contingent upon receipt of Progress Reports, which show satisfactory progress toward completion of performance measures and an accounting of expenditures as detailed in the attached Exhibits B and C. e. Once Provider has satisfied its obligations as provided in (c) payment will be made 21 days after receipt of the Progress Report and Request for Reimbursement or 21 days after due date of Progress Report whichever is later. L The County is not obligated to provide any other support to Provider in this or in succeeding fiscal years. 4. Agency Reporting. a. Provider will provide Orange County a Progress Report that includes a fiscal report and updates on performance measures as outlined in Exhibit B, Revised Scope of Services. . Progress Report dates are: April 1-June 30, July 1-September 30, October 1-December 31 and January 1-March 31. Reports are due on July 15, October 15, January 15 and April 15 of the program fiscal year. b. Provider agrees to allow the County to inspect its financial books and records, which document costs of those services,upon reasonable notice during normal working hours. 5. Termination. a. 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. Docusign Envelope ID: E196FFB6-481D-48D1-A670-07B90011COBE 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 parry may terminate the agreement at any time without penalty;provided that written notice of such termination is furnished to the other party at least 30 days prior to termination. In the event of such termination, any payment due shall be prorated to the date of termination and any unused funds shall be returned to the County within 10 days of termination. d. Any termination of this Agreement for default under this section that is later deemed to be unjustified shall be deemed a termination for convenience. e. Waiver. The payment of any sums by the County under this Agreement or the failure of the County to require compliance by the Provider with any provisions of this Agreement or the waiver by the County of any breach of this Agreement shall not constitute a waiver of any claim for damages by the County for any breach of this Agreement or a waiver of any other required compliance with this Agreement. 6. Responsibilities of the County. Cooperation and Coordination. The County has designated (Amy Eckberg) to act as the County's representative with respect to the Project who shall have the authority to render decisions within guidelines established by the County Manager or the County Board of Commissioners and who shall be available during working hours as often as may be reasonably required to render decisions and to furnish information. 7. Insurance. a. General Requirements. The Provider shall purchase and maintain, during the period of performance of this Agreement, insurance: i. Worker's Compensation. For protection from claims under workers' or workmen's compensation acts; ii. Comprehensive General Liability Insurance covering claims arising out of or relating to bodily injury, including bodily injury, sickness, disease or death of any of the Consultant's employees or any other person and to real and personal property including loss of use resulting thereof, iii. Comprehensive Automobile Liability Insurance, including hired and non-owned vehicles, if any, covering personal injury or death, and property damage; and iv. Professional Liability Insurance, covering personal injury, bodily injury and property damage and claims arising out of or related to the performance under this Agreement by the Consultant or his agents, consultants and employees. v. Sexual Misconduct. Sexual Abuse/Molestation Insurance is required when Provider works directly one-on-one with children, elderly or other at-risk populations. b. Limits of Coverage: Minimum limits of insurance coverage shall be as follows: Docusign Envelope ID: E196FFB6-481D-48D1-A670-07B90011COBE INSURANCE DESCRIPTION MINIMUM REQUIRED COVERAGE • Worker's Compensation Limits for Coverage A- Statutory State NC &Coverage B -Employers Liability $500,000 each accident, disease policy limit and disease each employee • Commercial General $1,000,000 Each Occurrence Liability $2,000,000 Aggregate • Automobile Liability $500,000 Combined Single Limit • Professional Liability $1,000,000 Each Occurrence $2,000,000 Aggregate • Sexual Misconduct $1,000,000 Each Occurrence $2,000,000 Aggregate c. All insurance policies (with the exception of Worker's Compensation and Professional Liability) required under this Agreement shall name the County as an additional insured party and as a certificate holder. For more information see the Orange County Risk Transfer Policy and Orange County Minimum Insurance Coverage Requirements, (each document is incorporated herein by reference and may be viewed at http://www.orangecountync.gov/departments/purchasing division/contracts.php.) Evidence of such insurance and all correspondence shall be sent to: Orange County Risk Manager Post Office Box 8181 Hillsborough,NC 27278 d. Nothing in this section is intended to affect or abrogate the County's sovereign immunity defenses. 8. General Provisions. a. Governing Law. This Agreement and the duties, responsibilities, obligations and rights of respective parties hereunder shall be governed by the laws of the State of North Carolina. By executing this Agreement Provider affirms that Provider and any subcontractors of Provider are and shall remain in compliance with Article 2 of Chapter 64 of the North Carolina General Statutes. By executing this Agreement Provider certifies that Provider has not been identified, and has not utilized the services of any agent or subcontractor identified, on the list created by the State Treasurer pursuant to G.S. 147-86.58. By executing this Agreement Provider certifies that Provider has not been identified, and has not utilized the services of any agent or subcontractor identified, on the list created by the State Treasurer pursuant to G.S. 147-86.81. b. Non-Discrimination. Provider agrees as part of consideration of the granting of funds by Orange County the parties hereto for themselves, their agents, officials, employees and servants agree not to discriminate in any manner of these basis of race, color, gender, national origin, age, handicap, religion, sexual orientation, familial status or veterans status with reference to any activities carried out by the grantee, no matter how remote. The parties hereto further agree in all respects to conform to the provision and intent of Orange County Civil Rights Ordinance, as amended and the Orange County Non-discrimination Policy, which is incorporated herein by reference and can be viewed at http://www.oran eg countync. og v/departments/purchasing division/contracts.php. The County may enforce this provision by an action for specific performance, injunctive relief, or other remedy as by law provided; this provision shall be binding on the grantees, the successors and assigns of the parties hereto with reference to the above subject manner. Docusign Envelope ID: E196FFB6-481D-48D1-A670-07B90011COBE 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.oran eg c�ync. og v/departments/purchasing_division/contracts.php. The County's living wage is $16.60 per hour. To the extent possible, Orange County recommends that Provider provide a living wage to its employees. e. Relationship of the Parties. Provider is an independent contractor of the County. Provider represents that they have or will secure, at his own expense, all personnel required in performing the services under this Agreement. Such personnel shall not be employees or have any contractual relationship with the County. All personnel engaged in work under this Agreement shall be fully qualified and shall be authorized and permitted under federal, state and local law to perform such services. f. Compliance with all Laws. The Provider, at its sole expense, shall comply with all laws, ordinances, orders and regulations of the federal, state or local governments, as well as their respective departments, commissions, boards, and officers, which are in effect at the time of execution of this Agreement or are adopted at any time following execution of this agreement. g. Subcontract. The County and Provider deem the services provided under this Agreement to be personal in nature and Provider may not subcontract any rights or duties under this Agreement to any other party without prior written consent from the County. h. Assignment. The Provider shall not assign this Agreement, including the rights to payment, to any other party without the prior written consent of the County. i. Indemnification. Provider agrees to defend, indemnify, and hold harmless the County, for all loss, liability, claims or expense (including reasonable attorney's fees) arising from bodily injury, including death or property damage, to any person or persons caused in whole or in part by the negligence or willful misconduct of the Provider, except to the extent same are caused by the negligence or willful misconduct of the County. It is the intent of this section to require Provider to indemnify the County to the extent permitted under North Carolina law. Nothing in this section is intended to affect or abrogate the County's sovereign immunity defenses. j. Non-Appropriation. This Agreement is subject to the availability of funds to purchase the specified services and may be terminated at any time if such funds become unavailable. k. Severability. All clauses found herein shall act independently of each other. If a clause is found to be illegal or unenforceable, it shall have no effect on the other provisions of this Agreement. It is understood by the parties hereto that if any part, term or provision of this Agreement is by the Courts held to be illegal or in conflict with any laws of the State of North Carolina or the United States, the validity of the remaining portions or provisions shall not be affected, and the rights and obligations of the parties shall be construed and enforced as if the Agreement did not contain the particular part,term or provision held to be invalid. Docusign Envelope ID: E196FFB6-481D-48D1-A670-07B90011COBE 1. 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 Town of Chapel Hill Attention: Amy Eckberg Attention: Brennan Bouma P.O. Box 8181 Address: 405 Martin Luther King Jr. Blvd. Hillsborough,NC 27278 Chapel Hill,NC 27514 Email:aeckberg@orangecountync.gov Email:bbouma@townofchapelhill.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. Rneltvndbehalf of the Provider TA" yvj, fir ' 5/22/2023 FB46A965C3F8485... Mary, ]ane Nirdlinger Deputy Town Manager Date F-u-r Vrehalf of Orange County Government bbin,& , hwAt,VsbR 6/7/2023 0637994B755E477... Bonnie Hammersley, County Manager Date Docusign Envelope ID: El 96FFB6-481 D-48D1-A670-07B9001 1 COBE Contract# From Munis Contract Entry TOWN OF CHAPEL HILL Print Form ROUTING FORM Vendor/Contractor Name: Town of Chapel Hill Document Name/Title: Orange County Community Climate Action Grant-EV Garbage TruckPilot Bid #(If applicable) N/A Department:Manager's Office Return To: Brennan Bouma Contact Person:Brennan Bouma Department: Manager's Office Phone Number:919-969-5011 Date Received Date Forwarded Initials DS Department Head (Review&Approve) 5/17/2023 5/17/2023 Purchasing & Contracts Manager 5/17/2023 5/17/2023 Finance Officer (Per Budget Act) 5/18/2023 5/18/2023 � (Legal Services 5/18/2023 5/18/2023 D5 Legal Review Administrator) (Legal—Form and 5/18/2023 5/18/2023 ��DS Authorization) Deputy/Town Manager (If Required) 5/22/2023 5/22/2023 IAL�N— Town Clerk (Attest, Date and Notarize) 5/24/2023 5/24/2023 D5 F 0- Purchasing & Contracts Mgr (Distribution and Mailing) 6/5/2023 6/5/2023 FiD;S Deadline for Signing:None G/L Account Number(s): Contract Dollar Amount(s): Special Distribution Instructions Contract 23501-44230 $50,000 routing and approvals conducted through DocuSign.Once complete,Brennan Bouma will provide a fully executed copy to the Town of Chapel Hill's Purchasing and Contracts Office. Notes/Explanation The Town of Chapel Hill is providing a service to Orange County(Electric Garbage Truck Pilot)per an approved Community Climate Action Grant project. Docusign Envelope ID: El 96FFB6-481 D-48D1-A670-07B9001 1 COBE Vendor Mailing Address/Telephone Town of Chapel Hill 405 Martin Luther King Jr Blvd Chapel Hill, NC 27514 919-968-2743 Form Revised 12/2017 Please do not remove form if revisions to document are necessary Docusign Envelope ID: El 96FFB6-481 D-48D1-A670-07B9001 1 COBE Town of Chapel Hill Signature Page from Small Service Contract (Revised 9/2019): This Contract is between the Town of Chapel Hill and Orange County for the Community Climate Action Grant awarded to the Town for their proposed EV Garbage Truck Pilot (see Exhibit A). IN WITNESS WHEREOF, the parties hereto cause this agreement to be executed in their respective names. O ga, umy br99'B'5!47 mu/'S�j6 Bonnie Hammerslev, County Manager SIGIA�nIE PRINTED NAME & TITLE FN 6st fL Joseph Herrin, Staff Attorney WMINIESS PRINTED NAME & TITLE TOWN OF CHAPEL HILL DOCUSigned by. "1 ^ Mr l DocuSigned by: l T DHEAD/EXECUTIVE DIRE T R OR DF ' TOWN MANAGER Mary ]ane Nirdlingproeputy Town Manager • • PRINTED NAME & DEPARTMENT �ES;FeBY TOWN CLERK: salvi" Mvt r TOWN CLtRK TOWN EAL 24 May 2023 Town Clerk attests date this the day of 120 �owdda S to Form and Authorization L�mts boktr ATTORNEY-FOR TOWN This instrument has been pre-audited in the manner required by the Local Government udg9V'af d Fiscal Control Act. h;. f U/ 15vial" 5/18/2023 299EDE4704A144F... Docusign Envelope ID: E196FFB6-481D-48D1-A670-07B90011COBE ORANGE COUNTY-INTERNAL USE ONLY Finance Information Vendor Name: Town of Chapel Hill Vendor Contact Person: Brennan Bouma Phone: 919-969-5011 Address:405 Martin Luther King Jr. Blvd. City Chapel Hill State:NC Zip: 27514 Department:Asset Management Services Amount: $50,000 Purpose: EV Garbage Truck Budget Code(s): 61370035-803078-30052 Vendor#64 Vendor Status with NCSOS: Vendor is a BOCC consultant: ❑Yes X No Contract Details Contract Type: ®New Amendment(Original Contract: )(Most Recent Amendment ) Effective Date 6/1/23 End Date 6/l/25 Notice Date (Notice Purpose ) Award X Approved by Board(Agenda Date: 1/17/23); ❑ Made or Administered by Signature Authority - ❑ BOCC Express Delegation(Agenda Date: - Policy 9.4: ❑Under$5,000; ❑ Service Under$90,000; ❑ Construction Under$250,000 - ❑ Budget Policy Section XV(Capital Improvement Project: ) Biddin ❑ 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. ❑ Services related to this agreement have already begun or been completed.Description of the nature of the emergency condition that was addressed: FS Docusigned by: � aVl�. Department Director's Signature Date: 6/5/2023 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 KV This instrument has been pre-audited in th HX9fWV JPP Tired by the Local Government Budget and Fiscal Control Act: � N 6/6/2023 Office of the Chief Financial Officer M4E5181ACC1409... Date: Legal Services This agreement is approved as to legal ,�OS 6/7/2023 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: El 96FFB6-481 D-48D1-A670-07B9001 1 COBE Exhibit A Provider's Outside Agency Application -Community Climate Action Grant Proposal -Agenda— 1.17.23 BOCC Board Meeting—Item 6b Docusign Envelope ID: El 96FFB6-481 D-48D1-A670-07B9001 1 COBE Exhibit B Community Climate Action Grant Program's Revised Scope of Services and Program Budget TOWN OF CHAPEL HILL Office of Sustainability and Resilience 405 Martin Luther King Jr.Blvd. Chapel Hill,NC 27514- 5705 sustainchapelhill.org (919)969-5075 MEMORANDUM To: Orange County Sustainability Program From: John Richardson, Community Resilience Officer Date: May 11, 2023 Subject: Revised Scope of Services and Program Budget— Electric Garbage Truck Pilot The scope of the project in the original Community Climate Action Grant (CCAG) application (see Exhibit A) was $74,600 to help cover the costs of purchasing and pilot-testing both an electric garbage truck and a set of electric landscaping equipment. After review, Orange County decided not to support the electric landscaping equipment pilot, and did approve funding support for the electric garbage truck pilot. The revised project budget is now $50,000 to cover "Cost match assistance for electric garbage truck and charging station," in service of pilot-testing that vehicle and charger and proactively sharing the results with local government partners in the County. Docusign Envelope ID: El 96FFB6-481 D-48D1-A670-07B9001 1 COBE Exhibit C Community Climate Action Grant Payment Schedule TOWN OF CHAPEL HILL Office of Sustainability and Resilience 405 Martin ,,. Luther King Jr.Blvd. Chapel Hill,NC 27514- 5705 sustainchapelhill.org (919)969-5075 MEMORANDUM To: Orange County Sustainability Program From: John Richardson, Community Resilience Officer Date: May 11, 2023 Subject: Alternative Payment Schedule— Electric Garbage Truck Pilot While the overall electric garbage truck pilot will take place over the course of a year, the equipment needs to be purchased to begin the project. The main grant supporting the 45% of the truck and charger purchase is a reimbursement-based grant meaning that this large amount of grant support will come at the end of the project. To reduce the impact of this large outlay of funds, the Town of Chapel Hill requests that the Orange County project funds be transferred at the beginning of the project, as follows: Quarter 1: $50,000 Quarter 2: $0 Quarter 3: $0 Quarter 4: $0 �ota I: $50,000 Docusign Envelope ID: E196FFB6-481D-48D1-A670-07B90011COBE ATTACHMENT "A" Orange County Certifications—FY 2022-2023 Community Climate Action Grant Performance Agreement Chief Contact,Administrators, Chief Executive Officer and Chief Financial Officer I certify that I have provided a list of the chief contact, administrators, chief executive officer and chief financial officer for my agency with this Agreement and that I will keep it current to the County of Orange. The list should be in writing with the name, title, residential address; phone and email address and if possible, fax number. Officers and Board of Directors I certify that I have provided a current list of the Officers and Board of Directors with this Agreement and that we will continue to update the list as changes occur. The list should be in writing, with the name, physical address, mailing address and if possible,phone, fax and email address. Budget Submission I certify that I have provided a budget for the period to be covered by funding Orange County, and that any substantive changes made to this budget have been in advance authorized in writing by Orange County. Annual Financial Review I certify that I have provided a copy of the latest annual Financial Review for our agency and the budget adopted by the agency for the fiscal years encompassing this Agreement. If not, please explain on a separate sheet of paper. Alignment with Organization's Mission I certify that the programs and services for which this funding is requested align with the mission of the organization. Intended Purpose I certify that the funds provided to the agency under the terms of this Agreement will be used for a public purpose and shall only be used for the purposes intended and any money not used for those purposes will be promptly returned to Orange County. DocuSigned by: y �&Vx �� Deputy Town Manager 5/22/2023 Certified by: FeasAss5c3F8485... Title: Date: (Provider's Signature) Climate Action Grant Program Revised 05123 Page 14 of'10 Docusign Envelope ID: El 96FFB6-481 D-48D1-A670-07B9001 1 COBE Community Climate Action Grant Program Application 2022-2023 SUBMISSION CHECKLIST Primary Applicant Organization: Town of Chapel Hill Project Name: Fleet Electrification Pilots Section Subsection Cover Page ® Applicant and Collaborator/Partner Contact Information ® Funding Request Summary ® Signed Application Cover Page Disclosure ® Signed Disclosure of Conflicts of Interest and Clause Applicant Organization and ® Applicant organization's Date of Incorporation(if applicable) Collaborator Information ® Applicant organization's Purpose/Mission(if applicable) ® Living Wage ® Schedule of Positions(if applicable) Project Information ® Project Name ® Project Description and Climate Plan Alignment ® Collaborator Information(if applicable) ® Criteria-Specific Sections 1-7 Attachments ® Applicant Organization's Annual Budget and Proposed Project Budget(Use template provided) (A description of these items is available on page 13:"Description ®Applicable Financial Records to prove eligibility: IRS Federal Form 990 or of Required Attachments."Please Applicant Organization's Tax Returns from 2021 contact us if it will not be possible to provide any of these ®Applicable Financial Records to prove eligibility of collaborator/partner(if required attachments at the time they are receiving project funds): IRS Federal Form 990 or Tax Returns from of application: 2021 aeckber2(a,oran2ecountync.2ov ® List of members of organization's Governing Board(if Board exists) ® Certificate of Insurance Page 1 of 21 Docusign Envelope ID: E196FFB6-481D-48D1-A670-07B90011COBE COVER PAGE Applicant Organization's Contact Information Organization's Legal Name: Town of Chapel Hill Physical Address: 405 Martin Luther King Jr Blvd Mailing Address: 405 Martin Luther King Jr Blvd Web Address: https://www.townofchapelhill.org/ Telephone Number: 919-968-2743 E-Mail: info@townofchapelhill.org Tax ID Number: 56-6001199 Funding Request Summary Please list all Fiscal Year 22-23 Community Climate Action Grant funding requested for the project you are proposing and the proposed use of funds(please list project name only).Applicants will be asked to provide more details on their proposed project budget in the Budget Worksheets attachment. Pr oiect Equipment Operations Personnel Total Fleet Electrification Pilots $74,600 $74,600 Briefly explain your proposed use of funds(2-4 sentences The requested funds will be used to help purchase and pilot test 1 electric garbage truck and 1 electric commercial mower with charging support equipment.These vehicles will replace older fossil fuel vehicles currently operating in the fleet.Lessons learned from operating this newly available equipment will be proactively shared with all other local governments in Orange County to help inform our shared interest in adding more electric vehicles to our fleets and better prepare all parties to take advantage of upcoming federal funding opportunities. To the best of my knowledge and belief all information and data in this application is true and current. Signature: �� 961U a, 8-19-2022 Applicant's Authorized Signatory Datc Page 2 of 21 Docusign Envelope ID: E196FFB6-481D-48D1-A670-07B90011COBE DISCLOSURE OF POTENTIAL CONFLICTS OF INTEREST AND NON- DISCRIMINATION CLAUSE Are any of the Board Members or employees of the organization which will be carrying out this project or their named project collaborators/partners or members of their immediate families,or their business associates: YES NO ® ❑ a)Employees of or closely related to employees of Orange County? ❑ ®b)Members of or closely related to members of the governing bodies of Orange County? ® ❑ c)Current beneficiaries of the program for which funds are being requested? ❑ ® d)Paid providers of goods or services to the program or having other financial interest in the program? If you have answered YES to any question or know of any other potential conflict of interest regarding your application, please provide a full explanation here: There are Town employees who are closely related to employees of Orange County,though these staff members are not working on this project directly.Town Board Members and employees who live in Chapel Hill could benefit from this project indirectly through reduced operational expenses/tax burden over time. NON-DISCRIMINATION Provider agrees as part of consideration of the granting of funds by funding agencies to the parties hereto for themselves,their agents, officials, employees and servants agree not to discriminate in any manner of these basis of race, color, gender, national origin, age, handicap, religion, sexual orientation, gender identity/expression, familial status or veterans status with reference to any activities carried out by the grantee, no matter how remote. The parties hereto further agree in all respects to conform to the provision and intent of Orange County Civil Rights Ordinance, as amended and the Orange County Anti-discrimination Policy. This provision is enforced by action for specific performance, injunctive relief, or other remedy as by law provided; this provision shall be binding on the grantees, the successors and assigns of the parties hereto with reference to the above subject manner. To the best of my knowledge and belief all of the above information is true and current. I acknowledge and understand that the existence of a potential conflict of interest does not necessarily make the program ineligible for funding, but the existence of an undisclosed conflict may result in the termination of any grant awarded. Signature: 5t"*ta� Seumlal 8-19-2022 Applicant's Authorized Signatory Date Page 3 of 21 Docusign Envelope ID: El 96FFB6-481 D-48D1-A670-07B9001 1 COBE ORANGE COUNTY NORTH CAROLINA Applicant Organization & Collaborator Information Please provide the following information about the primary applicant organization: Contact Information for Primary Contact,Chief Executive Officer/Executive Director,and Chief Financial Officer Primary Contact Name Brennan Bouma Title Sustainability Program Analyst Preferred phone number 919-969-5011 Email address bbouma@townofchapelhill.org Fax number(if applicable) Chief Executive Officer/Executive Director Name Mr. Maurice Jones Title Town Manager Preferred phone number 919-968-2743 Email address manager@townofchapelhill.org Fax number(if applicable) Chief Financial Officer Name Amy Oland Title Business Management Director/ Finance Officer Preferred phone number 919-968-2712 Email address finance@townofchapelhill.org Fax number(if applicable) P.O. Box 8181 * Hillsborough, North Carolina 27278 Telephone:919 245-2626 Docusign Envelope ID: El 96FFB6-481 D-48D1-A670-07B9001 1 COBE 1. Date of Incorporation 01/1851 (Month/Year): 2. Applicant organization's Our Mission: Learning, serving and working together—to build a Purpose/Mission (2-4 sentences): community where people thrive. 3. Please provide a brief description The Town is actively working to advance community sustainability of your organization's past and resilience. Many of these efforts are described here. Recently, achievements in carrying out the Town completed these similar projects: (1) Purchase and similar projects and evidence of operation of 3 grant-funded electric transit buses and charging successful record of meeting stations (2) installation of multiple public electric vehicle charging proposed budgets and stations, including recent upgrades at the 140 West parking deck, timetables (2-4 sentences): Town Hall and The Aquatic Center. If yes, is this organization an 4. Living Wage: Does this Orange County Living Wade organization pay permanent employees a minimum living Yes Certified Employer? Yes wage? (Yes/No) (Yes/No) If no, please briefly explain. 5. Schedule of Positions: a. Number of Full-Time Paid 762 Positons: b. Number of Part-Time Paid 7 Positions: Average hours c. Number of volunteers: Over 800 worked per Around 2 hours volunteer per month Collaborators: Please provide the following information about all significant collaborators and partners whether or not they will be receiving grant funding for this project. Feel free to copy and paste Questions "a"through"e" as needed if you have more than one significant collaborator/partner: a. Date of Incorporation N/A (Month/Year): b. Applicant organization's Purpose/Mission (2-4 sentences): Page 5 of 21 Docusign Envelope ID: El 96FFB6-481 D-48D1-A670-07B9001 1 COBE c. Please provide a brief description of your organization's past achievements in carrying out similar projects and evidence of successful record of meeting proposed budgets and timetables (2-4 sentences): If yes, is this organization an d. Living Wage: Does this Orange County organization pay permanent Living Wage employees a minimum living Certified Employer? wage? (Yes/No) (Yes/No) If no, please briefly explain. e. Schedule of Positions: a. Number of Full-Time Paid Positons: b. Number of Part-Time Paid Positions: Average hours c. Number of volunteers: worked per volunteer per month Page 6 of 21 Docusign Envelope ID: El 96FFB6-481 D-48D1-A670-07B9001 1 COBE Project Information *Please submit for each project if applying for funding for more than one project. 6. Project Name: Fleet Electrification Pilots The requested funds will be used to help purchase and pilot test 1 electric garbage truck and 1 electric commercial mower with charging support equipment.These vehicles will replace older fossil fuel vehicles currently operating in the fleet. Switching to electric vehicles would reduce GHG emissions, improve local air quality for residents, and improve the working environment for the 7. Please briefly describe the Town Staff who use these vehicles daily. Garbage trucks and commercial proposed project and the target grade lawnmowers are some of the newest vehicle classes to enter the population to benefit from the market. While early tests have shown they are capable vehicles,full pilot program. How many people will tests need to be conducted before the additional costs of these vehicles can benefit? (100-300 words) be justified. Lessons learned from operating this newly available equipment will be proactively shared with all other local governments in Orange County to help inform our shared interest in adding more electric vehicles to our fleets and better prepare all parties to take advantage of upcoming federal funding opportunities. ❑ Infrastructure/Clean Tech: New ❑ Infrastructure/Clean Tech: Repair 8. Please choose the best 0 Infrastructure/Clean Tech: Replacement description for the type of ❑ Communication/Education project: ❑ Natural Systems Management/Restoration ❑ Circular Economy/Waste reduction ❑ Analysis/Plan ❑ Other(Please describe): ❑ Energy Efficiency 9. Please choose the primary ❑ Renewable Energy climate change mitigation focus 0 Beneficial Electrification for this project (select all that apply): ❑ Carbon Sequestration ❑ Other(Please describe): 10. Has your organization or have ❑ Yes your collaborators/partners ❑ Funding used (Please describe): completed projects of this type in 0 No (This is new territory. Each new EV platform is engineered the past? If so, what funds were differently and these would be the first electric mower and electric used? garbage truck in our fleet.) Page 7 of 21 Docusign Envelope ID: El 96FFB6-481 D-48D1-A670-07B9001 1 COBE ❑ Other capital or operational funds ❑ None.This is a unique opportunity. 0 Unknown (please describe): the Town's vehicle replacement budget was eliminated and then brought back at a low level during the past 2 budget cycles due to the global pandemic.This past year we were able to purchase a single garbage truck with regular 11. If this project is not selected for funding in this round, what other funds. We also used one-time surplus funds to purchase additional funding might be used to support fleet replacement vehicles, but these are non-recurring funds. it within the next 5 years? Given that these vehicles and their charging equipment are often double the purchase price of a fossil-fueled vehicle and the limited funding available for replacing the legacy fossil-fueled fleet, our Business Management Office has told us that electric fleet vehicle purchases of this kind are unlikely with current resources. Pilot testing these vehicles should help us track actual lifecycle cost savings and make the case for future investments or federal grants. ❑ Carrboro: https://townofcarrboro.org/928/Community-Climate- Action-Plan 0 Chapel Hill: https://www.sustainchapelhiII.org/featured/2020/2/18/climate- action-and-response-plan 0 Orange County: In progress, please instead show alignment with the Orange County BOCC Goals and Priorities. This proposed project aligns with the above plan(s) in the following ways: 12. Please select the jurisdiction(s) This project's focus on improved operations and environmental where your project is focused protection through electrification, energy efficiency, decreased fuel and briefly state how your expenses, reliable infrastructure, and lower greenhouse gas project aligns with the relevant emissions are aligned with each of the following: Climate Action Plans (2-4 sentences). (1) The Town of Chapel Hill's near-term climate action goal of a 26-28% reduction in community carbon emissions by Please name the action items 2025; from each relevant plan that best (2) Our adopted goal within the Climate Action and Response align with your proposed project: Plan to electrify all light-and medium-duty fleet vehicles by 2040 and all Heavy-duty fleet vehicles by 2050. (3) The County's goal to "create, preserve, and protect a natural environment that includes clean water, clean air, wildlife, important natural lands, and sustainable energy for present and future generations" Page 8 of 21 Docusign Envelope ID: El 96FFB6-481 D-48D1-A670-07B9001 1 COBE Collaborators and Partners In some projects, collaborators and partners provide essential capacity and connections. If collaborators or partners are an essential part of your project whether or not they are receiving grant funds, please use this section to provide more details. If you are not working with collaborators or partners, please feel free to write N/A in this section and move to the Social Justice and Racial Equity section. 13. Please describe one to three key partnerships/collaborations that add the most value to the N/A success of the proposed project: Criterion 1-Social Justice and Racial Equity 14. Who will directly or More than 50% of the greenhouse gas emissions from Town operations come indirectly benefit from from the vehicle fleet,and those emissions are generated in chapel hill your project? Please be neighborhoods and parks. as specific as possible on the characteristics Garbage trucks are used daily to provide their essential service in every of those who will neighborhood across Chapel Hill.These heavy-duty vehicles drive long benefit including, distances each year and burn thousands of gallons of diesel fuel in the gender, race, age, process.Their pattern of stopping and starting during those miles,reduces income level and their efficiency and increases the wear-and-tear on the vehicle's brakes.This geographic location. driving pattern becomes an efficiency bonus when using regenerative braking in an electric vehicle.Garbage trucks also return to the depot each night, Also, what are the which can enable them to be fully recharged for the next day.These factors demographics of the make them an ideal fleet vehicle to electrify to help reduce lifetime costs and area where your neighborhood-based emissions. project takes place? Commercial zero-turn lawnmowers are critical pieces of equipment that Does your project help maintain the functionality of 1,376 acres of parkland and open space.This to address any racial space is distributed across town to bring it close to town residents(an disparities in the interactive map of the Town's parks can be found here: location it is proposed https://www.townofchapelhill.or2/Home/Components/News/News/17866/4048) for? Both of these vehicles also begin their workdays early in the morning and often operate close to residential areas.The large reduction in vehicle noise Please list any data associated with operating the electric versions of these vehicles would improve sources used and show the livability of all Chapel Hill neighborhoods as well as reducing the fumes the steps of any and noise that dozens of front-line Chapel Hill staff face each day when calculations: fueling and operating these vehicles. Based on the most recent census figures,Chapel Hill's racial demographics are as follows: 71.3%white,13.5%Asian,10.2%Black,73.2%Hispanic or Latino,and 3.8% all other categories.These proportions generally align with overall County racial demographics except for the Asian category which is 70% higher than the County's overall proportion.In part this is due to rage 9 of 21 Docusign Envelope ID: El 96FFB6-481 D-48D1-A670-07B9001 1 COBE Chapel Hill's refugee population which made up 9,600 of the roughly 61,000 Chapel Hill residents in 2019(15.8% of Chapel Hill residents were born outside of the U.S). 15. Please describe any Human services advocates working with marginalized communities across the ways in which low- Town of Chapel Hill were engaged in the creation and prioritization of income or marginalized projects in the Town's adopted Climate Action and Response Plan.Project communities/househol ideas were generated and prioritized through community workshops and a ds were engaged in the survey,and the adopted plan reflects the input of 9 advisory boards and more creation of this project than 35 public and private organizations,each representing a different set of proposal: community perspectives.This proposed project helps to implement that plan. 16. Please describe any None potential negative side effects of the project and describe the steps you are taking/will take to eliminate or minimize these impacts to any low-income or marginalized communities/househol ds: 17. Are the impacted If awarded,our plan is to share the positive impacts of this project with Town residents already residents.We are also considering vehicle decals and signage that would aware of the potential promote and educate about the positive impacts of the project. positive and negative impacts of your project and the steps you are taking? If not, please describe your plan to engage with them and how you will act based on their input: 18. During and after the Chapel Hill's Office of Sustainability and Resilience will be working with staff project, what will your from Parks and Solid Waste to track the emissions and cost reductions and continued engagement proactively communicate the ongoing performance of these vehicles on social with the community media and the sustainchapelhill.org website.Chapel Hill's sustainability staff be? will continue to partner with other local government sustainability staff directly and through our shared professional networks to share results. 19. Please describe any None other aspect of your project that is relevant to Social Justice and Racial Equity: Criterion 2- Emissions Reduced 20. How many tons of greenhouse Across the Town's 15 commercial lawnmowers the average annual gas emissions will your project use in 2021 was 157 engine hours.According the to calculations done Page I of 21 Docusign Envelope ID: El 96FFB6-481 D-48D1-A670-07B9001 1 COBE reduce/avoid each year? Please by the California Air Resources Board,"Today,operating the best- list any data sources used and selling commercial lawn mower for one hour emits as much smog- show the steps of any forming pollution as driving the best-selling 2017 passenger car,a calculations. Feel free to submit Toyota Camry,about 300 miles—approximately the distance from in a separate document if Los Angeles to Las Vegas." clearly labelled: Using the EPA Greenhouse Gases Equivalencies Calculator shows that each commercial mower the Town uses emits as much annual emissions as 4 gasoline passenger vehicles. Using a ratio from Fueleconomy.gov showing that EVs are 2—3 time more efficient at converting energy into motion,replacing one of our current gasoline-powered mowers with an electric mower should be equivalent to removing 2 cars from the road each year and save 9.3 metric tons of Carbon Dioxide(CO2)equivalent(MTCDE).Over the 7-year expected lifetime of this mower this should save on average 65.1 MTCDE. According to the EPA's Diesel Emissions Quantifier,replacing our diesel garbage truck with an all-electric garbage truck will save 33.11 metric tons of CO2 emissions per year.Over the expected 7 year working life of this truck,this will add up to 231.78 metric tons of avoided emissions. 21. For how many years will this As discussed above,the expected lifetime will be 7 years for both the emissions reduction take place new electric mower and the electric garbage truck. as a result of your project? Please consider the expected lifetime of the technology/program/impact etc. 22. Please describe the location of These are avoided vehicle emissions and so they would be burned in the emissions reduction. Where Chapel Hill. would fossil fuels have been burned if not for your project? For projects creating electricity usage reductions, it can be difficult to determine the location of the power produced. Please feel free to state "Grid-tied electricity reduction" 23. Please describe any other aspect of your project that is relevant to the amount of emissions that it will reduce or avoid. Criterion 3- Efficient use of Funds 1. Please estimate the impact of your project per grant dollar requested. Page 11 of 21 Docusign Envelope ID: El 96FFB6-481 D-48D1-A670-07B9001 1 COBE This cost per unit of impact must reflect the total program budget divided by the total impact of the project described in this application. If the proposed project is new, please write N/A in the first column of the table below, and just fill out the second column. Actual Annual Project Costs (If your proposed project Projected Project Costs expands or accelerates an ongoing effort) Total Cost of Project N/A $74,600 Unit of Impact: 296.88(total lifetime Total#of tons of greenhouse gases reduced MTCDE avoided) Cost Per Ton of GHG's Reduced $251.28 Unit of Impact: Total#of individuals served/benefitted 61,128 Cost Per Individual Served/Benefitted $1.22 Other Unit of Impact:Please describe here Cost Per Unit of Impact Other Unit of Impact:Please describe here Cost Per Unit of Impact (Please feel free to add rows if necessary to show any additional units of imp act.) 24. Please describe any avoided The total cost of the EV garbage truck and its charging equipment is financial costs or savings $470,554.To bring down the cost of this purchase,Chapel Hill has related to the project and over successfully applied for a Mobile Source Emissions Reduction Grant what period of time those costs from the NC Division of Air Quality.They have offered to provide will be avoided/reduced: 45% of the total cost($211,749). While this is a significant help,the remaining 55% of the cost is still a significant barrier at$258,805. As discussed previously,the Town's vehicle replacement funding was zeroed out over the pandemic and the small amount that is expected in the upcoming FY24 budget is uncertain. Even though this amount represent only 1/51'of the remaining cost match,the additional support of$50,000 from the County's Community Climate Action Grant would make sure that this vehicle was purchased. 25. Does your project accelerate or This would represent an important expansion of EVs into two new expand on existing programs vehicles classes in the Town's fleet. that already show positive impact? 26. Does your project also take Yes.This proposed project takes advantage of$211,749 in grant advantage of other funding funding as well as over$200,000 in the Town's annual funds. sources? Page 12 of 21 Docusign Envelope ID: El 96FFB6-481 D-48D1-A670-07B9001 1 COBE 27. Would your proposed project Yes.These 2 vehicles would be considered pilot projects which would help you to take advantage of help the Town and all other Orange County governments apply for funding from other sources millions of dollars in expected federal grant opportunities from the besides this grant in the future? Infrastructure Investment and Jobs Act and the Inflation Reduction Act. 28. Please describe any other aspect of your project that is relevant to the efficient use of grant funds: Criterion 4-Capacity of Applicant 29. Please describe any projects The Town currently operates 3 all-electric transit buses with 8 more that you have completed expected in the coming year.These were funded by several sources successfully in the past which including a federal grant,the N.C.Department of Transportation, are similar to the project you the Towns of Chapel Hill and Carrboro,UNC,and UNC's student- are proposing: run Renewable Energy Special Projects Committee. htti)s://www.dailytarheel.com/article/2022/04/city-new-electric-buses- reveal 30. If you are proposing to N/A collaborate with other organizations on this project, please briefly describe their relevant experience to the project and/or the target population: 31. Please describe any other Town sustainability staff have a combined 25 years of experience relevant expertise or capacity with alternative-fueled vehicles and grants management. to carry out the project in your application: Criterion 5- Local Economic Development 32. How many Orange County 218 residents are employed by your organization? Page 13 of 21 Docusign Envelope ID: El 96FFB6-481 D-48D1-A670-07B9001 1 COBE 33. What percent of project We will state a preference for project materials to be sourced materials will be purchased within Orange County and North Carolina, but we do not know from sources within Orange what the final percentage will be at this time. County or North Carolina? 34. Please describe any other aspect of your project that is relevant to local economic development. Criterion 6-Amount and Duration of Engagement 35. Please describe how you will Chapel Hill's Office of Sustainability and Resilience will be working engage with and/or educate with staff from Parks and Solid Waste to track the emissions and project participants. cost reductions and proactively communicate the ongoing performance of these vehicles on social media and the sustainchapelhill.org website.Chapel Hill's sustainability staff will continue to partner with other local government sustainability staff directly and through our shared professional networks to share results. We are also considering vehicle decals and signage that would promote and educate about the positive impacts of the project. 36. How will you measure the We are currently investing in open,2-way relationships with success of that engagement or communities in Chapel Hill who are most impacted by climate educational effort? change.Town communications staff already regularly pass along news,questions, and comments to the Sustainability Office.The Town also benefits from active and engaged residents who will help to provide an ongoing assessment of their experience with these EV pilots. 37. Please describe any other aspect of your project that is relevant to the amount, or quality, or length of engagement and/or education that your project will produce. Criterion 7-Time to Complete 38. How much time will your Global supply chain disruptions and the scarcity of raw materials project require to demonstrate and components have slowed the delivery of electric vehicles the positive impacts you worldwide. Should this proposal be funded,the Town will be describe? prepared to place our orders in the spring of this fiscal year with expected delivery in the winter/spring of 2024. Page 14 of 21 Docusign Envelope ID: El 96FFB6-481 D-48D1-A670-07B9001 1 COBE Submission Guidance Applications are to be submitted as email attachments to Orange County Sustainability Programs Manager,Amy Eckberg at aeckberg@orangecountync.gov. Please also CC the lead staff member supporting the Commission of the Environment, Wesley Poole at wpoole@orangecountync.gov. The Application Submittal Deadline for the Fiscal Year 22-23 round of the Community Climate Action Grant is Friday,August 19, 2022 at Spm. Please note that late, handwritten, or incomplete applications will not be accepted. Submit all documents including attachments in PDF format. This will ensure the original content and formatting is preserved. Digital signatures on applications are accepted. Accommodations for applicants with disabilities or those in need of technical assistance are available upon request. Please contact the Orange County Sustainability Programs Manager,Amy Eckberg(919- 245-2626, aeckberg@orangecountync.gov) to discuss what is needed. ATTACHMENTS Description of Required Attachments a) Applicant Organization's Budget and Project Budget Please complete the provided budget worksheets for your organization and your proposed project or submit your own budget file(as long as it contains the same information, and in a similar format,as requested in the provided worksheets. Please explain other in your budget). The Budget Worksheets file is available for download from the County website here. Please submit the budget in PDF form as well as in the original editable Excel format. b) IRS Federal Form 990 or 2020 Tax Returns A copy of the applicant organization's most recent Form 990 or IRS Tax Returns is required to determine eligibility. The specific form depends upon the applicant organization's financial activity. Review the IRS' guide, for more details. For Form 990-N (e-postcard) filers, include a copy of the postcard, with the organization's application materials. c) List of Board of Directors(if applicable) Provide the following information about each board of director's member: name, telephone number, and address, of each member and the list must identify the principal officers of the governing body, and length of term. Please feel free to use the template provided in Table 2 of the appendix or your own format. d) Certificate of Liability Insurance A copy of the applicant organization's current certificate, from the organization's insurance carrier. Table 1 below outlines insurance types and minimums required, for each jurisdiction. If exempt from Worker's Compensation compliance,include a statement explaining why,with the applicant organization's application materials. Page 15 of 21 Docusign Envelope ID: E196FFB6-481D-48D1-A670-07B90011COBE NOTE: Proof of insurance is not required at the time of application submission. If your agency is approved for funding, documentation of insurance must be provided to the jurisdiction awarding the funding when the contract is awarded. The insurance certificate should reflect the funding jurisdiction as an additional insured party and certificate holder and provide coverage for the duration of the funding period (two years, beginning as early as October 1, 2022). If proof of insurance can only be written for one year, an update will be required for all ongoing projects. Renewal certificates must be sent to the jurisdiction 30 days prior to any expiration date, cancellation or modification of any stipulated insurance coverage. NOTE: Upon request, insurance requirements may be reviewed on a case by case basis by the County. Please contact the staff identified on the Submission Requirements on Page 15 if you have questions or would like to request a review of your insurance requirements. APPENDIX Table 1. Forms of Liability Insurance and Minimum Policy Amounts Required INSURANCE ORANGE COUNTY3 300&� Worker's Compensation' Limits for Coverage A-Statutory State NC,for each employee Limits for Coverage B-Employers Liability of. $500,000 each accident,$500,000 Bodily Injury by Disease(BID).for each employee $500,000 for BID limit Commercial General $1 million Each Occurrence Liability $2 million Aggregate Automobile Liability $1 million Each Occurrence Professional Liability $1 million Each Occurrence $2 million Aggregate Sexual Abuse& $1 million Each Occurrence Molestation $2 million Aggregate Cyber Liability $1 million Each Occurrence $2 million Aggregate Environmental/Pollution Liability (Required if demolition,use $1 million Each Occurrence of hazardous material or environmental) sensitive ■ Visit the NC Industrial Commission's website for more information regarding Coverage A. Also, note that if an agency uses subcontractors, it must require subcontractors to have workmen's compensation insurance. ■ Please visit Orange County's Risk Management page for more information about the County's Minimum Insurance Requirements. Page 16 of 21 Docusign Envelope ID: El 96FFB6-481 D-48D1-A670-07B9001 1 COBE Table 2 - Contact Information for Board of Directors and Officers of the Board Name Physical Mailing Fax number(if (also title and term Phone number Email address length if Officer) Address Address applicable) [See link in attachment C] ATTACHMENTS Page 17 of 21 Docusign Envelope ID: E196FFB6-481D-48D1-A670-07B90011COBE A. ) Applicant Organization's Budget and Project Budget Enclosed on following page. The Town's budget can also be viewed here: https://www.townofchapelhill.org/government/departments-services/business- management/budget/2022-2023-budget-development/2022-2023- recommended-budget Page 18 of 21 Docusign Envelope ID: El 96FFB6-481 D-48D1-A670-07B9001 1 COBE Applicant Organization's Budget (Most recent complete calendar year or fiscal year) Starting date: July 1, 2021 IlEnding Date: June 30, 2022 ORGANIZATION NAME: Town of Chapel Hill Actual Total for Estimated Total Projected Total for Percent ORGANIZATION REVENUE Previous Year for Current Year Next Year Change Private Donations $ - $ - $ - 0 Generated Revenue(fees,sales,etc) $ 65,502,241 $ 68,717,055 $ 74,031,555 8% Local Government Grants (Please list separately): $ - $ - $ - 0 $ - $ - $ - 0 $ - $ - $ - 0 Other Government Grants Triangle United Way $ - $ - $ - 0 State Government $ - $ - $ - 0 Federal Government(CDBG/HOME/etc.) $ 950,914.00 $ 681,997.00 $ 681,997.00 $ - Private Foundation Grants $ - $ - $ - 0 Other Revenue:please briefly explain here $ - $ - $ - 0 Total Organization Revenue $ 66,453,155 $ 69,399,052 $ 74,713,552 8% AGENCY EXPENSES Compensation $ 50,281,000 $ 51,543,000 $ 52,897,000 3% Rent&Utilities $ 1,547,341 $ 1,558,288 $ 1,544,976 -1% Supplies&Equipment $ - $ - $ - 0 Travel&Training $ - $ - $ - 0 Other Expenses: all other Operating costs $ 14,459,659 $ 17,918,712 $ 21,154,024 18% Total Agency Expenses $ 66,288,000 $ 71,020,000 $ 75,596,000 6% SURPLUS/(DEFICIT) FOR PERIOD: 1 $ 165,155 $ (1,620,948) $ (882,448) 46% FY 2018-19 Agency Budget Docusign Envelope ID: El 96FFB6-481 D-48D1-A670-07B9001 1 COBE Proposed Project Budget PROJECT NAME: Fleet Electrification Pilots Use only if project is ongoing Use for all projects Actual Total Estimated for Total for Projected Total Percent PROJECT REVENUE Previous Year Current Year for Next Year Change Private Donations $ - $ - $ - 0 Project Generated Revenue: $ - $ - $ - 0 Local Government Grants (Please list separately): Orange County Community Climate Action Grant $ - $ - $ - 0 $ - $ - $ - 0 $ - $ - $ - 0 $ - $ - $ - 0 Other Government Grants Triangle United Way $ - $ - $ - 0 State Government $ - $ - $ - 0 Federal Government(CDBG/HOME/etc.) $ - $ - $ - 0 Private Foundation Grants $ - $ - $ - 0 Other Revenue:please briefly explain here $ - $ - $ - 0 Total Project Revenue $ - $ - $ - i PROJECT EXPENSES Compensation $ - $ - $ - 0 Rent&Utilities $ - $ - $ - 0 Supplies&Equipment $ - $ - $ - 0 Greenworks 60"COMMERCIAL ZERO TURN MOWER $ 21,000 100% Electrical upgrades for mower charging 1 $ 3,000 100% Portable battery charger for handheld equipment T $ 600 100% Cost match assistance for electric garbage truck and charging station $ 50,000 100% Travel&Training $ - $ - $ - 0 Other Expenses:please briefly explain here $ - $ - $ - 0 Total Project Expenses $ - $ - $ 74,600 0 SURPLUS/(DEFICIT) FOR PERIOD: $ - I $ - 1 $ (74,600)1 0 FY 2018-19 Program Budget Docusign Envelope ID: El 96FFB6-481 D-48D1-A670-07B9001 1 COBE B. ) Applicable Financial Records to prove eligibility: The Town is exempt from filing a 990. See guidance from IRS below: https://www.irs.gov/charities-non-profits/annual-exempt-organizationreturn- who-must-file. Every organization exempt from federal income tax under Internal Revenue Code section 501(a) must file an annual information return except: 1.A church,an interchurch organization of local units of a church,a convention or association of churches 2.An integrated auxiliary of a church 3.A church-affiliated organization that is exclusively engaged in managing funds or maintaining retirement programs 4.A school below college level affiliated with a church or operated by a religious order 5.Church-affiliated mission societies if more than half of their activities are conducted in,or are directed at persons in,foreign countries 6.An exclusively religious activity of any religious order 7.A state institution,the income of which is excluded from gross income under section 115, 8.A corporation described in Section 501(c)(1)that is organized under an Act of Congress,an instrumentality of the United States and is exempt from federal income taxes 9.A stock bonus,pension or profit-sharing trust that qualifies under Section 401(required to file Form 5500, Annual Return/Report of Employee Benefit Plan) 10.A religious or apostolic organization described in Section 501(d)(required to file Form 1065,U.S. Return of Partnership Income) 11.A governmental unit or an affiliate of a governmental unit that meets the requirements of Revenue Procedure 95-48 PDF,1995-2 C.B.418 12.A private foundation described in Section 501(c)(3)and exempt under Section 501(a)(required to file Form 990-PF,Return of Private Foundation) 13.A political organization that is a state or local committee of a political party,a political committee of a state or local candidate,a caucus or association of state or local officials,or required to report under the Federal Election Campaign Act of 1971 as a political committee 14.An exempt organization(other than a private foundation)that normally has annual gross receipts of $50,000 or less and therefore is eligible to file an annual electronic notice Form 990-N instead of an annual information return)* 15.A foreign organization,or an organization located in a U.S.possession,that normally has annual gross receipts from sources within the United States of$50,000 or less and therefore is eligible to file an annual electronic notice(Form 990-N instead of an annual information return) Page 19 of 21 Docusign Envelope ID: E196FFB6-481D-48D1-A670-07B90011COBE C. ) List of members of organization's Governing Board ( if Board exists) A full listing of the Mayor and Council members can be viewed here: https://www.townofchapelhill.org/government/mayor-and-council Page 20 of 21 Docusign Envelope ID: El 96FFB6-481 D-48D1-A670-07B9001 1 COBE D. ) Certificate of Insurance If awarded, the Town is prepared to provide proof of insurance in the form requested. Page 21 of 21 Docusign Envelope ID: E196FFB6-481D-48D1-A670-07B90011COBE ORANGE COUNTY BOARD OF COMMISSIONERS ACTION AGENDA ITEM ABSTRACT Meeting Date: January 17, 2023 Action Agenda Item No. 6-b SUBJECT: Community Climate Action Grant (CCAG) — FY 2022-23 Project Selection for General Applicants and Schools DEPARTMENT: Asset Management Services ATTACHMENT(S): INFORMATION CONTACT: 1) CCAG 2022-23 Project Descriptions, Amy Eckberg, (919) 245-2626 Scoring, and Comments for General Steven Arndt, (919) 245-2658 Applicants and Schools PURPOSE: To: 1) Receive the grant project funding recommendations from the Commission for the Environment (CFE) and the Human Relations Commission (HRC) for the FY 2022-23 Orange County Community Climate Action Grant Program; and 2) Approve funding for the recommended Community Climate Action Grant projects for FY 2022-23 as outlined in the attached report. BACKGROUND: As part of the FY 2019-20 budget, the Board of Orange County Commissioners (BOCC) created the Orange County Climate Action Fund dedicated to accelerating climate change mitigation actions in Orange County. This decision was motivated in part to help the County meet the climate change mitigation goals set by the Board in recent years: • Reduce greenhouse gas emissions community-wide by 26 percent by 2025 (from 2005 levels). • Transition to a 100% renewable energy based economy by 2050. For the 2022-23 funding cycle, $550,150 in funding was budgeted to support climate action projects that will benefit Orange County residents both socially and financially. Following the direction of the Board of Orange County Commissioners (BOCC), the process for soliciting and selecting projects to receive funding was conducted through a formal Community Climate Action Grant (CCAG) program. For this grant cycle, the BOCC reserved half of the total funding for this grant program ($275,075) to be awarded to projects submitted by either of Orange County's two public school districts. The remaining half ($275,075) was to be made available to all other eligible general applicants in this round. The Community Climate Action grant program received seven (7) applications in this round from a variety of general applicants representing non-profit and public organizations whose total requests add up to $585,873. No private sector applications were received. One (1) project, totaling $368,000 was submitted from the Chapel Hill Carrboro City School district. Docusign Envelope ID: El 96FFB6-481 D-48D1-A670-07B9001 1 COBE Grant applications were completed over the summer and reviewed and scored by the Commission for the Environment (CFE) and the Human Relations Commission (HRC). In fall 2022, each of these Commissions voted to forward their final scoring and comments to the BOCC. The following is a rank-order summary table of the combined project scoring and recommendations. More details on each project are available in Attachment 1: Total Rank* Funding Recommended Score (Out of 7 Project Applicant Requested Funding Level Running total Out of applica_ 26 is tions General Applicants: Habitat Rooftop Habitat for $112,000 $100,000 $100,000 24.2 1 Solar Humanity Rebuilding Weatherization Together of $150,000 $25,000 $125,000 23 2 the Triangle Food Waste Eno River Farmers $4,500 $4,500 $129,500 21.8 3 Monitors Market 203 Solar Project Town of $89,243 $40,575 $170,075 17.1 4 Carrboro Fleet Electrification Town of Pilot Chapel Hill $74,600 $50,000 $220,075 17 5 Solar Roof The $134,664 $55,000 $275,075 15.8 6 ArtsCenter Refillable Water The $20,866 $0 $275,075 10.9 7 Bottle Station ArtsCenter Total Requested by General $275,075 Applicants: $585,873 $275,075 (Funds available: ($275,075) School Applicants: Emission Reductions Chapel Hill Through HVAC Carrboro City $368,000 $275,075 Replacements Schools $275,075 19 1 Total Requested by Schools $368,000 (Funds available: $275,075) * All projects were placed in rank order by CFE and HRC voting. Docusign Envelope ID: E196FFB6-481D-48D1-A670-07B90011COBE FINANCIAL IMPACT: The Community Climate Action Grant Tax funding of $550,150 in FY 2022-23 intends to identify impactful projects and distribute these funds promptly to accelerate action on the urgent issue of climate change and to help further stimulate the local economy. SOCIAL JUSTICE IMPACT: The following Orange County Social Justice Goals are applicable to this item: • GOAL: ENSURE ECONOMIC SELF-SUFFICIENCY The creation and preservation of infrastructure, policies, programs and funding necessary for residents to provide shelter, food, clothing and medical care for themselves and their dependents. Social Justice and Racial Equity is the most heavily-weighted factor in scoring projects proposed through this grant program, ensuring that the equitable distribution of funds and the repair of environmental inequities are a central element of each funded project. Local investments in energy efficiency and renewable energy in Orange County provides direct reduction of monthly energy bills and supports jobs and investments in clean energy technologies. • GOAL: ESTABLISH SUSTAINABLE AND EQUITABLE LAND-USE AND ENVIRONMENTAL POLICIES The fair treatment and meaningful involvement of people of all races, cultures, incomes and educational levels with respect to the development and enforcement of environmental laws, regulations, policies, and decisions. Fair treatment means that no group of people should bear a disproportionate share of the negative environmental consequences resulting from industrial, governmental and commercial operations or policies. Reducing energy usage from the electric grid improves air quality impacts. Improving local air quality helps to protect the health of vulnerable populations in Orange County whose health is disproportionately affected by ground-level ozone and other emissions. ENVIRONMENTAL IMPACT: The following Orange County Environmental Responsibility Goal impacts are applicable to this item: • ENERGY EFFICIENCY AND WASTE REDUCTION Initiate policies and programs that: 1) conserve energy; 2) reduce resource consumption; 3) increase the use of recycled and renewable resources; and 4) minimize waste stream impacts on the environment. Investing in local climate change mitigation actions will conserve energy, reduce resource consumption, and increase the use of renewable resources. • RESULTANT IMPACT ON NATURAL RESOURCES AND AIR QUALITY Assess and where possible mitigate adverse impacts created to the natural resources of the site and adjoining area. Minimize production of greenhouse gases. The Climate Action Fund will continue to support high-impact projects which will improve local air quality and minimize the local production of greenhouse gases, reducing Orange County's contribution to the adverse impacts of climate change on human and natural resources both inside and outside of the County. RECOMMENDATION(S): The Manager recommends that the Board Docusign Envelope ID: El 96FFB6-481 D-48D1-A670-07B9001 1 COBE 1) Receive the grant project funding recommendations from the Human Relations Commission and the Commission for the Environment for the FY 2022-23 Orange County Community Climate Action Grant Program; and 2) Approve funding for the recommended Community Climate Action Grant projects for FY 2022-23. Docusign Envelope ID: El 96FFB6-481 D-48D1-A670-07B9001 1 COBE DATE(MM/DD/YYYY) A�" CERTIFICATE OF LIABILITY INSURANCE 05/05/2023 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). PRODUCER CONTACT Lori Hiatt,CIC,CSRM,Account Manager NAME: Surry Insurance PHONE (336)386-8228 FAX (336)386-4661 A/C No Ext: A/C,No): P.O.Box 128 E-MAIL lori.hiatt@surryinsurance.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Dobson NC 27017-0128 INSURERA: The Charter Oak Fire Insurance Company 25615 INSURED INSURER B: Town of Chapel Hill INSURER C: 405 Martin Luther King Jr.Blvd INSURER D: INSURER E: Chapel Hill NC 27514-5705 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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. INSR ADDLSUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RETED CLAIMS-MADE 19 OCCUR PREMISES Ea occurrence) $ 1,000,000 MED EXP(Any one person) $ ALl ZLP-41M7991A 07/01/2022 07/01/2023 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY F-1 PRO El LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident ANY AUTO BODILY INJURY(Per person) $ A OWNED SCHEDULED 810-5J243370 07/01/2022 07/01/2023 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ 10,000 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Certificate holder is an additional insured on the General Liability policy and the Auto policy with respect to the Climate Action Grant for an EV Garbage Truck. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Orange County ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 8181 AUTHORIZED REPRESENTATIVE Hillsborough NC 27278 'W ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Docusign Envelope ID: El 96FFB6-481 D-48D1-A670-07B9001 1 COBE DATE(MM/DD/YYYY) A�" CERTIFICATE OF LIABILITY INSURANCE 05/21/2025 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). PRODUCER CONTACT Lori Hiatt,CIC,CSRM,Account Manager NAME: Surry Insurance PHONE (336)386-8228 FAX (336)386-4661 A/C No Ext: A/C,No): P.O.Box 128 E-MAIL lori.hiatt@surryinsurance.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Dobson NC 27017-0128 INSURERA: The Charter Oak Fire Insurance Company 25615 INSURED INSURER B: The Travelers Indemnity Company 25658 Town of Chapel Hill INSURER C: 405 Martin Luther King Jr.Blvd INSURER D: INSURER E: Chapel Hill NC 27514-5705 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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. INSR TYPE OF INSURANCEADDLSUBR POLICY EFF POLICY EXP LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO CLAIMS-MADE � OCCUR FIR SES Ea oNcur RENTED $ 1,000,000 MED EXP(Any one person) $ A ZLP-41M7991A 07/01/2024 07/01/2025 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY ❑ PRO ElLOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED 810-5J243370 07/01/2024 07/01/2025 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 10,000,000 A EXCESS LIAB CLAIMS-MADE ZUP-41M79921 07/01/2024 07/01/2025 AGGREGATE $ 10,000,000 DED I X1 RETENTION $ 10,000 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ Each Occurrence Aggregate 3,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Certificate holder is an additional insured on the General Liability per attached form CGD4800219-Xtend Endorsement for Public Entities if required by written contract or agreement CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Orange County ACCORDANCE WITH THE POLICY PROVISIONS. 300 West Tryon Street AUTHORIZED REPRESENTATIVE PO Box 8181 1 Hillsborough NC 27278 LarI l H ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Docusign Envelope ID: El 96FFB6-481 D-48D1-A670-07B9001 1 COBE COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. XTEND ENDORSEMENT FOR PUBLIC ENTITIES C This endorsement modifies insurance provided under the following: y COMMERCIAL GENERAL LIABILITY COVERAGE PART ti GENERAL DESCRIPTION OF COVERAGE — This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be p excluded or limited by another endorsement to this Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general coverage description only. Read all the provisions of this endorsement and the rest of your policy C carefully to determine rights, duties, and what is and is not covered. • A. Owned Watercraft—25 Feet Long Or Less F. Blanket Additional Insured — Persons Or B. Who Is An Insured — Public Entities, Elected Or Organizations For Your Ongoing Operations As Appointed Officials, And Members Of Your Required By Written Contract Or Agreement Boards G. Knowledge And Notice Of Occurrence Or C. Who Is An Insured — Employees And Volunteer Offense Workers •N H. Blanket Waiver Of Subrogation p D. Who Is An Insured — Owners, Managers Or Lessors Of Premises I. Contractual Liability—Railroads C E. Who Is An Insured — Lessors Of Leased J. Damage To Premises Rented To You Equipment PROVISIONS B. WHO IS AN INSURED — PUBLIC ENTITIES, ELECTED OR APPOINTED OFFICIALS, AND w A. OWNED WATERCRAFT — 25 FEET LONG OR LESS MEMBERS OF YOUR BOARDS 1. The following is added to Paragraph 1. of 1. The following is added to Exclusion g., SECTION II —WHO IS AN INSURED Aircraft, Auto Or Watercraft, in Paragraph 2. of SECTION I — COVERAGES — If you are designated in the Declarations as COVERAGE A — BODILY INJURY AND a public entity, you are an insured. Your C PROPERTY DAMAGE LIABILITY lawfully elected or appointed officials, A This exclusion does not apply to a watercraft "executive officers" or directors are also you own that is: insureds, but only with respect to their duties as your elected or appointed officials, (a) 25 feet long or less; and "executive officers" or directors. Members of (b) Not being used to carry any person or "your boards" are also insureds, but only with property for a charge. respect to their duties for you or "your 2. The following is added to Paragraph 2. of boards". However, none of these officials, SECTION II—WHO IS AN INSURED "executive officers", directors or members are insureds for: Any person or organization that, with your a. "Bodily injury" or"personal injury": express or implied consent, either uses or is responsible for the use of a watercraft that (1) To you or to any of your"employees" you own that is: while in the course of his or her (1) 25 feet long or less; and employment or performing duties related to the conduct of your (2) Not being used to carry any person or business or to any of your"volunteer property for a charge. workers" while performing duties CG D4 80 02 19 ©2017 The Travelers Indemnity Company.All rights reserved. Page 1 of 4 Includes copyrighted material of Insurance Services Office, Inc.with its permission. Docusign Envelope ID: El 96FFB6-481 D-48D1-A670-07B9001 1 COBE COMMERCIAL GENERAL LIABILITY related to the conduct of your acting within the scope of their duties for business; you. Any such members of"your boards" (2) To the spouse, child, parent, brother providing or failing to provide first aid or or sister of that "employee" or "Good Samaritan services" during their "volunteer worker' as a work hours for "your boards" will be ^a consequence of Paragraph a.(1) deemed to be acting within the scope of above; their duties for you or"your boards". o b. "Property damage" to property: (3) To any fellow elected or appointed official, "executive officer" or director, (1) Owned, occupied or used by; v or fellow member of"your boards"; (2) Rented to, in the care, custody or C (4) To the spouse, child, parent, brother control of, or over which physical or sister of that fellow official, control is being exercised for any "executive officer', director or purpose by; C member as a consequence of you, any of your "employees" or Paragraph a.(3) above; or "volunteer workers", or that official, (5) For which there is any obligation to "executive officer", director or member. share damages with or repay Any of your lawfully elected or appointed someone else who must pay officials, "executive officers", directors or tidamages because of the injury members of "your boards" appointed at your described in Paragraphs a.(1) (2), request to serve with an outside tax-exempt (3) or(4) above. entity will be deemed to be acting within the CUnless you are in the business or scope of their duties for you. occupation of providing "professional 2. The following replaces the first sentence of health care services", Paragraphs a.(1) Paragraph 1.d. of SECTION II —WHO IS AN o (2), (3), (4) and (5) above do not apply to INSURED "bodily injury" arising out of providing or failing to provide: An organization other than a public entity, o partnership, joint venture or limited liability (1) First aid by any of your elected or company, you are an insured. •� appointed officials, "executive officers" or directors, or any 3. The following is added to the DEFINITIONS members of "your boards", other Section: than a doctor, nurse, nursing "Indian tribe" means a tribe, band, pueblo, assistant, physician assistant, dental village or community of American Indians, or C hygienist or assistant, optometrist, Alaska Natives, that has been recognized as emergency medical technician, an Indian tribe by the government of: p paramedic, coroner, physical therapist A or physical therapy assistant, a. The United States of America; or speech-language pathologist or b. Any state in the United States of speech therapy assistant, occupational America. therapist or occupational therapy "Joint powers authority" means any assistant, psychologist, counselor, organization formed by two or more public therapist, social worker or other entities, or by a public entity and one or more health care professional; or "Indian tribes", that have agreed in a contract (2) "Good Samaritan services" by any of or agreement to jointly exercise any power your elected or appointed officials, common to them. "executive officers" or directors, or any members of"your boards", other "Your boards": than a doctor or nurse. a. Means any board, commission, or other Any such elected or appointed officials, governmental unit or department that: "executive officers" or directors providing (1) Is under your jurisdiction; and or failing to provide first aid or "Good (2) Is funded and operated as part of Samaritan services" during their work hours for you will be deemed to be your total operating budget. Page 2 of 4 O 2017 The Travelers Indemnity Company. All rights reserved. CG D4 80 02 19 Includes copyrighted material of Insurance Services Office, Inc.with its permission. Docusign Envelope ID: El96FFB6-481D-48D1-A670-07B90011COBE COMMERCIAL GENERAL LIABILITY b. Does not include any "joint powers E. WHO IS AN INSURED — LESSORS OF authority". LEASED EQUIPMENT C. WHO IS AN INSURED — EMPLOYEES AND The following replaces Paragraph 5. of VOLUNTEER WORKERS SECTION II —WHO IS AN INSURED: �a 1. The following replaces the first sentence of 5. Any person or organization that is an Paragraph 2.a. of SECTION II —WHO IS AN equipment lessor is an insured, but only with o INSURED: respect to liability for"bodily injury", "property 4� Your "volunteer workers" only while damage" or "personal and advertising injury" performing duties related to the conduct of caused, in whole or in part, by your acts or your business, or your "employees", other omissions in the maintenance, operation or .o than either your "executive officers" (if you use by you of equipment leased to you by are an organization other than a public entity, such equipment lessor. partnership, joint venture, or limited liability The insurance provided to such equipment o company) or your managers (if you are a lessor does not apply to any"bodily injury" or .� limited liability company), but only for acts y within the scope of their employment by you "property damage" that occurs, or "personal or while performing duties related to the and advertising injury" caused by an offense conduct of your business. that is committed, after the equipment lease expires. ti 2. The following is added to Paragraph 2.a. of SECTION II—WHO IS AN INSURED F. BLANKET ADDITIONAL INSURED — �' PERSONS OR ORGANIZATIONS FOR YOUR Any of your "employees" appointed at your ONGOING OPERATIONS AS REQUIRED BY request to serve with an outside tax-exempt WRITTEN CONTRACT OR AGREEMENT entity will be deemed to be acting within the p scope of their employment by you or The following is added to SECTION II —WHO IS performing duties related to the conduct of AN INSURED: y your business. Any person or organization that is not otherwise D. WHO IS AN INSURED — OWNERS, an insured under this Coverage Part and that MANAGERS OR LESSORS OF PREMISES you have agreed in a written contract or The following replaces Paragraph 4. of agreement to include as an additional insured on SECTION II—WHO IS AN INSURED this Coverage Part is an insured, but only with respect to liability for "bodily injury", "property � 4. Any person or organization that is a damage", or "personal and advertising injury" c premises owner, manager or lessor is an that: insured, but only with respect to liability for p "bodily injury", "property damage" or a. Is "bodily injury" or "property damage" that A "personal and advertising injury" that arises occurs, or is "personal and advertising injury" out of the ownership, maintenance or use of caused by an offense that is committed, that part of any premises leased or loaned to subsequent to the signing of that contract or you. agreement; and The insurance provided to such premises b. Is caused, in whole or in part, by your acts or owner, manager or lessor does not apply to: omissions in the performance of your a. Any "bodily injury" or "property damage" ongoing operations to which that contract or that occurs, or "personal and advertising agreement applies or the acts or omissions injury" caused by an offense that is of any person or organization performing committed, after you cease to be a such operations on your behalf. tenant in or to borrow that premises; or The limits of insurance provided to such insured b. Structural alterations, new construction will be the minimum limits that you agreed to or demolition operations performed by or provide in the written contract or agreement, or on behalf of such premises owner, the limits shown in the Declarations, whichever manager or lessor. are less. CG D4 80 02 19 ©2017 The Travelers Indemnity Company. All rights reserved. Page 3 of 4 Includes copyrighted material of Insurance Services Office, Inc.with its permission. Docusign Envelope ID: El96FFB6-481D-48D1-A670-07B90011COBE COMMERCIAL GENERAL LIABILITY G. KNOWLEDGE AND NOTICE OF (b) Any employee authorized by such OCCURRENCE OR OFFENSE partnership, joint venture, limited liability The following replaces Paragraphs 2.e.(1) and company, trust or other organization to 2.e.(2) of SECTION IV — COMMERCIAL give notice of an "occurrence" or GENERAL LIABILITY CONDITIONS: offense. (1) Notice to us of such "occurrence" or offense H. BLANKET WAIVER OF SUBROGATION C must be given as soon as practicable only The following is added to Paragraph $. Transfer after the "occurrence" or offense is known to Of Rights Of Recovery Against Others To Us you (if you are an individual), any of your of SECTION IV — COMMERCIAL GENERAL lawfully elected or appointed officials, LIABILITY CONDITIONS C "executive officers" or directors (if you are a If the insured has agreed in a contract or public entity), any of your partners or agreement to waive that insured's right of members who is an individual (if you are a recovery against any person or organization, we partnership or joint venture), any of your waive our right of recovery against such person managers who is an individual (if you are a or organization, but only for payments we make limited liability company), any of your because of: "executive officers" or directors (if you are an a. "Bodily injury" or "property damage" that organization other than a public entity, occurs; or partnership, joint venture or limited liability b. "Personal and advertising injury" caused by company), any of your trustees who is an an offense that is committed; individual (if you are a trust) or any "employee" authorized by you to give notice subsequent to the execution of the contract or C of an "occurrence" or offense. agreement. (2) If you are a partnership, joint venture, limited I. CONTRACTUAL LIABILITY—RAILROADS o liability company or trust, and none of your 1. The following replaces Paragraph c. of the partners, joint venture members, managers definition of "insured contract" in the C or trustees are individuals, notice to us of DEFINITIONS Section: such "occurrence" or offense must be given c. Any easement or license agreement; •N as soon as practicable only after the "occurrence" or offense is known by: 2. Paragraph f.(1) of the definition of "insured contract" in the DEFINITIONS Section is (a) Any individual who is: deleted. (i) A lawfully elected or appointed J. DAMAGE TO PREMISES RENTED TO YOU official, executive officer or director p of any public entity; The following replaces the definition of"premises damage" in the DEFINITIONS Section: C (ii) A partner or member of any A partnership or joint venture; "Premises damage" means "property damage" to: (iii) A manager of any limited liability company; a. Any premises while rented to you or (iv) An executive officer or director of temporarily occupied by you with permission of the owner; or any other organization; or b. The contents of any premises while such (v) A trustee of any trust; premises is rented to you, if you rent such that is your partner, joint venture premises for a period of seven or fewer member, manager or trustee; or consecutive days. Page 4 of 4 ©2017 The Travelers Indemnity Company. All rights reserved. CG D4 80 02 19 Includes copyrighted material of Insurance Services Office, Inc.with its permission.