2022-059-E-Health-Club Nova Community-Outside Agency & MOE

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Orange County Outside Agency ARPA Fund and Managed Care Fund Performance Agreement Revised 9/2021 OUTSIDE AGENCY FUNDS AND MANAGED CARE FUNDS PERFORMANCE AGREEMENT THIS AGREEMENT, made and entered into the first day of July 2021, (“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 Club Nova Community, Inc., a not-for-profit corporation, located at 103-D West Main Street, Carrboro, North Carolina 27510 (“Provider”). WITNESSETH: WHEREAS, it is in the interests of the County that said program be assisted by the County and thereby enhance its availability to residents of the County, and said program addresses an important community human services need, as identified by the Board of Commissioners. NOW, THEREFORE, in consideration of the above and the mutual covenants and conditions hereafter set forth, the County and Provider agree as follows: 1. Term of the Agreement. The term of this Agreement shall be a program year beginning July 1, 2021 to June 30, 2022. 2. Scope of Services. a. Provider will provide services to the residents of Orange County, as outlined in the attached Outside Agency Funding Application and Managed Care (Maintenance of Effort) Funds Scope of Work which are attached as Exhibit “A” and “B” respectively, and herein incorporated by reference. The Scope of Services and the Program Budget may be different from the original Outside Agency Funding Application based on County appropriation. Revisions or amendments to the Agreement must be in writing, approved by the County, and attached to this Agreement. 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. Outside Agency Funding. i. Outside Agency Funding. The County agrees to appropriate funds for the provision of services as described in Exhibit C, Outside Agency Scope of Services and may be more particularly described in the Revised Program Budget in Exhibit C, the maximum sum of $25,000 in Outside Agency Funds. ii. The Provider shall be paid Outside Agency Funds in four equal installments in the amount of $6,250. The first payment is contingent upon receipt of the agency’s performance agreement; the remaining payments are contingent upon receipt of the request for reimbursement and related supporting documentation. b. Managed Care Funding. i. Managed Care Funding. The County agrees to appropriate funds for the Services DocuSign Envelope ID: 11DA72B8-CC83-439E-A25C-F64DE607C614