CORPORATED Bo The Regular Meeting will be held electronically using Zoom. Directions for logging in are below. The public can participate in the meeting using one of the below methods: 1. Join the meeting through Zoom on your computer or cellphone. Simply click on the following link or type it into your internet browser: ttps//us02webzo0m.S//819064720597Pwd-SIAKENSTRUROSCUE20HPQUERZZ09 You may also find the clickable link on the Town's website wwwsharpspurgnccom Meeting ID: 819 0647 2059 Password: 738442 Ifyou have not used Zoom before, you are encouraged to download the application from their website at Zoom.us and try it out prior to the meeting. There is no cost associated with the software or attending the meeting. 2. Join the meeting through audio only via telephone. Simply call: - 205 6099 US When prompted, enter meeting ID: 819 0647 2059 followed by the Pound sign (#). When prompted, enter the password. Password: 738442 Town of Sharpsburg, North Carolina Board A of Commissioners "Tri-County Hospitality' MAYOR AND BOARD OF COMMISSIONERS MAYOR ROBERT WILLIAMS LINDA VIRGIL RANDALL COLLIE DON PATEL DAVID PRIDE BEVERLY DAVIS ADMINISTRATION STEVIE COX, TOWN ADMINISTRATOR TRACY SULLIVAN, TOWN CLERK MARGE WIECEK, FINANCE OFFICER BRIAN SULLIVAN, PUBLIC WORKS DIRECTOR BRIAN PRIDGEN, TOWN ATTORNEY January 5, 2021 6:00PM 2 Town of Sharpsburg, North Carolina a Board of Commissioners AGENDA I. CALL TO ORDER II. ROLL CALL III. INVOCATION IV. PLEDGE OF ALLEGIANCE Mayor Williams will lead the Commissioners and those in attendance in reciting the Pledge of Allegiance to the Flag. "I pledge allegiance to the Hlag of the United States of America, and to the Republic for which it stands, one nation under God, indivisible, with liberty and justice for all." V. CONSENT AGENDA & REGULAR AGENDA (Make one motion to approve the consent and regular agenda which will approve all items listed below) The Board may by majority vote add items to or subtract items from both the proposed consent and regular agenda. As of this writing, the Administrator understands that the presented consent agenda items are routine and therefore concurs with adopting the presented consent agenda. 1. Approval of: a. November 10, 2020 Regular Meeting Minutes b. 2021 Holiday Schedule C. 2021 Regular Meeting Schedule of the Board of Commissioners VI. PETITIONS AND COMMUNICATIONS Citizens were advised to provide written comments to the Town Clerk prior to 5pm on December 31, 2020. 3 Town of Sharpsburg, North Carolina Board of Commissioners 0 The Town Clerk shall read any comments submitted at this time. All comments shall be limited to three (3) minutes and the Board reserves the right not to act on requests first presented this evening. VII. NEW BUSINESS a. Consideration by the Board to approve and award the Town Council Chamber Renovation Contract. b. Consideration by the Board to approve the Title VI Policy and Procedures and related documents. C. Approval of the Town Pandemic Policy: The Town Administrator is requesting that the Town Council consider approval of a Town Pandemic Policy for Town Employees. VIII. ADJOURNMENT SPECIAL NOTICE: Anyone who needs an interpreter or special accommodations to participate in the meeting should notify the Town Clerk, Tracy Sullivan at 252-446-9441 ext.221 at least forty-eight (48) hours priur Lu Lhe neeling. (Americans wilh Disabilities. Act (ADA) 1991.) "The Town of Sharpsburg is an equal opportunity provider and employer." To file a complaint of discrimination, write to: USDA, Assistant Secretary for Civil Rights, Office of the Assistant Secretary for Civil Rights 1400 Independence Avenue, S.W. Stop 9410, Washington, DC 20250-9410 or call 800)795-3272 (voice) or (202)720- 6382. 4 RP ORATED) & MINUTES OF THE REGULAR MIEETING OF THE SHARPSBURG BOARD OF COMMISSIONERS HELD ELECTRONICALEY VIA ZOOM November 10, 2020 6:00 PM Mayor Williams called the meeting to order at 6:03p.m. Mayor Williams offered the invocation and led those present in the Pledge of Allegiance. Tracy Sullivan, Town Clerk called the roll. BOARD MEMBERS PRESENT VIA SIMULTANEOUS COMMUNICIATION (ZOOM) Mayor Williams, Mayor Pro-Tem Pride, Commissioner Patel, Commissioner Collie, Commissioner Virgil and Commissioner Davis. All members present joined the meeting by 6:03 p.m. with the exemption of Commissioner Pride, which joined the meeting at 6:10pm. Commissioner Davis lost connection at 6:31pm during the motion to enter closed session and was unable to reconnect. All other members were present until the meeting concluded. BOARD MEMBERS ABSENT: None APPROVAL OF THE CONSENT & REGULAR AGENDA Commissioner Davis made a motion to approve the consent and regular agenda. Commissioner Patel seconded the motion. The motion carried by a roll call vote of4 yes - 0 no. CITIZEN PETITION AND COMPLAINTS Tracy Sullivan, Town Clerk stated that no public comments were received prior to the meeting. NEW BUSINESS a. Approval of the Non-Profit Funding Application. Commissioner Davis made a motion to approve an allocation of $500.00 for the application submitted by the Non-Profit, Attention before Detention Foundation. Commissioner Pride seconded the motion. The motion carried by a roll call vote of 5 yes - 0 no. b. Approval of the CRF Utility Assistance Policy and Application. Commissioner Pride made a motion to approve the temporary CRF Utility Assistance Policy and Application. Commissioner Virgil seconded the motion. The motion carried by a roll call vote of 5 yes - 0 no. C. Approval of the Parks and Recreation Committee Recommendation. Commissioner Patel made a motion to approve the purchase of gift cards from the Parks and Recreation budget and to allow the Parks and Recreation Committee to select the families that the cards would be given to for Thanksgiving. Commissioner Davis seconded the motion. The motion carried by a roll call vote of5 yes - 0 no. d. Speed Limit Reduction. Commissioner Davis made a motion to table reducing the city - wide speed limit from 25mph to 15mph until a traffic study could be conducted and further information gathered. Commissioner Patel seconded the motion. The motion carried by a roll call vote of5yes - 0 no. e. Golf Cart Ordinance Discussion. Commissioner Collie made a motion for the existing Golf Cart Ordinance to remain intact as written in March 2018. Commissioner Patel seconded the motion. The motion carried by a roll call vote of5 yes - 0 no. CLOSED SESSION Commissioner Virgil made a motion to enter into closed session to discuss personnel issues pursuant to N.C.G.S. 143-318 (a) (6). Commissioner Patel seconded the motion. The motion carried by a roll call vote of4 yes - 0 no. OPEN SESSION Commissioner Collie made a motion to return to open session. Commissioner Virgil seconded the motion. The motion carried by a roll call vote of 4 yes 0 no. ADJOURNMENT Commissioner Collie made a motion to adjourn the meeting. Commissioner Virgil seconded the motion. The motion carried by a roll call vote of 4 yes 0 no. Date Approved Mayor Town Clerk 2 Town of Sharpsburg 2021 Meeting Schedule 6:00 PM Regular Meeting January 5, 2021 February 2, 2021 March 2, 2021 April 6, 2021 May 4, 2021 June 1, 2021 July 6, 2021 August 3, 2021 September 7, 2021 October 5, 2021 November 9, 2021 December 7, 2021 Adopted by the Board of Commissioners on January 5, 2021. TOWN OF SHARPSBURG 2021 HOLIDAY SCHEDULE Holiday Observance Date New Year's Day 01/01/2021 Martin Luther King Jr's Birthday 01/18/2021 Good Friday 04/02/2021 Memorial Day 05/31/2021 Independence Day 07/05/2021 Labor Day 09/06/2021 Veteran's Day 11/11/2021 Thanksgiving 11/25/2021 11/26/2021 Christmas 12/23/2021 12/24/2021 12/27/2021 Adopted by the Board ofCommissioners on January 5, 2021. 2021 Holiday Schedule Holiday Observance Date Day of Week New Year's Day January 1, 2021 Friday Martin Luther King, January 18, 2021 Monday Jr. Birthday Good Friday April 2, 2021 Friday Memorial Day May 31, 2021 Monday Independence Day July 5, 2021 Monday Labor Day September 6, 2021 Monday Veterans Day November 11, 2021 Thursday November 25 & 26, Thanksgiving 2021 Thursday & Friday December 23, 24 & Thursday, Friday & Christmas 27, 2021 Monday ME MORANDUM TO: Robert Williams, Mayor Town Council Members FROM: Stevie Cox, Town Administrator VIA: Brian Sullivan, Public Works Director CC: Brian Pridgen, Town Attorney DATE: December 3, 2020 REF: Approval and Award of Town Council Chamber Renovation Contract Summary: In the adopted Capital Improvement Plan Fiscal Year 2020 - 2021 Budget, Town Council has allocated funding for the renovations oft the Town Council Chamber. Background: In June 2020, the Town Council approved the Fiscal Year 2020 = 2021 Budget and Five - Year Capital Improvement Plan. In the Fiscal Year Budget, the Town Council had allocated funding for the renovations of the Town Council Chambers. Staff has sought and received three bids for this project. Contractor Address Bid Amount Small Town Handyman 109 Ruffin Place $15,600 Rocky Mount, North Carolina Mike Bryant 122 Tobacco Road $14,750 Rocky Mount, North Carolina Viverette's Construction 6780 Lancaster Store Road $20,970 Spring Hope, North Carolina Small Town Handyman and Mike Bryant have submitted bids that are close in price with each other. Viverette's Construction bid is much higher and they do not have liability insurance. The Office oft the' Town Administrator Town ofSharpsburg, 110 West Railroad Street, Sharpsburg, North Carolina 27878 Phone 252) 446-9441 Fax - (252) 977-7488 MEMO - PAGE 2 lowest most responsible bidder is Mike Bryant. All contractors have stated that they can complete this work within 4 -6 weeks. Recommendation: Staff recommends that the Town Council approve and award the contract for the renovation of the Town Council Chamber to Mike Bryant. Attachment: Bids for the Renovation of the Town Council Chambers Office of the Town Administrator Town ofSharpsburg, 110 West Railroad Street, Sharpsburg, North Carolina 27878 Phone 252) 446-9441 Fax- (252) 977-7488 CONTRACTOR ESTIMATE SHEET Estimate Submitted Tor Phone: Date: Town of shpbu Street: lob Name: Lonfowe Ros City, State and Zip Code lob Location: 108 DESCRIPTION: Rermoe clpencly End delh fles Lophn hodrel Inhn newceky siler Beyplhee / donsle Shosl cnidir Iklan bare hoand Triin nert focehs Pantalihk asKKR.. ThA does noieckli Loten IH HEREBY. astimate to furnish abor and materals 3 compiete accordance ath the abcve cecifications Estimate Cost: fyzro ACCEPTANCE OF ESTIMATE: The above orices and specifications are satistactory and are hereby accepted Date Signature Mhe Byant 252-886-0022 Invoice INV0004 Page 1 of 1 INVOICE INV0004 William Viverette/ Viverette's DATE construction 10/14/2020 252-375-7683 BALANCE DUE Dudww777@gmal.com USD $20,970.00 BILLTO Brian Sullvan/Sharpsburg town hall remodel Bsulvan@snapabugrcon DESCRIPTION RATE QTY AMOUNT tear out all old wall coverings, tear out drop ceiling $17,475.00 1 $17,475.00 panels,replace and frame new 32" windows,replace 24"x24" drop ceiling panels, paint tan walls,paint white trim,install crown molding, install new shoe molding, install new windows and door trim,install 54-4'x12' drywall and finish with drywall mud and tape,tear out 36" metal door and replace with new 36" metal door,tear out 60" metal double door and replace with new 60" double metal door. Viverette's construction/Wiliam Viverette:wil need to get installments week by week until job is complete in 6 weeks:$3495.00 by week until complete. SUBTOTAL $17,475.00 TAX (20%) $3,495.00 TOTAL $20,970.00 BALANCE DUE USD $20,970.00 Wliam Vivaroite 6780 Lancad Store Rd 637882 Spnins Mope ittps:lapp.invoicesimple.com/api/nyoices.8yZlyyRzxe.htm! 10/15/2020 SMALL TOWN HANDYMAN 109 Ruffin Place Rocky Mount, NC 27803 US smaltownhandymant120@gmai.com Estimate ADDRESS ESTIMATE # 1181 Town of Sharpsburg DATE 07/27/2020 110 W Railroad Street Sharpsburg, NC 27878 SERVICE QTY RATE AMOUNT Labor & Material 1 15,600.00 15,600.00 Demo meeting room Installation of new Drywall Lay in ceiling/tile Windows/trim Paint Flooring LED lighting HVAC registers/returns Deposit of 7800$to begin job TOTAL 3v draws 2600$ $15,600.00 weekly of Accepted By Accepted Date J. Brian Pridgen Bpngenecautepnagencom Cauley-Pridgen. WYERS PHONE; 252 291 3848 I FAX: 252 237 8117 TOLLF FREE: 1 877 641 8848 2500 Nash Street N, Ste C Wilson, NC27896-1394 MEMORANDUM FROM: Brian Pridgen DATE: December 4, 2020 SUBJECT: Title VI Policy and Procedures The North Carolina Department ofTransportation's Office of Civil Rights is requiring that all municipalities enact a formal Title VI Policy. The Title VI ofthe Civil Rights Act of 1964 states that no person shall on the ground of race, color, or national origin be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving federal financial assistance. The 1987 Civil Rights Restoration Act extended these protections to all NCDOT programs and activities, whether federally-assisted or state-funded. Additional categories ofp protection! havel been enacted: including sex, sexual orientation, low-income, limited English proficiency, age, disability, and religion / creed. To comply with Title VI, the following attached documents require adoption by the Board: 1. Title VI Resolution 2. Title VI Nondiscrimination Policy Statement 3. Title VI Discrimination Complaint Form and Instructions In conjunction with the adoption of these documents, the Town must take the following steps: 1. Appoint a Title VI Liaison - This designation is included in the Resolution. 2. Post the Nondiscrimination Policy Statement on the Town's S website and in Town Hall. 3. Have available hard copies oft the documents for citizens at Town Hall. 4. Following adoption of the documents, please submit to me and I will provide a completed submission package to NCDOT's Title VI Officer for approval. Once approved, a compliance report will be issued requiring the Town's signature. 5. Include the attached "Title VI Assurances for Contracts" in any contract involving NCDOT funds. 6. The Title VI Policy adopted must be renewed each year and submitted to NCDOT. Additionally, municipalities are: required to develop a method ofdata collection and analysis for identification of underserved populations within the municipality borders for anticipation of services. NCDOT has indicated that they will provide future guidance on how to comply with this requirement. Should you have any questions regarding these documents or steps, please do not hesitate to contact me. www.cauleypidgen.con Wilson Raleigh Kinston RESOLUTION TO ADOPT A TITLE VI POLICY FOR THE TOWN OF SHARPSBURG TO PROHIBIT DISCRIMINATION IN PROGRAMS AND SERVICES AND IN ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE WHEREAS, in 1964, Congress enacted the Civil Rights Act of 1964, which included that section labeled Title VI which prohibits discrimination in any activity which is financed by federal funds or receives federal financial assistance; and WHEREAS, since the adoption of Title VI, additional federal regulations and court decisions have further refined the definition of 'federal financial assistance" and what entities are affected and controlled by Title Vi; and WHEREAS, It is the policy of the Town of Sharpsburg to ensure that no person, shall, on the grounds of race, color, national origin, limited English Proficiency, income-level, sex, sexual orientation, age, or disability, be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any Town of Sharpsburg program or activity, including, where applicable, religion, as provided by Title VI of the Civil Rights Act of 1964 and other pertinent nondiscrimination authorities. WHEREAS, the Town of Sharpsburg has no formal policy in place for defining and preventing discrimination in the activities and for the entities Title VI affects; and WHEREAS, the interpretation and application are not intuitive or readily understood, requiring an understanding of what "federal financial assistance" might be in any particular situation and what persons or entities must comply with Title Vi; and WHEREAS, a policy and procedure for reporting violations will provide guidelines for the Town, Town Departments and private persons and companies doing business with the Town and receiving federal financial assistance. NOW, THEREFORE, BE IT RESOLVED by the Town Board of Commissioners of the Town of Sharpsburg that the attached "Title VI Policy" is hereby adopted as the official policy of the Town of Sharpsburg for applying, reporting and enforcing Title VI of the Civil Rights Act of 1964. AND BE IT FURTHER RESOLVED that the Town Administrator be designated as the Town's Title VI Coordinator to assure that appropriate program measures are implemented and monitored. IT IS FURTHER RESOLVED that the Town Administrator is authorized to approve this policy on a yearly basis if no changes are made to it. ADOPTED, this day of 2020. Robert Williams, Mayor Attest: Tracy Sullivan, Town Clerk Title VI Nondiscrimination Policy Statement It is the policy of the Town of Sharpsburg to ensure that no person, shall, on the grounds of race, color, national origin, limited English Proficiency, income-level, sex, sexual orientation, age, or disability, be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any Town of Sharpsburg program or activity, including, where applicable, religion, as provided by Title VI of the Civil Rights Act of 1964 and other pertinent nondiscrimination authorities. The following practices are hereby prohibited throughout the Town of Sharpsburg to comply, at ar minimum, with Title VI and related requirements: Denying to an individual any standard service, financial aid, or other program benefit without good cause; Providing any service, financial aid, or other benefit to a person which is distinct in quantity or quality, or is provided in a different manner, from that provided to others under the program; Subjecting a person to segregation or separate treatment in any part of a program; Restrictions in the enjoyment of any advantages, privileges, or other benefits enjoyed by others; Methods of administration which, directly or through contractual relationships, would defeat or substantially impair the accomplishment of effective nondiscrimination; Different standards, criteria, or other requirements for admission, enrollment, or participation in planning, advisory, contractual or other integral activities; Acts of intimidation or retaliation, including threatening, coercing, or discrimination against any individual for the purpose of interfering with any right or privilege secured by any pertinent nondiscrimination law, or because s/he has made a complaint, testified, assisted, or participated in any manner in an investigation, proceeding, or hearing; Discrimination in any employment resulting from a program, a primary objective of which is to provide employment. To assure that appropriate program measures are implemented and monitored, the Town Administrator will serve as the Town of Sharpsburg's Title VI Coordinator; Stevie Cox, (252) 446-9441, townadminstratoresharpsburgnc.com. As an expression of my commitment to and support of the Town's Title VI Nondiscrimination Program, below is my signature as the Town Administrator of the Town of Sharpsburg. This the day of 2020. Stevie Cox, Town Administrator TOWN OF SHARPSBURG EXTERNAL DISCRIMINATION COMPLAINT INSTRUCTIONS INTRODUCTION The Town of Sharpsburg is responsible for processing discrimination complaints filed under Title VI of the Civil Rights Act of 1964 and related nondiscrimination laws. Participants and beneficiaries of programs and activities administered or funded by the Town who feel they have been discriminated against based on race, color, national origin, income-level, Limited English Proficiency (LEP), sex, age, or disability have a right to file a complaint. Complaints of alleged discrimination will be investigated by the Town. Note: Religion is only covered under NCDOT's Right of Way program (Fair Housing) and programs funded by the Federal Aviation Administration (FAA) or. Federal Transit Administration (FTA). FILING OF COMPLAINTS 1. Applicability These complaint procedures apply to NCDOT programs, activities and services, including subrecipients (e.g., municipalities, counties, Metropolitan Planning Organizations (MPO), transit agencies) and contractors (e.g., subcontractors, consultants, License Plate Agencies) receiving federal or state funds through NCDOT. Note: Title VI does not include internal complaints related to Equal Employment Opportunity (EEO). 2. Eligibility - Any person or class of persons who believes he/she has been subjected to discrimination based on race, color, national origin, income-level, LEP, sex, age, or disability, (and religion, where applicable) may file a written complaint with the Town's Title VI Coordinator. The law also prohibits intimidation or retaliation against anyone who files a complaint. 3. Filing Options and Time Limits - Complaints may be filed by the affected individual(s) or a representative and must be filed no later than 180 calendar days after the following: The date ofthe alleged act of discrimination; or The date when the person(s) became aware ofthe alleged discrimination; or Where there has been a continuing course of conduct, the date on which that conduct was discontinued or the latest instance of the conduct. Title VI and related discrimination complaints may be submitted to the following entities: > North Carolina Department of Transportation, Office of Civil Rights, External Civil Rights, 1511 Mail Service Center, Raleigh, NC 27699-1511; 919-508-1808 or toll free 800-522-0453 > US Department oft Transportation, Departmental Office of Civil Rights, External Civil Rights Programs Division, 1200 New Jersey Avenue, SE, Washington, DC 20590; 202-366-4070 Federal Highway Administration, Office of Civil Rights, 1200 New Jersey Avenue, SE, & Floor, E81-314, Washington, DC 20590, 202-366-0693 / 202-366-0752 Federal Highway Administration, North Carolina Division Office, 310 New Bern Avenue, Suite 410, Raleigh, NC 27601,919-747-7010 Federal Transit Administration, Office of Civil Rights, ATTN: Title VI Program Coordinator, East Bldg. 5th Floor - TCR, 1200 New Jersey Avenue, SE, Washington, DC 20590 Federal Motor Carrier Safety Administration, Office of Civil Rights, 1200 New Jersey Avenue, SE, Room #W65-312, Washington, DC 20591, 202-366-8810 Federal Aviation Administration, Office of Civil Rights, 800 Independence Avenue, SW, Washington, DC 20591, 202-267-3258 > US Department of Justice, Special Litigation Section, Civil Rights Division, 950 Pennsylvania Avenue, NW, Washington, DC 20530, 202-514-6255 or toll free 877-218-5228 4. Format for Complaints - Complaints must be in writing and signed by the complainant(s) or a representative, and include the complainant's name, address, and telephone number. Complaints received by fax or e-mail will be acknowledged and processed. Allegations received by telephone will be reduced to writing and provided to the complainant for confirmation or revision before processing. Complaints will be accepted in other languages, including Braille. (See DISCRIMINATION COMPLAINT FORM included below.) 5. Complaint Basis = Allegations must be based on issues involving race, color, national origin, income-level, LEP, sex, age, or disability; (and religion, where applicable). The term "basis" refers to the complainant's membership in a protected group category. Note: Religion (or creed) is only protected under Right of Way, Public Transportation and Aviation programs. Protected Definition Examples Pertinent Statutes and Categories Regulations FHWA FTA Race An individual belonging to one ofthe Black/African Title VI of Title VI of accepted racial groups; or the perception, American, the Civil the Civil based usually on physical characteristics Hispanic/Latino, Asian, Rights Act of Rights Act of that a person is a member of a racial group American Indian/Alaska 1964; 1964; Native, Native 49 CFR Part 49 CFR Part Hawaiian/Pacific 21; 21; Islander, White 23 CFR 200; Circular Color Color of skin, including shade of skin Black, White, brown, (Executive 4702.1B; within a racial group yellow, etc. Order 13166) (Executive National Place of birth. Citizenship is not a factor. Mexican, Cuban, Order 13166) Origin (Discrimination based on language or a Japanese, Vietnamese, (LEP) person 's accent is also covered) Chinese; Russian; French Income- An individual or household determined to Poverty status Executive Order 12898 Level be low-income Sex The sex of an individual. Women and Men 1973 Title IX of Note: Sex under this program does not Federal-Aid the Education include sexual orientation. Highway Act Amendments of 1972 Age Persons of any age 21 year old person Age Discrimination Act of 1975 Disability Physical or mental impairment, permanent Blind, alcoholic, para- Section 504 of the or temporary, or perceived amputee, epileptic, Rehabilitation Act of 1973; diabetic, arthritic Americans with Disabilities Act of 1990 Religion Creed. An individual belonging to a Muslim, Christian, Sikh, Title VIII oft the Civil Rights religious group; or the perception, based Hindu, etc. Act of 1968 (Fair Housing usually on distinguishable characteristics Act); 49 USC 47123 (FAA); that a person is a member of ai religious 49 USC 5332 (FTA) group COMPLAINT RECEIPT AND RESPONSE 1. The Town's Title VI Coordinator will provide written acknowledgment of your complaint within ten (10) calendar days, by registered mail. 2. The Town will review your complaint upon receipt to ensure the required information was provided, the complaint was timely filed, and jurisdictional requirements were met. a. If the complaint is complete and no additional information is needed, the Town's Title VI Coordinator will send you a letter of acceptance as well as a Complainant Consent/Release form. b. If the complaint is incomplete, you will be contacted in writing or by telephone to obtain the needed information. Note: Failure to respond and/or provide the requested information within 15 calendars days may be considered good cause for a determination of no investigative merit. 3. Within 15 calendar days of receiving your complaint, the Town will determine its jurisdiction in pursuing the matter and whether the complaint has sufficient merit to warrant investigation. Within five (5) days of this decision, the Town will notify you and Respondent (the person(s) against whom you have filed the complaint), by registered mail, stating the decision. a. If the decision is to not investigate the complaint, the notification shall specifically state the reasons for the decision. b. If the decision is to investigate the complaint, the notification shall state the grounds of the Town's jurisdiction and require your and the Respondent's full cooperation in assisting the investigator. C. Interviews may be recorded during the investigation. Consent to record may be required if the interviewee is located outside ofNC. 4. The Town will attempt to resolve all discrimination complaints within 60 days of accepting the complaint for investigation. Every effort will be made to obtain early resolution of complaints at the lowest level possible. The option of informal mediation between the affected parties and NCDOT staff may be utilized for resolution. The Town will make known all filing options and avenues of appeal. DISCRIMINATION COMPLAINT FORM Any person who believes that he/she has been subjected to discrimination based upon race, color, sex, age, national origin, disability, income-level, or limited English proficiency, may file a written complaint with the Town of Sharpsburg's Title VI Coordinator within 180 days after the discrimination occurred. Last Name: First Name: Male Female Mailing Address: Town State Zip Home Telephone: Work Telephone: E-mail Address Identify the Category of Discrimination: RACE COLOR NATIONAL ORIGIN LIMITED ENGLISH PROFICIENCY AGE RELIGION DISABILITY SEX INCOME-LEVEL NOTE: Religion is covered as al basis only under NCDOT's Right of Way Unit (Fair Housing) and Public Transportation and. Aviation Divisions. Identify the Race oft the Complainant Black White Hispanic Asian American American Indian Alaskan Native Pacific Islander Other Date and place of alleged discriminatory action(s). Please include earliest date of discrimination and most recent date of discrimination. Names ofi individuals responsible for the discriminatory action(s): How were you discriminated against? Describe the nature of the action, decision, or conditions of the alleged discrimination. Explain as clearly as possible what happened and why you believe your protected status (basis) was a factor in the discrimination. Include how other persons were treated differently from you. (Attach additional page(s), if necessary) The law prohibits intimidation or. retaliation against anyone because he/she has either taken action, or participated in action, to secure rights protected by these laws. Ifyou feel you have been retaliated against, separate from the discrimination alleged above, please explain the circumstances below. Explain what action you took which you believe was the cause for the alleged retaliation. (Attach additional page(s), ifr necessary) Names ofj persons (witnesses, fellow employees, supervisors, or others) whom we may contact for additional information to support or clarify your complaint: (Attached additional page(s), ifnecessary). Name Address Telephone 2. 3. 4. DISCRIMINATION COMPLAINT FORM Have you filed, or intend to file, a complaint regarding the matter raised with any ofthe following? Ifyes, please provide the filing dates. Check all that apply. Federal Highway Administration Federal Transit Administration Federal Motor Carrier Safety Administration US Department ofTransportation Federal or State Court Other Have you discussed the complaint with any Town representative? Ifyes, provide the name, position, and date of discussion. Please provide any additional information that you believe would assist with an investigation. Briefly explain what remedy, or action, are you seeking for the alleged discrimination. **WE CANNOT ACCEPT AN UNSIGNED COMPLAINT. PLEASE SIGN AND DATE THE COMPLAINT FORM BELOW. COMPLAINANT'S: SIGNATURE DATE MAIL COMPLAINT FORM TO: TOWN OF SHARPSBURG ATTN: TITLE VI COORDINATOR 110 West Railroad Street, Sharpsburg, NC 27878 (252) 446-9441 FOR OFFICE USE ONLY Date Complaint Received: Processed by; Case #:. Referred to: OFHWA JFTA OFMCSA Date Referred: NCDOT - March 6, 2017 TITLE VI ASSURANCES The provisions of this section related to United States (6) Incorporation of Provisions: The contractor will Department ofTransportation (US DOT) Order 1050.2A, Title include the provisions of paragraphs one through six in 49 Code of Federal Regulations (CFR) part 21, 23 United everys subcontract, including procurements of materials and States Code (U.S.C.) 140 and 23 CFR part 200 (or 49 CFR leases of equipment, unless exempt by the Acts, the 303, 49 U.S.C. 5332 or 49 U.S.C. 47123) are applicable to all Regulations and directives issued pursuant thereto. The North Carolina Department of Transportation (NCDOT) contractor will take action with respect to any subcontract contracts and to all related subcontracts, material supply, or procurement as the Recipient or the FHWA may direct engineering, architectural and other service contracts, as a means of enforcing such provisions including regardless of dollar amount. Any Federal provision that is sanctions for noncompliance. Provided, that if the specifically required not specifically set forth is hereby contractor becomes involved in, or is threatened with incorporated by reference. litigation by a subcontractor, or supplier because of such direction, the contractor may request the Recipient to enter NCDOT Title VAssurance (1050.2A. AppendicesABE) into any litigation to protect the interests of the Recipient. In i. During the performance of this contract, the contractor, for addition, the contractor may request the United States to itself, its assignees, and successors ini interest (hereinafter enter into the itigation to protect the interests oft the United referred to as the "contractor") agrees as follows: States. (1) Compliance with Regulations: The contractor ii. During the performance of this contract, the contractor, (hereinafter includes consultants) will comply with the Acts for and the Regulations relative to Nondiscrimination in itself, its assignees, and successors in interest (hereinafter Federally-assisted programs of the U.S. Department of referred to as the "contractor") agrees to comply with the Transportation, Federal Highway Administration (FHWA), following nondiscrimination statutes and authorities; as they may be amended from time to time, which are including but not limited to: herein incorporated by reference and made a part of this Pertinent Nondiscrimination, Authorities contract. Title VI ofthe Civil Rights Act of1 1964 (42 U.S.C. S 2000d (2) Nondiscrimination: The contractor, with regard to the et seq.. 78 stat. 252), (prohibits discrimination on the work performed by it during the contract, will not basis ofr race, color, national origin); and 49 CFR Part 21. discriminate ont the grounds ofrace, color, orn national origin The Uniform Relocation Assistance and Real Property ini the selection and retention of subcontractors, including Acquisition Policies Act of 1970, (42 U.S.C. S 4601), procurements of materials and leases of equipment. The (prohibits unfair treatment of persons displaced orv whose contractor will not participate directly or indirectly in the property has been acquired because of Federal or discrimination prohibited by the Acts and the Regulations, Federal-aid programs and projects); including employment practices when the contract covers Federal-Aid Highway Act of 1973, (23 U.S.C. S 324 et any activity, project, or program set forth in Appendix B of seq.), (prohibits discrimination on the basis of sex); 49 CFR Part 21. Section 504 oft the Rehabilitation. Act of 1973, (29 U.S.C. (3) Solicitations for Subcontractors, Including S 794 et seq.), as amended, (prohibits discrimination on Procurements of Materials and Equipment: In all the basis of disability); and 49 CFR Part 27; solicitations, either by competitive bidding, or negotiation The Age Discrimination Act of 1975, as amended, (42 made by the contractor for work to be performed under a U.S.C. S 6101 et seq.), (prohibits discrimination on the subcontract, including procurements of materials, orl leases basis of age); of equipment, each potential subcontractor or supplier will Airport and Airway Improvement Act of 1982, (49 USC S be notified by the contractor of the contractor's obligations 471, Section 47123), as amended, (prohibits under this contract and the Acts and the Regulations discrimination based on race, creed, color, national relative to Nondiscrimination on the grounds of race, color, origin, or sex); or national origin. The Civil Rights Restoration Act of 1987, (PL 100-209), (4) Information and Reports: The contractor will provide (Broadened the scope, coverage and applicability ofTitle all information and reports required by the Acts, the VI oft the Civil Rights Act of 1964, The Age Discrimination Regulations, and directives issuedp pursuant thereto and will Act of 1975 and Section 504 of the Rehabilitation Act of permit access to its books, records, accounts, other 1973, by expanding the definition of the terms programs sources of information, and its facilities as may be or activities" to include all of the programs or activities of determined by the Recipient or the FHWA to be pertinent the Federal-aid recipients, sub-recipients and to ascertain compliance with such Acts, Regulations, and contractors, whether such programs or activities are instructions. Where any informationi required ofa a contractor Federally funded or not); is in the exclusive possession of another who fails or Titles II and III of the Americans with Disabilities Act, refuses to furnish the information, the contractor will sO which prohibit discrimination on the basis of disability in certify to the Recipient or the FHWA, as appropriate, and the operation of public entities, public and private will set forth what efforts it has made to obtain the transportation systems, places of public information. accommodation, and certain testing entities (42 U.S.C. (5) Sanctions for Noncompliance: In the event of a SS 12131-12189) as implemented by Department of contractor's noncompliance with the Non-discrimination Transportation: regulations at 49 C.F.R. parts 37 and 38; provisions of this contract, the Recipient will impose such The Federal Aviation. Administration's Nondiscrimination contract sanctions as it or the FHWA may determine to be statute (49 U.S.C. S 47123) (prohibits discrimination on appropriate, including, but not limited to: the basis of race, color, national origin, and sex); (a) withholding payments to the contractor under the Executive Order 12898, Federal Actions to Address contract until the contractor complies; and/or Environmental Justice in Minority Populations and Low- (b) cancelling, terminating, or suspending a contract, in Income Populations, which ensures Nondiscrimination whole or in part. against minority populations by discouraging programs, 1 policies, and activities with disproportionately, high and applicable) be excluded from participation in, be denied the adverse human health or environmental effects on benefits of, or be subjected to discrimination under any minority and low-income populations; programs, activities, or services conducted or funded by Executive Order 13166, Improving Access to Services NCDOT. Contractors and other organizations under contract for Persons with Limited English Proficiency, and or agreement with NCDOT must also comply with Title VI and resulting agency guidance, national origin discrimination related authorities, therefore: includes discrimination because of Limited English . During the performance of this contract or agreement, proficiency (LEP). To ensure compliance with Title VI, contractors (e.g., subcontractors, consultants, vendors, you must take reasonable steps to ensure that LEP prime contractors) are responsible for complying with persons have meaningful access to your programs (70 NCDOT's Title VI Program. Contractors are not required to Fed. Reg. at 74087 to74100); prepare or submit Title VII Programs. (USDOJ Title VI Legal Title IX of the Education Amendments of 1972, as Manual, VI(F)) amended, which prohibits you from discriminating i. Subrecipients (e.g. cities, counties, LGAS, MPO/RPOS) because of sex in education programs or activities (20 may be required to prepare and submit a Title VI Program U.S.C. 1681 et seq). to NCDOT, which may include Title VI Nondiscrimination Assurances and/or agreements. Subrecipients must also NCDOT Title VI Nondiscrimination Program (23 CFR ensure that their contractors and subrecipients comply with 200.5(p)) Title VI. (23 CFR 200.9(b)(7) The North Carolina Department of Transportation (NCDOT) ii. If reviewed or investigated by NCDOT, the contractor or has assured the US DOT that, as a condition to receiving subrecipient agrees to take affirmative action to correct any federal financial assistance, NCDOT will comply with Title VI deficiencies found within a reasonable time period, not to oft the Civil Rights Act of 1964 and all requirements imposed exceed 90 calendar days, unless additional time is granted by Title 49 CFR part 21 and related nondiscrimination by NCDOT. (23 CFR. 200.9(b)(15)) authorities to ensure that no person shall, on the ground of race, color, national origin, limited English proficiency, income-level, sex, age, or disability, (or religion, where 2 ME MORANDU M TO: Robert Williams, Mayor Town Council Members FROM: Stevie Cox, Town Administrator VIA: CC: Brian Pridgen, Town Attorney DATE: December 23, 2020 REF: Approval Infectious Disease Policy for Town Employees Summary: In March 2020, the Country was faced with a COVID-19 Pandemic that required how we conduct our daily lives to change. Staffis proposing an infectious disease policy and procedures that will cover this current event and future events like this. Background: In March 2020, the Country was faced with the COVID-19 Pandemic. Over the next several months, this pandemic has resulted in the loss of life and hospitalization of thousands of North Carolinians and Americans. In the early days of the pandemic, State and Federal Guidelines were ever changing. Local Governments have been left to put together a patchwork or protocol and dialogue on how to address this pandemic. Staff has prepared a Proposed Infectious Disease Policy. It is staff' S expectation that the State and Local Government will become eligible for some disaster relief funding related to this and we will be required to have an adopted infectious disease policy. The following provides a brief overview of the Proposed Infectious Disease Policy. It is the goal of the Town of Sharpsburg during a period of an infectious disease outbreak or pandemic to maintain essential functions and services and provide a safe and healthy work environment for employees, vendors and the public. The Town of Sharpsburg is committed to establishing methods for monitoring the severity and duration of an outbreak or pandemic, Office of the Town Administrator Town of Sharpsburg, 110 West Railroad Street, Sharpsburg, North Carolina 27878 Phone - 252) 446-9441 Fax - (252) 977-7488 MEMO = PAGE 2 implementing measures to minimize exposure in the workplace and sustaining essential functions until the organization is able to resume normal operations. The Town Administrator or Designee will oversee the implementation of this policy and coordinate communications from management to employees and other stakeholders. Duties include: Monitoring and coordinating events and communications around an infectious disease outbreak or pandemic; and Creating work rules that could be implemented to promote safety through infection control. Oversight includes the maintenance of a current list of contacts including: Government agencies; Emergency response and healthcare facilities and services; and Equipment suppliers and service contractors who can or have agreed to assist during and after an outbreak or pandemic. If there is the issuance of a Governor's Executive Order in relationship to an Infectious Disease Outbreak or Pandemic, this policy shall not supersede it. This Policy would be a compliment to the Governor's Executive Order. Recommendation: Staff recommends that the Town Council approve the Proposed Infectious Disease Policy and Procedures. Staff recommends that the Proposed Infectious Disease Policy be made effective retroactive to March 30, 2020. Attachment: Proposed Infectious Disease Policy and Procedures Proposed COVID-19 Questionnaire Office of the Town Administrator Town of Sharpsburg, 110 West Railroad Street, Sharpsburg, North Carolina 27878 Phone - 252) 446-9441 Fax - (252) 977-7488 Pagel 11 Town of Sharpsburg Infectious Disease Policy Purpose: It is the goal ofTown of Sharpsburg during a period of an infectious disease outbreak or pandemic to maintain essential functions and services and provide a safe and healthy work environment for employees, vendors and the public. Town of Sharpsburg is committed to establishing methods for monitoring the severity and duration of an outbreak or pandemic, implementing measures to minimize exposure in the workplace and sustaining essential functions until the organization is able to resume normal operations. Town Administrator or Designee will oversee the implementation of this policy and coordinate communications from management to employees and other stakeholders. Duties include: Monitoring and coordinating events and communications around an infectious disease outbreak or pandemic; and Creating work rules that could be implemented to promote safety through infection control. Oversight includes the maintenance of a current list of contacts including: Government agencies; Emergency response and healthcare facilities and services; and Equipment suppliers and service contractors who can or have agreed to assist during and after an outbreak or pandemic. If there is the issuance of a Governor's Executive Order in relationship to an Infectious Disease Outbreak or Pandemic, this policy shall not supersede it. This Policy would be a compliment to the Governor's Executive Order. Town of Sharpsburg Infectious Disease Policy Effective Date: December 7, 2020 Pagel 12 Safety and Health Measures: Town of Sharpsburg will implement disease mitigation and protective measures for employees working onsite and offsite and for interactions with customers, vendors and the public during the outbreak or pandemic. Town ofSharpsburg is committed to providing the most current and credible information about the disease, including the manner in which it spreads, symptoms and measures to prevent its transmission. Pre-Work Day Protocol. Each Department Head or Designee will be required to have each employee to complete a questionnaire prior to the start of their workday. This will include having the employee's body temperature taken and recorded. Ifthe employee answers yes to any of the questions, they will be require to self-quarantine or self-isolate. The employee will be required to get tested. The employee must provide a negative test results, before they are allowed to return to work. Reducing transmission. To ensure a clean and safe workplace, Town of Sharpsburg will conduct a regular cleaning of frequently uscd objccts and arcas, including: Conference rooms; Bathrooms; Cafeterias and break rooms; Door handles; Telephones; and Hand railings. Employees and other individuals who enter the workplace will be advised to follow personal hygiene practices to prevent infection (e.g., hand washing with soap and water or the use of hand sanitizer with at least 60% alcohol, avoid touching of the face) and will be provided access to basic hygiene supplies (e.g., soap, water, hand sanitizer, etc.). Facemask Requirement. All employees will be required to wear a facemask or covering, when they are within six feet of others or riding in the same vehicle. The Town of Sharpsburg will provide all employees with facemasks or covering that they shall use. Exposure risk assessment. Specific measures to minimize the spread of infection at each work location will be based on the risk level of exposure to employees. The Town of Sharpsburg may install protective devices or adopt other interventions to Town of Sharpsburg Infectious Disease Policy Effective Date: December 7, 2020 Page - 3 prevent or mitigate exposure to an infectious disease when and where feasible. Controls may include: Physical barriers to control spread of the disease (e.g., plastic sneeze guards); or Administrative controls, such as staggered work schedules to minimize the number of individuals at the workplace or allow for thorough cleaning and disinfection between work shifts. Health monitoring. Supervisors or other designated personnel will be trained to identify persons with signs and symptoms of an infectious disease as described in guidance provided by the Centers for Disease Control and Prevention (CDC) (e.g., fever, cough and shortness ofl breath) and determine the course of action to separate the person or persons from others or remove them from the workplace (e.g., send them home). Such personnel will also be trained in other techniques to minimize disease exposure and direct person-to-person contact, including social distancing (i.e., avoiding large gatherings and maintaining distance approximately six feet) from others when possible (e.g., breakrooms and cafeterias)). All employees will be notified on how to self-monitor for symptoms and report to a supervisor or management when they are ill or experience infectious disease symptoms. Stay home when sick. Employees are urged not to report to work when they are feeling ill or are experiencing symptoms of an infectious disease (e.g., fever, cough or shortness of breath). An employee who appears to exhibit infectious disease symptoms upon arrival at work or who becomes sick during their time at work will be separated from others and sent home. If an employee is confirmed to have contracted an infectious disease, the Town of Sharpsburg will inform other employees oft their possible exposure in the workplace, but the confidentiality of the infected employee will be maintained as required by the Americans with Disabilities Act (ADA). The employee's co-workers will be instructed to self-monitor for symptoms and be provided with guidelines for doing SO. Remote work. Employees who normally work onsite and are also capable of performing work from home or remotely may be encouraged or told to do sO during an infectious disease outbreak or pandemic. The arrangement may be temporary or long-term depending on pandemic-relatedl.ontagion-related conditions such as public shelter-in-place orders, quarantines, childcare service disruptions or school closings and other related factors. All remote or telework arrangements or requests will be determined on a case-by- case basis, taking into account factors including; Town of Sharpsburg Infectious Disease Policy Effective Date: December 7, 2020 Page14 Appropriateness of the job for telecommuting: Tenure; Seniority; Employee performance; Flexibility; The reason(s) for telecommuting; and The ability to work independently. Town of Sharpsburg will determine what equipment, if any, to provide to the employee to facilitate the remote or telework arrangement. The employee may designate a workspace or off-site work area for installing any equipment to be used while telecommuting. The employee will be expected to maintain the workspace in a safe condition, free from hazards to people and equipment. Social distancing. Town of Sharpsburg will implement social distancing guidelines to reduce the spread of the infectious disease in the workplace. In accordance with CDC recommendations, employees and other individuals who enter the workplace are encouraged to maintain a minimum distance of minimum of six (6) feet recommended by the CDC for proper social distancing, e.g., six feet] from any other person during an infectious disease outbreak or pandemic. All business meetings may be held via phone or video conference. Employees and others may be prohibited from congregating in meeting rooms, common areas and all other onsite locations. Cleaning and disinfection after positive case. In the event an employee or any other person at the workplace tests positive for an infectious disease, cleaning and disinfection protocols will be implemented in accordance with CDC: recommendations, including instructions and supplies for employees to disinfect their personal work areas. Employees should make efforts to avoid using other employees' phones, desks, offices or other work tools and equipment, when possible. If necessary, clean and disinfect them before and after use. Town of Sharpsburg will take steps to clean and disinfect all facility areas that have been used or may have been used by a person with a confirmed positive test result for the disease or who exhibited disease symptoms while at work. Travel restrictions. Town of Sharpsburg will evaluate the risk of employee exposure to the infectious disease from business travel, and may restrict, cancel or ban business travel as necessary to minimize or prevent risk ofinfection. In making Town of Sharpsburg Infectious Disease Policy Effective Date: December 7, 2020 Page 15 such determinations, consideration will be given to any travel bans or advisories issued by government agencies, including the US Department of State and the CDC. Nonessential activities. During an infectious disease outbreak or pandemic, the Town of Sharpsburg may postpone or cancel all nonessential activities, including meetings, gatherings and training sessions. Affected employees would be notified as soon as practicable. Relocation of essential activities. Town of Sharpsburg will notify all affected employees in the event essential onsite facilities or activities must be relocated and will provide instructions to continue or resume essential functions. Testing for Infectious Disease Requirement. Town of Sharpsburg will attempt to make a vaccine for the infectious disease accessible at the workplace once a vaccine is publicly available. Employees are encouraged to contact their doctor or healthcare provider to get vaccinated.) Attendance: Attendance. Town ofSharpsburg attendance policies will remain in place during an infectious disease outbreak or pandemic, unless otherwise notified. If an employee has a particular challenge (e.g., child care issues in the event of a school closure), they should speak to their supervisor to determine an alternative plan. Employees will be notified of any work schedule changes caused by an infectious disease outbreak or pandemic. Requests to adjust individual work schedules will be addressed on a case-by-case basis. If an employee is out of work because of exposure to an infectious disease, or other illness or condition recognized by federal, state or local law, the employee may be required to submit additional information for the absence. See the Town of Sharpsburg's leave or accommodation policy, e.g. Families First Coronavirus Act (FFCRA) Policy for more information. The Town of Sharpsburg offers sick, family or other leave: To the extent permissible by law, Town of Sharpsburg may modify its leave policies in force during normal operations to reflect conditions during a declared infectious disease outbreak or pandemic. Town of Sharpsburg Infectious Disease Policy Effective Date: December 7, 2020 Page16 Pay: Employees will be paid for all hours worked during an infectious outbreak or pandemic. If an employee is sent or required to be tested, the employee shall be compensated for an hour of time to do SO. Employees will be notified of any changes in pay rates for nonexempt employee hourly rate of pay or exempt employee salary because oflong-term business needs caused by significant business disruption or economic shutdown due to an infectious disease outbreak or pandemic. Closings and Layoffs: In the event of a temporary or permanent closing due to unforeseen business circumstances related to the infectious disease outbreak or pandemic, employees will be notified as soon as practicable concerning a layoff or termination of employment. Employees will be provided with as much notice as practicable concerning a layoff or business closing due to unforeseen business circumstances related to the infectious disease outbreak or pandemic, including an explanation as to why notice was not provided if the layoff is implemented without advance notice. Employees subject to a layoff under this policy will be notified about available benefits and where to obtain additional information and guidance. Return to Work: Employees who have tested positive for an infectious disease (e.g., COVID-19) or who have isolated or quarantined with symptoms of infection may return to work when they have met the following criteria: Provide documentation of confirmed negative results of an FDA-approved assay for the infectious disease (confirmed means a second test validates an initial positive test or screen); or Seven days have passed since receipt of a confirmed positive test result and there have been no subsequent illness or symptoms ofillness (e.g., cough, fever, difficulty breathing); or At least 72 hours have passed since the resolution of fever without the use of fever-reducing medications and improvement in respiratory symptoms AND at least 7 days have passed since symptoms first appeared. Town of Sharpsburg Infectious Disease Policy Effective Date: December 7, 2020 Page 17 Town of Sharpsburg understands that doctors and other health care professionals may be too busy during and immediately after an outbreak to provide fitness-for-duty documentation. Town of Sharpsburg may rely on other credible sources such as local clinics to provide a form, a stamp or an email to certify that an individual does not have an infectious disease. Onsite Work Prohibited: Town of Sharpsburg reserves the right to prohibit an employee or another individual with a confirmed positive test for an infectious disease from entering onsite facilities, programs and functions if a determination is made that the entry introduces a recognized hazard to the workplace and the restriction protects the safety and health of employees, customers and others. Every effort will be made to accommodate such employees prohibited from onsite work with remote work, or other alternative work. Confidentiality: Infectious disease-related diagnostic information about employees will be treated as confidential, privileged information. All information about an employee's illness will be treated as a confidential medical record in compliance with the Americans with Disabilities Act (ADA). The employer will adhere to all federal, state and local public health reporting requirements. Town of Sharpsburg Infectious Disease Policy Effective Date: December 7, 2020 COVID-19 Questionnaire 1. Within the last 10 days have you been diagnosed with COVID-19 or had a test confirming you have the virus? Yes No 2. Do you live in the same household, or have you had close contact (been within 6 feet for over 10 minutes) with someone who has been in isolation for COVID-19 or has had a test confirming they have the virus, in the past 14 days? Yes No 3. Have you had close contact (within 6 feet for at least 15 minutes) in the last 14 days with someone diagnosed with COVID-19, or has nay health department or health care provider advised you to quarantine? Yes No 4. Do you have a fever (100.4 or higher) or chills? Yes No 5. Do you have a new cough (unrelated to allergies)? Yes No 6. Do you have a new shortness of breath or difficulty breathing? Yes No 7. Do you have a new loss of taste or smell? Yes No 8. Have you had any one or more of these symptoms today or within the past 24 hours, which is new or not explained by another reason? Symptoms Yes No Fatigue Muscles or Body Aches Headache Sore Throat Congestion or Runny Nose Diarrhea Employee Name: Date: Temperature: