HomeMy WebLinkAboutFY23 Engineering StRAP StreamFlow Rehab ProgSteve Troxler North Carolina Department of Agriculture
Commissioner and Consumer Services
November 3, 2022
Dru Harrison
New Hanover SWCD
230 Government Center Drive, Suite 100
Wilmington, NC 28403
ACCEPTANCE OF AWARD NOTIFICATION
Dear Dru Harrison,
N. David Smith
Chief Deputy Commissioner
On behalf of Commissioner Steve Troxler and the N.C. Department of Agriculture and Consumer
Services, we are pleased that you have accepted the Department's offer of $263,594.00.
By accepting our offer of financial assistance, you have agreed to the specific stipulations, terms and
conditions, and reporting requirements contained in the contract that you signed. Enclosed is a fully
executed contract for your records.
The forms listed below are used to fulfill the departmental reporting requirements of the StreamFlow
Rehabilitation Program (StRAP).
1. StreamFlow Assistance 50% Progress Report,
2. Streamflow Rehabilitation Assistance Program (StRAP) Quarterly Progress Report
3. Request for Payment form
If you have any questions regarding the contract, please contact Heather Reichert at 919-707-3768
or by email at heather.reichert@ncagr.gov.
I would like to take this opportunity to thank you for your participation in the StreamFlow Rehabilitation
Program.
In
cerely
N. David mi
Chief Deputy Commissioner
Enclosures:
cc: Heather Bruce, Grants Manager
Email: David.Smith@ncagr.gov
1001 Mail Service Center, Raleigh, North Carolina, 27699-1001
(919) 707-3033 0 Fax (919) 715-0026
An Equal Opportunity Affirmative Action Employer
NORTH CAROLINA DEPARTMENT OF AGRICULTURE AND CONSUMER SERVICES
Steven W. Troxler, Commissioner
Contract Check Off List for Grantee (Government State Funds)
INSTRUCTIONS: Check the "Yes" boxes in the left column for the document titles that are being returned with the two signed, dated and witnessed copies of the
contract, with signatures in blue ink. Be sure to include all the other documents specified in your contract package. If "No" has been checked off for you, that
document is not required for this grant program or project.
GRANTEE ORGANIZATION NAME: New Hanover SWCD
PROJECT TITLE/NAME: Streamflow Rehab Assistance Program
CONTRACT #: 22-080-4024
GO Entities Only
Check One Box
Document Title
Department Use –
Documents Attached
or On File
Grants and Contracts -
Documents Attached
or On File
Yes
No
Contractual "Check Off List for Grantee
Yes
No
/ Yes
i No
Yes
No
Contract Cover To be signed, dated & witnessed
Yes
No
/ Yes
No
Yes
No
Attachment A– General Terms and Conditions – Government/University
Yes
No
Yes
No
Yes
No
Attachment B – Scope of Work includes Timeline and Line Item Budget)
es
No
Yes
No
Yes
l No
Attachment C – Certifications and Assurances Section
Yes
No
Yes
No
Yes
No
Attachment D – NC O enBook Supplemental Information
Yes
No
' Yes
No
Yes
No
Attachment E – Signature Card
Yes
No
Yes
No
Yes X No
Attachment F – StreamFlow Assistance 50% Progress Re ort***
Yes
X No
Yes
/ No
Yes X
No
Attachment G – Streamflow Rehabilitation Assistance Program [StRAPI Quarter) Progress Report—
Yes
X No
Yes
/ No
Yes I X1 No
Attachment H- Reouest for Payment form***
Yes
X No
Yes
/ No
" NC Substitute W-9 and VEP forms are already on file and won't be required to be collected with contract.
Rev. 6117, 4/22 ***Attachments F, G and H do NOT need to be returned with the final contract � � l (112 2s
Steve Troxler North Carolina Department of Agriculture N. David Smith
Commissioner and Consumer Services Chief Deputy Commissioner
June 20, 2022
Dru Harrison
New Hanover SWCD
230 Government Center Drive, Suite 100
Wilmington, NC 28403
NOTIFICATION OF FUNDING OFFER
Dear Dru Harrison,
On behalf of Commissioner Steve Troxler and the North Carolina Department of Agriculture and Consumer
Services - Division of Soil & Water Conservation, I am pleased to inform you that $263,594.00 for your
project, StreamFlow Rehabilitation Program (StRAP), was approved.
The original contract packet must be completed and _returned to the NCDA&CS, making sure that the contracts and
certain forms have been signed, dated, and witnessed. Since this is a witness contract, there are two (2) options to
complete the contract. It is acceptable to have everyone sign the contract electronically or submit two (2) original
signed contracts. Depending on the method you choose, please return as shown below:
Electronic Signed Contract: OrhJnal siknatures einail:
Heather Reichert Heather Reichert, Administrative Specialist
Administrative Specialist N.C. Department of Agriculture & Consumer Services, Division Name
Heather.reichert@ncaar.gov 1614 Mail Service Center
Raleigh, NC 27699-1614
By completing these documents, you are agreeing to the specific stipulations, the general terms and conditions and
specific reporting requirements. All authorized representative signatures must be in blue or black ink. Please use
the Contract Check Off List to ensure all attachments are included and are in the correct order for each contract
packet. Failure to complete and return the contract packets within 60 days of this letter or the deadline of any
written extension provided will result in fundincancellation for he ro'leet.
One fully -executed, an original contract will be returned to you for your records. If you have any questions about
your contract or any of the forms contained in your offer packet, please call Heather Reichert at 919-707-3768, or
feel free to send an email to heather.reichert@ncagr.gov.
ncagr.gov.
I would like to take this opportunity to thank you for participating in the StreamFlow Rehabilitation Program
(StRAP).
Sincerely
David ii
Chief Deputy Commissioner
Enclosures
cc: Heather Bruce, Grants Manager
Email: David.Smith@ncagr.gov
1001 Mail Service Center, Raleigh, North Carolina, 27699-1001
(919) 707-3033 0 Fax (919) 715-0026
An Equal Opportunity Affirmative Action Employer
STATE OF NORTH CAROLINA
COUNTY OF WAKE
Departmental Use Only
CENTER:2740
ACCOUNT: 536431
AMOUNT: $263.594
TIME PERIOD: June 1. 2022 -
Dec. 31, 2024
North Carolina Department of Agriculture and Consumer Services
Division of Soil & Water Conservation
Streamflow Rehabilitation Assistance Program— Government
CONTRACT # 22-080-4024
This Contract is hereby entered into by and between the North Carolina Department of Agriculture and
Consumer Services, Division of Soil & Water (the "Agency") and New Hanover SWCD, ("Grantee"), and
referred to collectively as the "Parties." The Grantee's federal tax identification number is 56-6000324 and is
physically located in New Hanover County and is further located at 230 Government Center Drive, Suite 100
Wilmington, NC 28403.
The purpose of this Contract is to assist in protecting and restoring the integrity of drainage
infrastructure through routine maintenance to existing streams and drainage ways. The Grantee's project title
is Streamflow Rehabilitation Assistance Program. This Contract is funded by State appropriations provided
through Session Law 2021-180, Senate Bill 105 Section 5.9(a)(1). Funds awarded under this Contract must
be used for the purposes for which they are intended and provided in Session Law 2021-180, Senate Bill 180
Section 5.9(k) -(o).
The Grantee's fiscal year ends June 30.
Contract Documents:
This Contract consists of the Grant Contract and its attachments, all of which are identified by name
as follows:
1. This Contract
2. General Terms and Conditions (Attachment A)
3. Scope of Work providing details on the stream debris removal and watershed structure projects
and timelines (Attachment C)
4. NC Openbook Supplemental Information (Attachment D)
5. Signature Card (Attachment E)
6. Streamflow Rehabilitation Assistance Program (StRAP) Quarterly Progress Report
(Attachment F)
7. Streamflow Assistance 50% Progress Report (Attachment G)
8. Request for payment form (Attachment H)
These documents constitute the entire agreement between the Parties and supersede all prior oral or written
statements or agreements.
I. Precedence Among Contract Documents:
In the event of a conflict between or among the terms of the Contract Documents, the terms in the
Contract Document with the highest relative precedence shall prevail. The order of precedence shall be
the order of documents as listed in Paragraph 1, above, with the first -listed document having the highest
precedence and the last -listed document having the lowest precedence. If there are multiple Contract
Amendments, the most recent amendment shall have the highest precedence and the oldest amendment
shall have the lowest precedence.
II. Effective Period:
This Contract shall be effective on June 1.2022. and shall terminate on December 31.2024. with the
option to extend, if mutually agreed upon, through a written amendment as provided for in the General
Terms and Conditions as described in Attachment A.
III. Grantee's Duties:
The Grantee has 60 days to return the original contract from the offer letter. If more than 60 days is
needed, a written explanation providing a detailed explanation for the extension need is required.
The letter will also need to include a date that the contract will be signed and returned. The letter will
be subject to approval. Failure to return the contract within 60 days or a written explanation will
result in funding cancellation for the project.
The Grantee shall provide the planned repairs to the named stream/drainage channels and watershed
projects listed in Attachment B, Scope of Work. The Grantee shall be responsible for obtaining
necessary landowner authorization for site access and all permits needed to complete the planned
work.
Grantee will need to have Fifry percent [50%� of award funds committed (i.e., encumbered) with
vendors by February 28, 2023. If by February 28, 2023, this condition hasn't been met, the grantee's
remaining unencumbered funds are subject to reversion and reallocation by the Commission.
IV. Agency's Duties:
The Agency shall pay the Grantee in the manner and in the amounts specified in the Contract
Documents. The total amount paid by the Agency to the Grantee under this Contract shall not exceed
$263,594.00. The funds are provided from State appropriations allocated through Session Law 2021-180,
Senate Bill 105 Section 5.9(a)(1). By February 28. 2023, fifty percent (50%) of the award amount
$131,797.00 should be encumbered by contracts.
[X] a. There are no matching requirements from the Grantee.
[ ] b. There are no matching requirements from the Grantee; however, the Grantee has committed the
following match to this project:
In Kind $
Cash $
] c. The Grantee's matching requirement is , which consists of:
In Kind
Cash $
The total Contract amount with matching funds is $ $263,594.00
V. Conflict of Interest Policy:
NCDA&CS (State Funds Govt Contract Cover) Rev. 7/14;12/14; 8/17; 4/2022 Page 1 of 6
V. 4 2022 Streamflow Assistance- GOVERNMENT
The Agency has determined that the Grantee is a government agency and is not subject to N.C.G.S. §
143C -6-23(b). Therefore, the Grantee is not required to file a Conflict -of -Interest Policy with the Agency
prior to disbursement of funds.
VI. Statement of No Overdue Tax Debts:
The Agency has determined that Grantee is a government agency and is not subject to N.C.G.S. §
143C -6-23(c). Therefore, the Grantee is not required to file a Statement of No Overdue Tax Debts with
the Agency prior to disbursement of funds.
VII. Reversion of Unexpended Funds:
Any unexpended grant funds shall revert to the Agency upon termination of this Contract.
VIII. Reporting Requirements:
• State Reporting Requirements [N.C.G.S. 143C-6-23]:
o The Agency has determined that the Grantee is a governmental entity and is not subject to
the State reporting requirements mandated by N.C.G.S. § 143C-6-23. Therefore, the Grantee
does not have to file annual electronic reports with the NC Office of State Budget &
Management.
• Agency Reporting Requirements:
o The Grantee shall submit quarterly progress reports, with each report due on or before the
last day of January, April, July, and October, continuing until the project is complete and
final project report is approved.
o First report will be due on or before the last day of October 2022.
o The quarterly report will be submitted using the form shown as Attachment F- Streamflow
Rehabilitation Assistance Program (StRAP) Progress Report. This report will be used for the
quarterly and final report. Each report shall include a narrative summary of the work
completed each quarter and for the project to date and a summary of cash and in-kind
expenditures for the quarter and total project.
o The quarterly progress report is required even if no activity has occurred for the quarter and
no reimbursement is requested for the quarter.
o Grantee shall submit a Streamflow Assistance 50% Progress Report (Attachment GG) by end
of business hours on February 28, 2023. The report will provide detailed information on
the contracts that have been approved and executed for the project. This report requires the
grantee to show 50% of contract funds being encumbered by contracts. The report needs to
be submitted to the Agency contract administrator via email. The report is also subject to the
review and approval of the Soil & Water Commission.
o Grantee shall submit a Final Financial report and Final Invoice no later than 60 days after the
expiration or termination of this Contract.
o Grantee will provide award letters for any subgrant.
o Failure to submit timely and accurate reports will delay action on submitted invoices.
Repeated reporting issues can also result in further discussion with the Soil & Water
Commission to determine continued participation in the program.
IX. Payment Provisions:
All Request for Payment forms should be received no more than monthly. Payment requests will be
submitted using Attachment H- StreamFlow Rehabilitation Assistance Pro am Pro 'ect Invoice Form,
along with an appropriate certified invoice showing expenditures and matching funds, if applicable, for
the current period and cumulatively for the entire project. Upon approval by the Agency payment shall be
made within 30 days. All payments are subject to the availability of funds and verification that the
Grantee is current on all reporting requirements.
NCDA&CS (State Funds Govt Contract Cover) Rev. 7/14;12/14; 8/17; 4/2022 Page 2 of 6
V. 4 2022 Streamflow Assistance- GOVERNMENT
For sites for which this contract is supplementing USDA Emergency Watershed Protection Program
(EWPP) funding, completed work must also satisfy EWPP requirements prior to payment being
authorized.
A portion of the funds awarded to the Grantee may be used to reimburse actual documented
engineering, technical assistance, and administrative expenses for the project, excluding any salary,
benefits, and operating expenses that would normally have been paid by the Grantee. Reimbursement of
engineering, technical assistance, and administrative expenses shall be limited to 15% of total reimbursed
expenditures.
The Grantee shall expend funds in accordance with G.S. 143C-6-23 (fl)(2)0). The Grantee shall
account for any income earned, which may result from any funds awarded under this Contract, on the
Agency "Program Project Invoice" form. Eligible uses of income earned are:
• Expanding the project or program.
• Continuing the project or program after grant ends; or
• Supporting other projects or programs that further the broad objectives of the grant program.
This contract can be terminated prior to the original end date once the Grantee completes their final
report. if this Contract is terminated prior to the original end date, the Grantee may submit a final Request
for Payment form. All unexpended funds shall be returned by the Grantee to the Agency within 60 days
of the Contract termination date with a complete final financial report, accompanied by a final invoice.
The Agency shall have no obligation to honor requests for payment based on expenditure reports
submitted later than 60 days after termination or expiration of the Contract period.
Reimbursement requests shall be completed on a "Request for Reimbursement" form furnished to the
Grantee by the Agency. All reimbursement forms must include support documentation, including but not
limited to copies of invoices, individual time sheets and travel logs that have been signed by the employee
and supervisor, salary registers or payrolls that include fringe benefits, hourly rates of pay, and signature
of the Grantee's responsible financial person, cancelled checks and lease agreements.
Eligible expenditures for payment must be within the effective period noted in the Contract.
Reimbursement may not be considered prior to the submission and final execution of the Contract.
All travel reimbursement shall be made in accordance with the current State rates, at the time of the
expenditure, and shall be made in accordance with the "State Budget Manual"
https://www.osbm.nc.eovibudget/budget-manual
All matching funds, including in-kind and cash, must be spent concurrently with funds provided by
the Contract. Both types of matching funds expended shall be accounted for on the monthly certified
invoices.
Indirect costs are not allowable expenditures under this Contract.
X. Fraud, Waste and Abuse
Grantee, including its employees, contractors, agents, interns, or any subrecipients, shall report
suspected fraud, waste and abuse activities related to any state employee, vendor or sub recipient of state
funds or state resources.
There are three methods for reporting suspected fraud, waste or abuse (FWA). Grantee can report
suspected FWA directly to the Agency's Audit Services Division, to any member of the Agency's
management team or through the FWA reporting website below.
N.C.G.S. 143-748 permits Audit Services to treat all information as confidential. However, if an
individual wishes to remain anonymous, reports can be submitted through the FWA reporting website:
httns://www.ncagr.Dov/internalaudit/ReportForm.htm
Under no circumstances should an individual attempt to personally conduct investigations or
interviews /interrogations related to any suspected FWA act.
NCDA&CS (State Funds Govt Contract Cover) Rev. 7/14;12/14; 8/17; 4/2022 Page 3 of 6
V. 4 2022 Streamflow Assistance- GOVERNMENT
Investigation results will not be disclosed or discussed with anyone other than those who have a
legitimate need to know. This is important to avoid damaging the reputations of persons suspected but
subsequently found innocent of wrongful conduct.
It is the Agency's policy that employees/contractors/sub recipients/interns will not suffer retaliation
or harassment for reporting in good faith any FWA concerns. The Agency encourages openness and will
support anyone who raises genuine concerns in good faith under this policy, even if they turn out to be
unsubstantiated.
X1. Contract Administrators:
All notices permitted or required to be given by one Party to the other and all questions about the
Contract from one Party to the other shall be addressed and delivered to the other Party's Contract
Administrator. The name, post office address, street address, telephone number, fax number, and email
address of the Parties' respective initial Contract Administrator are set out below. Either Party may
change the name, post office address, street address, telephone number, fax number, or email address of
its Contract Administrator by giving timely written notice to the other Party.
For the Agency:
IF DELIVERED BY US POSTAL SERVICE
IF DELIVERED BY ANY OTHER MEANS
Heather Reichert
Heather Reichert
1614 Mail Service Center
Division of Soil & Water Conservation
Raleigh, NC 27699-1614
216 West Jones Street
Telephone: 919-707-3768
Raleigh, NC 27603
Email: heather.reichert@ncagr.gov
Grants & Contracts General Email:
ag_r. grantsQncagr. gov
For the Grantee:
Grantee Contract Administrator- Mailing Address
Grantee Principal Investigator or Lej Personnel
Dru Harrison
Same
New Hanover SWCD
230 Government Center Drive, Suite 100
Wilmington, NC 28403
910-798-7135
drharrison@nhcgov.com
XII. Supplementation of Expenditure of Public Funds:
The Grantee assures that funds received pursuant to this Contract shall be used only to supplement,
not to supplant, the total amount of federal, State, and local public funds that the Grantee otherwise
expends for activities involved with specialty services and related programs. Funds received under this
Contract shall be used to provide additional public funding for such services. The funds shall not be used
to reduce the Grantee's total expenditure of other public funds for such services.
XIII. Disbursements:
As a condition of this Contract, the Grantee acknowledges and agrees to make disbursements in
accordance with the following requirements:
• Will implement or already have implemented adequate internal controls over disbursements.
• Pre -audit all invoices presented for payment to determine:
o Validity and accuracy of payment
NCDA&CS (State Funds Govt Contract Cover) Rev. 7/14;12/14; 8/17; 4/2022 Page 4 of 6
V. 4 2022 StreamFlow Assistance- GOVERNMENT
o Payment due date
o Adequacy of documentation supporting payment
• Legality of disbursement
• Assure adequate control of signature stamps/plates.
• Assure adequate control of negotiable instruments; and
• Have procedures in place to ensure that account balance is solvent and to reconcile the account
monthly.
X1. Outsourcing:
The Grantee certifies that it has identified to the Agency all jobs related to the Contract that have been
outsourced to other countries, if any. Grantee further agrees that it will not outsource any such jobs during
the term of this Contract without providing prior notice to the Agency.
XIV. N.C.G.S. § 133-32 and Executive Order 24:
N.C.G.S. § 133-32 and Executive Order 24 prohibit the offer to, or acceptance by, any State employee
of any gift from anyone with a Contract with the State, or from any person seeking to do business with
the State. By execution of any response in this procurement or Contract, you attest, for your entire
organization and its employees or agents, that you are not aware that any such gift has been offered,
accepted, or promised by any employee of your organization.
(This space is internally left blank)
NCDA&CS (State Funds Govt Contract Cover) Rev. 7/14;12/14; 8/17; 4/2022 Page 5 of 6
V. 4 2022 Streamflow Assistance- GOVERNMENT
XV. Signature Warranty:
The undersigned represent and warrant that they are authorized to bind their principals to the terms of
this Contract.
IN WITNESS WHEREOF, the Grantee and the Agency execute this Contract as an electronic original,
each party will be provided a fully executed copy via electronic mail. It is required that each party retain a
fully executed copy of this contract.
Grantee: t�4 x
gnature of Authorized Representative
Lisa Wurtzbacher, Assistant County Manager
Printed Name
Witness:
c5" W+" -
Signature
EV Sa ✓� �/`! y h n
Printed Name
10/21/2022
Date
Title
Date
CKe c wd-: ve Ns s4-.
Title
0 1--N
North Carolina Department of Agriculture and Consumer Services
Signature of Authorized
N. David Smith, Chief Deputy Commissioner
Date
NCDA&CS (State Funds Govt Contract Cover) Rev. 7/14;12/14; 8/17; 4/2022 Page 6 of 6
V. 4 2022 StreamFlow Assistance- GOVERNMENT
DEFINITIONS
)cal Governments)
General Terms and Conditions
Unless indicated otherwise from the context, the
following terms shall have the following meanings in
this Contract. All definitions are from 9 NCAC
3M.0102 unless otherwise noted. If the rule or
statute that is the source of the definition is changed
by the adopting authority, the change shall be
incorporated herein:
(1) "Agency" (as used in the context of the
definitions below) shall mean and include
every public office, public officer or official
(State or local, elected or appointed),
institution, board, commission, bureau,
council, department, authority or other unit of
government of the State or of any county,
unit, special district or other political
subagency of government. For other
purposes in this Contract, "Agency" shall
mean the entity identified as one of the
parties hereto.
(2) "Audit" means an examination of records or
financial accounts to verify their accuracy.
(3) "Certification of Compliance" means a report
provided by the Agency to the Office of the
State Auditor that states that the Grantee has
met the reporting requirements established
by this Subchapter and included a statement
of certification by the Agency and copies of
the submitted grantee reporting package.
(4) "Compliance Supplement" refers to the North
Carolina State Compliance Supplement,
maintained by the State and Local
Government Finance Agency within the
North Carolina Department of State
Treasurer that has been developed in
cooperation with agencies to assist the local
auditor in identifying program compliance
requirements and audit procedures for
testing those requirements.
(5) "Contract" means a legal instrument that is
used to reflect a relationship between the
agency, grantee, and subgrantee.
(6) "Fiscal Year" means the annual operating
year of the non -State entity.
(7) "Financial Assistance" means assistance that
non -State entities receive or administer in the
form of grants, loans, loan guarantees,
property (including donated surplus
property), cooperative agreements, interest
subsidies, insurance, food commodities,
direct appropriations, and other assistance.
Financial assistance does not include
amounts received as reimbursement for
services rendered to individuals for Medicare
and Medicaid patient services.
Attachment A
(8) "Financial Statement" means a report
providing financial statistics relative to a
given part of an organization's operations or
status.
(9) "Grant" means financial assistance provided
by an agency, grantee, or subgrantee to
carry out activities whereby the grantor
anticipates no programmatic involvement
with the grantee or subgrantee during the
performance of the grant.
(10) "Grantee" has the meaning in G.S. 143C -6-
23(a)(2): a non -State entity that receives a
grant of State funds from a State agency,
department, or institution but does not
include any non -State entity subject to the
audit and other reporting requirements of the
Local Government Commission. For other
purposes in this Contract, "Grantee" shall
mean the entity identified as one of the
parties hereto.
(11) "Grantor" means an entity that provides
resources, generally financial, to another
entity in order to achieve a specified goal or
objective.
(12) "Non -State Entity" has the meaning in
N.C.G.S. 143C -1-1(d)(18): Any of the
following that is not a State agency: an
individual, a firm, a partnership, an
association, a county, a corporation, or any
other organization acting as a unit. The term
includes a unit of local government and
public authority.
(13) "Public Authority" has the meaning in
N.C.G.S. 143C -1-1(d)(22): A municipal
corporation that is not a unit of local
government or a local governmental
authority, board, commission, council, or
agency that (i) is not a municipal corporation
and (ii) operates on an area, regional, or
multiunit basis, and the budgeting and
accounting systems of which are not fully a
part of the budgeting and accounting
systems of a unit of local government.
(14) "Single Audit" means an audit that includes
an examination of an organization's financial
statements, internal controls, and compliance
with the requirements of federal or State
awards.
(15) "Special Appropriation" means a legislative
act authorizing the expenditure of a
designated amount of public funds for a
specific purpose.
(16) "State Funds" means any funds
appropriated by the North Carolina General
Assembly or collected by the State of North
Carolina. State funds include federal
NCDA&CS - General Terms and Conditions — Public - Local Governmental Entities
Eff. 07/14;4/15;1 /17
Page 1 of 4
PUBLIC SECTOR CONTRACTS (including Local Governments)
financial assistance received by the State
and transferred or disbursed to non -State
entities. Both federal and State funds
maintain their identity as they are subgranted
to other organizations. Pursuant to N.C.G.S.
143C -6-23(a)(1), the terms "State grant
funds" and "State grants" do not include any
payment made by the Medicaid program, the
Teachers' and State Employees'
Comprehensive Major Medical Plan, or other
similar medical programs.
(17) "Subgrantee" has the meaning in G.S.
143C -6-23(a)(3): a non -State entity that
receives a grant of State funds from a
grantee or from another subgrantee but does
not include any non -State entity subject to
the audit and other reporting requirements of
the Local Government Commission.
(18) "Unit of Local Government has the meaning
in G.S. 143C -1-1(d)(29): A municipal
corporation that has the power to levy taxes,
including a consolidated city -county as
defined by G.S. 160B-2(1), and all boards,
agencies, commissions, authorities, and
institutions thereof that are not municipal
corporations.
Relationships of the Parties
Independent Contractor: The Grantee is and shall
be deemed to be an independent Contractor in the
performance of this Contract and as such shall be
wholly responsible for the work to be performed and
for the supervision of its employees. The Grantee
represents that it has, or shall secure at its own
expense, all personnel required in performing the
services under this agreement. Such employees shall
not be employees of, or have any individual
contractual relationship with, the Agency.
Subcontracting: The Grantee shall not subcontract
any of the work contemplated under this Contract
without prior written approval from the Agency. Any
approved subcontract shall be subject to all
conditions of this Contract. Only the subcontractors
or subgrantees specified in the Contract documents
are to be considered approved upon award of the
Contract. The Agency shall not be obligated to pay
for any work performed by any unapproved
subcontractor or subgrantee. The Grantee shall be
responsible for the performance of all of its
subgrantees and shall not be relieved of any of the
duties and responsibilities of this Contract.
Subgrantees: The Grantee has the responsibility to
ensure that all subgrantees, if any, provide all
information necessary to permit the Grantee to
comply with the standards set forth in this Contract.
Assignment: No assignment of the Grantee's
obligations or the Grantee's right to receive payment
hereunder shall be permitted. However, upon written
request approved by the issuing purchasing authority,
the State may:
(a) Forward the Grantee's payment check(s)
directly to any person or entity designated by
the Grantee, or
(b) Include any person or entity designated by
Grantee as a joint payee on the Grantee's
payment check(s).
In no event shall such approval and action obligate
the State to anyone other than the Grantee and the
Grantee shall remain responsible for fulfillment of all
Contract obligations.
Beneficiaries: Except as herein specifically
provided otherwise, this Contract shall inure to the
benefit of and be binding upon the parties hereto and
their respective successors. It is expressly
understood and agreed that the enforcement of the
terms and conditions of this Contract, and all rights of
action relating to such enforcement, shall be strictly
reserved to the Agency and the named Grantee.
Nothing contained in this document shall give or
allow any claim or right of action whatsoever by any
other third person. It is the express intention of the
Agency and Grantee that any such person or entity,
other than the Agency or the Grantee, receiving
services or benefits under this Contract shall be
deemed an incidental beneficiary only.
Indemnity
Indemnification: The Grantee agrees to indemnify
and hold harmless the Agency, including any of its
Divisions, and any of its officers, agents and
employees, from liability of any kind, and from any
claims of third parties arising out of any act or
omission of the Contractor in connection with the
performance of this Contract to the extent permitted
by law.
Default and Termination
Termination by Mutual Consent: The Parties may
terminate this Contract by mutual consent with 60
days notice to the other party, or as otherwise
provided by law.
Termination for Cause: If, through any cause, the
Grantee shall fail to fulfill its obligations under this
Contract in a timely and proper manner, the Agency
shall have the right to terminate this Contract by
giving written notice to the Grantee and specifying
the effective date thereof.
In that event, all finished or unfinished deliverable
items prepared by the Grantee under this Contract
NCDA&CS - General Terms and Conditions — Public - Local Governmental Entities
Eff. 07114;4115;1/17
Page 2 of 4
>t IRI Ir SECTOR CONTRACTS (Inc ludtna t, I Govprnn� ; i0
shall, at the option of the Agency, become its
property and the Grantee shall be entitled to receive
just and equitable compensation for any satisfactory
work completed on such materials, minus any
payment or compensation previously made.
Notwithstanding the foregoing provision, the Grantee
shall not be relieved of liability to the Agency for
damages sustained by the Agency by virtue of the
Grantee's breach of this agreement, and the Agency
may withhold any payment due the Grantee for the
purpose of setoff until such time as the exact amount
of damages due the Agency from such breach can be
determined. The filing of a petition for bankruptcy by
the Grantee shall be an act of default under this
Contract.
Waiver of Default: Waiver by the Agency of any
default or breach in compliance with the terms of this
Contract by the Grantee shall not be deemed a
waiver of any subsequent default or breach and shall
not be construed to be modification of the terms of
this Contract unless stated to be such in writing,
signed by an authorized representative of the Agency
and the Grantee and attached to the Contract.
Availability of Funds: The parties to this Contract
agree and understand that the payment of the sums
specified in this Contract is dependent and contingent
upon and subject to the appropriation, allocation, and
availability of funds for this purpose to the Agency.
Force Majeure: Neither party shall be deemed to be
in default of its obligations hereunder if and so long
as it is prevented from performing such obligations by
any act of war, hostile foreign action, nuclear
explosion, riot, strikes, civil insurrection, earthquake,
hurricane, tornado, or other catastrophic natural
event or act of God.
Survival of Promises: All promises, requirements,
terms, conditions, provisions, representations,
guarantees, and warranties contained herein shall
survive the Contract expiration or termination date
unless specifically provided otherwise herein, or
unless superseded by applicable federal or State
statutes of limitation.
Intellectual Property Rights
Copyrights and Ownership of Deliverables: All
deliverable items produced pursuant to this Contract
are the exclusive property of the Agency. The
Grantee shall not assert a claim of copyright or other
property interest in such deliverables.
Compliance with Applicable Laws
Compliance with Laws: The Grantee shall comply
with all laws, ordinances, codes, rules, regulations,
and licensing requirements that are applicable to the
conduct of its business, including those of federal,
State, and local agencies having jurisdiction and/or
authority.
Equal Employment Opportunity: The Grantee
shall take affirmative action in complying with all
federal and State statutes and all applicable
requirements concerning fair employment of people
with disabilities, and concerning the treatment of all
employees without regard to discrimination by reason
of race, color, religion, sex, national origin or
disability. For additional information see Title VI of the
Civil Rights Act of 1964 (42 U.S.C., 2000d, 2000e-
16), Title XI of the Education amendments of 1972,
as amended (20 U.S.C. 1681-1683 and 1685-1686),
and section 504 of the Rehabilitation Act of 1973 as
amended (29 U.S.C. 794).
Executive Order 24: In accordance with Executive
Order 24, issued by Governor Perdue, and N.C.G.S.§
133-32, a vendor or contractor (i.e. architect, bidder,
contractor, construction manager, design
professional, engineer, landlord, offeror, seller,
subcontractor, supplier, vendor, or grantee), is
prohibited from making gifts or giving favors to any
employee of the Agency of Agriculture and Consumer
Services. This prohibition covers those vendors,
contractors, and/or grantees who:
(a) have a Contract with a governmental
Agency; or
(b) have performed under such a Contract within
the past year; or
(c) anticipate bidding on such a Contract in the
future.
For additional information regarding the specific
requirements and exemptions, vendors, contractors,
and/or grantees are encouraged to review Executive
Order 24 and N.C.G.S. § 133-32.
Confidentiality
Confidentiality: Any information, data, instruments,
documents, studies or reports given to or prepared or
assembled by the Grantee under this agreement
shall be kept as confidential and not divulged or
made available to any individual or organization
without the prior written approval of the Agency. The
Grantee acknowledges that in receiving, storing,
processing or otherwise dealing with any confidential
information it will safeguard and not further disclose
the information except as otherwise provided in this
Contract.
Oversight
Access to Persons and Records: The State Auditor
and the using agency's internal auditors shall have
NCDA&CS - General Terms and Conditions — Public - Local Governmental Entities
Eff. 07/14;4/15;1/17 Page 3 of 4
access to persons and records as a result of all
Contracts or grants entered into by State agencies or
political subdivisions in accordance with General
Statute 147-64.7 and Session Law 2010-194, Section
21 (i.e., the State Auditors and internal auditors may
audit the records of the contractor during the term of
the Contract to verify accounts and data affecting
fees or performance).
Record Retention: Records shall not be destroyed,
purged or disposed of without the express written
consent of the Agency. State basic records retention
policy requires all grant records to be retained for a
minimum of five years or until all audit exceptions
have been resolved, whichever is longer. If the
Contract is subject to federal policy and regulations,
record retention may be longer than five years since
records must be retained for a period of three years
following submission of the final Federal Financial
Status Report, if applicable, or three years following
the submission of a revised final Federal Financial
Status Report. Also, if any litigation, claim,
negotiation, audit, disallowance action, or other
action involving this Contract has been started before
expiration of the five-year retention period described
above, the records must be retained until completion
of the action and resolution of all issues which arise
from it, or until the end of the regular five-year period
described above, whichever is later.
Miscellaneous
Choice of Law: The validity of this Contract and any
of its terms or provisions, as well as the rights and
duties of the parties to this Contract, are governed by
the laws of North Carolina. The Grantee, by signing
this Contract, agrees and submits, solely for matters
concerning this Contract, to the exclusive jurisdiction
of the courts of North Carolina and agrees, solely for
such purpose, that the exclusive venue for any legal
proceedings shall be Wake County, North Carolina.
The place of this Contract and all transactions and
agreements relating to it, and their situs and forum,
shall be Wake County, North Carolina, where all
matters whether sounding in Contract or tort, relating
to the validity, construction, interpretation, and
enforcement shall be determined.
Headings: The Section and Paragraph headings in
these General Terms and Conditions are not material
parts of the agreement and should not be used to
construe the meaning thereof.
Time of the Essence: Time is of the essence in the
performance of this Contract.
Care of Property: The Grantee agrees that it shall
be responsible for the proper custody and care of any
property furnished to it for use in connection with the
performance of this Contract and will reimburse the
Agency for loss of, or damage to, such property. At
the termination of this Contract, the Grantee shall
contact the Agency for instructions as to the
disposition of such property and shall comply with
these instructions.
Amendment: This Contract may not be amended
orally or by performance. Any amendment must be
made in written form and executed by duly authorized
representatives of the Agency and the Grantee.
Severability: In the event that a court of competent
jurisdiction holds that a provision or requirement of
this Contract violates any applicable law, each such
provision or requirement shall continue to be
enforced to the extent it is not in violation of law or is
not otherwise unenforceable and all other provisions
and requirements of this Contract shall remain in full
force and effect.
Travel Expenses: Reimbursement to the Grantee
for travel mileage, meals, lodging and other travel
expenses incurred in the performance of this
Contract shall be reasonable and supported by
documentation. State rates shall be used.
International travel shall not be reimbursed under this
Contract.
Sales/Use Tax Refunds: If eligible, the Grantee and
all subgrantees shall: (a) ask the North Carolina
Department of Revenue for a refund of all sales and
use taxes paid by them in the performance of this
Contract, pursuant to G.S. 105-164.14; and (b)
exclude all refundable sales and use taxes from all
reportable expenditures before the expenses are
entered in their reimbursement reports.
Advertising: The Grantee shall not use the award of
this Contract as a part of any news release or
commercial advertising.
Indirect Costs Policy: The Agency has adopted a
"Zero" policy that indirect costs are unallowable
expenditures in all State funded grant applications
and/or grant guidance, informational or directional
documents.
Allowable Uses of State Funds: Expenditures of
State funds by any grantee shall be in accordance
with the Cost Principles outlined in the Office of
Management and Budget (OMB) CFR Title 2, Part
200 Uniform Administrative Requirements, as
applicable. If the grant funding includes federal
sources, the grantee shall ensure adherence to the
cost principles established by the Federal Office of
Management and Budget. [09 NCAC 03M.020]
NCDA&CS - General Terms and Conditions — Public - Local Governmental Entities
Eff. 07/14;4/15;1/17 Page 4 of 4
Attachment B
I Streamflow Rehabilitation Assistance Program Scope of Work v.1 J
Applicant Name: New Hanover County
Payee Name New Hanover County Payee Tax ID 1 56-6000324
TREAM DEBRIS REMOVAL Revised Scope of Work ,<<< :.: ,• : L.n2 ti -
PL -566 WATERSHED STRUCTURE Revised Scope of Work (Insert Additional Lines as Needed)
PL -566 Watershed Watershed Project Estimated Cost to
Project Name Structure Number Description of Needed Repair Description of Planned Repair Repair
A _
B
C
D
E 0
Project Timeline T
Linear Feet of
Milestones
A July - Sept 2022
Agreements signed; Project Scoping and Bid packages prepared; Access Permission Initiated where needed
B Oct - Dec 2022
Bid Advertisement
Stream/Drainage
Channel Proposed
D Apr -June 2023
Planned Repair and Removal
Number of Known
Estimated Cost to
F Oct - Dec 2023
Channel Name
for Repair
Description of Damage
from Floodplain
Beaver Dams
Repair
J Oct -Dec 2024
Severe Vegetative Debris in
Channel; log jams; etc. behind
Remove vegetative debris and
A
Prince George Creek
1000
5001 Blue Clay Road
logjams from floodplain
0
$40,000
Vegetative debris in channel;
log jams; etc. behind Adams Remove vegetative debris and
B
Barnard Creek
5300
Landing N log jams from floodplain
0
$60,000
Vegetative debris in channel;
logjams; etc. between
Remove vegetative debris and
C
Smith Creek
2600
Lynbrook and Kerr Ave.
log jams from floodplain
0
$32,500
Vegetative debris in channel;
log jams; etc. south of Rockhill
Remove vegetative debris and
D
Dock Creek
2000
Road
log jams from floodplain
0
$30,000
Vegetative debris in channel;
Remove vegetative debris and
E
Mott Creek
3500
log jams; etc. Glen Ellen Area
lo?,;ams from floodplain
0
$50,000
Vegetative debris in channel;
logjams; etc. McQuillan Drive
Remove vegetative debris and
F
Lords Creek
3700
area
log jams from floodplain
0
$51,000
All debris will be hauled off site.
TOTALS: 18100 1 0
263500
PL -566 WATERSHED STRUCTURE Revised Scope of Work (Insert Additional Lines as Needed)
PL -566 Watershed Watershed Project Estimated Cost to
Project Name Structure Number Description of Needed Repair Description of Planned Repair Repair
A _
B
C
D
E 0
Project Timeline T
Time Period
Milestones
A July - Sept 2022
Agreements signed; Project Scoping and Bid packages prepared; Access Permission Initiated where needed
B Oct - Dec 2022
Bid Advertisement
C Jan - Mar 2023
Bid Award; Notice to Poceed; Begin Work
D Apr -June 2023
Completed Work; Final Inspections
E Jul -Sept 2023
Final reporting and reimbursement requests
F Oct - Dec 2023
G Jan - Mar 2024
H Apr - June 2024
1 July - Sept 2024
J Oct -Dec 2024
Certifications and Assurances
Attachment C
CERTIFICATIONS REGARDING LOBBYING, NONPROCUREMENT, DEBARMENT,
SUSPENSION AND DRUG-FREE WORKPLACE
Applicants should refer to the regulations cited below to determine the certification to which they are
required to attest. Signature of this form provides for compliance with certification requirements under 2
CFR, Subtitle B, Chapter IV, Part 417, "Nonprocurement Debarment and Suspension," Part 418, "New
Restrictions on Lobbying," and Part 421, "Requirements for Drug -Free Workplace (Financial Assistance),"
and 2 CFR Part 180. The certifications shall be treated as a material representation of fact upon which
reliance will be placed when the Department of Agriculture & Consumer Services determines to award the
covered transaction, grant, or cooperative agreement.
1. LOBBYING
As required by authority: 31 U.S.C. 1352 and U.S.C. 301 and implemented at 2 CFR Part 180, for persons
entering into a grant or cooperative agreement over $100,000, as defined at 2 CFR Section 418.110, the
applicant certifies that to the best of their knowledge and belief, that:
1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned,
to any person for influencing or attempting to influence an officer or employee of an agency, a
Member of Congress, an officer or employee of Congress, or an employee of a Member of
Congress in connection with the awarding of any Federal contract, the making of any Federal
contract, the making of any Federal loan, the entering into of any cooperative agreement, and the
extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan,
or cooperative agreement.
2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for
influencing or attempting to influence an officer or employee of any agency, a Member of
Congress, an officer or employee of Congress, or an employee of a Member of Congress in
connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall
complete and submit Standard Form -LLL, "Disclosure Form to Report Lobbying" in accordance
with its instructions.
3) The undersigned shall require that the language of this certification be included in the award
documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under
grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose
accordingly.
This certification is a material representation of fact upon which reliance was placed when this transaction
was made or entered into. Submission of this certification is a prerequisite for making or entering into this
transaction imposed by section 1352, title 31, U.S. Code. Any person who fails to file the required
certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for
each such failure.
2. NONPROCUREMENT DEBARMENT AND SUSPENSION
As required by Executive Order 12549, Debarment and Suspension, and implemented at 2 CFR Part 180
and 2CFR Part 417, for prospective participants in primary covered transactions, as defined at 2 CFR
180.435 and Subpart C, 417.332, the applicant certifies that it and its principals:
a) Are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily
excluded from covered transactions by any Federal department or agency;
b) Have not within a three-year period preceding this application been convicted of or had a civil
judgment rendered against them for commission of fraud or a criminal offense in connection with
obtaining, attempting to obtain, or performing a public (Federal, State, or local) transaction or
contract under a public transaction; violation of Federal or State antitrust statutes or commission of
embezzlement, theft, forgery, bribery, falsification or destruction of records, making false
statements, or receiving stolen property;
NCDA&CS Certifications & Assurances
Rev 9/12, 10/12, 11/13;1/17
Page 1 of 3
c) Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity
(Federal, State, or local) with commission of any of the offenses enumerated in paragraph 2. (a)
(b) of this certification.
d) Have not within a three-year period preceding this application had one or more public transaction
(Federal, State, or local) terminated for cause or default.
e) Agree to include a term or condition in lower tier covered transactions requiring lower tier
participants to comply with subpart C of the OMB guidance in 2 CFR part 180, as supplemented by
subpart C of Part 417.
Where the applicant is unable to certify to any of the statements in this certification, he or she shall attach
an explanation to this certification.
3. DRUG-FREE WORKPLACE (GRANTEES OTHER THAN INDIVIDUALS)
As required by the Drug -Free Workplace Act of 1988, and implemented at 2 CFR Part 182, Subparts B,
and C, for grantees:
The applicant certifies that it will:
a) Make a good faith effort, on a continuing basis, to maintain a drug-free workplace. You must
agree to do so as a condition for receiving any award covered by this part.
b) Publish a drug-free workplace statement and establish a drug-free awareness program for your
employees (see Sections 182.205 through 182.220); and
c) Take actions concerning employees who are convicted of violating drug statutes in the workplace
(see Section 182.225), including notification to any Federal agency on whose award the convicted
employee was working and within 30 days take appropriate personnel action against the
employee, up to and including termination, consistent with the requirements of the Rehabilitation
Act of 1973 (29 U.S.C. 794), as amended; or require the employee to participate satisfactorily in a
drug abuse assistance or rehabilitation program approved for these purposes by a Federal, State
or local health, law enforcement, or other appropriate agency.
d) You must identify all known workplaces under your Federal awards (see Section 182.230).
The grantee must provide the location site(s) for the performance of work done in connection with the
specific grant.
Place(s) of Performance (Street address, city, county, state, zip code)
Various locations within New Hanover
County, as specified in the project
scope
DRUG-FREE WORKPLACE (GRANTEES WHO ARE INDIVIDUALS)
As required by the Drug -Free Workplace Act of 1988, and implemented at 2 CFR Part 182:
A. As a condition of the grant, I certify that I will comply with drug-free workplace requirements in
Subpart B (or Subpart C, if the recipient is an individual) of part 421, which adopts the Government -
wide implementation (2 CFR part 182) of sec. 5152-5158 of the Drug Free Workplace Act of 1988
(Pub.1-100-690, Title V, Subtitle D; 41 U.S.C. 701-707).
NCDA&CS Certifications & Assurances Page 2 of 3
Rev 9/12, 10/12, 11/13;1/17
B. I agree to notify the agency as required by 2 CFR 182.300(b) of any conviction for a criminal drug
offense within ten days.
Notice shall include the identification number(s) of each affected grant.
As the duly authorized representative of the Grantee, I hereby certify and state to the best of my
knowledge and belief, that the Grantee will comply with the above certifications.
New Hanover County
Grantee Organization Name
10/21/2022
Signature of Authorized Representative Date
Lisa Wurtzbacher Assistant County
Manager
Printed Name of Authorized Representative Title
NCDA&CS Certifications & Assurances
Rev 9/12, 10/12, 11/13;1/17
Page 3 of 3
Attachment D
NC OpenBook Supplemental Information
Instructions: Complete the information below and return it to the Contract Administrator identified in your
original contract. This information must be submitted as part of your contract. If you have questions,
please contact the Contract Administrator or the Alternate Contact as reflected in your contract.
Grantee Name: New Hanover County
County of Residence: New Hanover
GRANTEE INFORMATION:
District Number (MusraEFlt_LED1N): NC Hs 18,19,20
Tax Id Number: 56-6000324
UEI Number**: F7TLT2GMEJEI I have started the UEI process but not received a UEI number.❑
"Due to the SAM.gov migration from DU& Bradstreet, obtaining a UEl number has created unforeseen issues with the SAM.gov website search engines and portals. Due to the
massive backlog in validation ticket issues, we are not requiring the UE/ numbers at this time; however, ifyou have started the process, please let us know OR if you UEI number
please provide it.
Fiscal Year End: 06/30 Grantee's Website: NHCGOV.COM
(MM/DD) Format
PROJECT INFORMATION:
Brief Description and Background/History of your Organization: Be sure to include the number of years in existence,
number of employees, mission and goals of your organization. MAX CHARACTERS: 250
New Hanover County is committed to providing equitable opportunities and exceptional public services through good
governance to ensure a safe, healthy, secure and thriving community for all. The County employees approximately 1800
employees.
Current project timeline: Begin date 06/01/2022
End Date 12/31/24
Expected outcomes and specific deliverables: Expected outcome is intended result of your grant
program. The specific deliverables are the accomplishments that will be achieved with the grant. EXAMPLE: Funding for the Farmers Produce Box
program will allow an additional 150 boxes to be created this year. This will allow approximately 37 additional families to receive these the boxes 4
times a week to help resolve their food insecurity. MAX CHARACTERS: 300
To protect and restore the integrity of drainage infrastructure through routine maintenance to existing streams and
drainage ways.
Project Location Benefit Information: (Location(s) in which funding will be spent and/or
Food commodities will be received.)
❑✓ Single County
❑ Regional** -If your answer is Regional, list all Counties that are receiving
❑Mountains
benefit:
Piedmont
❑Inner Coastal Plain
❑ Tidewater
❑ Statewide
NCDA&CS NC OpenBook Supplemental
Information Rev 07/14; 4117; 5/22
Page 1 of 1
nature Card Attachment E
CONTRACT & FINANCIAL DOCUMENTS
INSTRUCTIONS: Please read and fill in the required information to the right of each field where applicable. Signatures
must match the Contract signatures. In the event the affixed signature(s) are no longer valid, a revised form must
be submitted prior to processing any contractual documents or submitting "Request for Payments" or any other
financial documents. If more than two people will sign for the organization, this form may be duplicated.
SECTION I.
Date:
10/21/22
Legal Applicant Organization/Agency Name:
New Hanover County
Federal Tax Identification Number:
56-6000324 LID: F7TLT2GMEJE1
SECTION II.
Certification:
By affixing my signature below, I certify that person(s) identified are designated having legal authorization to sign on
behalf of the organization named in Section I., above, for purposes of executing contractual documents and preparing,
approving and executing all financial documents; including "Requests for Payments." I understand the legal implications
of any and all misrepresentation, which include but are not limited to defrauding the State of North Carolina, and certify
that the person signing below has full authority to execute this Agreement on behalf of the named organization.
NON-GOVERNMENTAL ORGANIZATIONS ONLY Must match Contract signature)
Board Chair, Executive Director, etc.
Financial Representative, Treasurer, etc.
Print Name & Title:
Print Name & Title:
Signature:
Signature:
GOVERNMENTAL ENTITIES Must match Contract signature)
Authorized Governmental Official
_ Chief Fiscal Officer
Print Name & Title:
Print Name & Title:
Lisa Wurtzbacher, Assistant County Manager
Eric Credle, Chief Financial Officer
S, nature:
Signature:
NCDA&CS - Signature Card — NGO & Governmental Page 1 of 1
Rev 7/14; 1/17; 11 /17