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HomeMy WebLinkAboutFY23 JCPC ADMIN PROGRAM AGREEMENTDocuSign Envelope ID: C1262179-A813-463C-B8F2-FF80DOFC863F Wor"Ap- North Carolina Department of Public Safety JCPC Program - Program Agreement SECTION I A SPONSORING AGENCY AND PROGRAM INFORMATION FUNDING PERIOD: FY 22-23 DPS/JCPC FUNDING # (cont only) 965-XXXX COUNTY: New Hanover AREA: Eastern Area Multi -County: No Multi -Components No NAME OF PROGRAM: JCPC Administration SPONSORING AGENCY: New Hanover County SPONSORING AGENCY PHYSICAL ADDRESS: PROGRAM TYPE SPONSORING AGENCY MAILING ADDRESS: EACH COMPONENT TYPE: Public Zip: FEDERAL ID #1566000324 25 Program Manager Name & Address (same person on signature page) Name: TOTAL COST OF COMPONENT ID # NAME OF PROGRAM COMPONENT PROGRAM TYPE Mailing Address: EACH COMPONENT 36207 JCPC Certification JCPC Certification $ 9,900 Zip: Total cost of components: $ 9,900 Program Manager Name & Address (same person on signature page) Name: Jay Corpening Title: Mailing Address: 138 N. 4th Street City: Wilmington Zip: 28401 Suite 165 Phone: (910) 772-6612 Fax: E-mail: julius.h.corpening@nccourts.org Contact Person (if different from program manager) Name: Jay Corpening Title: Mailing Address: 138 N. 4th Street City: Wilmington Zip: 28401 Suite 165 Phone: (910) 772-6612 Fax: E-mail: julius.h.corpening@nccourts.org Program Fiscal Officer (cannot be program manager) Name: Lisa Wurtzbacher Title: Mailing Address: 230 Government Ctr Dr City: Wilimington Zip: 28401 Suite 165 Phone: (910) 798-7187 Fax: E-mail: Iwurtzbacher@nhcgov.com Form JCPC/PA 001 JCPC Program Agreement Form structure last revised 12/31/2012 Department of Public Safety DocuSign Envelope ID: C1262179-A813-463C-B8F2-FF80DOFC863F JUVENILE CRIME PREVENTION COUNCIL CERTIFICATION STANDARDS G.S. 1436-853 allows for a 2 -year funding cycle for programs that meet the requirements of the statute and have been awarded funds in a prior funding cycle. Indicate below if the JCPC plans to allow for a 1 -year or 2 -year funding cycle. 2 -Year Funding: FY 2021-2022 and FY 2022-2023 Membership A. Have the members of the Juvenile Crime Prevention Council been appointed by county commissioners? Yes B. Are members appointed for two-year terms and are those terms staggered? Yes C. Is membership reflective of social -economic and racial diversity of the community? Yes D. Does the membership of the Juvenile Crime Prevention Council reflect the required positions as provided by N.C.G.S.§143B-846? Yes If not, which positions are vacant and why? Organization A. Does the JCPC have written Bylaws? Yes B. Bylaws are Attached C. Bylaws contain Conflict of Interest section per JCPC policy and procedure. Yes D. Does the JCPC have written policies and procedures for funding and review? Yes E. These policies and procedures On file F. Does the JCPC have officers and are they elected annually? Yes Meetings A. JCPC meetings are considered open and public notice of meetings is provided. Yes B. Is a quorum defined as the majority of membership and required to be present in order to conduct business at JCPC meetings? Yes C. Does the JCPC meet six (6) times a year at a minimum? Yes D. Are minutes taken at all official meetings? Yes E. Are minutes distributed prior to or during subsequent meetings? Yes Planning A. Does the JCPC conduct a biennial planning process which includes a needs assessment, monitoring of programs and funding allocation process? Yes B. Is this Biennial Plan presented to the Board of County Commissioners and to DPS? Yes C. Is the Funding Plan approved by the full council and submitted to Commissioners for their approval? Yes Public Awareness A. Does the JCPC communicate the availability of funds to all public and private non-profit agencies which serve children or their families and to other interested community members? Yes 0 RFP, Distribution List, and Advertisement attached B. Does the JCPC complete a biennial needs assessment and make that information available to agencies which serve children or their families, and to interested community members? Yes No Overdue Tax Debt A. As recipient of the county DPS JCPC allocation, does the County certify that it has no overdue tax debts, as defined by N.C.G.S. §105-243.1, at the Federal, State, or local level? Yes Form JCPC/OP 002 (a) Juvenile Crime Prevention Council Certification Agreement Form structure last revised August 2020 NC Department of Public Safety DocuSign Envelope ID: C1262179-A813-463C-B8F2-FF80DOFC863F JUVENILE CRIME PREVENTION COUNCIL CERTIFICATION STANDARDS Briefly outline the plan for correcting any areas of standards non-compliance. No areas of standard non-compliance as the County has no overdue tax debts, as defined by N.C.G.S. §105-243.1, at the Federal, State, or local level. Form JCPC/OP 002 (a) Juvenile Crime Prevention Council Certification Agreement Form structure last revised August 2020 NC Department of Public Safety DocuSign Envelope ID: C1262179-A813-463C-B8F2-FF80DOFC863F JUVENILE CRIME PREVENTION COUNCIL CERTIFICATION STANDARDS Instructions: N.C.G.S. § 14313-846 specifies suggested members be appointed by county commissioners to serve on local Juvenile Crime Prevention Councils. In certain categories, a designee may be appointed to serve. Please indicate the person appointed to serve in each category and his/her title. Indicate appointed members who are designees for named positions. Indicate race and gender for all appointments. Specified Members Name Title Designee Race Gender 1) School Superintendent or designee Julie Varnum Asst. Superintendent, White Female Student Support Q Services 2) Chief of Police or designee Melissa Moore Social Worker Q White Female 3) Local Sheriff or designee Christopher Smith Sergeant lWhite Male 4) District Attorney or designee Ashton Herring Assistant District Q White Female Attorney 5) Chief Court Counselor or designee Robert Speight Chief Court Counselor White Male 6) Director, Local Management Entity/ Dena Hamilton System of Care White Female Managed Care Organization (LME/MCO), or Coordinator Q designee 7) Director DSS or designee Mary Beth Rubright CPS Supervisor Q White Female 8) County Manager or designee Tuffana Bradley Deputy County Q Black or African- Female Manager American 9) Substance Abuse Professional Ryan Estes Treatment White Male Operations Director 10) Member of Faith Community Rev. Edwrin Sutton Pastor Black or African- Male American 11) County Commissioner Tuffana Bradley Deputy County Q Black or African- Female Manager American 12) A Person Under the Age of 21 Joshua Barber Student Black or African- Male American 13) A Person Under the Age of 21, or a member Alexis Rivenbark Student White Female of the public representing the interests of families of at -risk juveniles 14) Juvenile Defense Attorney Lyana Hunter Attorney Black or African- Female American 15) Chief District Judge or designee Jay H. Corpening II Chief District Court White Male Judge 16) Member of Business Community Rita Ozolins Business Owner - White Female Psychologist 17) Local Health Director or designee Carla Turner Assistant Director of Q White Female Public Health 18) Rep. United Way/other non-profit Tommy Taylor President, Cape Fear White Male United Way 19) Representative/Parks and Rec 20) County Commissioner appointee Beth Looney At -Large Member White Female 21) County Commissioner appointee Cecilia Reyna At -Large Member White Female 22) County Commissioner appointee Justin Ovaska At -Large Member White Male 23) County Commissioner appointee Kelly Silivanch At -Large Member White Female Form JCPC/OP 002 (a) Juvenile Crime Prevention Council Certification Agreement Form structure last revised August 2020 NC Department of Public Safety DocuSign Envelope ID: C1262179-A813-463C-B8F2-FF80DOFC863F JUVENILE CRIME PREVENTION COUNCIL CERTIFICATION STANDARDS Specified Members Name Title Designee Race Gender 24) County Commissioner appointee Martin Greene At -Large Member White Male 25) County Commissioner appointee Wanda Marino At -Large Member White Female 26) County Commissioner appointee Zachery Mitcham At -Large Member Black or African- American Male Form JCPC/OP 002 (a) Juvenile Crime Prevention Council Certification Agreement Form structure last revised August 2020 NC Department of Public Safety DocuSign Envelope ID: C1262179-A813-463C-B8F2-FF80DOFC863F SECTION V Terms of Agreement This Agreement is entered into by and between Department of Public Safety (hereinafter referred to as DPS), and New Hanover County, (hereinafter referred to as the County), the County's Juvenile Crime Prevention Council (hereinafter referred to as the JCPC) and New Hanover County (hereinafter referred to as the Sponsoring Agency). DPS, the County, the JCPC and the Sponsoring Agency do mutually agree as follows: Term of Agreement This Agreement shall become effective Jul 1, 2022 and shall terminate Jun 30, 2023. Payment to Sponsoring Agency All parties agree that services will be delivered as described in the approved Program Agreement and that funds will be disbursed in an amount not to exceed the amount $9900 for the term of this agreement, unless amended by an approved Program Agreement Revision. Availability of Funds: All parties to this Agreement agree and understand that the payment of the sums specified in this Program Agreement budget, or most recently approved Program Agreement Revision, is dependent and contingent upon and subject to the appropriation, allocation, and availability of funds for this purpose to DPS. Responsibilities of the Parties DPS shall: 1. Disburse funds monthly to County Governments, for payment to the Sponsoring Agency, from funds appropriated by the General Assembly; 2. Reserve the right to suspend payment to the County for any non-compliance of reporting requirements by the Sponsoring Agency set forth in the DPS JCPC Policy; 3. Immediately notify, in writing, the JCPC, County, and Sponsoring Agency (including the Board of Directors, if applicable), if payments are suspended and again once payments resume; 4. Pay only for work as described in the Program Agreement, or most recently approved Program Agreement Revision, provided by the Sponsoring Agency and approved subcontractors; 5. Provide technical assistance, orientation, and training to the Sponsoring Agency, the County and the JCPC; 6. Monitor the Sponsoring Agency's funded program(s) in accordance with DPS JCPC Policy 3. Operations: Program Oversight and Monitoring; and 7. Notify parties entering into this Agreement of all due dates in a timely manner in order for reports to be submitted by Form structure last revised 12/20/2013 Department of Public Safety DocuSign Envelope ID: C1262179-A813-463C-B8F2-FF80DOFC863F the established due dates. The Sponsoring Agency shall: 1. 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; 2. Comply with all Federal and State laws relating to equal employment opportunity; 3. Keep as confidential and not divulge or make available to any individual or organization without the prior written approval of DPS any information, data, instruments, documents, studies or reports given to or prepared or assembled by the Sponsoring Agency under this Agreement; 4. Acknowledge that in receiving, storing, processing or otherwise dealing with any confidential information, it will safeguard and not redisclose the information, except as otherwise provided in this Agreement; 5. Comply with the DPS JCPC Policy and North Carolina Administrative Code procedures; 6. Secure local match, if applicable, pursuant to 14B NCAC 11 B.0105, for the approved DPS funds; 7. Create and adopt individualized written agency guidelines specific to the funded program, while also adhering to DPS JCPC Policy for the specific funded program type; 8. Ensure that state funds received are spent in accordance with the approved Program Agreement, or most recently approved Program Agreement Revision, and be accountable for the legal and appropriate expenditure of those state funds; 9. Maintain reports, records, and other information to properly document services rendered and outcomes; also maintain an ability to send and receive electronic communication; 10. Have the capacity to use the DPS electronic, internet-based system for tracking clients served; also maintain an ability to electronically sign required DPS documents; 11. Use generally accepted accounting procedures that guarantee the integrity of the expenditure of funds, and maintain reports, records, and other information to properly account for the expenditure of all State funds provided to the Sponsoring Agency; 12. When refunds are requested from the North Carolina Department of Revenue for sales and/or use taxes paid by the agency in the performance of the Program Agreement, or most recently approved Program Agreement Revision, as allowed by NCGS § 105-164.14(c), the agency shall exclude all refundable sales and use taxes from reportable expenditures submitted to the County and DPS; 13. Submit Program Agreement Revisions, Third Quarter Accounting, Final Accounting, and annual detailed expenditures through NCALLIES. These reports must be in accordance with the submission process as outlined in the DPS JCPC Policy and with the due dates established by DPS; 14. Make personnel, reports, records and other information available to DPS, the County, the JCPC, and/or the State Auditor for oversight, monitoring and evaluation purposes; Form structure last revised 12/20/2013 Department of Public Safety DocuSign Envelope ID: C1262179-A813-463C-B8F2-FF80DOFC863F 15. Submit any other information requested by DPS, the County, the JCPC, and/or the State Auditor; 16. Be responsible for the performance of all subcontractors as described in the Program Agreement or most recently approved Program Agreement Revision; 17. Indemnify, defend, and hold harmless DPS, the State of North Carolina, the County, the JCPC and any of their officers, agents and employees, from any claims of third parties arising out of any act or omission of the Sponsoring Agency in connection with the performance of the Program Agreement or most recently approved Program Agreement Revision; 18. Receive written permission and budgetary approval from DPS prior to using the Program Agreement, or most recently approved Program Agreement Revision, as a part of any news release or commercial advertising, and acknowledge DPS funding in partnership with the County; 19. Comply with DPS JCPC Policy 6: Operations: Program Eligibility for Funding regarding any trainings and requirements for the United States Department of Justice national standards to prevent, detect, and respond to prison rape under the Prison Rape Elimination Act (PREA) and any additional requirements in 14B NCAC 11 C 20. Be deemed an independent contractor in the performance of services described in the Program Agreement, or most recently approved Program Agreement Revision, and as such shall be wholly responsible for the services to be performed and for the supervision of its employees, interns, volunteers and subcontractors; and 21. Represent that it has, or shall secure at its own expense, all personnel required in performing the services as described in the Program Agreement, or most recently approved Program Agreement Revision. Such personnel shall not be employees of or have any individual contractual relationship with DPS. Sponsoring Agency and Use of Contractor(s)/Subcontractors The Sponsoring Agency may engage with independent contractors as needed to perform services or support services described in line item 190 the Program Agreement, or most recently approved Program Agreement Revision. When independent contractors are providing services the Sponsoring Agency must: 22. Upload a signed Contract for Professional Services (Form JCPC/PO 001 Contract for Professional Services Template) into NCALLIES once the Program Agreement or Program Agreement Revision is approved by DPS; 23. Be responsible for the performance of all contractors or subcontractors as described in the Program Agreement, or most recently approved Program Agreement Revision; 24. Hold any contractor or subcontractor to which the Sponsoring Agency provides State funds accountable for the legal and appropriate expenditure of State funds and require compliance with all applicable laws and DPS JCPC Policy; and 25. Ensure that all contractors or subcontractors provide all information necessary to comply with the standards set forth in the Program Agreement, or most recently approved Program Agreement Revision. The JCPC shall: Form structure last revised 12/20/2013 Department of Public Safety DocuSign Envelope ID: C1262179-A813-463C-B8F2-FF80DOFC863F 1. Ensure the Sponsoring Agency uses JCPC funds only for the purposes approved by DPS in the JCPC Program Agreement or most recently approved JCPC Program Agreement Revision; 2. Comply with the DPS JCPC Policy, the North Carolina Administrative Code procedures (14B NCAC 11 B), and N.C. G.S. §§ 14313-845 to 851; 3. Review and locally approve Program Agreements, Program Agreement Revision(s), and Third Quarter Accounting and submit information to the County in a timely manner to meet due dates established by DPS; 4. Submit any other information requested by the County or DPS; and 5. Monitor the Sponsoring Agency's currently funded JCPC program(s) in accordance with DPS JCPC Policy 3. Operations: Program Oversight and Monitoring. Reference: 14B NCAC 118.0202 and DPS JCPC Policy (policies 1, 3, 7, 8, 9, 10 and 11). The County shall: 1. Ensure the Sponsoring Agency is appropriately licensed when applicable, and either a local public agency, a 501(c) 3 nonprofit corporation or local housing authority (applicable only to the JCPC funding process); 2. Use funds only for the purposes approved by DPS in the Program Agreement, or most recently approved Program Agreement Revision; 3. Disburse funds monthly and oversee funds to the Sponsoring Agency in accordance with 14B NCAC 11 B.0108; 4. Comply with the DPS JCPC Policy and North Carolina Administrative Code procedures (14B NCAC 11 B); 5. Review and locally approve Program Agreement Revisions received from the Sponsoring Agency for final approval from DPS; and 6. Review and locally approve Third Quarter and Final Accounting forms for the JCPC and all funded programs according to the procedures and due dates established by DPS. Reference: 14B NCAC 11 B.0108; DPS JCPC Policy (policies 8 and 9). 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. Choice of Law: The validity of this Program Agreement and any of its terms or provisions, as well as the rights and duties of the parties to this Program Agreement, are governed by the laws of North Carolina, including the relevant provisions of G.S. Chapter 143B, Article 13, Part 3, Subpart F, and the Rules of 14B NCAC Chapter 11. The parties, by signing this Program Agreement, agree and submit, solely for matters concerning this Program Agreement, to the exclusive jurisdiction of the courts of North Carolina and agree, solely for such purpose, that the exclusive venue for any legal proceedings shall be Wake County, North Carolina. The place of this Program Agreement and all transactions and agreements relating to it, and their situs and forum, shall be Wake County, North Carolina, where all Form structure last revised 12/20/2013 Department of Public Safety DocuSign Envelope ID: C1262179-A813-463C-B8F2-FF80DOFC863F matters, whether sounding in Program Agreement or tort, relating to the validity, construction, interpretation, and enforcement shall be determined. Assignment: No assignment of the Sponsoring Agency's obligations or the Sponsoring Agency's right to receive payment hereunder shall be permitted. However, upon written request approved by the issuing purchasing authority, DPS may: (a) Forward the Sponsoring Agency's payment check(s) directly to any person or entity designated by the Program Manager, or (b) Include any person or entity designated by the Sponsoring Agency as a joint payee on the Sponsoring Agency's payment check(s). In no event shall such approval and action obligate DPS or County Government to anyone other than the Sponsoring Agency, and the Sponsoring Agency shall remain responsible for fulfillment of all Program Agreement, or the most recently approved Program Agreement Revision, obligations. Beneficiaries: Except as herein specifically provided otherwise, this Program Agreement 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 Program Agreement, and all rights of action relating to such enforcement, shall be strictly reserved to DPS, the County Government, and the Sponsoring Agency. Nothing contained in this document shall give or allow any claim or right of action whatsoever by any third person. It is the express intention of DPS and County Government that any such person or entity, other than DPS or the County Government or the Sponsoring Agency receiving services or benefits under this Program Agreement shall be deemed an incidental beneficiary only. Property Rights Intellectual Property: All deliverable items produced pursuant to this Program Agreement are the exclusive property of DPS. The Sponsoring Agency shall not assert a claim of copyright or other property interest in such deliverables. Physical Property The Sponsoring Agency agrees that it shall be responsible for the proper custody and care of any property purchased for or furnished to it for use in connection with the performance of this Program Agreement, or the most recently approved Program Agreement Revision, and will reimburse DPS for loss of, or damage to, such property. At the termination of this Program Agreement, the Sponsoring Agency, County Government, and JCPC shall follow the guidelines for disposition of property set forth in the North Carolina Administrative Code and DPS JCPC Policy 1. Operations: JCPC Operations. Reference: 14B NCAC 118.0110. Disbursements and Internal Controls Reversion of Unexpended Funds Any remaining unexpended funds disbursed by DPS to the County for the Sponsoring Agency must be refunded/ reverted back to DPS at the close of the fiscal year or upon termination of this Agreement. Accountability for Funds Form structure last revised 12/20/2013 Department of Public Safety DocuSign Envelope ID: C1262179-A813-463C-B8F2-FF80DOFC863F Audit Requirement - Local Government or Public Authority Requirements Local Government or Public Authorities in accordance with N.C.G.S. § 159-34 must have an audit performed in conformity with generally accepted auditing standards. The audit shall evaluate the performance of a unit of local government or public authority regarding compliance with all applicable Federal and State agency regulations. This audit, combined with the audit of financial accounts, shall be deemed to be the single audit described by the "Federal Single Audit Act of 1984". Oversight Access to Persons and Records The State Auditor shall have access to persons and records related to all Program Agreements entered into by State agencies or political subdivisions in accordance with N.C.G.S. § 147-64.7. Additionally, as the State funding authority, DPS shall have access to persons and records related to all Program Agreements entered into by State agencies or political subdivisions. Record Retention Records shall not be destroyed, purged, or disposed of without the express written consent of DPS. State basic records retention policy requires all records to be retained for a minimum of five (5) years or until all audit exceptions have been resolved, whichever is longer. If the Program Agreement is subject to Federal policy and regulations, record retention may be longer than five (5) years since records must be retained for a period of three (3) years following submission of the final Federal Financial Status Report, if applicable, or three (3) 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 Program Agreement 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. No Overdue Tax Debt Not for profit organizations ONLY must comply with this section. This form must be uploaded in NCALLIES when submitting a Program Agreement. The Sponsoring Agency shall be responsible for the payment of all State, local, and Federal taxes. Consistent with N. C.G.S. § 143C -6-23(c), not for profit organizations shall file with DPS and the County a written statement completed by that Sponsoring Agency's Board of Directors or other governing body, stating whether or not the Sponsoring Agency has any overdue tax debts, as defined by N.C.G.S. § 105-243.1, at the Federal, State, or local level. This written statement, No Overdue Tax Debts, shall be completed by the Sponsoring Agency to certify when there are no overdue taxes. If the agency has overdue taxes, the Sponsoring Agency must notify DPS at the time a Program Agreement is submitted. Conflict of Interest Not for profit organizations ONLY must comply with this section. This form must be uploaded in NCALLIES when submitting a Program Agreement. Consistent with the N.C.G.S. § 143C -6-23(b), not for profit organizations shall file with DPS and the County, a copy of that Sponsoring Agency's policy addressing conflicts of interest that may arise involving the Sponsoring Agency's management employees and the members of its Board of Directors or other governing body. The policy shall address situations in which any of these individuals may directly or indirectly benefit, except as the Sponsoring Agency's employees or members of its Board or other governing body, from the Sponsoring Agency's disbursing of State funds and shall include actions to be taken by the Sponsoring Agency or the individual, or both to avoid conflicts of interest and the appearance of impropriety. The policy shall be filed before the County or DPS will disburse any funds. The Sponsoring Agency shall also complete the DPS Conflict of Interest Policy Statement (Form DPS 13 001) and upload the statement in NCALLIES along with and the Sponsoring Agency's policy addressing conflicts of interests. Form structure last revised 12/20/2013 Department of Public Safety DocuSign Envelope ID: C1262179-A813-463C-B8F2-FF80DOFC863F Proof of 501(c)(3) Not for profit organizations ONLY must comply with this section. This form must be uploaded in NCALLIES when submitting a Program Agreement. Not for profit organizations must upload proof of the agency's 501(c)(3) status when submitting a program agreement in NCALLIES. Amendment: This Agreement may not be amended orally or by performance. Any amendment must be requested by the Sponsoring Agency through submission of a Program Agreement Revision and executed by duly authorized representatives of DPS, the County Government, JCPC, and Sponsoring Agency. Severability: In the event that a court of competent jurisdiction holds that a provision or requirement of this Program Agreement 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 Program Agreement shall remain in full force and effect. Termination for Cause: If, through any cause, the Sponsoring Agency shall fail to fulfill its obligations under this Program Agreement in a timely and proper manner, DPS shall have the right to terminate this Program Agreement by giving written notice to the Sponsoring Agency and specifying the effective date thereof. In that event, all finished or unfinished deliverable items prepared by the Sponsoring Agency under this Program Agreement shall, at the option of DPS, become its property and the Sponsoring Agency 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 Sponsoring Agency shall not be relieved of liability to DPS for damages sustained by DPS by virtue of the Sponsoring Agency's breach of this agreement, and DPS may withhold any payment due the Sponsoring Agency for the purpose of setoff until such time as the exact amount of damages due DPS from such breach can be determined. The filing of a petition for bankruptcy by the Sponsoring Agency shall be an act of default under this Program Agreement. Termination without Cause: DPS, the County Government, or the Sponsoring Agency may terminate this Agreement at any time and without cause by giving at least thirty (30) days advance written notice to the other parties. If this Program Agreement is terminated by DPS as provided herein, the Sponsoring Agency shall be reimbursed on a pro rata basis for services satisfactorily provided to DPS under this Program Agreement, or the most recently approved Program Agreement Revision, prior to Program Agreement termination. Waiver of Default: Waiver by DPS of any default or breach in compliance with the terms of this Program Agreement, or the most recently approved Program Agreement Revision, by the Sponsoring Agency 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 Program Agreement unless stated to be such in writing, signed by an authorized representative of DPS, County Government, the JCPC, and the Sponsoring 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 as a result of events beyond its reasonable control, including, without limitation, fire, power failures, any act of war, hostile foreign action, nuclear explosion, riot, strikes, civil insurrection, earthquake, hurricane, tornado, or other catastrophic natural event, pandemic, or act of God. Survival of Promises: All promises, requirements, terms, conditions, provisions, representations, guarantees, and warranties contained herein shall survive the Program Agreement expiration or termination date unless specifically provided otherwise herein, or unless superseded by applicable Federal or State statutes of limitation. Entire Agreement: This Program Agreement (including any documents mutually incorporated specifically herein) represents the entire agreement between the parties and supersedes all prior oral or written statements or Form structure last revised 12/20/2013 Department of Public Safety DocuSign Envelope ID: C1262179-A813-463C-B8F2-FF80DOFC863F agreements. END OF SECTION V — Terms of Agreement Form structure last revised 12/20/2013 Department of Public Safety DocuSign Envelope ID: C1262179-A813-463C-B8F2-FF80DOFC863F SECTION VI: BUDGET NARRATIVE JCPC Administration Fiscal Year FY 22-23 Item # Justification Expense In Kind Expense 190 Clerical support for the JCPC ($20 per hour) $6,000 220 Food for JCPC meetings $3,200 260 General Office Supplies paper, note books, etc. $200 370 Advertising costs to advertise RFP $500 TOTAL $9,900 Annual Expense Annual In Kind Job Title Wages Wages TOTAL Form JCPC/PA 001 JCPC Program Agreement Form structure last revised 12/31/2012 Department of Public Safety DocuSign Envelope ID: C1262179-A813-463C-B8F2-FF80DOFC863F SECTION VII Program: JCPC Administration Fiscal Year: FY 22-23 Cash Number of Months: 12 In Kind Total I. Personnel Services $6,000 $6,000 120 Salaries & Wages $0 180 Fringe Benefits $0 190 Professional Services" $6,000 $6,000 *Contracts MUST be attached 230 Education & Medical II. Supplies & Materials $3,400 $3,400 210 Household & Cleaning $0 220 Food & Provisions $3,200 $3,200 230 Education & Medical $0 240 Construction & Repair $0 250 Vehicle Supplies & Materials $0 260 Office Supplies and Materials $200 $200 280 Heating & Utility Supplies $0 290 Other Supplies and Materials $0 III. Current Obligations & Services $500 $500 310 Travel & Transportation $0 320 Communications $0 330 Utilities $0 340 Printing & Binding $0 350 Repairs & Maintenance $0 370 Advertising $500 $500 380 Data Processing $0 390 Other Services $0 IV. Fixed Charges & Other Expenses $0 410 Rental or Real Property $0 430 Equipment Rental $0 440 Service and Maint. Contracts $0 450 Insurance & Bonding $0 490 Other Fixed Charges $0 V. Capital Outlay $0 [This Section Requires Cash Match] 510 Office Furniture & Equipment $0 530 Educational Equipment $0 540 Motor Vehicle $0 550 Other Equipment $0 580 Buildings, Structure & Improv. $0 Total $9,900 $9,900 Form JCPC/PA 001 JCPC Program Agreement Form structure last revised 12/31/2012 Department of Public Safety DocuSign Envelope ID: C1262179-A813-463C-B8F2-FF80DOFC863F SECTION VIII SOURCES OF PROGRAM REVENUE (ALL SOURCES) FY 22-23 New Hanover County Funding ID: 965-XXXX Sponsoring Agency: New Hanover County Program: JCPC Administration $9,900 0% $9,900 DPS/JCPC Funds " This is the amount approved in your application Local Match Rate Is the Local Match Rate 10%, 20% or 30%? County Cash (Specify Source) Local Cash (Specify Source) Local Cash (Specify Source) Local In -Kind (Specify Source) Other (Specify Source) Other (Specify Source) Other (Specify Source) Other (Specify Source) TOTAL $0 $0 Required Local Match Match Provided Docu Signed by: ,}e G�GGGG 798FE7A4BD9F419... lll��� 5/19/2022 Authorizing Official, Department of Public Safety Date The following signature certifies that this program agreement has been locally approved by the Board of County Commissioners. E�,Doc�.u�JS�Iigned by:L ' wau vx, �vuWKA CFO- 5/17/2022 9507FA3F06164E9... Chair, County Board of Commissioners or County Finance Director Date The following signature certifies that this program agreement has been locally approved by the Juvenile Crime Prevention Council. EDocuSigned by: 9 R (ovpun *" if M NE15D4A2540C... 5/10/2022 Chair, Juvenile Crime Prevention Council Date DocuSigned by: �M1r �MD 8E15D4A2540C.C... 5/10/2022 Program Manager Form JCPC/PA 001 JCPC Program Agreement Form structure last revised 12/31/2012 Department of Public Safety Date DocuSign Envelope ID: C1262179-A813-463C-B8F2-FF80DOFC863F New Hanover County, NC Juvenile Crime Prevention Council Bylaws ARTICLE I NAME AND PURPOSE 1.1 Name. The name of this JCPC shall be known as the New Hanover County Juvenile Crime Prevention Council (JCPC). 1.2 Purpose. The purpose of the JCPC shall be to: (1) Annually review and assess the needs of juveniles in New Hanover County (County) who are at risk of delinquency or who have been adjudicated undisciplined or delinquent, evaluate the adequacy of resources available to meet those needs, and develop or propose ways to address unmet needs, giving particular attention to the needs of status offenders and juvenile delinquents, and report those findings to the Board of County Commissioners (Board of Commissioners). (2) Assist the County in planning and administering intervention and delinquency prevention programs for court involved and at -risk juveniles by providing funds for service for treatment, counseling, or rehabilitation for juveniles and their families. These services may include court-ordered parenting responsibility classes. (3) Evaluate the performance of juvenile services and programs in the community and evaluate each funded program as a condition of continued funding. (4) Increase public awareness of the cause of delinquency and of strategies to reduce the problem. (5) Develop strategies to intervene and appropriately respond to and treat the needs of juveniles at risk of delinquency through appropriate risk assessment instruments. (6) Plan for the establishment of a permanent funding stream for delinquency prevention services. ARTICLE II MEMBERSHIP 2.1 Appointment. 2.1.1 JCPC members shall be approved and appointed by the Board of Commissioners for two-year terms. Amended December 15, 2006 and approved by New Hanover County Board of Commissioners on January 8, 2007. Amended Section 4. 1.1 of Article IV on August 21, 2009 and approved by Board of Commissioners on September 7, 2009. DocuSign Envelope ID: C1262179-A813-463C-B8F2-FF80DOFC863F 2.1.2 Appointment shall be arranged so that the term of approximately one-fourth of the members noted in section 2.3 below in positions 9, 10, 12, 13, 15, 17, 18 and 19 shall expire each year. 2.2 Replacement. The Chairperson shall advise the Board of Commissioners of members who should be replaced because of resignation, limited interest and participation, or conflict of interest. Appointments to fill vacancies shall be for the remainder of the former member's term. Members shall be removed for malfeasance or nonfeasance as determined by the Board of Commissioners. 2.3 Composition. The membership shall be no more than 26 persons and should include, if possible: (1) Local school superintendent or designee (2) Chief of Police or designee (3) Local Sheriff of designee (4) District Attorney or designee (5) Chief Court Counselor or designee (6) Director of Mental Health or designee (7) Director of Social Services or designee (8) County Manager or designee (9) Substance Abuse Professional (10) Member of Faith Community (11) County Commissioner or designee (12) Two persons under 21 or a concerned citizen (13) Juvenile Defense Attorney (14) Chief District Court Judge or designee (15) Member of Business (16) Health Director designee (17) United Way or nonprofit (18) Parks and Recreation representative (19) Up to 7 members appointed by the Board of Commissioners 2.4 Conflict of Interest. 2.4.1 No member shall participate in the hearing, consideration or determination of any matter in which he or she has a conflict of interest (Conflict). A Conflict exists when a member engages in any business or transaction or has a financial or other personal interest, direct or indirect, that is incompatible with the proper discharge of his or her official duties or would tend to impair his or her independence of judgment and action in the performance of his or her official duties. A Conflict exists when any member: (1) Has a financial interest as owner, member, partner, officer, employer, stockholder or other participant in a private business or professional enterprise that will be affected by the outcome of any matter under consideration before him or her in his or her capacity as a member. (2) Has such interest in any matter which may be averse to the public interest and the proper performance of his or her duties as a member. (3) Has an interest in speculative or investment activities that will benefit from use of confidential information obtained as a member. Amended December 15, 2006 and approved by New Hanover County Board of Commissioners on January 8, 2007. Amended Section 4.1.1 of Article IV on August 21, 2009 and approved by Board of Commissioners on September 7, 2009. DocuSign Envelope ID: C1262179-A813-463C-B8F2-FF80DOFC863F 2.4.2 Personal as distinguished from financial interest includes an interest arising from blood or marriage relationship, by consanguinity or affinity within and include the third degree. 2.4.3 No member shall vote on any matter in which he/she has a Conflict. ARTICLE III OFFICERS 3.1 Officers. The officers shall include a Chairperson, Vice -Chairperson and Secretary -Treasurer. 3.2 Election. These officers shall be elected by the JCPC membership at the May meeting of each year. New officers will assume office on July 1. 3.3 Term. Officers shall be elected for one year terms and may succeed themselves. ARTICLE IV MEETINGS 4.1 Meetings of Members 4.1.1 Regular Meetings. The JCPC shall meet at least six times a year in accordance with a schedule and at a location adopted by the JCPC. Meetings are to be held on the 3rd Friday of the month. 4.1.2 Special Meetings. The Chairperson may call such special meetings as deemed necessary to carry out the duties of the JCPC and notice shall be given to all members of the JCPC in writing or by phone at least two (2) days prior to the scheduled meeting. 4.1.3 Virtual Meetings. Meetings may be held virtually when necessary. If/when meetings are held virtually, the link to join the meeting will be distributed to the membership. A link to join the meeting will also be made available to anyone requesting it. 4.2 Cancellation If a meeting must be cancelled, the Chairperson shall notify the JCPC members in writing or by phone at least two (2) days prior to the scheduled meeting. 4.3 Open Meetings All meetings shall be open to the public. 4.4 Quorum No official business can be transacted unless a quorum is present, whether it be an in-person or virtual meeting. A quorum is a majority of the total members of the JCPC. A majority vote of the quorum is required for passing a motion. 4.5 Minutes Minutes shall be taken at every meeting and distributed prior to or at subsequent meetings. Amended December 15, 2006 and approved by New Hanover County Board of Commissioners on January 8, 2007. Amended Section 4.1.1 of Article IV on August 21, 2009 and approved by Board of Commissioners on September 7, 2009. DocuSign Envelope ID: C1262179-A813-463C-B8F2-FF80DOFC863F ARTICLE V EXECUTIVE COMMITTEE 5.1 Composition. The Executive Committee will be composed of all officers and Standing Committee Chairpersons. 5.2 Duties. The Executive Committee shall evaluate the progress of the JCPC and make recommendations as to its direction. 5.3 Meetings. 5.3.1 Biannual. The Executive Committee shall meet no less than twice each fiscal year. These meetings may be held in-person or virtually. 5.3.2 Call. The Chairperson of the JCPC, or two Executive Committee members, may call such meetings as deemed necessary to carry out its duties. 5.3.3 Notice. The membership of the Executive Committee shall be notified of all meetings in writing or by phone at least fourteen (14) days prior to the meeting. ARTICLE VI STANDING COMMITTEES 6.1 Membership The JCPC Chairperson shall appoint at least three members of the JCPC to each of the following standing committees: (1) Planning Committee (Risk & Needs), whose purpose shall be to plan and carry out the process of reviewing and assessing the needs of juveniles in the County who are at risk for delinquency or who have been adjudicated undisciplined or delinquent and putting those needs in priority order, determining the resources available to address those needs, proposing ways to address any unmet needs, and report its findings and make recommendations for prioritizing needs for funding to the JCPC. (2) Program Funding Committee, whose purpose shall be to review the grant proposals and make recommendations to the JCPC for the use of DJJDP funds, or any other funds available to the County that would meet the needs as prioritized by the JCPC and recommend the level of funding to the JCPC. (3) Program Evaluation & Monitoring Committee, whose purpose shall be to gather information about JCPC funded programs and monitor the performance of those programs and report to the JCPC. (4) Publicity and Public Awareness Committee, whose purpose shall be to keep juvenile service agencies, appropriate governmental and community boards, and the general public aware of the causes of delinquency, strategies and services available to reduce the problem and the unmet needs in the community and to report to the JCPC. Amended December 15, 2006 and approved by New Hanover County Board of Commissioners on January 8, 2007. Amended Section 4. 1.1 of Article IV on August 21, 2009 and approved by Board of Commissioners on September 7, 2009. DocuSign Envelope ID: C1262179-A813-463C-B8F2-FF80DOFC863F 6.2 Chairpersons. The JCPC Chairperson shall appoint the Chairpersons of the Standing Committees. 6.3 Additional Committees. The JCPC Chairperson may at his/her discretion, appoint any other committees which he/she deems necessary to carry out the general purpose of the JCPC. ARTICLE VII SELECTION OF PROGRAMS 7.1 Review of Proposals. 7.1.1 All proposals to fund programs submitted to the JCPC will be reviewed by the Program Funding Committee. 7.1.2 Proposals will be presented to the JCPC individually by the Program Funding Committee and will be scrutinized by the JCPC in terms of its meeting the JCPC prioritized needs, effectiveness, staffing, amount requested and expectations. 7.2 Funding Vote. The JCPC will vote on each proposal individually to determine if it should be funded at the level recommended by the Program Funding Committee. 7.3 Approval Process. 7.3.1 Proposals approved by the JCPC for funding shall be submitted to the Board of Commissioners for their approval. If approved by the Board of Commissioners, the proposal(s) shall be submitted to the regional consultant for review. Following review, the proposal(s) is submitted to the DJJDP for final approval. 7.3.2 Proposals not approved for funding shall be notified in writing. 7.4 Evaluation Process. Funded proposals shall be evaluated by the Program Evaluation & Monitoring Committee. ARTICLE VIII GENERAL 8.1 Amendments. The bylaws may be amended or repealed, and new bylaws adopted by the affirmative vote of a majority of the membership at any regular or special meeting of the JCPC. 8.2 Policies. Policies shall be formulated by the JCPC and revised from time to time as necessary. Amended December 15, 2006 and approved by New Hanover County Board of Commissioners on January 8, 2007. Amended Section 4. 1.1 of Article IV on August 21, 2009 and approved by Board of Commissioners on September 7, 2009. DocuSign Envelope ID: C1262179-A813-463C-B8F2-FF80DOFC863F 8.3 Funded Agencies. A current copy of the bylaws and policies of the JCPC should be made available to agencies whose program proposals was funded upon request and shall be deemed acceptable to such funded agencies unless the JCPC is otherwise notified. An effort should be made by the Chairperson to cause a copy of the bylaws and policies to be furnished to such agencies after each amendment. 8.4 Manuals. Manuals shall be furnished by the JCPC to each of its members at the time of becoming a JCPC member so that such member may be informed fully of JCPC duties and responsibilities. The manual shall contain a current copy of the bylaws and policies adopted by the JCPC. The manual shall contain a description of the programs funded on advice of the JCPC and may contain important procedural documents from funding agencies. As amended and adopted by the JCPC membership on November 20, 2020. Amended December 15, 2006 and approved by New Hanover County Board of Commissioners on January 8, 2007. Amended Section 4. 1.1 of Article IV on August 21, 2009 and approved by Board of Commissioners on September 7, 2009. DocuSign Envelope ID: C1262179-A813-463C-B8F2-FF80DOFC863F Family Support Network of Southeastern NC Wilmington Health Access for Teens 1601 South College Road 4005 Oleander Drive The Carousel Center for Abused Children Suite 301 Wilmington, NC 28403 Wilmington, NC Wilmington, NC 28403guestionsgwhatswhat.org admingcarouselcenter.or fsnsoutherasterngjzmail.coom s Mary Beth Rubright Ms. Louise Hicks The Children's Museum of Wilmington Assistant Director Communities in Schools of Cape Fear th p 11 Orange Street New Hanover County Dept. Social Services mrubright@nnhcgov.com 20 North 4 Street, #210 Wilmington, NC 28401 Wilmington, NC 28401 info@,play/wilmin tg on.org louisekciscapefear. org Mr. Tommy Taylor Wilmington Downtown, Inc. Cape Fear Area United Way P.O. Box 2235 5919 Oleander Drive, Building II, Suite 115 Wilmington, NC 28402 Wilmington, NC 28403 partnership�ic ,wilmingtondownton.com Tommy.tqylorkCFAUW.org Child Advocacy and Parenting Place P.O. Box 4305 Wilmington, NC 28406 eg neral9cappcenter.org Trillium P.O. Box 4147 Wilmington, NC 28406 New Hanover Co. Bd. of Education 6410 Carolina Beach Rd. Wilmington, NC 28412 DREAMS of Wilmington P.O. Box 363 Wilmington, NC 28402 dreapro rg am&ec.rr.com Mr. Jimmy Pierce Kids Making It, Inc. 15 South Water Street Wilmington, NC 28401-8422 Kmi. j immy0b gmail. com Ben David District Attorney P. O. Box 352 Wilmington, NC 28402 New Hanover County JCPC Advertised on the New Hanover County Members & Distribution List website (www.nhcgov.com) Smart Start of NHC 3539 South College Road, Suite F Wilmington, NC 28412 Melissa Moore Wilmington Police Department P. O. Box 1810 Wilmington, NC 28402-1810 Melisssa.moorekwilmin tg onnc.gov Brigade Boys & Girls Club 2759 Vance Street Wilmington, NC 28412 New Hanover County Sheriff's Office DocuSign Envelope ID: C1262179-A813-463C-B8F2-FF80DOFC863F Request for Proposals NCDPS JCPC Continuation Funding FY 2022-2023 New Hanover County $92,345 December 15, 2021 Anticipated Annual Allocation Date Advertised The Juvenile Crime Prevention Council having studied the needs of juveniles in the county hereby publishes this Request for Proposals. The North Carolina Department of Public Safety (NCDPS) anticipates annual funds in the above stated amount will be available for programs serving delinquent and at -risk youth beginning on or after July 1, 2022. Local match rate for JCPC funds required: 20%. Based on identified needed programs and possible gaps in the service continuum, the following marked (X) program types will be considered for funding: • Teen Court • Mediation/Conflict Resolution As a result of the Risk Assessment and YASI data in the above named county, programs that reduce risk, address the needs of juveniles, and increase protective factors will be considered for funding. Elevated Risk Factors for delinquency: • Association with other delinquent peers or peers involved with gangs • Peer relationship problems and conflict • Moderate to serious behavioral problems at school • Prior assaultive behavior • Involvement in alcohol and substance use • Prior referrals to juvenile court • Referral to juvenile court prior to age 12 • Inadequate supervision by parents/guardians Elevated Needs for adjudicated juveniles: • Association with delinquent peers involved with gangs; peer relationship problems and conflict • Mental health needs including school behavior problems; involvement in alcohol/substance use; referral/involvement with juvenile court prior to age 12; some association with delinquent peers • Inadequate supervision by parents/guardians • Moderate to serious behavioral problems at school Protective Factors to address risk and needs: 1. Program services compatible with research that are shown to be effective with juvenile offenders. 2. Program services are outcome -based. 3. The program has an evaluation component. 4. Program services detect gang participate and divert individuals, if applicable. The web -based program application (NCALLIES) and instructions are available on line at the Department of Public Safety web -site: https://www.ncdps.gov/lndex2.cfm?a=000003,002476,002483,002482,002514 Only local public agencies, 501c3 non-profit corporations and local housing authorities will be considered for funding. Private non -profits are required to upload the following forms into NC ALLIES or your application is considered incomplete: 1) No Over Due Tax form (available at the above link) 2) Notarized DPS Conflict of Interest Statement Template (available at the above link), 3) The non -profit's Conflict of Interest Policy; and 4) Proof of 501(c)(3) status. For additional information regarding the application process: J.H. Corpening II JCPC Chairperson / or Designee 910-550-1622 Telephone # For information about the program application workshop and other technical assistance: Pam Stokes , Area Consultant at (919) 920-4975. The deadline for application submission (Mail or deliver) to: into NCALLIES: January 17, 138 North 4th Street, Suite 307, Wilm., NC 28403 2022 Page 1 of 2 DocuSign Envelope ID: C1262179-A813-463C-B8F2-FF80DOFC863F Page 2 of 2 Certificate Of Completion Envelope Id: C1262179A813463CB8F2FF80DOFC863F Subject: DPS eSignature Request for New Hanover 965-11455 JCPC Administration Source Envelope: Document Pages: 25 Signatures: 4 Certificate Pages: 5 Initials: 0 AutoNav: Enabled Envelopeld Stamping: Enabled Time Zone: (UTC -05:00) Eastern Time (US & Canada) Record Tracking Status: Original 5/10/2022 11:05:16 AM Signer Events Jay Corpening julius.h.corpening@nccourts.org Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Accepted: 5/10/2022 4:57:57 PM I D: 4789d2c2-3ce8-49c7-b 111 -8d042c56260d J H Corpening II julius.h.corpening@nccourts.org Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Accepted: 5/10/2022 4:58:30 PM ID:5e8ce665-c5b2-4197-9447-dfOb575ae5ce Martha Wayne, Interim CFO mwayne@nhcgov.com Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Accepted: 5/17/2022 3:12:28 PM ID:753eb2be-3f07-40ca-9adb-c28ca0c36268 Holder: DPS-DJJ Community Programs djjdp.applicationsupport@ncdps.gov Signature DocuSigned by: 'I���1ypt,lnd � D 8E15D4A2540C... Signature Adoption: Pre -selected Style Signed by link sent to julius.h.corpening@nccourts.org Using IP Address: 204.152.2.230 CDocuSignetl by: R (ops" 3DD8E15D4A2540C... Signature Adoption: Pre -selected Style Signed by link sent to julius.h.corpening@nccourts.org Using IP Address: 204.152.2.230 EADOCUSig"Id by: A6164E%�VX, IVNN`:, CfV Signature Adoption: Pre -selected Style Signed by link sent to mwayne@nhcgov.com Using IP Address: 70.63.86.17 DocuSign Status: Completed Envelope Originator: DPS-DJJ Community Programs 3040 Hammond Business PI Raleigh, INC 27603 djjdp.applicationsupport@ncdps.gov IP Address: 207.4.107.7 Location: DocuSign Timestamp Sent: 5/10/2022 11:05:18 AM Viewed: 5/10/2022 4:57:57 PM Signed: 5/10/2022 4:58:03 PM Sent: 5/10/2022 4:58:04 PM Viewed: 5/10/2022 4:58:30 PM Signed: 5/10/2022 4:58:37 PM Sent: 5/10/2022 4:58:38 PM Viewed: 5/17/2022 8:18:04 AM Signed: 5/17/2022 3:15:36 PM Signer Events Signature Timestamp Cindy Porterfield Sig -d by: Sent: 5/17/2022 3:15:38 PM cindy.porterfield@ncdps.gov �O CCD ""'0�d� `�'' Viewed: 5/19/2022 9:37:06 AM Director of Juvenile Community Programs 798FE7A4ED9F419.. Signed: 5/19/2022 9:37:10 AM NC Dept of Public Safety Signature Adoption: Pre -selected Style Security Level: Email, Account Authentication (None) Signed by link sent to cindy.porterfield@ncdps.gov Using IP Address: 199.90.60.4 Electronic Record and Signature Disclosure: Not Offered via DocuSign In Person Signer Events Signature Timestamp Editor Delivery Events Status Timestamp Agent Delivery Events Status Timestamp Intermediary Delivery Events Status Timestamp Certified Delivery Events Status Timestamp Carbon Copy Events Status Timestamp Witness Events Signature Timestamp Notary Events Signature Timestamp Envelope Summary Events Status Timestamps Envelope Sent Hashed/Encrypted 5/10/2022 11:05:18 AM Certified Delivered Security Checked 5/19/2022 9:37:06 AM Signing Complete Security Checked 5/19/2022 9:37:10 AM Completed Security Checked 5/19/2022 9:37:10 AM Payment Events Status Timestamps Electronic Record and Signature Disclosure Electronic Record and Signature Disclosure created on: 4/3/2018 2:57:43 PM Parties agreed to: Jay Corpening, J H Corpening II, Martha Wayne, Interim CFO CONSUMER DISCLOSURE From time to time, NC Dept of Public Safety (we, us or Company) may be required by law to provide to you certain written notices or disclosures. 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