FY22 LIBRARY LSTA VIRTUAL PROG G0572DocuSign Envelope ID: CFCF86AB-299C-457D-B7D9-13F505423755
GRANT AGREEMENT
LSTA 2021-2022 EZ Grant
State Project Code: NC -21- 27
This is an agreement by and between New Hanover County Public Library
hereinafter referred to as "the Library," and the State Library of North Carolina, Department of Natural and
Cultural Resources, hereinafter referred to as the "State Library."
Institution and/or Library Name: New Hanover County Public Library
Mailing address: 201 Chestnut St
City, State, ZIP: Wilmington NC 28401
Project manager name/title: Leigh Thomas
Project manager telephone: 910-798-6327
Project manager email: lethomas@nhcgov.com
DUNS number: 40029563
Federal Employer Identification Number: 56-6000324-25
Indirect cost rate for this award: N/A
Library fiscal year ending date: June 30
Federal Award Identification Information required by 2 CFR 200.332
Federal Award ID number: LS -249980 -OLS -21
Federal Award Date: January 19, 2021
Grant Award Period Start and End Date: July 1, 2021 - June 30, 2022
Amount of Federal Funds Obligated by this Action: $ 20000
Federal Award Project Description as required by FFATA: LSTA State Grants
Contact information for awarding official: Catherine Prince, Federal Programs Consultant, State Library
of North Carolina, 4640 Mail Service Center, Raleigh, NC, 27699-4600, 919-814-6796,
catherine.prince@ncdcr.gov.
CFDA Name / Number: LSTA State Grants / 45.310
This award is not R&D.
The State Library has agreed to fund this grant with federal Library Services and Technology Act (LSTA)
funds to be disbursed through North Carolina Accounting System accounting fund 46011495410145.
IN CONSIDERATION OF RECEIVING THE ABOVE REFERENCED GRANT FUNDING,
THE LIBRARY HEREBY AGREES TO:
1. Accept and administer an LSTA grant from the State Library in the amount of $ 20000
for costs associated with the project represented in the Library's grant application, grant
award letter, and any amendments thereto.
2. Abide by all Grant Provisions as certified in this document and the grant application; including any
certifications submitted with this grant agreement such as Children's Internet Protection Act (CIPA)
Compliance and Certification Regarding Debarment and Suspension; Lobbying; Federal Debt Status;
and Nondiscrimination.
2021-2022 LSTA Grant Agreement page 1 of 5
DocuSign Envelope ID: CFCF86AB-299C-457D-B7D9-13F505423755
3. Regularly inform the State Library on the progress of project activities as defined in the grant
application.
4. Encumber and expend project funds (grant and matching)
• only upon or after the effective date of this grant agreement and before its termination;
• in accordance with the project budget as submitted with the project application, or as modified in
the grant award letter, or as amended and approved by the State Library; and
• in accordance with all applicable local, state and federal laws and regulations.
5. Expend project funds in a manner that ensures free and open competition.
6. Submit grant reimbursement requests with appropriate documentation of eligible project expenditures
(grant and matching) as defined in the grant application, at least quarterly, on or before October 15,
January 15, and April 15.
7. Submit grant project status reports, briefly describing current and anticipated project expenditures and
project activities, as requested by the State Library.
8. On or before April 15, 2022, request a minimum of seventy-five percent (75%) of the award amount
and provide documentation for seventy-five percent (75%) of the required match; provide a list of
remaining activities with an estimate of remaining grant and matching expenditures as defined in the
grant application.
9. Complete all project expenditures (grant and matching) by June 30, 2022, or by the termination date
of this agreement as amended by mutual consent.
10. On or before July 15, 2022, submit a final request for reimbursement.
11. If eligible, the Library 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
N.C.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.
12. Request prior written approval from the State Library for any equipment with a per unit price above
$5,000. List this equipment on the State Library Annual Equipment Tracking Survey, provided each
January, for the remainder of its useful life. If fair market value at the time of surplus or disposal
exceeds $5,000, disposal must be cleared with the State Library.
13. Acknowledge the Institute of Museum and Library Services in all related publications and activities
in conjunction with the use of grant funds as follows: "This publication/activity/program/etc. was
supported by grant funds from the Institute of Museum and Library Services under the provisions of
the federal Library Services and Technology Act (LSTA) as administered by the State Library of
North Carolina, a division of the Department of Natural and Cultural Resources (IMLS grant number
LS -249980 -OLS -21)." Submit a copy of any publications or materials produced under the grant to
the State Library.
14. Provide library services resulting from the grant to all members of the community served, in
compliance with all Federal statutes relating to non-discrimination on the basis of race, color, national
origin, sex, handicap, or age.
15. Request prior written approval from the State Library for any subcontracting or assignment to any
subgrantee or assignee. Neither the Library nor any subgrantee or assignee is relieved of the duties
and responsibilities of this agreement. Subgrantees and assignees agree to abide by the terms of this
2021-2022 LSTA Grant Agreement page 2 of 5
DocuSign Envelope ID: CFCF86AB-299C-457D-B7D9-13F505423755
agreement and must provide all information necessary for the Library to comply with the terms of this
agreement.
16. Only approved, awarded expenditures are allowable; any funds not expended as defined in the grant
application will be repurposed by the State Library upon termination of this agreement.
17. Submit a final report to the State Library by August 31, 2022, providing a description of project
expenditures, a narrative of project activities, and other elements required by the funder.
18. Certify upon completion of the grant that grant funds were received, used, and expended for the
purposes for which they were granted.
19. Complete the Single Audit Certification as directed and maintain adequate financial records to ensure
complete reporting, and retain programmatic, financial, and audit records relating to the grant for a
minimum of three years from the due date of the final grant report at the end of the Five Year Plan, or
until all audit exceptions have been resolved, whichever is longer. Provide access upon request to the
Department of Natural and Cultural Resources, Office of the State Auditor, Institute of Museum and
Library Services and the Comptroller General or their designees, to all records and documents related
to the award, including audit work papers in possession of any auditor of the Library.
20. Ensure that grant funds are audited in compliance with state and federal audit requirements for local
governments and public authorities, institutions of higher education, and non-profit organizations,
and, as applicable, according to the standards of 2 CFR 200, Subpart F - Audit Requirements, as
supplied by the Executive Office of the President, Office of Management and Budget, Washington,
DC.
21. Comply with the requirements of North Carolina General Statute 143C-6-23: "State grant funds:
administration; oversight and reporting requirements" and the corresponding rules of North Carolina
Administrative Code, Title 9, Subchapter 03M, "Uniform Administration of State Grants," including
submission of required financial reports within six months (or nine months for $500,000 threshold) of
the end of the Library's fiscal year(s) in which grant funds are received.
22. The State Auditor and the using agency's internal auditors shall have 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 and after the term of the contract to
verify accounts and data affecting fees or performance).
23. If not already on file, file with the State Library a copy of the Library's policy addressing conflicts
of interest that may arise involving the Library's management employees and members of its board
of directors, commissions, or other governing body. The policy shall address situations in which any
of these individuals may directly or indirectly benefit, except as the Library's employees or members
of its board, commissions, or other governing body, from the Library's disbursing of grant funds and
local matching funds and shall include actions to be taken by the Library or the individual, or both, to
avoid conflicts of interest and the appearance of impropriety. (N.C.G.S. 143C -6-23(b)). The policy
shall be filed before the State Library may disburse the grant funds, unless the Library is covered by
the provisions of N.C.G.S. 160A-479.11 and 14-234.
24. File with the State Library the Library's sworn written statement completed by the Library's board of
directors or other governing body stating that, pursuant to N.C.G.S. 143C -6-23(c), the Library does
not have any overdue tax debts, as defined by N.C.G.S. 105-243.1, at the federal, State, or local
level. The policy shall be filed before the State Library may disburse the grant funds, unless the
Library is covered by the provisions of G. S. 160A-479.11 and 14-234.
2021-2022 LSTA Grant Agreement page 3 of 5
DocuSign Envelope ID: CFCF86AB-299C-457D-B7D9-13F505423755
THE STATE LIBRARY AGREES TO:
1. Award LSTA grant funds to the Library in the amount and under the terms and conditions stated
above, subject to the availability of funds.
2. Pay LSTA grant funds upon receipt of reimbursement requests for approved, awarded expenditures
submitted quarterly by the Library. Pay by June 30, 2022, all approved requests received on or before
April 15, 2022, and by August 31, 2022, all approved requests received by July 15, 2022.
3. Assist the Library as appropriate and necessary with the implementation of this project. Provide
monitoring and oversight through a combination of periodic emails, calls, visits, and review of
reimbursement requests and reports.
4. Report on this project to the federal funding agency, the Institute of Museum and Library Services,
and the North Carolina Office of State Budget and Management in accordance with all applicable
federal and state requirements.
THIS AGREEMENT is in effect upon signing by all parties. It may be amended, if necessary, upon the
mutual acceptance of a written amendment to this agreement signed and dated by the Library and the
State Library. Such amendment(s) shall state any and/or all change(s) to be made. This agreement may
be terminated by mutual consent with 60 days' prior written notice or as otherwise provided by law.
Returning signed agreements signifies accepting the grant award; awards not accepted by September 30,
2021 may be withdrawn.
[Please sign below.]
DocuSigned by:
x
raint, OWLA&S
Signature, Library Director
Paige Owens
Printed Name
DocuSigned by:
x 5�
Signature, Local Government or Institutional Representative
Sheryl Kelly
6/11/2021
Date
6/15/2021
Date
Assistant County Manager
Printed Name Title
DocuSigned by:
fi�bf i ;. O-W,,l,S 6/15/2021
X
Signature, Timothy G. Owens, State Librarian Date
X Reviewed by Teresa Hewett, Grants and Project Analyst
2021-2022 LSTA Grant Agreement page 4 of 5
DocuSign Envelope ID: CFCF86AB-299C-457D-B7D9-13F505423755
GRANT PROVISIONS
The following state and federal provisions apply to the LSTA
grant program. Libraries awarded grants must agree to comply
with these provisions.
1. Grant Agreement and Timing of Expenditures
Official notification of the grant award must be received from the
State Library and a grant agreement (formal agreement between
the grantee and the State Library) signed by both the
representatives of the library and the State Librarian before any
funds may be encumbered or expended for the project.
2. Allowable and Unallowable Costs
Grantees must carry out the grant project according to the
approved grant application, and all federal funds must be
expended solely for the purpose for which a grant was awarded.
The following costs are unallowable and may not be proposed as
grant project costs: bad debts, contingencies, contributions and
donations, entertainment, fines and penalties, under recovery of
costs under grant agreements (excess costs from one grant
agreement are not chargeable to another grant agreement).
3. Legal and Regulatory Compliance
Grantees must expend grant funds in accordance with all
applicable local, state, and federal laws and regulations.
4. Budget Revisions and Programmatic Changes
Grantees must not deviate from the approved budget and plan
for carrying out the grant project as contained in the approved
grant application unless prior approval is obtained from the State
Library.
5. Records Retention
Grantees must maintain adequate records to ensure complete
reporting, and retain programmatic and financial records relating
to the grant for a minimum of three years from the due date of
the final grant report at the end of the Five Year Plan, or until all
audit exceptions have been resolved, whichever is longer.
6. Free and Open Competition
Purchases made from grant funds must be carried out to ensure
free and open competition to the extent possible. Libraries
eligible to purchase under state contract may use this option for
grant purchases.
7. Debarment & Suspension
Transactions for the purposes of this grant will not knowingly be
made with parties who have been debarred or suspended from
receiving Federal financial assistance under Federal programs
and activities (Debarment and Suspension Certification). See
Excluded Parties List System at https://www.sam.gov .
8. Equipment Purchases and Inventory
Equipment with a per unit price above $5,000 requires advance
written approval from the State Library. If fair market value at the
time of surplus or disposal exceeds $5,000, disposal must be
cleared with the State Library.
9. Publicizing & Acknowledging Funds
Grantees are required to credit IMLS/LSTA in all related
publications and activities in conjunction with the use of grant
funds. Grantees should publicize grant -supported activities in
available and appropriate media. The following statement must be
used when meeting these requirements: "This publication/
activity/program was supported by grant funds from the Institute of
Museum and Library Services under the provisions of the federal
Library Services and Technology Act as administered by the State
Library of North Carolina, a division of the Department of Natural
and Cultural Resources." Copies of any publications or materials
produced under the grant must be submitted to the State Library.
IMLS logos are available at
http://www.imis.gov/recipients/imis acknowledgement. aspx
10. Lobbying
Grantees are prohibited by federal law from using grant funds to
pay costs associated with lobbying Congress or the public for
purposes of influencing elections, legislation, or the award of any
federal funds. Grantees receiving an award of over $100,000 must
file a certification regarding lobbying.
11. Non-discrimination
All library services provided as a result of federal grant funds must
be available without discrimination to all members of the community
served. Participation may not be denied on the basis of race, color,
national origin, handicap, age, or sex. Relevant legislation includes
but is not limited to the following: Title VI of the Civil Rights Act of
1964 (42 U.S.C. 2000d through 2000d-4); Title IX of the Education
Amendments of 1972 (20 U.S.C. 1681-1683); Section 504 of the
Rehabilitation Act of 1973 (29 U.S.C. 794); The Age Discrimination
Act (42 U.S.C. 6101 et. seq); 45 CFR 1110 - Nondiscrimination in
federally assisted programs; 45 CFR 1170 - Nondiscrimination on
the basis of handicap in federally assisted programs and activities;
45 CFR 1181 - Enforcement of nondiscrimination on the basis of
handicap in programs or activities conducted by the Institute of
Museum and Library Services.
12. Trafficking in Persons
Grantees must comply with 22 U.S.C. § 7104(g) which prohibits
engaging in trafficking in persons, procuring a commercial sex act,
or using forced labor.
13. Audit and Financial Reporting Requirements
LSTA grants must be audited in compliance with federal and state
audit requirements for local governments and public authorities,
institutions of higher education, and non-profit organizations. The
following source documents outline the standards and
requirements:
• United States Office of Management and Budget (OMB) 2 CFR
200, Subpart F - Audit Requirements
• North Carolina General Statute 143C-6-23 "State grant funds:
administration; oversight and reporting requirements," and the
corresponding rules of North Carolina Administrative Code,
Title 09, Chapter 03M, "Uniform Administration of State
Grants."
LEGAL REFERENCES:
• 2 CFR 200 Uniform Administrative Requirements, Cost
Principles, and Audit Requirements for Federal Awards
[address grants and cooperative agreements pertaining to
institutions of higher education, states, local governments,
Indian tribes, and nonprofit organizations]
• 2 CFR Part 3185 - Nonprocurement debarment and
suspension
• 2 CFR 3186 - Requirements for drug-free workplace
2021-2022 LSTA Grant Agreement page 5 of 5
DocuSign Envelope ID: CFCF86AB-299C-457D-B7D9-13F505423755
CERTIFICATION REGARDING DEBARMENT AND SUSPENSION; LOBBYING;
FEDERAL DEBT STATUS; AND NONDISCRIMINATION
L DEBARMENT AND SUSPENSION
The grantee shall comply with 2 CFR Part 3185. The undersigned, on behalf of the grantee, certifies to
the best of his or her knowledge and belief that neither the grantee nor any of its principals:
(a) Are presently excluded or disqualified;
(b) Have been convicted within the preceding three years of any of the offenses listed in 2 CFR
section 180.800(a) or had a civil judgment rendered against you for one of those offenses within that
time period;
(c) Are presently indicted for or otherwise criminally or civilly charged by a governmental entity
(Federal, State or local) with commission of any of the offenses listed in 2 CFR section 180.800(a);
or
(d) Have had one or more public transactions (Federal, State, or local) terminated within the
preceding three years for cause or default.
Where the grantee is unable to certify to any of the statements in this certification, he or she shall
attach an explanation to this submission.
The grantee is required to communicate the requirement to comply with 2 CFR Part 180 Subpart C
(Responsibilities of Participants Regarding Transactions Doing Business With Other Persons) to persons
at the next lower tier with whom the grantee enters into covered transactions.
2. LOBBYING
As required by Section 1352, Title 31 of the United States Code, and implemented for persons entering
into a grant or cooperative agreement over $100,000, the grantee certifies to the best of his or her
knowledge and belief that:
(a) 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 any 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 a Federal contract, the making of a Federal grant, the making of a
Federal loan, the entering into of a cooperative agreement, or the extension, continuation, renewal,
amendment, or modification of a Federal contract, grant, loan, or cooperative agreement.
(b) If any funds other than appropriated Federal funds have been paid or will be paid to any person
(other than a regularly employed officer or employee of the grantee) 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 request, complete, and submit Standard Form
LLL, "Disclosure of Lobbying Activities," in accordance with its instructions.
(c) 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.
page 1 of 2
DocuSign Envelope ID: CFCF86AB-299C-457D-B7D9-13F505423755
3. FEDERAL DEBT STATUS
The undersigned, on behalf of the grantee, certifies to the best of his or her knowledge and belief that the
grantee is not delinquent in the repayment of any Federal debt.
4. NONDISCRLMINATION
As required by the Civil Rights Act of 1964, the Rehabilitation Act of 1973, the Education Amendments
of 1972, and the Age Discrimination in Employment Act of 1975, as implemented at 45 C.F.R. Part
1180.44, the undersigned, on behalf of the grantee, certifies that the grantee will comply with the
following nondiscrimination statutes and their implementing regulations:
(a) Title VI of the Civil Rights Act of 1964, as amended (42 U.S.C. § 2000 et seq.), which provides
that no person in the United States shall, on the grounds of race, color, or national origin, be
excluded from participation in, be denied the benefits of, or otherwise be subject to discrimination
under any program or activity receiving Federal financial assistance;
(b) Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. § 701 et seq.), which
prohibits discrimination on the basis of disability in Federally -assisted programs; (c) Title IX of the
Education Amendments of 1972, as amended (20 U.S.C. §§ 1681-83, 1685- 86), which prohibits
discrimination on the basis of sex in education programs and activities receiving Federal financial
assistance;
(d) The Age Discrimination in Employment Act of 1975, as amended (42 U.S.C. § 6101 et seq.),
which prohibits discrimination on the basis of age in Federally -assisted programs;
The undersigned further provides assurance that it will include the language of these certifications in all
subawards and that all subrecipients shall certify and disclose accordingly.
As the duly authorized representative of the grantee, I hereby certify that the grantee will comply with the
above certifications.
DocuSigned by:
s,L ,
Signa e o uthorized Certifying Official
Sheryl Kelly Assistant County Manager
Print Name and Title of Authorized Certifying Official
6/15/2021
Date
I have attached my Conflict of Interest Policy
X My Conflict of Interest Policy is on file
X I have attached my LSTA Partner Statement(s)
My LSTA Partner Statement(s) are on file or I don't have eligible partners
Certification Regarding Debarment and Suspension; Lobbying; etc.
X LST/Stal' Check/ercrfalldacumenfshavebeearecervedandallsignatureshaiebeengathe�ed
page 2 of 2
DocuSign Envelope ID: CFCF86AB-299C-457D-B7D9-13F505423755
CIPA COMPLIANCE CERTIFICATION FORM
for Public Libraries
As the authorized library representative, I hereby certify that the library is
(check only one of the following boxes)
A. x❑ CIPA Compliant
The applicant library has complied with the requirements of Section 9134(f)(1) of the Library
Services and Technology Act.
OR
B. ❑ The CIPA requirements do not apply because no funds made available under the LSTA program
will be used to purchase electronic equipment capable of accessing the Internet or to pay for
direct costs associated with accessing the Internet.
Paige Owens
te9g"*kY:of library director
Pe B E3
Signature o i rary director
6/11/2021
Date
CIPA Compliance Certification Form
State Library of North Carolina
DocuSign Envelope ID: CFCF86AB-299C-457D-B7D9-13F505423755
CIPA COMPLIANCE INFORMATION
Libraries that are neither public libraries nor public elementary or secondary school libraries are not subject to
CIPA and do not have to comply with this law.
Overview
CIPA is the Children's Internet Protection Act, which applies to public libraries and public elementary and
secondary school libraries seeking funds under the federal Universal Service (E -rate) program or the Library
Services and Technology Act (LSTA) grant programs funded by the Institute of Museum and Library Services
(IMLS) and administered by the State Library of North Carolina.
Affected Libraries
The following types of libraries applying for LSTA grants from the State Library of North Carolina must be
CIPA compliant and must submit the CIPA Compliance Certification Form with their signed Grant
Agreement.
• Public libraries
• Public school libraries
• Consortia with public and/or public school libraries
If a library type listed above is already compliant with CIPA under the rules for receiving E -rate funds, that
library is not affected by the rules established for LSTA grant recipients. Accordingly, the compliance
information in this document applies only to libraries meeting all three of the following conditions.
The library is:
1) a public library or public elementary or secondary school library,
2) NOT required to comply with CIPA through the federal Universal Service (E -rate) program, and
3) seeking LSTA funds for the purchase of technology used to access the Internet and/or for the payment of
direct costs associated with accessing the Internet.
Libraries that are required to comply with CIPA because of the receipt of funds from the Universal Service (E-
rste) program must adhere to a different and more stringent set of requirements. More information about those
requirements may be found at <http://statelibrary.dcr.state.nc.us/hottopic/cipa/cipa.htm>. The compliance
information in this document does not apply to libraries that must comply with CIPA under the Universal
Service (E -rate) rules.
Purchases That Require CIPA Compliance
A library that is subject to CIPA under the rules for LSTA must comply with the law when either of the
following are approved for purchase with LSTA funds:
• technology used to access the Internet, or
• direct costs associated with accessing the Internet (i.e., the costs of connecting to an Internet service
provider [ISP]).
Requirements for Compliance
The policy requires that some form of "technology protection measure" be in use on all computers used to
access the Internet. This includes computers that were not purchased with LSTA funds but that are used to
access the Internet. The law provides no other guidance on technology protection measures. According to the
CIPA legislation, the technology protection measure may be disabled upon the request of the user for "bona fide
research or other lawful purposes." The law as applied to LSTA grant recipients does not differentiate between
minors and adults when a request is made to disable the technology protection measure or unblock a website.
Anyone may make such a request. For purposes of CIPA, a "minor" is someone under 17 years of age.
LSTA CIPA Compliance Information Page 1 of 2
State Library of North Carolina
DocuSign Envelope ID: CFCF86AB-299C-457D-B7D9-13F505423755
To receive LSTA funds for purchases listed above, the library must have in place a policy of:
a) Internet safety for minors that includes the operation of a technology protection measure with respect to any
of its computers with Internet access that protects against access through such computers to visual
depictions that are (1) obscene; (11) child pornography; or (III) harmful to minors; and is enforcing the
operation of such technology protection measure during any use of such computers by minors; and
b) Internet safety that includes the operation of a technology protection measure with respect to any of its
computers with Internet access that protects against access through such computers to visual depictions that
are (I) obscene; (11) child pornography; and is enforcing the operation of such technology protection
measure during any use of such computers."
Note that the difference between (a) and (b) is that (a) applies to minors and includes the category of "visual
depictions" that are "harmful to minors", while (b) applies to adults and does not include the category "harmful
to minors".
LSTA CIPA Compliance Information Page 2 of 2
State Library of North Carolina
DocuSign Envelope ID: CFCF86AB-299C-457D-B7D9-13F505423755
LSTA PARTNER STATEMENT
In order for the library to qualify for a 10% match, partners must contribute a deliverable to the project.
Complete one form for each partner.
1. Library Name
New Hanover County Public Library
2. Grant Category
EZ Grant
3. Partner Organization
(name, address, phone)
New Hanover County
230 Government Center Drive
Wilmington, NC 28405
4. Partner Contribution
This may be a cash amount or in-kind contribution such as donated personnel, training space, transportation,
supplies, materials, printing, or other items to be used in implementing the project. Specify the expected
quantity, frequency, etc. such as "the partner will provide an instructor for 2 one hour classes each month,
totaling 20 classes over 10 months."
$6,250
5. Partner Roles/Responsibilities
Provide match
The undersigned partner organization agrees to carry out the activities described in numbers 4 and 5 above.
Name and Title of Partner Organization Representative
Signature of Partner Organization Representative
Date
LSTA Partner Statement
State Library of North Carolina