FY23 ROD NC OSBM ROD HISTORIC DOC PRESERVATION Page 1 of 6
North Carolina Office of State Budget and Management
Contract # _________________
This Agreement is hereby entered into by and between the NC Office of State Budget and Management (the
"AGENCY") and __________________________________________________________________________
(the "RECIPIENT") (referred to collectively as the “Parties”).
1. EFFECTIVE TERM:
The RECIPIENT’s performance period for this agreement shall be effective starting July 1, 2021, through
June 30, 2023. The PARTIES’ duties of record-keeping, monitoring, reporting, and auditing continue
thereafter as provided below.
2. RECIPIENT’S DUTIES:
The RECIPIENT is authorized by this agreement to use funds for purposes referenced in the Current
Operations Appropriations Act, Session Law (S.L.) 2021-180, as amended by S.L. 2021-189. The RECIPIENT’s
scope of work is a complete and concise scope of goods or services supported by this agreement and
consistent with language in S.L. 2021-180, as amended by S.L. 2021-189.
The RECIPIENT agrees to use the funds in the amounts allocated for the budget cost items set forth in the
RECIPIENT’s Budget. RECIPIENT may reallocate and/or redistribute among budgeted items up to 10% in
overall budget costs without the express written permission of the AGENCY.
The RECIPIENT understands and acknowledges that the first round of funding is $2,000. Depending upon
availability, a second round of funding may occur at AGENCY discretion. The RECIPIENT acknowledges they
have provided the following additional documentation:
a. Internal Revenue Service W-9 form (includes address, Tax ID) ____________________
b. Electronic Payment Form & Supporting Document (if required) ____________________
The RECIPIENT understands and acknowledges required compliance with all statutory provisions outlined in
G.S. 143C-6-22 Use of State funds by non-State entities, 9 N.C.A.C. Subchapter 3M and the requirements
found in S.L. 2021-180, Section 24.2; and as amended by S.L. 2021-189.
The RECIPIENT shall ensure:
a. RECIPIENT shall use grant funds for the preservation of historic records and files. Allowable uses
of the funds include, but are not limited to, document restoration, reparation, deacidification,
and placement in protected archival binders.
b. Funds may be used for document digitization only if the original documents will continue to be
maintained and preserved.
DocuSign Envelope ID: D4902B78-75FC-485E-8241-EA2D3BF68626
2078RD1
County of New Hanover
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c. RECIPIENT must provide a one hundred percent (100%) match for all grant funds awarded.
d. Interest earnings on funds shall be used for the same purposes for which the grant was made.
e. Submission of reports on financial and performance progress. This shall include financial and
performance progress of the RECIPIENT.
f. Compliance with 9 N.C.A.C. Subchapter 3M.0205.
g. RECIPIENT is not permitted to subgrant funds to another organization.
Pursuant to G.S 143C-6-8, the RECIPIENT understands and agrees that funding shall be subject to the
availability of appropriated funds. However, in the event of agreement termination due to lack of adequate
appropriated funds, the AGENCY will ensure that it will pay for services and goods acquired and obligated on
or before the notice of agreement termination.
3. AGENCY’S DUTIES & PAYMENT PROVISIONS:
The AGENCY shall ensure that funds allocated and disbursed pursuant to Session Law 2021-180, as amended
by S.L. 2021-189, comply with the intent and guidance found in these Session Laws and ensure compliance
with related state statutes and financial management standards.
The AGENCY is subject to the following requirements:
a. Upon execution of this contract and the RECIPIENT’s submission of documents identified in Section
2 of this contract, the AGENCY shall pay the RECIPIENT the full amount as identified in the scope of
work within 30 days.
b. Develop RECIPIENT financial and performance reporting document that shall incorporate the
requirements of 9 N.C.A.C. Subchapter 3M.0205 and require the RECIPIENT to:
i. Certify that funds received or held were used for the intended purpose.
ii. Provide an accounting for funds received, interest earned, funds expended.
iii. Provide activities, accomplishments, and performance measures.
iv. Provide a list of employees and the amount of State funds used for the employee’s
annual salary.
v. Provide supporting invoices, contracts, payroll information or other documents to
support expenditures.
c. Provide a secure method for submitting financial and performance reports.
d. Conduct financial and performance monitoring until the contract is completed.
e. Funds will not revert until June 30, 2023.
4. FUNDS MANAGEMENT:
The RECIPIENT agrees that funds paid through this contract shall be subject to the following:
a. Accounted for in a separate fund and accounting structure within the RECIPIENT’s central accounting
and / or grant management system. This shall include accounting for interest earned on these funds.
b. All accounts payable disbursements, check register disbursements and related transactions shall be
managed in a detailed manner that supports fully transparent accounting of all financial transactions
associated with this funding allocations described in Section 3 above.
c. Expenditures for travel mileage are not eligible under this Contract.
d. If eligible, the RECIPIENT:
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i. Request from the North Carolina Department of Revenue 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
ii. Exclude all refundable sales and use taxes from all reportable expenditures before the
expenses are entered in their quarterly project status reports.
5. POST-GRANT AWARD DOCUMENTATION REQUIREMENTS:
The RECIPIENT agrees to submit the required quarterly report on or before the 10th day following the end of
each quarter. The first report is due on or before July 10, 2022, to the AGENCY. The AGENCY shall provide
the format and method for reporting. All reports and supporting documents shall include the RECIPIENT and
all SUB-RECIPIENT information and shall be submitted as prescribed by the AGENCY.
RECIPIENT agree that all program activity results information reported shall be subject to review and
authentication as described in Paragraph 7 and RECIPIENT will provide access to work papers, receipts,
invoices, and reporting records, if requested by the AGENCY, as the AGENCY executes any monitoring or
internal audit responsibilities.
6. AGREEMENT ADMINISTRATORS:
All notices permitted or required to be given by one Party to the other and all questions about the
Agreement from one Party to the other shall be addressed and delivered to the other Party’s Agreement
Administrator. The name, post office address, street address, telephone number, fax number, and email
address of the Parties’ respective initial Agreement Administrators are set out below. Either Party may
change the name, post office address, street address, telephone number, fax number, or email address of
its Agreement Administrator by giving timely written notice to the other Party.
RECIPIENT and AGENCY Point of Contact
RECIPIENT Contract Administrator AGENCY Contract Administrator
Name: __________________________________
Email: ___________________________________
Fiscal year end date: _______________________
Bessie Dsouza
NC Office of State Budget and Management
116 West Jones Street, 5th Floor
Raleigh, NC 27603
Direct Phone: 984-236-0600
Email: osbm-rdgrants@osbm.nc.gov
DocuSign Envelope ID: D4902B78-75FC-485E-8241-EA2D3BF68626
Tpiver@nhcgov.com
2022
Tammy T Piver
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7. MONITORING AND AUDITING:
The RECIPIENT acknowledges and agrees that, from and after the date of execution of this Agreement and
for five (5) years following its termination, the books, records, documents, and facilities of the RECIPIENT
are subject to being audited, inspected, and monitored at any time by the AGENCY upon its request (whether
in writing or otherwise). The RECIPIENT further agrees to provide AGENCY staff and staff of the Office of
State Auditor with access to financial and accounting records to support internal audit, financial reporting,
and related requirements.
The RECIPIENT acknowledges and agrees that, regarding the grant funds, it will be subject to the audit and
reporting requirements prescribed in G.S. 159-34, Local Government Finance Act – Annual Independent
Audit, rules, and regulations. Such audit and reporting requirements may vary depending upon the amount
and source of grant funding received by the RECIPIENT and are subject to change.
8. TAXES:
The RECIPIENT shall be considered to be an independent RECIPIENT and as such shall be responsible for all
taxes. The RECIPIENT agrees to provide the AGENCY with the RECIPIENT'S correct taxpayer identification
number upon the execution of this Agreement. The RECIPIENT agrees that failure to provide the AGENCY
with a correct taxpayer identification number authorizes the AGENCY to withhold any amount due and
payable under this Agreement.
9. SITUS:
This Agreement shall be governed by the laws of North Carolina and any claim for breach or enforcement of
this Agreement shall be filed in State court in Wake County, North Carolina.
10. COMPLIANCE WITH LAW:
The RECIPIENT shall remain an independent RECIPIENT and as such shall be wholly responsible for the scope
of work to be performed under this Agreement and for the supervision of his employees and assistants. The
RECIPIENT represents that it has, or will 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. The RECIPIENT shall be responsible for compliance with all laws, ordinances,
codes, rules, regulations, licensing requirements and other regulatory matters that are applicable to the
conduct of his business and work performance under this Agreement, including those of Federal, State, and
local agencies having appropriate jurisdiction.
The Recipient acknowledges and agrees that, in its conduct under this Contract and in connection with any
and all expenditures of grant funds made by it, it shall comply with the cost principles enunciated in the
Code of Federal Regulations, 2 CFR, Part 200.
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11. TERMINATION OF AGREEMENT:
This agreement may be terminated by mutual consent upon sixty (60) days written notice to the other party,
or as otherwise provided by law. As soon as reasonably possible following termination of this agreement,
the amount of any residual unexpended funds shall be transferred to the AGENCY.
12. AMENDMENTS:
This Agreement may be amended in writing which documents approval of changes by both the AGENCY and
the RECIPIENT.
13. AGREEMENT CLOSE-OUT PROCESS:
The RECIPIENT agrees to submit to the AGENCY a complete performance and expenditure status report (final
quarterly report) within ninety (90) days after the completion of the project or final expenditure date,
whichever is later. Unexpended funds should be promptly returned to the AGENCY at this time.
RECIPIENT will be deemed noncompliant if its final report is not submitted within the 90-day period stated
above. Once the complete final performance and financial status report package has been received and
evaluated by the AGENCY, the RECIPIENT will receive official notification of agreement close-out. The letter
will inform the RECIPIENT that the AGENCY is officially closing the agreement and retaining all agreement
files and related material for a period of five (5) years or until all audit exceptions have been resolved,
whichever is longer.
14. AUTHORIZED SIGNATURE WARRANTY:
The undersigned represent and warrant that they are authorized to bind their principals to the terms of this
agreement. In Witness Whereof, the RECIPIENT and the AGENCY have executed this Agreement in duplicate
originals, with one original being retained by each party.
RECIPIENT NAME
_______________________________________________________________________________________
Signature Date
_______________________________________________________________________________________
Printed Name Title
DocuSign Envelope ID: D4902B78-75FC-485E-8241-EA2D3BF68626
Tammy Theusch Piver
5/27/2022
Registrar
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NC OFFICE OF STATE BUDGET AND MANAGEMENT
_______________________________________________________________________________________
Signature Date
______________________________________________________________________________________
Printed Name Title
DocuSign Envelope ID: D4902B78-75FC-485E-8241-EA2D3BF68626
Charles Perusse State Budget Director
5/28/2022