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FY24 JCPC ADMIN PROGRAM AGREEMENTDocuSign Envelope ID: 48EC6CE0-AB30-4BDF-932E-73CE99FF30BA North Carolina Department of Public Safe Juvenile Justice and Delinquency Prevention JCPC Program Agreement Revision SECTION I A SPONSORING AGENCY AND PROGRAM INFORMATION FUNDING PERIOD: FY 22-23 DPS/JCPC FUNDING # (cont only) 965-11455 COUNTY: New Hanover AREA: Eastern Area NAME OF PROGRAM: JCPC Administration SPONSORING AGENCY: New Hanover County Name: Jay Corpening Title: Mailing Address: 138 N. 4th Street City: Wilmington Zip: 28401 Phone: (910) 772-6612 Fax: E-mail: julius.h.corpening@nccourts.org Program Manager Name & Address (same person on signature page) THE REASONS FOR THIS BUDGET REVISION ARE AS FOLLOWS: ❑ INCREASE IN DPS/JCPC REVENUES ❑ DECREASE IN DPS/JCPC REVENUES ❑ INCREASE IN OTHER REVENUES ❑ DECREASE IN OTHER REVENUES ❑ CAPITAL EXPENDITURE ADJUSTMENT ❑ CONTRACTED SERVICE ADJUSTMENT ❑ LAPSED SALARY ADJUSTMENT ❑Q LINE ITEM ADJUSTMENT ❑ CHANGE IN COMPONENT (attach revised Component Narrative) COMMENTS: Line item adjustment to purchase office supplies LINE ITEMS IN THE CURRENT DPS/JCPC APPROVED BUDGET ARE BEING ADJUSTED AS FOLLOWS: Item # Increase Decrease Explanation 220 $331 Adjustment to reflect actual cost of food for JCPC meetings 260 $398 Adjustment to purchase office supplies 370 $67 Adjustment to reflect actual cost to advertise RFP Total $398 $398 Difference $0 Form JCPC/PR 001 JCPC Program Agreement Revision Form structure last revised 12/12/2012 Department of Public Safety DocuSign Envelope ID: 48EC6CE0-AB30-4BDF-932E-73CE99FF30BA 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 $2,869 260 General Office Supplies paper, note books, etc. $598 370 Advertising costs to advertise RFP $433 TOTAL $9,900 $0 Annual Expense Annual In Kind Job Title Wages Wages TOTAL Form JCPC/PR 001 JCPC Program Agreement Revision Form structure last revised 12/12/2012 Department of Public Safety DocuSign Envelope ID: 48EC6CE0-AB30-4BDF-932E-73CE99FF30BA Budget Information Page Program: JCPC Administration Fiscal Year: FY 22-23 Number of Months: 12 Cash 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 II. Supplies & Materials $3,467 $3,467 210 Household & Cleaning $0 220 Food & Provisions $2,869 $2,869 230 Education & Medical $0 240 Construction & Repair $0 250 Vehicle Supplies & Materials $0 260 Office Supplies and Materials $598 $598 280 Heating & Utility Supplies $0 290 Other Supplies and Materials $0 III. Current Obligations & Services $433 $433 310 Travel & Transportation $0 320 Communications $0 330 Utilities $0 340 Printing & Binding $0 350 Repairs & Maintenance $0 370 Advertising $433 $433 380 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/PR 001 JCPC Program Agreement Revision Form structure last revised 12/12/2012 Department of Public Safety DocuSign Envelope ID: 48EC6CE0-AB30-4BDF-932E-73CE99FF30BA SOURCES OF PROGRAM REVENUE (ALL SOURCES) CURRENT BUDGET REVENUE NEW BUDGET REVENUE $9,900 DPS/JCPC Funds $9,900 DPS/JCPC Funds County Cash Local Cash 1 Local Cash 2 $0 Local In -Kind Local In -Kind 1 Local In -Kind 2 Local In -Kind 3 Local In -Kind 4 Local In -Kind 5 Other 1 Other 2 Other 3 Other 4 $9,900 TOTAL $0 Required Local Match Source of County Cash Source of Local Cash 1 Source of Local Cash 2 Source of Local In -Kind Source of Local In -Kind 1 Source of Local In -Kind 2 Source of Local In -Kind 3 Source of Local In -Kind 4 Source of Local In -Kind 5 Source of Other 1 Source of Other 2 Source of Other 3 Source of Other 4 DIFFERENCE $0 0% $0 Local Match Rate Local Match Provided County Cash Source of County Cash Local Cash 1 Source of Local Cash 1 Local Cash 2 Source of Local Cash 2 $0 Local In -Kind Source of Local In -Kind Local In -Kind 1 Source of Local In -Kind 1 Local In -Kind 2 Source of Local In -Kind 2 Local In -Kind 3 Source of Local In -Kind 3 Local In -Kind 4 Source of Local In -Kind 4 Local In -Kind 5 Source of Local In -Kind 5 Other 1 Source of Other 1 Other 2 Source of Other 2 Other 3 Source of Other 3 Other 4 Source of Other 4 $9,900 TOTAL $0 0% $0 Required Local Match Local Match Rate Local Match Provided Form JCPC/PR 001 JCPC Program Agreement Revision Form structure last revised 12/12/2012 Department of Public Safety DocuSign Envelope ID: 48EC6CE0-AB30-4BDF-932E-73CE99FF30BA —DocuSigned by: .f 6 ��onrG�eeanoGe�o [l�� 6/19/2023 Authorizing Official, Department of Public Safety Date —DocuSigneddby: �G (,& C6n88CFC5D1A485_.. 6/15/2023 Chair, County Board of Commissioners or County Finance Director Date DocuSigned by: nn8F1sn4A2540C 6/7/2023 Chair, Juvenile Crime Prevention Council Date DDoocuSignedd by: l` ��nnnF sndn,ITUU" 6/7/2023 Program Manager Date Form JCPC/PR 001 JCPC Program Agreement Revision Form structure last revised 12/12/2012 Department of Public Safety Certificate Of Completion Envelope Id: 48EC6CEOAB304BDF932E73CE99FF30BA Subject: DPS eSignature Request for New Hanover 965-11455 JCPC Administration Source Envelope: Document Pages: 5 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 6/7/2023 7:58:01 AM Signer Events Jay Corpening julius.h.corpening@nccourts.org Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Accepted: 6/7/2023 1:54:04 PM ID:923eb78f-b992-46b0-9f6a-4b7213ec58c4 J H Corpening II julius.h.corpening@nccourts.org Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Accepted: 6/7/2023 5:25:53 PM ID:31101114-2f0a-4bd7-adf5-ef70faa56a9e Eric Credle ecredle@nhcgov.com Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Accepted: 6/15/2023 1:11:54 PM ID:ebaa7321-6632-4cbf-abOc-be90667568c5 Cindy Porterfield cindy.porterfield@ncdps.gov Director of Juvenile Community Programs NC Dept of Public Safety Security Level: Email, Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign Holder: DPS-DJJ Community Programs djjdp.applicationsupport@ncdps.gov Signature E,.0,USi,n,1 1ylI��11%% 8E15D4A2540C Signature Adoption: Pre -selected Style Using IP Address: 204.152.2.232 ED ... Sig -d by: N (muu," N 30D8E1504A2540C... Signature Adoption: Pre -selected Style Using IP Address: 204.152.2.231 EDOCUSigned y: 'b�I' � C6B88CFC5D1A4B5... Signature Adoption: Pre -selected Style Using IP Address: 152.31.193.130 by: ED—Sign1d 798FE7A4BD9F419.. Signature Adoption: Pre -selected Style Using IP Address: 70.40.80.201 DocuSign Status: Completed Envelope Originator: DPS-DJJ Community Programs 3040 Hammond Business PI Raleigh, NC 27603 djjdp.applicationsupport@ncdps.gov IP Address: 207.4.107.7 Location: DocuSign Timestamp Sent: 6/7/2023 7:58:03 AM Viewed: 6/7/2023 1:54:04 PM Signed: 6/7/2023 1:54:12 PM Sent: 6/7/2023 1:54:14 PM Viewed: 6/7/2023 5:25:53 PM Signed: 6/7/2023 5:25:59 PM Sent: 6/7/2023 5:26:01 PM Viewed: 6/15/2023 1:11:54 PM Signed: 6/15/2023 5:16:20 PM Sent: 6/15/2023 5:16:22 PM Viewed: 6/19/2023 12:31:18 PM Signed: 6/19/2023 12:31:22 PM 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 6/7/2023 7:58:03 AM Certified Delivered Security Checked 6/19/2023 12:31:18 PM Signing Complete Security Checked 6/19/2023 12:31:22 PM Completed Security Checked 6/19/2023 12:31:22 PM 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, Eric Credle 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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