bk  SAMPSON COUNTY BOARDOFCOMMISSIONERS MEETING AGENDA January 7,2013  7:00 pm Convene Regular Meeting (County Auditorium),  Invocation and Pledgeof Allegiance Approve Agenda as Published a. Monthly Update  Tabl Roads  1 2-3 4-8 9 10-12 13 14  b. Secondary Roads Annual Statement for 2012 (for information only) C. Request for Addition of Carly Lane to State Secondary Road System a. TA-12-12-1 Request to Amend Section 3.3.1 of the Sampson County Zoning Ordinance to Include Automobile Wholesale as a Special  Tab2 Planning and Zoning Items  Use in an RA-Residential Agriculture District b. Appointment to Planning Board a. Recognition of Retirees Financial Report  Tab3 Reports and Presentations  b, Introductionof Animal Shelter Director  Tab4 Action Items  a., Public Hearing - 2014 Community Transportation Program Grant b. Acceptance and Budgeting of Grant Funding and Donations for C. Designation of Voting Delegate for NCACCLegilative Goals d. Designation: of Dates for February Planning Session  15-63 64-72 73-83 84 85 86 87-96 97-100  (continuedf from December 3, 2012)  Animal Shelter Conference  e. Appointments  Board of Health  Tab5 Consent Agenda  a. Approve the minutes of the November 5, 2012meeting b. Adopt a resolution seeking amendment of NC Session Law 2004- 75/Senate Bill 1161 Enacted July 8, 2004 regarding notice of land-use Adopt a resolution requesting Mid Carolina Rural Planning Organization: (RPO) to initiate the process to add USHighway 421 as a new. corridor on, the Strategic Highway Corridors Vision Plan,  planning changes near military bases  101    Tab5, cont.  d. Authorize the submission of an application for 2013 Urgent Repair e. Approve a disabled veterans exclusion application from Barney D.  102-120 121-123 124-147 148-160 161 162 163-210 211 212-213  Grant funding by the Department of Aging  Brewington f. Approve tax refunds 8 Approve budget amendments  Tab6 Board Information  a, Update on Request for Bids on Carter Street Lot b. Cumberland Community Action, Inc, Community Block Grant Application and Projected Budget for 2012-2013 NCOEMS! Notificationt and Solicitation of Comments Regarding Wake Hospital's Trauma Program or Related Delivery of Care d. Notification: of Filing of Intent to Petition for State Recognition of  Tuscarora Nation of North Carolina, Inc.  County Manager Reports  Tab7 Public Comment Period (See policies and procedures in agenda.)  214  Adjournment:  OUR PUBLIC CHARGE  The Board of Commissioners pledges to the citizens of Sampson County its respect, The Board asks its citizens to likewise conduct themselves m a respectful, courteous manner, both with Board members and fellow citizens. At any time should any member of the Board or any citizen fail to obserue this public charge, the Chair (or presiding oficer) will ask the ofending person to leave the meeting until that individual regains personal control. Should decorum faltol be restored, the Chair (or presiding officer) will recess the meeting until such time that a genune commitment to this public charge 15 observed. All electronic devices such as cell phones, pagers, and computers should please be turned off OT set to  silent/vibrate,    SAMPSON: COUNTY BOARD OFC COMMISSIONERS  ITEM ABSTRACT  ITEMNO. 1(a-c)  a-b Information Only Report/Presentation Action Item Consent. Agenda  Public Comment Closed Session Planning/Zoning Water DistrictIssue  Meeting Date: January 7, 2013  SUBJECT: DEPARTMENT: PUBLICHEARING: CONTACTPERSON: PURPOSE:  Roads  NCI Department of Transportation  No  Keith Eason, Highway Maintenance, Engineer Robert Butler, Assistant District Engineer  Tooffer monthly response to citizen questions and concerns with regard to roads; to provide required secondary roads annual statement; to consider addition of road to secondary roads system 2012Secondary Roads Annual Statement Resolution  ATTACHMENTS: BACKGROUND:  a, Our NGDOT representatives will offer their monthly update and respond to any questions or concerns of the Board or citizens with regard to Sampson County roads. b. Pursuant: to NC General Statute, the NCDOT District Director has provided the Board with a Copy of the Secondary Roads Inaddition to receiving questions and comments: with regard tor roads, the Department of transportation has provided the Board with a proposed resolution for consideration. The resolution requests that the Department add Carly Lane to the state secondary road system. The District Office has competed a field survey which indicates that all property owners have signed the petition. According to the memo received from NCDOT, they are prepared to add the road if the Board  Annual Statement for 2012,  adopts the necessary resolution.  RECOMMENDED  Motion to adopt a resolution requesting the addition of Carly Road  ACTION! OR MOTION: to the state secondary roads system.  1    STATE OF NORTH CAROLINA  DEPARTMENT OF TRANSPORTATION  BEVERLYEAVES PERDUE GOVERNOR  EUGENEA A. CONTI,JR. SECRETARY  December 20, 2012  Sampson County Board of Commissioners 313 East Rowan Street Clinton, North Carolina 28328  Subject: Secondary Roads Annual statement for 2012  General Statute 136-44.9 states that the Department of Transportation shall, before the end of the calendar year, prepare and file with the Board of County Commissioners a statement setting forth (1) each secondary road designated by number, located in the county upon which the paving or improvement was made during the calendar year; (ii) the amount expended for improvements of each such secondary road during the calendar Please find attached the Secondary Roads Annual Statement for Sampson County for the calendar year of 2012. The numbers are based on current balances as of December 1,  year; (ir) the nature ofsuch improvements.  2012. Sincerely, azLot L.E. Reynolds, PE District Engineer  LER:ler  Cc: K.E. Fussell, PE David L. Thomas, PE Delbert Roddenberry w/ map  Att  Clinton District Engineer's Office 2201 North] Boulevard. Clinton, NC28328 Telephone (910)5 592- -2- x(910)592-8209    2012 Annual Report To Sampson County Commissioners  Subd or! Mapl SR# From To Length! Width Type WBS  Spent 2011  Status  Rural #  R 1 SR 1004 SR1157 US421 5.85 22 S9.5A/3C.082046) $25,110.00 Complete R 2 SR 1004 SR 1960 SR 1939 3.6 22 S9.5A/3C.082047 $1 14,538.00 Complete R 3 SR 1004 SR 1960 US421 7.7 22 S9.5A/3C.C .082048 $ 28,269.00 Complete R 4 SR1801 US13 SR1 1703 1.4 20 BST 3C.082049 $ 52,601.00 Complete R 5 SR 1940 SR 1147 DE 0.6 20 BST 3C.082051 $76,776.92 Under const R 6 SR 1911 SR 1004 NC24 0.33 22 S9.5A/3C.082052 $ 11.00 Complete R 7 SR1 1904 NC403 Dup CL 8 22 S9.5A/3C.082053 $ 4,054.00 Complete R 8 SR 1648 US13 DE 0.5 20 BST 3C.082054 $ 60,816.00 Under const R 9 SR1148 US701 SR1141 0.6 20 BST 3C.082055 $ 88,728.00 Under const R 10 SR 1477 US 421 SR 1636 1.25 22 $9.5A/3C.082056) $ 94,666.00 Under const R 12 SR 1703 US421 US13 9.8 22 S9.5A/3C.082058 $608,000.00 Under const R 15 SR 1636 SR 1477 NC55 6.2 22 S9.5A/3C.082061 $490,000.00 Under const R 16 SR 1637 SR 1636 DE 0.5 20 BST 3C.082062 $ 52,271.00 Under const  R 11 SR 1246 NC: 242 CL R 13 Various R 14 Various  3 22 $9.5A/3C.082057 $738,714.00 Complete  $9.5A/3C.082059 $281,194.00 Complete na 3C.082060 $ 96,742.00 Complete  Code EOP End of Pavement DE Dead End BST Bituminous Treatment (Road Oil) S9.5A Hot Mix Asphalt  Maps 4, 5,8,9& 16 are Grade, Base, Drain and Pave  Maps 1,2,3,6,7,10,11, 12& 15 are pavement improvement made by widening road 2 feet on each  side of roadway Map 13 - Various mill patching Map 14 Various stone stabilization  -3-    RTTMATCN e  COUNT EUGENE A. CONTI, JR, SECRETARY  STATE OF NORTHCAROLINA  DEPARTMENT OF IRANSPORTATION  BEVERLY EAVES PERDUE GOVERNOR  December 17,2012  DIVISION3, DISTRICT2 Duplin /Sampson County  Dear Ms. Holder:  This office has completed the investigation of CarlyLn. in Lakewood Country Club Subdivision located offofsRA134Plakewood Drive) in Sampson County. We received a request that this A field survey has been completed which indicates that the property owner has signed the We are prepared to add this subdivision road but Ineed ai resolution from the County Commissioners to move forward with this process.I Ihave enclosed a copy oft the map from the  road be added to the State System for maintenance.  petition.  Sampson County Mapping Dept. for your reference.  If youl have any questions or concers please call me at (910)592-6174.  Sincerely, ReltButk, Robert Butler Assistant District Engineer REB/reb  220 North Blvd., Clinton, NC 283: 4 92-6174F FAX/910)592-8209    North Carolina Department of Transportation  Division of Highways  Request for Addition to State Maintained Secondary Road System  North Carolina County:  Sampson  Road Description: Lakewood Country Club- Carly Lane  WHEREAS, the attached petition has been filed with the Board of County Commissioners of the County of Sampson requesting that the above described road, the location of which has been indicated in WHEREAS, the Board of County Commissioners is of the opinion that the above described road should be added to the Secondary Road System, if the road meets minimum standards and criteria established by the Division of Highways of the Department of Transportation for the addition of roads to  red on the attached map, be added to the Secondary Road Syster, and  the System.  NOW, THEREFORE, be it resolved by the Board of County Commissioners of the County of Sampson that the Division of Highways is hereby requested to review the above described road, and to take over the road for maintenance ifi it meets established standards and criteria.  CERTIFICATE  The foregoing resolution was duly adopted by the Board of Commissioners of the County of  Sampson at a meeting on the WITNESS my hand and official seal this the  day of  20_  day of  20  Official Seal  Clerk, Board of Commissioners  County:  PLEASE NOTE:  Forward direct with request to the Division Engineer, Division of Highways  Form SR-2 (3/2006)  -5-    NORTH CAROLINA DEPARTMENT OF TRANSPORTATION  PETITION. FOR ROAD ADDITION FORM SR-1 REVISED I-99  ROADWATINFORMATION: (Piease Print) CwSdmpson  Road Name:  Lane street  lista (Pleasel Carly  names and! lengthso ont theb backo oft this form.)  Subdivision' Name: Lakeislood CouateyClub. Length (miles) 720fet Cpcor)  Number of occupied homes having street frontage: 5  Location: %o milesN s( Ev W ofthe intersection of RomC242 We, the undersigned, being property owners and/or developer of Carly hane  and Route R/349  (Circle one)  (SR, NCorUS)  (SR,NCorUS)  in  Sampsan County, do hereby request the Division ofHighways to addt the above described road.  CONTACT PERSON: Name and Address of First Petitioner. (Please Print) Name: hakewiaod sand Campany  Phonel Number: 90-525-4514  * EFFerson  Pres.  Street Address: Mailing Address: NAME  Strickland,  750 Cocintry Club R4,  SAlembrg,NC: 28385  PROPERTYOWNERS MAILINGADDRESS  TELEPHONE  habeniod Landla. DaniKaye Heinz  756Cudry CHERSnkE ACa535-451  a1 Barlylane SalnburgAc 28385  910- 535-5124  hnjSharnHlad 105 lwdlalagEIs fio 535-3870 D.PahetE.Margaue Asayhaa-slmhg.ahagAEasaiss 5780 Askley-/Sandy Odum 18Crlylane, SalembugncDEss 910 525-3638 KylesKarea Bandleman 34 phplmgaats 910525-5636 Kta.sbihlam4,Ank. 602 Eairfey St ClintonE 18328 910572-0251  Striekland Fonily Tastk  32 6-    SAMPSON  COUNTY  NORTH CAROLINA  PREPARED BY THE NORTH CAROLINA DEPARTMENT OF TRANSPORTATION DIVISION OF HIGHWAS-PLAMNNG AND RESEARCH BRANCH IN COOPERATION WITH THE U.S.DEPARTMENT OF TRANSPORTATION FEDERAL HIGHWAY ADMINISTRATION  SCALE  CHEEIEpE  Airport $1302 )  1: 1737 1331  olds 1311  Concord 1240  31  1205  in  141  oP.  1414  fuez 1405  Bathabare 1430 Clement 1435  141  143E '14Z.  VE    @  0  n ,8! thi  -8-    SAMPSONICOUNTY BOARDOFCOMMISSIONERS  ITEM ABSTRAGI  ITEMNO. 2(a-b)  Information: Only Repor/Presentation Action Item Consent Agenda  a Public Comment Closed Session Planning/Zoning Water District Issue  Meeting Date: January7,2013  SUBJECT; DEPARTMENT: PUBLICHEARING: CONTACTPERSON: PURPOSE: ATTACHMENTS: BACKGROUND:  Planning and Zoning Items Clinton-Sampson! Planning and Zoning Mary Rose, Planning Director by Planning Board  Yes -item a  Tod consider actions on planning and zoningitems as recommended Planning StaffMemoranda; Planning Board Minutes  a, TA-12-12-1 Planning staff will review a request to amend Section 3.3.loft the Sampson County Zoning Ordinance,, The applicant, RochelleParker, had requested that Section3.3.11 be amended toi include Automobile, Wholesale as a permitted use in a RAReidensalAgiallure District. Planning staff recommended that the requestb be modified toi instead amend Section 3.3.1toi include Automobile, Wholesale as a special use in a RA-Residential Agriculture: District. b, Appointment of Planning Board Member Planning Director Mary Rose has requested thatScott Brown be re-appointed for as second term on the Sampson County Planning Board. a. Motion to approve TA-12-12-1 amend Section 3.3.1toi include Automobile, Wholesale as a special use in a RA-Residential b. Motion to re-appoint Scott Brown for a second term to the  RECOMMENDED ACTIONORMOTION:  Agriculture District Planning Board.  9-    MEMORANDUM 227 LISBON STREET CLINTON,NC 28328  CLINTON-SAMPSON PLANNING AND DEVELOFMENT  To: Ed Causey, County Manager From: Mary M. Rose, Planning Director Date: December 19, 2012  Subject: December 17,2012 Sampson County Planning and Zoning Board Meeting -  County Board of Commissioners January 7,2013 Agenda Item  The following request was addressed by thel Planning and Zoning Board at their December 17,2012 meeting: TA-12-12-1 - A text amendment request by Rochelle Parker to amend Section 3.3.1 ofthe Sampson County Zoning Ordinance to include. Automobile, Wholesale as a permitted use in an RA-Residential Agriculture District was amended byt the Sampson County Planning Board to unanimously recommend. at text amendment to amend Section 3.3.1 ofthe Sampson County Zoning Ordinance toi include Automobile, Wholesale as a special use ina al RA- Residential. Agriculture  district.  Please contact my office with any questions or comments. cc: Susan Holder, Assistant County Manager  attachment  -10-    MINUTES OF1 THE SAMPSON COUNTY PLANNING AND ZONING BOARD  Meeting Date December 17,2012  Members Present David Alexander Sherri Smith Debra Bass Scott Brown Clayton Hollingsworth Gary Mac Herring Billy Cottle Minutes Approved  Members Absent  Upon a motion by Scott Brown, seconded by Gary Mac Herring, the minutes of the November  19,2012 meeting were unanimously approved as presented.  V-12-12-1  Gary Wood - 195 Sandy Ridge Road  A variance request by Gary Wood at 195 Sandy Ridge Road from Sections 5.1 and 5.5 of the Sampson County Zoning Ordinance with regard to extension of a nonconforming use. (See Ms. Rose presented the Planning Board with the following findings of fact for consideration:  attached site plan)  1. Gary Wood has signed the variance application as the applicant. 2. The property is currently zoned R-Residential Agriculture.  3. The lot is approximately 0.51 acres as shown by the Sampson County Tax Office. 4. The applicant is proposing a 12x 161 foot screened-in porch to the side oft the existing residence. The existing residence encroaches into the 15 foot minimum side setback. The proposed addition would encroach 1'7" into the minimum side setback requirement in R-Residential district. (See section 3.3.2 of the Sampson County  Zoning Ordinance)  5.1 Thej property under consideration has been posted.  Mr. Gary Wood appeared before the board as applicant and contractor to explain the request. Mr. Wood informed the Board it would cost just as much to construct the porch smaller as it would to construct it at the proposed size, therefore he wanted to request their consideration ofa Scott Brown asked Ms. Rose if the planning board would be setting a precedent by allowing the addition to be built while encroaching upon the side setback. Ms. Rose said that each case should be taken on a case by case consideration based upon the facts, however she believed the planning board would be setting aj precedent by allowing this addition to be built as proposed. Upon a motion made by Scott Brown, that the variance be approved provided the new addition meet the current 15 foot side setback, the motion was seconded by Clayton Hollingsworth and  variance.  unanimously approved by the Board as amended by Mr. Brown's motion.  Ayes: Unanimous  -11-    TA-12-12-1  Section 3.3.1- Automobile Wholesale  TA-12-12-1 = A text amendment request by Rochelle Parker to amend Section 3.3.1 of the Sampson County Zoning Ordinance to include Automobile, Wholesale as a permitted use in an Planning Staff recommends the proposed text amendment request be modified to instead amend Section 3.3.1 of the Sampson County Ordinance to include Automobile, Wholesale as a special Mr. Parker explained that there would only be a few cars kept on site while the ownership of the Ms. Rose explained to the Board as a special use each wholesale automobile operation would be required to submit a site specific plan and special use application for consideration on a case by case basis by the Planning Board. The Planning Board would be able to place specific conditions upon approval if the Board felt it was necessary to meet the intent of the Sampson County After discussion, Scott Brown made a motion to amend the proposed request by instead amending Section 3.3.1 of the Sampson County Zoning Ordinance to include Automobile, Wholesale as a special use in a RA-Residential Agriculture District. The request was seconded  RA-Residential Agriculture District.  use in a RA-Residential Agriculture District.  care was being transferred.  Zoning Ordinance requirements for a special use.  by Billy Cottle and unanimously recommended by the Board.  Ayes: Unanimous  Adjournment  There being no further business, the meeting was adjourned at 7:15 p.m.  Chairman  Secretary  -12-  2    O   CLINTON  Climnton-Sampson 2271 Lisbon Street Post Office. Box 199 Clinton, North Carolina 28329  Planning and Development  HCAROI  To: Ed Causey, County Manager From: Mary M. Rose, Planning Director Date: December 19, 2013  Subject: Agenda Item - Sampson County Planning Board Appointment  At this time Planning staff respectfully requests consideration of appointment of Mr. Scott Brown to a second term as a Sampson County Planning Board member. Mr. Brown resides at 9339 High House Road, Salemburg, NC. Additionally, Mr. Brown was initially appointed to the Planning Board in December 2009 and has been an exemplary Planning Board member with a Thank you for your consideration ofN Mr. Brown's appointment, please contact my office with  high record of attendance. any questions or comments.  cc: Susan Holder, Assistant County Manager  P.0. Bov 199,linsen, sorth Carelina 2A329. ELEPHOVE 14)  atiice) (910) 591-4261(x)  -13-    SAMPSON COUNTY BOARD OFG COMMISSIONERS  ITEM ABSTRACI  ITEMNO.  3(a)  Information Only Report/Presentation Action Item Consent Agenda  Public Comment Closed Session Planning/Zoning Water District Issue  Meeting Date: January7,2013  SUBJECT: DEPARTMENT: PUBLICHEARING: CONTACT PERSON: PURPOSE: ATTACHMENTS: BACKGROUND:  Recognition of Retirees Governing Board No  Chairman Billy Lockamy  Torecognize retiring County employees for their years of service  None  The following individuals have retired from County service as of December 31,2012. The combined years total164 years of service to  Sampson County,  DwightT. Barber, Sheriff's Office (1986-2012) Faye H. Barefoot, Social Services (1990-2012) SallieM. Bryant, Aging(1990-2012) Barbara F. Burch, Social Services (1983-2012) Daniel F.Holland, Health (1981-2012) Cynthia B. Masters, Social Services (1982-2012) Kent D. Wooten, Cooperative Extension (2008-2012)  RECOMMENDED  Present those able to attend with county plaques in recognition of  ACTIONOR MOTION: their service  14-    SAMPSON COUNTY BOARDOF COMMISSIONERS  TEMABSTRACT  ITEMNO.  4(a) X Public Comment Closed Session Planning/Zoning Water District-Issue  Information Only Report/Plesentation Action Item Consent Agenda  Meeting Date: January7,2013  SUBJECT: DEPARTMENT: PUBLICHEARING: CONTACT PERSON: PURPOSE:  PublicHearing 2014 Community Transportation: Grant Department of Aging/Sampson Area ransportation  (continued from January 7,2013)  Yes  Todd Daughtry, SAT Coordinator  To consider public comments with regard to the submissiont of the application for CTP transportation grant funding for the period Public Hearing Notice; CIP Grant Documents; Grant Resolution: Each year the County applies to the North Carolina Department: of Transportation: for Community Transportation: Funding, which is used by our Sampson. Area Transportationt program to coordinate existing transportation: programs: operating in Sampson County and provide transportation services within our communities, The Department of Aging has proposed that an application be submitted in the amount of $211,967, which requires a $29,073 local match. The match will bel budgeted in the Department of Agings2013-2014 budget. Wea are. required to provide the public the opportunity to comment on the application prior to  July 1,2013- - June 30, 2014  ATTACHMENTS: BACKGROUND:  submission.  PRIOR BOARD ACTION: CTP Grant is submitted annually  RECOMMENDED, ACTIONORI MOTION:  Adopt Grant Resolution authorizing submission of grant and making assurances: and certifications regarding compliance with  federal and state requirements  15-    - 5 a $  C $  sn $  e  $  -16-    STATE OF NORTH CAROLINA  DEPARTMENT - OF TRANSPORTATION  BEVERLY EAVES PERDUE GOVERNOR  EUGENEA A. CONTI,JR. SECRETARY  October11,2012  MEMORANDUM  To: From: Subject:  Community Transportation Program Applicants Teresa A. Hart, PE, CPM, Director NCDOT Public Transportation Division  FY 2014 Community Transportation Program Application Package Section 5311  The Fiscal Year 2014 Community Transportation Program (CTP) application package contains the administrative, capital, operating assistance and facility safety and security improvements grant programs. The final FY 2014 Certifications and Assurances will be sent to you under The purpose oft the Section 5311 program is to support public transportation for people living in any area outside ofa an urbanized area designated by the Bureau of the Census. An urbanized area consists ofa core area and the surrounding densely populated area with a total population of 50,000 or more, with boundaries fixed by the Bureau ofthe Census. Areas not currently within the urbanized area are eligible for Section 5311 funding even ift they are included within the The 5311 program is intended to provide financial assistance for the. support of public transportation services in nonurbanized areas. The transportation services must be open to the general public on an equal and continuing basis. The 5311 funds can be used for the costs of transit planning activities, local project administration, transit operations and the purchase of capital equipment or facilities to aid in the provision oftransit services in rural areas, as well as  separate cover as soon as the Federal Register is released.  metropolitan area planning boundary.  provide funds for state-level administration.  NC MAILING DEPARTMENT ADDRESS: OF TRANSPORTATION PUBLIC TRANSPORTATIONI DIVISION 1550N MAIL SERVICE CENTER RALEIGH, NC 27699-1550  TELEPHONE: FAX: 919-733-1391 919-733-4713 WwwAcIaL-17-  LOCATION: TRANSPORTATION BUILDING SOUMWANgIONSIRET RALEIGH,NC    Page 2 Public Hearing  As part oft the CTP application, aj public hearing must be held in front ofthe applicant's governing body. The applicant must publish one public hearing notice in a newspaper(s) having general circulation in the project' 's proposed service area. The public hearing notice shall an minimum ofseven (7) calendar days notice and ai maximum of fourteen (14) calendar provide notice between the time that the public hearing notice is published in the actual public hearing date. In accordance with the DOT LEP Guidance, 70FR newspaper 74087, (Dec. 2005), a public notice will also be published in Spanish in counties that have 1,000 or 5% oftheir 14, population that speaks Spanish at home, but speaks English less than well. Al list of counties that are required toj publish the public notice in Spanish is in Appendix B oft the Program Overview. PTD is not including a Spanish version of the public notice in the application package. Applicants should have the public notice translated locally to ensure the accuracy oft the  and days the  translation.  Certifications and Assurances cover once thel Federal Register is released. Administrative and Operations Funding  Federal and State Certifications and Assurances for SFY2014 will be released under  separate  Due to the limited availability of funding, administrative and operating funds are capped the FY 20131 level. Applicants should request no more than the total funds approved in their at 2013 CTP administrative and operating budgets. Indirect costs remain an eligible expense, FY provided the applicant obtained an approved indirect cost rate. Direct expenses should be budgeted first. Administrative budgets must be sufficiently developed to cover administrative costs directly attributable to the execution of the Section 5311 grant. only A Capital Replacement Schedule to clarify the useful life of capital items is included. Construction ofnew facilities or major renovation projects will not be considered unless all planning and environmental requirements have been met at the time oft the application.  those  Capital Budget  Relationship to Other Grant Programs  While the overall objectives of Section 5311 and Section 5310 differ (the former is toj provide transportation to the general publicin non-urbanized areas and the latter is to serve elderly individuals and individuals with disabilities in both rural and urbanized areas), there are between the two programs. These parallels make it desirable for states to consider both parallels and to plan for their use in a complementary way. Fori instance, the same state agency administers resources, both programs. FTA encourages participation in such coordinated efforts so long as the coordinated services continue to meet the purposes oftheirrespective) programs. Federal Funding Accountability and Transparency Act (FFATA) Due to this legislation, all applicants must have a DUNS number (unique nine-digit number issued by Dun & Bradstreet). ADUNS: number may be obtained free of charge at: p/Rpibsmasaiome Applications without a DUNS number will not be considered  for funding.  -18-    Page 3  The FY 2014 CTP grant application must be transmitted through the online NCDOT Grants Module no later than 5:00 p.m. EST, December 28, 2012. The documents identified in the Application Submission Checklist must be submitted as attachments within the online Grants Module. Note that documents with original signatures must be scanned for electronic submittal (ensure that seal is visible for documents with seals) and some forms/other documents must be saved and attached in their original form (Microsoft Word/Excel), as indicated in the Application Ifyou have questions or need assistance, you should contact your Mobility Development Specialist (MDS) in your respective district; see attached listing ofMDS assignments.  Submission Checklist.  -19-    COMMUNITY TRANSPORTATION PROGRAM RESOLUTION  Section 5311 FY2014 RESOLUTION  Applicant seeking permission to apply for Community Transportation North Carolina Department of Transportation, provide the Ar motion was made by (Board Member's Name).  Program funding, enter into agreement with the  necessary assurances and the required local match.  and seconded by (Board Member's Name or  adoption of the following resolution, and upon being put to a vote was duly adopted.  N/A, ifnot required).  fort the  WHEREAS, Article 2B of Chapter 136 oft the North Carolina General Statutes and the Governor administering federal and state public transportation funds; and (NCDOT) as the agency responsible for WHEREAS, the North Carolina Department of Transportation will apply for a grant from the US Transportation, Federal Transit Administration and receives funds from the North Carolina General Department of WHEREAS, the purpose of these transportation funds is to provide grant monies to local provision ofr rural public transportation services consistent with the policy requirements for agencies for the and agency involvement, service design, service alternatives, training and conference planning, community other requirements (drug and alcohol testing policy and program, disadvantaged business participation, reporting and matching funds; that its staff has the technical capacity to implement and manage the project, required local state statutes, regulations, executive orders, Section 5333 (b) Warranty, and all comply with the federal and related to the applications made to and grants received from the Federal Transit administrative Administration, requirements NOW, THEREFORE, be it resolved that the (Authorized Official's Title)* County Manager of (Name ofA Body) the County of Sampson is hereby authorized to submit a grant application for federal Applicant's Governing make the necessary assurances and certifications and be empowered to enter into an and state funding,  have designated the North Carolina Department of Transportation  of North Carolina  provide assistance for rural public transportation projects; and  Assembly to  and fully allocated costs analysis); and WHEREAS, (Legal Name ofA Applicant)  enterprise program,  hereby assures and certifies that it will provide the  reports, obtain required training, attend meetings and conferences; and agrees to  prepare required as well as the  provisions of Section 1001 of Title 18, U.S.C.  NCDOT to provide rural public transportation services.  agreement with the  (Certifying Official's Name)* Susan J.Holder (Certifying Official's Title) Clerk to the Baord do Board of Commissioners duly held on the 3rd day of December, 2012.  and correct copy of an excerpt from the minutes of a meeting of the (Name ofA Applicant's hereby certify that the above is at true  Governing Board) Sampson County  Signature of Certifying Official  *Note that the authorized official, certifying official, and notary public should be three separate individuals.  Seal Subscribed and sworn to me (date)  Affix Notary Seal Here  Notary Public*  Printed Name and Address My commission expires (date)  -20-    LOCAL SHARE CERTIFICATION FOR FUNDING  Sampson County (Legal Name of Applicant)  Requested Funding Amounts Project Administrative Capital (Vehicles & Other) Operating (Small fixed route, regional, and  Total Amount $157,507 $54,460 $  Local Share $23.627(15%) $5,446 (10%) $ *Note: Small fixed route systems contribute more than 50% $29,073 Total Local Share  *(50% or more)  consolidated urban-rural systems)  TOTAL  $211.967 Total Funding Requests  The Local Share is available from the following sources:  Source ofFunds County Contribution  Amount $29,073.00 $. $ $ $29,073.00  TOTAL  I,th the undersigned representing (Legal Name of Applicant) Sampson County do hereby certify to the North Carolina Department of Transportation, that the required local funds for the FY2014 Community Transportation Program will be available as of July1,2013, which has a period of  performance of. July 1, 2013 - June 30, 2014.  Signature of Authorized Official Edwin W. Causey, County Manager Type Name and Title of Authorized Official  Date  -21-    State Fiscal Year 2014 Public Transportation Programs Federal and State Assistance Certifications and Assurances  ####ATHIS IS ONLY AN EXAMPLE BASED ON CURRENT (SFY2013) CERTIFICATIOS & ASSURANCES. THE FINAL DOCUMENT WILL BE SENT UNDER SEPARATE COVER ONCE FEDERAL REGISTER IS RELEASED WITH CERTIFICATIONS & ASSURANCES FOR FEDERAL FY2013***** FEDERAL (FTA) AND STATE (NCDOT) CERTIPICATIONS AND ASSURANCES FOR  UBLICTRANSPONTATION PROGRAMS STATE FISCAL YEAR2 2014  Before the North Carolina. Department of Transportation (NCDOT) may award Federal and/or. State transit assistance funds to support a project, each. Subrecipient must provide certain certifications and assurances required by Federal/State law or regulation. You must provide all certifications and assurances required t0 support Wei request that) you read each certification and assurance carefully and select all certifications and assurances that might apply to all projects for which you might seek FTA/NCDOT funding. We can avard FTANCDOT/nmding for your project only ffyou provide. adequate certifications and assurances. as required by Federa!/State law or Wel have consolidated our certifications and assurances into 18 groups. At ai minimum, you must provide the assurances in Category 01. Depending on the nature oft the Subrecipient and its project, the Subrecipient may need tOA provide some of the certifications and assurances in Categories 03 through 18. However; instead individua! groups ofcertifications and assurances, your may make a single selection. that wille encompass ofselecting all groups ofcertifications and assurances applicable 10 all FTA/NCDOT, programs. NCDOTand: the Subrecipient understand and agree that not every provision ofthese certifications and assurances will apply to every. Subrecipient or project we, find. The type ofproject and Subrecipient will determine which certifications and assurances apply. every The Subrecipient also understands and agrees that these certifications and assurances are special pre-award requirements and do not include all FahmancpoTrgp.hnmeme, that may apply to the. Subrecipient or its project. Thel FTA Master Agreement. MA(18). for Federal Fiscal Year 2013, p/hnm.fadaisorlecienlBatrnl, Except in limited circumstances, the Subrecipient is ultimately responsible, for compliance with the certifications and assurances that apply to itselfo or its project irrespecthve of Subrecipient, participation in the project. Because FFY2013. certifications and assurances will require Subrecipient compliance, we. strongly recommend. that you many take appropriate measures to assure the validity ofyour certifications and assurances. The. Subrecipient understands and agrees that when applying fory funding on behalfofac consortium, joint venture, partnership, or team, each member ofthat consortium, joint venture, partnership, or team is responsible for compliance with the Note that by an opinion ofthel North Carolina. Attorney General's office, all Federal requirements have been passed The Applicant must. submit its certifications and assurances by completing and submitting the selection and signature pages at the endo oft this document: 1) Certifications and. Assurances selection page; 2)Affirmation of Applicant; 3)4 Affirmation of Applicant's Attorney; 4) Certifications and Restrictions on. Lobbying; and  applications for FTANCDOT/unding during Federal fiscal year (FFY) 2013.  regulation.  contains a list of fmost ofthose requirements.  and  assurances that the Subrecipient selects. down to. State) funded assistance.  certifications  S)Certification of Equivalent Service.  0L.ASSURANCES REQUIRED FOR EACH APPLICANT  Each Subrecipien! of FTA assistance avarded to NCDOT and each Subrecipient of State assistance must! provide all assurances int this Category "01." NCDOT may not aard any. State or Federal assistance until the Applicant  provides thej following assurances by selecting Category "0I."  -22-    State Fiscal Year 2014 Public Transportation Programs Federal and State Assistance Certifications and Assurances  A. Assurance ofAuthority ofthe Applicant and. Its Representative  The authorized representative of the Applicant and the Applicant's attorney who sign these certifications, assurances, and agreements, affirm that both the Applicant andi its authorized representative may, under North Carolina, local, or Indian tribal law and regulations, and the. Applicant's by-laws or internal rules, undertake the 2. Execute and file its certifications, assurances, and agreements binding its compliance, and 3. Execute Grant Agreements or Cooperative Agreements, or both, with NCDOT.  following activities on behalf of the Applicant: I. Execute and filei its application for Federal/State funds;  B. Standard, Assurances The Applicant assures that:  I. It has sufficient authority under North Carolina, local, or Indian tribal law, regulations by-laws and internal rules to carry out each FTA/NCDOT funded project as required by Federal/State laws and regulations; 2. It will comply with all applicable! Federal/State statutes and regulations to carry out any FTA/NCDOT funded 3. Itis under a continuing obligation to comply with the terms and conditions of the NCDOT Grant Agreement fort the project, including the FTA Master Agreement incorporated by reference and made part oft the latest 4. Itrecognizes that Federal/State laws and regulations may be modified from time to time and those 5. Iti understands thate executive orders of the President of the United States or the Governor of the State ofl North Carolina and FederaV/State directives, including Federal/State policies andj program guidance, may be issued 6. Ita agrees that the most recent Federal/State laws, regulations, and directives will apply to the project, unless  project;  amendment to Grant Agreement; modifications may affect project implementation; concerning matters affecting the Applicant ori its project; and NCDOT determines otherwise in writing. C. Intergovermmental Review Assurance  The Applicant assures that it has or will submit each] Federal/State funding application to the appropriate State and local agencies for intergovermmental. review to facilitate compliance with U.S. Department ofTransportation (U.S. DOT): regulations, Intergovernmental Review ofl Department ofTransportation Programs and. Activities,"49CFR  part 17.  D. Nondiscrimination Assurance.  The Applicant assures that it will comply with the following laws and regulations so that no person in the United States willl be denied the benefits of, or otherwise be subjected to discrimination in any U.S. DOTor FTA/NCDOT funded program or activity (particularly in thel level and quality oft transportation services and ransportation-related benefits on the basis of race, color, national origin, creed, sex, or age: a. Federal transit law, specifically 49 U.S.C. 5332 (prohibiting discrimination on the basis of race, color, creed, national origin, sex, or age, andi in employment or business opportunity), b. Title VI oft the Civill Rights Act of 1964, as amended, 42 U.S.C. 2000d, and U.S. DOT regulations, "Nondiscrimination: in Federally-Assisted, Programs oft the Department of TrampertatiomFfrecmation ofTitle VI of the Civil Rights Act,"49 CFR part 21. a. It will comply with 49 U.S.C. 5332, 42 U.S.C. 2000d, and 49 CFR part 21 in the manner:  2. As required by 49 CFR 21.7, the Applicant assures that:  (1) Itconducts each project, (2) Itu undertakes property acquisitions, and (3) Itoperates the project facilities, including: (a) Its entire facilities, and  (b) Its façilities operated in connection with its project,  -23-    State Fiscal Year 2014 Public Transportation Programs Federal and State Assistance Certifications and Assurances  b. This assurance applies toi its entire project and entire facilities, including facilities operated in connection (1) Notifying the public that discrimination complaints about ransportation-related services or benefits (2) Submitting information. about its compliance with these provisions to U.S. DOT OrFTANCDOT d. Ifitt transfers FTA/NCDOT funded real property, structures, or improvements to another party, any deeds andi instruments recording that transfer will contain a covenant running with the land assuring (1) While the property. is used for the purpose that the Federal/State funding is extended, (2) While the property is used for another purpose involving the provision ofs similar services or benefits, The United States has a right to seekj judicial entorcement of any matter arising under:  withi its project,  Itwill promptly take the necessary actions to carry out this assurance, including:  may be filed with U.S. DOT or FTA/NCDOT, and  upon their request, nondiscrimination:  (I) Title VIoft the Civil Rights Act, 42 U.S.C. 2000d, (2) U.S. DOT regulations, 49 CFR part 21, and  (3) This assurance, request to comply with:  Itwill make any changes in its Title VI implementing procedures as U.S.) DOT or FTA/NCDOT may  (1) Title VI of the Civill Rights Act, 421 U.S.C.2 2000d, (2) U.S. DOT regulations, 49 CFR part 21, and (3) Federal transit law, 49 U.S.C.. 5332, party participant, including: (1) Any subrecipient, (2) Any transferee, (3) Any third party contractor or subcontractor al any tier, (4) Any successor in interest, (5) Any lessee, or (6) Any other participant in the project, CFR part 21 to each third party agreement, including: (1) Each subagreement, (2) Each property transfer agreement, (3) Each third party contract or subcontract at any tier, (4) Each lease, or (5) Each participation agreement,  g. Itv will extend the requirements of 491 U.S.C. 5332, 42 U.S.C. 2000d, and 49 CFR part 21 to each third  h. Itwill include. adequate provisions to extend the requirements of49 U.S.C. 5332, 42 U.S.C. 2000d, and 49  The assurances it has made will remain in effect for the longest oft the following: (1) As long asl Federal/State funding is extended to the project,  (2) As long as the Project property is used for a purpose for which thel Federal/State funding is extended, (3) As long as the Project property is used for aj purpose involving the provision ofsimilar services or (4) As long as the Applicant retains ownership or possession of the project property.  benefits, or  E.A Assurance Nondiscrimination on the Basis of Disability,  The Applicant assures that it andi its project implementation and operations will comply with all applicable a. Thel Rehabilitation Act of1973, as amended, 291 U.S.C. 794, et seq., b. The Americans with Disabilities Act of 1990, as amended, 42 U.S.C. 12101 ets seq., U.S. DOT regulations, specifically 49 CFR parts 27,37, and 38, and d. Any other applicable Federal/State laws that may be enacted or Federal/State regulations that may be 2. As required by U.S. DOT regulations, Nondiscrimination on the Basis of] Handicap in! Programs and Activities Receiving or Benefiting from Federal Financial Assistance," 49 CFR part 27, specifically 49 CFR  requirements of:  promulgated,  27.9, the Applicant assures that:  -24-    State Fiscal Year 2014 Public Transportation: Programs Federal and State Assistance Certifications and Assurances  a. The following prohibition against discrimination on the basis of disability is a condition to the approval or  extension of any FTA/NCDOT funding awarded to: (2) Obtain any rolling stock or other equipment,  (1) Construct any facility, (3) Undertake studies, (4) Conduct research, or disability, be: (1) Excluded from participation, (2) Denied benefits, or (3) Otherwise subjected to discrimination.  (5) Participate in or obtain any benefit from any FTA/NCDOT administered  b. Ina any program or activity receiving or benefiting from Federal/State funding program, FTA/NCDOT or any within U.S.DOT administers, no otherwise qualified people with a disability will, because of their entity  F.Suspension and. Debarment.  1. U.S. DOT regulations, "Nonprocurement Suspension and Debarment,"2CFR; part 1200, which adopts and supplements the provisions ofU.S. Office ofl Management and Budget (U.S.OMB)" "Guidelines to Agencies on Govermentwide Debarment and Suspension Nomprocuremem,"2CFK part 180, permit certifications to 2. The Applicant certifies to the best ofitsl knowledge and belieft that, it, its principals, and first tier a. Are eligible to participate in covered transactions ofa any Federal/State department or agency subrecipients: and are not  assure the Applicant acknowledges that:  presently: (I) Debarred, (2) Suspended, (3) Proposed for debarment, (4) Declared ineligible, or (5) Voluntarily excluded, or (6) Disqualified,  b. Have not within a three-year period preceding its latest application or proposal been convicted of or hada (1) Commission of fraud or a criminal offense in connection with obtaining, attempting to obtain, or performing aj public (Federal, State, or local) transaction, or contract under aj public transaction, (3) Commission of embezzlement, theft, forgery, bribery, falsification or destruction of records, making Are not presently indicted for or otherwise criminally or civilly charged by a governmental entity (Federal, State, or local) with commission ofa any oft the offenses listed in the preceding Section 2.b oft this d. Have not had one or more publict transactions (Federal, State, or local) terminated for cause or default Willj promptly provide anyi information to the FTANCDOTifatal later time any information contradicts Will treat each lower tier contract or lower tier subcontract under the Project as a covered lower tier  civilj judgment rendered against any oft them for: (2) Violation ofa any Federal or State antitrust statute, or any false statement, or receiving stolen property,  certification,  within a three-year period preceding this certification, thes statements ofsubparagraphs (1) through (4) above, and contract for purposes of2 CFR part 1200 and2 CFR part 180i ifit: (3) Requires the consent ofal Federal/State official, Will require that each covered lower tier contractor and subcontractor: (1) Comply with the Federal requirements of2 CFR part 1200 and2 CFR part 180, and (2) Assure that each lower tier participant in the Project is not presently declared by any Federal/State (a) Debarred fromj participation in the federal/state funded project, (b) Suspended fromj participation in the federal/state funded project, (c) Proposed for debarment: from participation in the federally/state funded project, (d) Declared ineligible to participate in the federal/state funded project,  (1) Equals or exceeds $25,000, (2) Is for audit services, or  department or agency to be:  -25-    State Fiscal Year 2014 Public Transportation Programs Federal and State Assistance Certifications and Assurances  (e) Voluntarily excluded from participation in the federal/state funded project, or (f) Disqualified from participation in the federal/state funded Project.  3. The Applicant will provide a written explanation indicated on its Signature Page or aj page attached in NCDOT's Grants Management System ifit or any ofi its principals, including any ofi its first tiers subrecipients or lower tier participants, is unable to certify to the preceding statements in this certification. (These assurances are consistent with U.S. OMB assurances required in SF-424B and SF-424D.)  G.U.S. OMB. Assurances in SF-424B and SF-424D. 1. Administrathe. Activities. The Applicant assures that: manage, and complete the project, including: (1) The legal authority to apply for Federal/State funding, and (2) The institutional capability, (3) The managerial capability, and  a. For every project described in any application its submits, it has adequate resources toj properly plan,  (4) The financial capability (including funds sufficient to pay the non-Federal/State share of project cost). b. Itwill give access and the right to examine project-related materials, including but not limited to: (3) Ifappropriate, the State ofNorth Carolina, through any authorized. representative, C. Itwill establish a proper accounting system in accordance with generally accepted. accounting standards or d. Itwille establish safeguards to prohibit employees from using their positions for a purpose that: (1) Results in a personal or organizational conflict of interest, or personal gain, or (2) Presents the appearance ofay personal or organizational conflict of interest or personal gain. a. Following receipt OfFTA/NCDOT award, it willl begin and complete Project work within the applicable (1) Itwill comply with FTA/NCDOT provisions concerning the drafting, review, and approval of (2) Itwill tot the extent practicable provide. and maintain competent and adequate engineering supervision at the construction site to assure that the completed work conforms with the approved] plans and (3) Itwill include a covenant in thet title offederal/state funded real property acquired to assure nondiscrimination during the useful life oft the project, (4) Tot the extent FTA/NCDOT requires, it will record thel Federal/State interest in the title to FTA/NCDOT assistedi real property or interests in realj property, and (5) To the extent practicable, without permission and instructions from FTA/NCDOT, it will not alter the site of the FTA/NCDOT funded construction project or facilities by: (a) Disposing oft the underlying real property or other interest in the site and facilities, (b) Modifying the use of the underlying realj property or other interest in thes site and facilities, or (c) Changing the terms oft the underlying real property title or other interest in thes site and facilities. C. Itwill furnish progress reports and other information as FTA/NCDOT or the State ofNorth Carolina may a. It will comply with all applicable Federal/State statutes relating to nondiscrimination including, but not (1) Prohibitions against discrimination on the basis ofrace, color, or national origin ofTitle VId ofthe (a) Title IX of the Education Amendments of 1972, as amended, 20 U.S.C. 1681 - 1683, and 1685- (b) U.S. DOT regulations, Nondiscrimination on the Basis of Sex inl Education Programs or Activities Receiving Federal Financial Assistance," 49 CFR part 25,  (1) FTA,  (2) The Comptroller General of the United States, and,  agency directives,  2. Project Specifics. The. Applicant assures that:  time periods,  b. For FTA/NCDOT funded construction projects: construction plans and specifications  specifications,  require. limited to the:  3. Statutory and Regulatory: requirements. The. Applicant assures that:  Civil Rights Act, 421 U.S.C. 2000d,  (2) Prohibitions against discrimination on the basis ofsex of:  1687, and  -26-    State Fiscal Year 2014 Public Transportation Programs Federal and State Assistance Certifications and Assurances  (3) Prohibitions against discrimination on the basis of agei in federally assisted programs oft the. Age (4) Section 504 of thel Rehabilitation Act of1973, as amended, 291 U.S.C. 794, which prohibits (5) Prohibitions against discrimination on the basis of disability of Section 504 oft the Rehabilitation Act (6) Nondiscrimination requirements relating to the sale, rental, or financing ofl housing ofTitle VIII of (7) Prohibitions against discrimination on the basis of drug abuse oft the Drug Abuse Office and (8) Prohibitions against discrimination on the basis of alcohol abuse oft the Comprehensive Alcohol Abuse and. Alcoholism Prevention Act of1970, as amended, 42 U.S.C. 4541 et seq., (9) Confidentiality requirements for the records of alcohol and drug abuse patients oft thel Public Health (10) Nondiserimination, provisions of any other statute(s) that may apply tot the project, Regardless of whether Federal/State funding has been provided for any of the real property acquired for Project purposes, it will provide for fair and equitable treatment of displaced persons or persons whose property is acquired as a result of federal/state assisted programs, and: (1) It! has the necessary legal authority under State and local law to comply with: (a) The Uniform Relocation Assistance and Real Property. Acquisition. Policies Act of 1970, as amended, (Uniform Relocation Act) 42 U.S.C. 4601 et seq., as specified by sections 210 and 305 (b) U.S. DOT regulations, "Uniform Relocation Assistance and Reall Property Acquisition for Federal and Federally Assisted Programs," 49 CFR part 24, specifically 49CFR24.4. (2) Itl has complied with or will comply with the Uniform Relocation Act and implementing U.S. DOT (a) Itwill adequatelyi inform each affected person oft the benefits, policies, and procedures provided (b) As required by 42 U.S.C. 4622, 4623, and 4624, and 49 CFR part 24, it will provide fair and reasonable relocation payments and assistance for displacement, resulting from any (c) Asp provided by 42 U.S.C. 4625 and 49 CFR part 24, it will provide relocation assistance programs offering thes services described in to the U.S. DOTr regulations to such displaced: (d) As required by 42 U.S.C. 4625(c)(3), within a reasonable time before displacement it will make Carry out the relocation process to provide displaced persons with uniform and consistent Make available replacement housing in the same range of choices with respect to such housing to all displaced persons regardless of race, color, religion, or national origin, (f) Itwilll be guided to the greatest extent practicable under State law, by the real property (g) It will pay or reimburse property owners for their necessary expenses as specified in 42 U.S.C. 4653 and 4654, understanding that FTA/NCDOT will provide Federal/State funding fori its eligible costs of providing payments for those expenses, as required by 42 U.S.C. 4631, (h) It will execute the necessary implementing amendments to third party contracts and subagreements financed with FTA/NCDOT funding, and (i) Itwill execute, furnish, and be bound by such additional documents as FTA/NCDOT may determine necessary to effectuate or implement these assurances, and Itwilli incorporate these assurances by reference into and make them a part ofa any third party contract or subagreement, or any amendments thereto, relating to any FTA/NCDOT funded project involving relocation or land acquisition, and  Discrimination Act of 1975, as amended, 42 U.S.C. 6101 -6107,  discrimination on the basis of disability, of1973, as amended, 29 U.S.C. 794, the Civil Rights Act, 42 U.S.C. 3601 et seq., Treatment Act of1972, as amended, 21 U.S.C. 1101 ets seq., Service Act, as amended, 42 U.S.C.: 290dd- 290dd-2, and  of that Act, 42 U.S.C. 4630. and 4655, respectively, and regulations including but not limited to doing the following:  fori in 49 CFR part2 24, FTA/NCDOT funded project, of: Families andi individuals, Partnerships, corporations, or associations, Families and individuals, Partnerships, corporations, or associations,  available comparable replacement dwellings to families and individuals,  (e) Itwill:  services, and  acquisition policies of4 42U.S.C. 4651 and 4652,  -27-    State Fiscal Year 2014 Public Transportation Programs Federal and State Assistance Certifications and Assurances  (k) Itv will provide in any affected document that these relocation and land acquisition provisions To the extent practicable, it will comply with the Lead-Based Paint Poisoning Prevention Act, 42 U.S.C. 4831(b), which prohibits the use ofl lead-based paint in the construction or rehabilitation of residence d. Itwill, to the extent practicable, comply with the protections for human subjects involved in research, (1) Thel National Research. Act, Pub. L.! 93-348, July 12, 1974, as amended, 42 U.S.C. 289 ets seq., and Itwill, to the extent practicable, comply with the labor standards andj protections for federal/state funded (2) Sections 1 and 2 oft the Copeland "Anti-Kickback" Act, as amended, 18 U.S.C. 874, and 40 U.S.C. (3) The Contract Work Hours and Safety Standards Act, as amended, 401 U.S.C. 3701 ets seq., Itwill, to the extent practicable, comply with any applicable environmental: standards that may be prescribed to implement the following Federal/State laws and executive orders, including but not limited (I) Itwill comply with the institution ofe environmental quality control measures under the National Environmental. Policy Act ofl 1969, as amended, 42 U.S.C. 4321 - 4335 andl Executive Order No. (2) It will comply with notification of violating facilities pursuant to Executive Order No. 11738, 42 (3) It will comply with protection of wetlands pursuant tol Executive Order No. 11990, 42 U.S.C. 4321 (4) Ity will comply with evaluation of flood hazards ini floodplains in accordance with Executive Order (5) Itv will comply with an assurance of project consistency with the approved State management program developed pursuant to the requirements of the Coastal Zone Management Act of1972, as amended, (6) Itwillo comply with Conformity of Federal actions to! State (Clean Air) Implementation Plans under section 176(c) of the Clean Air Act of 1955, as amended, 42 U.S.C. 7401 - 7671q, (7) Itwill comply with protection ofunderground sources of drinking water under the Safe Drinking (8) Ity will comply with protection ofe endangered: species under the Endangered Species Act of1973,as (9) It will comply with environmental protections for Federal/State transportation programs, including, but not limited to, protections for parks, recreation areas, or wildlife or waterfowl refuges of national, State, or local significance or any land from a historic site ofr national, State, or local significance to be used ina a transportation project as required by 49 U.S.C. 303(b) and 303(c), (10) Ity will comply with protection of the components of the national wild and scenic rivers systems, as required under the Wild and Scenic Rivers Act of1968, as amended, 16 U.S.C. 1271-1 1287, and (a) Section 106 of thel National. Historic Preservation Act of 1966, as amended, 16 U.S.C. 470f, (b) The. Archaeological and] Historic Preservation Act of1974, as amended, 161 U.S.C. 469. -4 469c, (c) Executive Order No. 11593 (identification and protection of historic properties), 16U.S.C.4 470 Tot the extent practicable, it will comply with Federal/State requirements for the care, handling, and treatment of warm blooded. animals held or used for research, teaching, or other activities supported by (2) U.S. Department of Agriculture regulations, "Animal Welfare,"9 CFR. subchapter A, parts 1,2,3,  must supersede any conflicting provisions,  structures,  development, and related activities supported by FederalState funding of: (2) U.S.DOT regulations, "Protection ofl Human Subjects," 49 CFR part 11, (1) The Davis-Bacon. Act, as amended, 40 U.S.C. 3141 ets seq.,  projects of:  3145, respectively, tot thei following:  11514, as amended, 42 U.S.C. 4321 note,  U.S.C. 7606 note, note,  No. 11988, 42 U.S.C. 4321 note, 16U.S.C. 1451-1465,  Water Act of1974, as amended, 42 U.S.C. 300f-3 300j-6, amended, 16 U.S.C. 1531 - 1544, and  (11) It will comply with and facilitate compliance with  and note,  Federal/State funding of: and 4,  (1) The Animal Welfare Act, as amended, 7U.S.C. 2131 ets seq., and  -28-    State Fiscal Year 2014 Public Transportation: Programs Federal and State Assistance Certifications and Assurances  h. To the extent practicable, before accepting delivery of any FTA/NCDOT funded building it will obtaina certificate ofc compliance with the seismic design and construction requirements ofU.S. DOT: regulations, To the extent practicable, ita and itss subrecipients located in special flood hazard areas will comply with section 102(a) of the Flood Disaster Protection Act of1973, as amended, 42 U.S.C. 4012a(a), by: (2) Purchasing floodi insurance ift the total cost ofi insurable construction and acquisition is $10,000or (I) Thel Hatch Act, 5U.S.C. 1501 - 1508, 7324 - 7326, which limits the political activities of State and local agencies and their officers and employees whose primary employment activities are financed in whole or part with Federal/State funds including al Federal/State loan, grant agreement, or cooperative (2) 49U.S.C. 5307(k)(2) and 23 U.S.C. 142(g), which provide an exception from Hatch Act restrictions forar nonsupervisory employee ofap public transportation: system (or ofany other agency or entity performing related functions) receiving FTA/NCDOT funding to whom thel Hatch. Act does not (2) U.S. OMB Circular. A-133,"Audits of States, Local Governments, and Non-Profit Organizations," (3) The most recent applicable U.S. OMB A-133 Compliance Supplement provisions for the U.S. DOT, Itwill, to the extent practicable, comply with all applicable provisions of all other Federal/State laws or regulations, and follow Federal/State directives governing the project, except to the extent that  "Seismic Safety," 49 CFR part 41, specifically 49 CFR.41.117(d), (1) Participating in the Federal flood insurance program, To the extent practicable, it will comply with:  more,  agreement, and otherwise apply, Revised, and and  k. Itwilll have performed the financial and compliance audits as required by: (1) The Single Audit Act Amendments of 1996, 31 U.S.C. 7501 et seq.,  FTA/NCDOT has expressly approved otherwise in writing.  02.LOBBYING CERTIFICATION  An Applicant that submits an application. t0 NCDOT for State or (FTA) Federal assistance exceeding. $100,000 is required to provide the following certification. NCDOTmay not award State or Federal assistance exceeding As required by 31 U.S.C. 1352 and U.S. DOT regulations, "New Restrictions on Lobbying," specifically49CFR  S100,000 until the Applicant provides this certification by selecting Category "02."  20.110, the Applicant understands that:  a. The lobbying restrictions of your certification apply to requests for: (1) $100,000 or more in Federal funding fora a grant or cooperative agreement, and (2) $150,000 or more inl Federal finding for a loan, line of credit, or loan guarantee, b. Its certification covers the lobbying activities of: (I) It, (2) Its principals, and (3) Its first tier subrecipients:  The Applicant certifies to the best of its knowledge and belief, that: a. To influence or attempt toi influence: b. Regarding the award ofa:  1. No Federal/State appropriated funds have been or will bej paid by or oni its behalf to any person:  (1) An officer or employee ofa any Federal/State agency, (2) Al Member of Congress or State Legislature, an employee ofa member of Congress or State Legislature, or an officer or employee of Congress or State Legislature, (1) Federal/'State grant or cooperative agreement, or (2) Federal/State loan, line of credit, loan guarantee, or loan insurance  2. Itwills submit a complete OMB Standard Form-LLL, "Disclosure ofLobbying Activities (Rev. 7-97),"in accordance withi its instructions, ifany funds other than Federal/State appropriated funds have been or willl be  paid to any person:  -29-    State Fiscal Year 2014 Public Transportation Programs Federal and State Assistance Certifications and Assurances a. Toinfluence or attempt toi influence: b. Regarding any application fora a:  (1) An officer or employee of any Federal/State agency, (1) Federal/State grant or cooperative. agreement,  (2) AI Member of Congress or State Legislature, an employee ofal Member of Congress or State Legislature, or an officer or employee of Congress or State Legislature, or (2) Federal/State loan, line ofcredit, loan guarantee, or loan insurance, and  3. It will include the language of this certification in the award documents for alls subawards at all tiers  but not limited to: a. Subcontracts, b. Subgrants, Subagreements, and d. Third party contracts under a:  including,  (1) Federal/State grant or cooperative agreement, or  (2) Federal/State loan, line ofcredit, loan guarantee, or loan insurance, and  4. Itunderstands that:  a. This certification is a material representation of fact that the Federal/State Goverment relies on, and b. Itmusts submit this certification before the Federal/State Government may award funding for a transaction 5. Italso understands that any person who does not file a required certitication will be subject toad civil penalty  covered by3 31 U.S.C. 1352, including a: (1) Federal/State grant or cooperative agreement, or  (2) Federal/State loan, line of credit, loan guarantee, or loan insurance, and less than $10,000 and not more than! $100,000 for each such failure.  not  of  03. PROCUREMENT COMPLIANCE  Ind accordance with 49 CFR. 18.36/g)3)), each. Applicant that is a. State, local, or Indian tribal government. submits an application to NCDOT for State or (FTA). Federal assistance 10 acquire property or services in support that ofits project is requested to provide thej following certification by selecting Category "03." NCDOT also requests other Applicants to) provide thej following certification. NCDOT may not provide State or Federal assistance to an applicant for State or Federal assistance, property ors serrices in support ofits project until the Applicant provides The Applicant certifies that its procurements and procurement system will comply with all applicable Federal/State  this certification by. selecting Category "03."  laws and regulations in accordance with applicable Federal/State directives.  04. PROTECTIONS FOR PRIVATE TRANSPORTATION PROVIDERS Each Applicant that submits an application to NCDOTfor. State or Federal assistance authorized under 49 U.S.C. chapter. 53 to acquire any property or an interest in the property ofaprivate provider ofpublic transportation or to operate public transportation equipment ory facilities in competition with, or in addition to, transportation. service provided by an existing private provider ofpublic transportation is required to provide thej following certification. NCDOTI may not award. State or Federal assistance for such a project until the Applicant provides this certification  bys selecting Category "04." 1. Before it:  As required by 49 U.S.C. 5323(a)(1), the Applicant certifies that: b. Operates public transportation equipment or facilities:  a. Acquires the property or an interest in the property ofap private provider of public transportation, or (1) Inc competition with transportation service provided by an existing public transportation company, or (2) Ina addition to transportation. service provided by an existing public transportation company,  2. Ithas or will have:  -30-    State Fiscal Year 20141 Public Transportation Programs Federal and State Assistance Certifications and. Assurances  a. Determined that the funding is essential to carrying out a program ofp projects as required by 49 U.S.C. b. Provided for the participation of private companies engaged in public transportation to ther maximum Paidj just compensation under State or local law to the company for any franchise or property acquired.  5303,5304, and 5306, extent feasible, and  05. PUBLIC HEARING  An. Applicant seeking State OT Federal assistance authorized under 49 U.S.C. chapter. 53 forac capital project that will substantially affect a community ora community's, public ransportation service is required. to provide the following certification. NCDOTmay not award. State or Federal assistance for a capital project ofthat type until the  Applicant provides this certification by selecting Category "05." As required by 491 U.S.C. 5323(b), the Applicant certifies that: . Before submitting an application for a capital project that:  a. Will substantially affect: (1) A community, or b. Also will affect: Itwill:  (2) The public transportation: service ofa community, and  (1) Significant economic interests, (2) Significant social interests, or (3) Significant environmental interests,  (1) Provide an adequate opportunity for public review and comment on the project, after giving notice (b) Has been published ina a newspaper ofg general circulation in the geographic area the project.  that:  (a) Includes a concise description of the proposed project; and (2) Hold a public hearing on the project ift the project affects: (a) Significant economic, interests, (b) Significant social, interests, or (c) Significant environmental interests,  2. It will have considered the economic, social, and environmental effects oft the project, and 3. It will have determined that the project is consistent with official plans for developing the community. 06. ACQUISITION OF ROLLING STOCK FOR USE IN REVENUE SERVICE An. Applicant seeking State or Federal assistance authorized under 49 U.S.C. chapter 53 to acquire any rolling. stock for use in revenue service is required to) provide thej following certification. NCDOTmay not award any State o1 Federal assistance to acquire. such. rolling. stock until the Applicant provides this certification by selecting Category  "06."  The Applicant certifies thati inj procuring revenue. service rolling stock, it will comply with:  1. Federal transit law, specifically 491 U.S.C. 5323(m),  2. FTA regulations, "Pre-Award and Post-Delivery. Audits of Rolling Stock Purchases," 49 CFR part 663, specifically 49 CFR 663.7, as modified by amendments authorized bys section. 3023(k) OfSAFETEA-LU, a. Conduct or cause to be conducted the required preaward and post delivery reviews, and Maintain on file the certifications required by 49 CFR part 663, subparts B, C, and D.  including the requirements to:  .ACQUISITION OF CAPITAL ASSETS BY LEASE  -31-    State Fiscal Year 2014 Public Transportation Programs Federal and State Assistance Certifications and Assurances  An Applicant that intends to request the use ofState or Federal assistance authorized under 49 U.S.C. chapter 53 to acquire capital assets by lease is required. to) provide thej following certifications. NCDOTmay not provide State or Federal assistance to support those cosIs until the Applicant provides this certification by selecting Category "07." As required by FTA regulations, "Capital Leases," 49 CFR part 639, specifically 639.15(b)(1) and 639.21,ift the Applicant acquires any capital asset by lease financed with Federal/State funding authorized under 49 U.S.C. 1. Itwill not use Federal/State funding authorized under 49 U.S.C. chapter 53 to finance the cost ofl leasing any a. Itp performs calculations demonstrating that leasing the capital asset would be more cost-effective than  chapter 53, the Applicant certifies as follows:  capital asset until:  purchasing or constructing a similar asset, and b. Itcompletes these calculations before the later of: (I) Entering into the lease, or (2) Receiving a capital grant for the asset, and  2. Itwill not enter into a capital lease for which FTA/NCDOT can provide only incremental Federal/State funding unless it has adequate financial resources to meet its future lease obligations fFederal/State funding is  not available.  08. BUS TESTING  An Applicant for State or Federal assistance appropriated. or made available for 49 U.S.C. chapter 53 to acquire any new or newly configured bus or a bus with new. major components is required. to provide the folloving  certification by selecting Category "08." The Applicant certifies that: a. Before:  1. Itwill comply with Federal transit law, specifically 49 U.S.C. 5318,  2. FTA regulations, "Bus Testing,"4 49 CFR part 665, specifically 49 CFR 665.7, requires that  (1) Spending any Federal (or State) funds to acquire: (a) The first bus ofa any new bus model,  (b) The first bus with a new: major change in configuration or components, or (1) Ensure that the bus model has been tested at FTA's bus testing facility, and (2) Have received a copy oft the test report prepared on the bus model.  (2) Authorizing final acceptance ofa new bus model or a bus model with ai major change in components  ord configuration:  b. Itwill:  09. CHARTER SERVICE AGREEMENT  You must enter in this Charter Service. Agreement by. selecting Category "09"you appby for State or Federal assistance to acquire or operate tramsit facilities and equipment, unless you qualif for an exception under Federal As required by 491 U.S.C. 5323(d) and (g) and FTA regulations, "Charter Service," 49 CFR part 604, specifically 49 1. Except in certain circumstances described in its regulations, FTA's "Charter Service" regulations restrict transportation by charter service using facilities and equipment acquired by FTA for transportation projects  larand regulations.  CFR 604.4, the. Applicant understands and agrees that: with Federal funding derived from: (1) Federal transit laws, 49 U.S.C. chapter 53, or (2) 23U.S.C. SS 133 or 142, 2. FTA's charter service restrictions extend to: a. The Applicant when itbecomes ar recipient ofFederal funding under: (1) Federal transit laws, 491 U.S.C. chapter 53, or  -32-    State Fiscal Year 2014 Public Transportation Programs Federal and State Assistance Certifications and Assurances  (2) 23U.S.C. SS 133 or 142, b. Any third party participant thati receives Federal funding derived from: (1) Federal transit laws, 49 U.S.C. chapter 53, or (2) 23 U.S.C. SS 133 or 142, Athird party participant includesa a: (1) Subrecipient at any tier, (2) Lessee, (4) Other participant in the project, operations, except as permitted under:  (3) Third party contractor ors subcontractor at any tier, and Federal transit laws, specifically 49 U.S.C. $5 5323(d) and (g), b. FTA regulations, "Charter Service," 49 C.F.R. Part 604, Any other) Federal Charter Service regulations, or d. Federal directives, except as FTA determines otherwise in writing.  3. Neither the Applicant nor any third party participant involved ini its Project will engage in charter service  4. The Applicant agrees that the latest Charter Service. Agreement: it has selected in its latest annual Certifications and Assurances isi incorporated by reference in and made part oft the underlying Agreement accompanying an a. FTA/NCDOT may require corrective measures ori impose remedies on it or any subrecipient that has (1) Conducting charter operations prohibited by Federal transit laws and FTA's Charter Service (2) Otherwise violating the Applicant's Charter Service Agreement it has elected ini its latest annual (I) Barring it or any third party participant operating public transportation under the Project that has provided prohibited charter service from receiving FTA/NCDOT funds, or (2) Withholding an amount of Federal/State funds as provided by Appendix D to FTA's Charter Service  award ofFTA funding. 5. The Applicant agrees that:  engaged in a pattern of violations of FTA's Charter Service regulations by:  regulations, or Certifications and Assurances. These corrective measures and remedies may include:  regulations.  10. SCHOOL TKANSPORTATION AGREEMENT  You must enter in this School Transportation. Agreement by selecting Category "IO" ifyou apply for State ol" Federal assistance to acquire or operate transit facilities and equipment, unless you qualif for an exception under As required by 49 U.S.C. 5323(f) and (g) and FTA regulations, "School Bus Operations," 49 CFR part 605, to the extent consistent with 491 U.S.C. 5323(f) and (g), the Applicant understands and agrees that: 1. FTA's "Schooll Bus Operations", regulations restrict. school bus service as defined in the FTA regulations using facilities and equipment acquired with Federal funding derived from: (1) Federal transit laws, 491 U.S.C. chapter 53,or (2) 23 U.S.C. SS 133 or 142, 2. FTA's-schoo!: bus operations restrictions extend to: a. The Applicant when itl becomes a recipient of Federal funding under: (I) Federal transit laws, 49 U.S.C. chapter 53, or (2) 23 U.S.C. SS 133 or 142, b. Any third party participant that receives Federal funding derived from: (I) Federal transit laws, 49 U.S.C. chapter 53,or (2) 23 U.S.C. SS 133 or 142, Athird party participant includesa: (1) Subrecipient at any tier, (2) Lessee, (4) Other participant in the project,  Federal law and regulations.  (3) Third party contractor or subcontractor at any tier, and  -33-    State Fiscal Year 20141 Public Transportation Programs Federal and State Assistance Certifications and. Assurances  3. Neither the Applicant nor any third party participant involved ini its Project will engage in school transportation operations in competition with private operators ofs school transportation, except as permitted under: b. FTA regulations, "School Bus Operations," 49 C.F.R. Part 605, to the extent consistent with 49 U.S.C. $  a. Federal transit laws, specifically 49 U.S.C. $ 5323(f) and (g), Any other Federal School Transportation regulations, or d. Federal directives, except as FTA determines otherwise in writing.  5323(f) and (g),  4. The. Applicant agrees that the latest School Transportation Agreement it has selected in its latest annual Certifications and Assurances isi incorporated by reference in and made part of the underlying Agreement 5. The Applicant agrees that FTA will bar the Applicant or any third party participant that has violated this School Transportation Agreement from receiving Federal transit funding in an amount FTA considers  accompanying an award ofFTA funding,  appropriate.  11. DEMAND RESPONSIVE SERVICE  You must select the following certification in Category "ll"ifyou operate demand responsive service and) you apply for State or Federal assistance authorized. under 49 U.S.C. chapter 53 to acquire non- rail transit vehicles. Ast required by U.S. DOT regulations, Transportation Services for Individuals with Disabilities (ADA),"4 49 CFR . The following public transportation services it offers are equivalent in level and quality ofs service: a. Its demand responsive service offered toi individuals with disabilities, including individuals who use  part37, specifically 49 CFR: 37.77(d), the Applicant certifies that:  wheelchairs,  b. Its service offered to individuals without disabilities, a. Provided in the mosti integrated setting feasible, and  2. Viewed in its entirety, the Applicant's service for individuals with disabilities is: b. Equivalent to the service it offers individuals without disabilities with respect to:  (1) Response time, (2) Fares, (3) Geographic service area, (4) Hours and days ofs service, (5) Restrictions on trip purpose,  (6) Availability ofinformation: and reservation capability, and (7) Constraints on capacity or service availability.  12. ALCOHOL MISUSE AND PROHIBITED DRUG USE  Ifan Applicant is required. by FTA regulations, "Prevention of Alcohol. Misuse and Prohibited. Drug Use in Transit Operations,' "at 49 CFR part 655, to provide thej following certification concerning its actirities IO prevent alcohol misuse and prohibited drug use in its public transportation operations, NCDOTmay not provide State or Federal As required byl FTA regulations, "Prevention of Alcohol Misuse and Prohibited Drug Use in Transit Operations,"  assistance to the Applicant untili it provides this certification by selecting Category "12" specifically 49 CFR part 655, subpart I, the Applicant certifies that it:  1. Has established and implemented: a. An alcohol misuse program and b. An anti-drug program, and  2. Has complied with or will comply with all applicable requirements oft this part.  13. NTELLIGENTTRANSPORTATION SYSTEMS  -34-    State Fiscal Year 2014 Public Transportation Programs Federal and State. Assistance Certifications and. Assurances  An Applicant for State or (FTA) Federal assistance for an. Intelligent Transportation Systems (ITS) project ora project in. support ofan ITS project is requested to) provide thej following assurance by selecting Category "13." An Applicant) for ITSA project funding that) fails to provide this assurance, without providing other documentation assuring its commitment to comply with applicable. Federal/State ITS standards and protocols, may be ineligible for As used in this assurance, the term Intelligent Transportation Systems (ITS), project is defined toi include any project that in whole or in part finances the acquisition of technologies or systems of technologies that provide or significantly contribute to the provision of one or more ITS user services as defined in the National ITS  avard of Federal/State, funding for that ITS project.  Architecture. " The Applicant assures that:  1. As provided in subsection 307005AFETEALU, 23 U.S.C. 512 note:  "Intelligent transportation system projects carried out using funds made available from the Highway Trust Fund, including funds made available under this subtitle to deploy intelligent transportation system technologies, [will) conform to the national architecture, applicable standards or provisional standards, and protocols developedi under subsection (a) [ofsection 53070fSAFETEA-LU)" b. ITS: standards will not applyi ifit obtains an exception to subsection 5307(c) OfSAFETEA-LU,231 U.S.C. 2. Itwill use its best efforts to assure that any ITS project it undertakes will not preclude interface with other intelligent transportation systems in the Region, if supported with Federal funding not derived from: 3. To facilitate compliance with subsection. 5307(c) of23 U.S.C. 512 note, except as thel Federal Government a. FTANotice, "FTA National ITS Architecture Policy on Transit Projects,"661 FR 1455, January 8, 2001, b. Other FTA policies that may be issued in connection with any ITS project it undertakes financed with  512 note.  a. Title 49, United States Code, or b. Title 23, United States Code.  determines otherwise in writing, the Applicant assures that it will comply with: (1) Applicable provisions of Section V (Regional ITS Architecture, and funds authorized under Title 49 or Title 23, United States Code,  specifically:  (2) Section VI (Project Implementation), and  14. URBANIZED AREA FORMULA PROGRAM  Each Applicant for Urbaniced. Area Formula. Progrant assistance authorized under 49 U.S.C. 5307 is requiredto provide thej following certifications on behalfo of itselfand any subrecipients participating in its projects. Unless. FTA determines otherwise in writing, the Applicant is ultimately responsible for compliance with its certifications and assurances even though a. subrecipient, lessee, third! party contractor or other participant may participate in that project. Consequently, in providing certifications and assurances that involve the compliance ofi its prospective subrecipients, the Applicant is strongly encouraged 10 take appropriate. measures, including but not limited to obtaining sufficient documentation, from each. subrecipient, to assure the validity ofall certifications and assurances the Applicant has made to FTA. K howevera "Designated. Recipient" as defined at 49 U.S.C. 5307(a)(2)(A) enters into a. Supplemental. Agreement with. FTA and a Prospective Grantee, that Grantee is recognized. as the Applicant for Urbanized. Area Formula. Program assistance and must provide the following certifications and assurances. Each. Applicant is required by 49 U.S.C. 5307(d)(1)() to expend at least one (1) percent ofits Urbanized. Area Formula Progran assistancey for public transportation securily projecis, unless the. Applicant has certified that such expenditures are not necessary. Information about the Applicant S intentions willl be recorded in the "Securily"tab page ofthe TEAM-Web "Project Information'  window when the Applicant enters its Urbanized. Area Formula FTA may not award Urbaniced. Area Formula. Program assistance. to any Applicant that is required. by 490 U.S.C. 5307(d)(1)(K) to expend one (1) percent ofits Urbanized. Area Formula Program assistance for eligible transit enhancements unless that Applicant's quarterly report) for thej fourth quarterofthe preceding Federal fiscal) year has been submitted to FTA andi includes thei requisite list or the. Applicant attaches in TEAM-Web or includes in its quarterh reporti information sufficien! 10 demonstrate that the Designated Recipients in its ared logether have  Program application in TEAM-Web.  -35-    State Fiscal Year 2014 Public Transportation Programs Federal and State. Assistance Certifications and Assurances  expended one (1) percent oft the amount ofUrbanized. Area Program assistance made available to them, for transit FTA may not avard Federal assistance for the Urbanized. Area Formula. Program to the Applicant until the  enhancement; projects.  Applicant provides these certifications and assurances by selecting Category "14."  15. ELDERLY INDIVIDUALS AND INDIVIDUALS WITH DISABILITIES FORMULA GRANT PROGRAM AND PILOT PROGRAM  The North Carolina Department Transportation (NCDOT) administers the Elderly. Individuails and Individuals with Disabilities. Formula Program and, ifapplicable, the Elderly Individuals and Individuals with. Disabilities. Pilot Program on behalfofisefand. its Subrecipients andi is required 10 provide thej following certifications on behalfof itselfande each. Subrecipient. NCDOT may not award assistance for the Elderly. Individuals and Individuals with Disabilities Formula Program or the Elderly Individuals and Individuals with Disabilities Pilot Program until the The following certifications and assurances apply to each State or State organization (NCDOT) serving as Applicant for funding and each Subrecipient of funding under the Elderly Individuals and Individuals with) Disabilities Formula Grant Program authorized under 49 U.S.C. 5310, andt the Elderly Individuals and Individuals with  Applicant provides these certifications by selecting Category "15."  Disabilities Pilot Program authorized unders subsection: 3012(b) of SAFETEA-LU. 1. NCDOT assures and requires each Applicant (Subrecipient) to assure that:  a. Each Subrecipient is:  (1) Recognized under State law as aj private nonprofit organization with the legal capability to contract (2) A public body that has met the statutory requirements to receive Federal funding authorized for 49 b. NCDOT can conclude from information in aj private nonprofit Subrecipient'sa application for 49 U.S.C. (I) The transit service provided or offered to be provided by existing public or private transit operators cannot meet the special needs ofelderly individuals andi individuals with disabilities, because iti is:  with the State to carry out thej proposed project, or  U.S.C.5310, 53101 funding that: (a) Unavailable, (b) Insufficient, or (c) Inappropriate,  C. As required by 49 U.S.C. 5310(d)(2)(A) and subsection 3012(b)(2) OfSAFETEA-LU, NCDOT certifies and the Subrecipient agrees that, before itt transfers funds to a project funded under 49 U.S.C. 5336, the project has been or willl have been coordinated with private nonprofit providers of services under 49 d. As required by 49 U.S.C. 5310(d)(2)(C), NCDOT certifies and the Subrecipient agrees that allocations to Subrecipients 491 U.S.C. 5310: funding or subsection 3012(b) funding will be distributed on a fair and As required by 49 U.S.C. 5310(d)(2)(B) and subsection 0I2DO)OSAFETEALLA NCDOT certifies (1) The projects NCDOT. has selected or will select for funding under that program were derived from a (2) That locally developed, coordinated plan was produced through ap process that included: (a) Representatives ofp public, private, and nonprofit transportation providers, (b) Representatives of public, private, and nonprofit human services providers, and  U.S.C. 5310, equitable basis, and and the Subrecipient agrees that: (a) Locally developed, and (b) Coordinated, and  public transit-human services transportation plan that has been:  (c) Participation byt the public.  2. As permitted by 49 U.S.C.. 5310(d), the Federal Transit Administrator has selected certain requirements of49 U.S.C. 5307 tol be appropriate for the Elderly Individuals and Individuals with Disabilities Formula Grant Program authorized by 49 U.S.C. 5310, and the Elderly Individuals and Individuals with) Disabilities Pilot Program authorized by subsection: 3012(b) OfSAFETEA-LU,4 49 U.S.C. 5310 note, ofwhich some require  -36-    State Fiscal Year 2014 Public Transportation Programs Federal and State Assistance Certifications and Assurances  certifications. Therefore, as specified under 49 U.S.C.5307(d)0), NCDOT certifies and the Subrecipient a. As required by 49 U.S.C. 5307(d)(I)(A), NCDOT and each Subrecipient has or willl have the:  agrees that:  (1) Legal capacity to carry outi its proposed projects, (2) Financial capacity to carry out its proposed projects, (3) Technical capacity to carry out its proposed projects, (4) Safety aspects of its proposed projects, and (5) Security aspects ofits proposed projects, equipment and facilities adequately,  b. As required by 49 U.S.C. 5307(d)(I1)(B), NCDOT and each Subrecipient has or willl have satisfactory As required by 49 U.S.C. 5307(d)(1)(C), NCDOT and each Subrecipient will maintain the project d. As required by 49 U.S.C. 5307(d)(1)(E), when carrying out aj procurement under thel Elderly Individuals and Individuals withl Disabilities Formula Grant Program authorized by 49 U.S.C. 5310, or the Elderly Individuals and Individuals with Disabilities Pilot Program authorized bys subsection 3012(b) of SAFETEA-LU, 491 U.S.C. 5310 note, NCDOT and each Subrecipient will: (1) Use competitive procurement (as defined or approved by FTA/NCDOT), (2) Not use exclusionary or discriminatory specifications ini its procurements, (4) Comply with the general provisions for FTA programs of4 49 U.S.C.: 5323, and (5) Comply with the third party procurement: requirements of4 49 U.S.C. 5325, Asr required by 49 U.S.C. 5307(d)(I)(G), NCDOT and each Subrecipient: (1) Has or will have the amount of funds required for the local share, (a) As required by 49 U.S.C. 5310(c), and (b) Subsections 3012(b)(3) and (4) OfSAFETEA-LU, ifa applicable, (2) Will provide the local share funds from approved non-Federal: sources except as permitted by Federal (3) Will provide the local share funds when needed, and As required by 49 US.C.5307d))0), NCDOT and each Subrecipient will comply with: (1) The requirements of4 49 U.S.C. 5301(a) forp public transportation systems that: (a) Maximize the safe, secure, and efficient mobility ofpeople, (b) Minimize environmental impacts, and (c) Minimize transportation-related fuel consumption and reliance on foreign oil, (2) The requirements of49 U.S.C. 5301(d) fors special efforts to: (a) Design public transportation for elderly individuals and individuals with disabilities, and (b) Provide public transportation for elderly individuals andi individuals with disabilities, and (3) The requirements of49 0.S.C.5303 - 5306 for: (a) Metropolitan. and State Planning, and (b) Private enterprise participation.  continuing control overt thet use of project equipment and facilities,  (3) Comply with applicable Buy America laws, and  law, and  16. NONURBANIZED AREA FORMULA PROGRAM FOR STATES  NCDOT requires each. Applicant for Nonurbanized Area Formula Grant Program assistance authorized. under 49 U.S.C. 5311 and State Assistance to provide the following certifications. NCDOT may not aard Federal assistance for the Nonurbanized. Area. Formula Grant Program or State assistance until the Applicant provides these (You) The Applicant itselfis utimately responsible for compliance with its certifications and assurances even thougk as subrecipient, lessee, third party contractor; or other participant may. participate in that project, unless FTA/NCDOT determines otherwise in writing. Consequently, NCDOTstrongly encourages) you to take the appropriate. measures including, but not limited to, obtaining sufficient documentation, from each subrecipient, to  certifications by selecting Category "16."  assure the validity ofall certifications and assurances you have made.  -37-    State Fiscal Year 2014 Public Transportation Programs Federal and State Assistance Certifications and Assurances  The following certifications and assurançes apply to each State or State organization (NCDOT)s serving as the Applicant for funding under the Nonurbanized Area Formula Program authorized under 49 U.S.C.5311.The  Applicant assures and requires each Subrecipient to assure that: 1. Ithas or will have the necessary legal, financial, andi managerial capability to: a. Apply, receive and disburse 49 U.S.C. 5311(c)(1) funding, and b. Carry out each project, including the: (1) Safety aspects ofits proposed projects, and (2) Security aspects ofits proposed projects,  2. It has or will have satisfactory continuing control over the use ofp project equipment and facilities, 4. As required by 49 U.S.C. 5311(b)(2XC)6), its program has provided for a fair distribution of Federal funding authorized for 491 0.S.C.5311 within the State, including Indian reservations within the State, 5. As required by 49 U.S.C. 5311(b)2)(C)), its program provides or will provide the maximum feasible coordination of public transportation service to receive funding under 491 U.S.C. 5311 with transportation  3. The project equipment and facilities will be adequately maintained,  service assisted by other Federal sources,  6. The projects ini its Nonurbanized Areal Formula Program are included in: a. The Statewide Transportation Improvement Program, and b. To the extent applicable, a metropolitan Transportation Improvement Program,  7. Ithas or willl have the amount of funds required for thel local share, as required by 49 U.S.C. 5311(g), and a. Will provide the local share funds from approved non-Federa!: sources except as permitted by Federal law, a. It(NCDOT) will spend at least fifteen (15)percent ofi its 491 U.S.C.5311 funding available that fiscal year to develop ands support intercity bus transportation within the State, with eligible activities including: (4) Operating grants through purchase-of-service agreements, user-side subsidies, and demonstration (5) Coordinating rural connections between small public transportation operations and intercity bus b. It(NCDOT) will provide to thel Federal Transit Administrator a certification of the State's chiefexecutive (1) After consulting with the affected intercity bus service providers about the intercity bus needs of the  and  b. Will provide the local share funds when needed, and 8. Asr required by 49 U.S.C.: 5311(f), each fiscal year:  (1) Planning and marketing for intercity bus transportation, (2) Capital grants for intercity bus shelters, (3) Joint-use stops and depots, projects, and carriers, or officer that: State,  (2) The State'si intercity bus service needs are being met adequately.  17.JOB ACCESS AND REVERSE COMMUTE (JARC)  FORMULA GRANT PROGRAM  Each. Applicant for. Job Access and Reverse Commute (JARC) Formula Grant Program assistance authorized under 49 U.S.C. 5316is required to) provide thej following certifications.. NCDOTmay not award Federal assistance for the. JARC Formula Gran! Program until the Applicant provides these certifications by selecting Category "17." The following certifications and assurançes apply to each. Applicant for and Subrecipient of funding under the. Job Access and) Reverse Commute (JARC) Formula Grant funding authorized under 49 U.S.C.5 5316. a. As required by 49 U.S.C. 5316(d)(4), it will make awards ofJARC funding on a competitive basis (1) An areawide solicitation in cooperation with the appropriate metropolitan planning organization for applications for funding under 5316(c)(I)(A) (see 49 U.S.C. 5316(d)(1)), and (2) A statewide solicitation for applications for. JARC: funding under 49 U.S.C. 5316(c)(1)(B) or 49  1. The Applicant certifies that: following:  U.S.C. 5316(c)(I)(C), (see 491 U.S.C. 5316(d)(2)) and  -38-    State Fiscal Year 2014 Public Transportation Programs Federal and State Assistance Certifications and Assurances  b. Asr required by 491 U.S.C. 5316(f)(2), any allocations to Subrecipients of funding authorized under 49 (1) The projects it has selected or will select for funding under that program were derived from a public (2) That locally developed, coordinated plan was produced through a process thati included: (a) Representatives: ofp public, private, and nonprofit transportation providers, (b) Representatives of public, private, and nonprofit human services providers, and d. As required by 491 U.S.C. 5316(g)(2), before it transfers funds to a project funded under 491 U.S.C. 5336, that project has been or willl have been coordinated with private nonprofit providers of services, and As required by 491 U.S.C. 5316(c)(3), before using funds apportioned for projects serving an area other than that for which funding was apportioned under 49 U.S.C. 5316(c)(1)(B) or (C): (1) The State's chiefe executive officer, or his or her designee, willl have certified that all the. JARC program objectives of49 U.S.C. 5316 are being met in the area from which the funding would be (2) Ifthe State has a statewide program for meeting the. JARC program objectives of49 U.S.C. 5316, the 2. Under 49 U.S.C.5316(0(), the requirements of49 U.S.C. 5307 apply to the JARC Program, authorized under 49 U.S.C. 5316. Therefore, as specified under 491 U.S.C. 5307(d)(1), the Applicant certifies that a. Asr required by 49 U.S.C. 5307(d)(I)(A), it and each Subrecipient has or will have the:  U.S.C. 5316 willl be distributed on a fair and equitable basis, transit-human services transportation plan that has been:  As required by 491 U.S.C. 5316(g)(3): (a) Locally developed, and (b) Coordinated,  (c) Participation! byt thep public, and  derived,  funds can be used for projects anywhere in the State. (1) Legal capacity to carry out its proposed projects, (2) Financial capacity to carry out its proposed projects, (3) Technical capacity to carry out its proposed projects, (4) Safety aspects ofi its proposed projects, and (5) Security aspects ofits proposed projects, control over the use ofproject equipment and facilities,  b. As required by 49 U.S.C.5 5307(d)(I)(B), it and each Subrecipient has or will have satisfactory continuing As required by 491 U.S.C. 5307(d)(1)(C), it and each Subrecipient will maintain the project equipment and d. As required by 49 U.S.C.5 5307(d)(1)(D), it and each Subrecipient will ensure that the following individuals will be charged. not more than fifty (50) percent of the peak hour fare for transportation during non-peak hours using or involving project facilities or equipment supported under 49 U.S.C.5316: (3) Individuals presenting al Medicare cardi issued to himself or herselfpursuant to title II or title XVIII of As required by 49 U.S.C. 5307(d)(1)(E), when carrying out a procurement under the. JARCI Program, 49  facilities adequately, (1) Elderly individuals, (2) Individuals with disabilities, or  the Social Security Act (42 U.S.C. 401 et seq. or 42U.S.C. 1395 etseq.), (1) Use competitive procurement (as defined or approved by FTA/NCDOT), (2) Not use exclusionary or discriminatory specifications in its procurements, (4) Comply with the general provisions for FTA programs of 491 U.S.C.5 5323, and (5) Comply with thet third party procurement requirements of4 491 U.S.C.5325,  U.S.C. 5316, it will:  (3) Comply with applicable Buy America laws,  As required by 491 U.S.C. 5307(d)(I)(F), it and each Subrecipient has complied with or will comply with (1) Has informed or willi inform the public oft the amount ofi its JARC: Program funds available under 49 (2) Has developed or will develop, in consultation with interested parties including private transportation (3) Has published or will publish al list ofi its projects in a way that affected citizens, private transportation providers, and local elected officials willl have an opportunity to examine and submit comments on  49 U.S.C. 5307(c) because it:  U.S.C.5316, and the projects it proposes to undertake, providers, the projects proposed to be funded, the proposed projects andi its performance,  -39-    State Fiscal Year 2014 Public Transportation Programs Federal and State Assistance Certifications and Assurances  (4) Has provided or will provide an opportunity for a public hearing to obtain the views of citizens on the (5) Has assured or will assure that the proposed projects provide for coordination of transportation services assisted under 49 U.S.C. 5336 with federally assisted transportation services supportedb bya (6) Has considered or will consider the comments and views received, especially those ofp private  proposed projects,  Federal government. source other than U.S. DOT, transportation providers, inj preparing its final list ofprojects, and (7) Has made or will make the final list of projects available to the public, Asr required by 49 U.S.C. 5307(d)(1)(G), it and each Subrecipient: (1) Has or will have the amount oft funds required for the local share, (3) Will provide thel local share funds when needed, h. As required by 49 U.S.C. 5307(d)(I)(H), it and each Subrecipient will comply with: (I) The requirements of49 U.S.C. 5301(a) for public transportation systems that: (a) Maximize the safe, secure, and efficient mobility of people, (b) Minimize environmental impacts, and (c) Minimize transportation-related fuel consumption. and reliance on foreign oil, (2) The requirements of 49 U.S.C.: 5301(d): fors special efforts to: (a) Design public transportation: for elderly individuals and individuals with disabilities, and (b) Provide public transportation for elderly individuals and individuals with disabilities, and (3) The requirements of4 49 U.S.C. 5303 - 5306: for: (a) Metropolitan and Statel Planning, and (b) Private enterprise participation, and and consider public comment before: (1) Raising ai fare, or  (2) Will provide thel local share funds from approved non-Federal. sources except as permitted by Federal  law, and  As required by 491 U.S.C. 5307(d)(1)(I), it and each Subrecipient has al locally developed process to solicit  (2) Implementing a major reduction of public transportation.  18. NEW FREEDOM PROGRAM  Each Applicant for New Freedom. Program assistance authorized. under 49 U.S.C. 5317 must provide thej following certifications. NCDOTmay not avard Federal assistance for thel New Freedom. Program until the Applicant  provides these certifications by. selecting Category "18."  I. The Applicant certifies that: following:  a. As required by 49 U.S.C. 5317(d)(4), it will make awards of New Freedom funding on a competitive basis (1) An areawide solicitation in cooperation with the appropriate metropolitan planning organization for applications for funding under 5317(c)(I)(A) (see 49 U.S.C. 5317(d)(1)), and (2) As statewide solicitation for applications for. JARC funding under 49 U.S.C. 5317(CXI)B)or49 Asr required by 49 U.S.C. 5317(e)(2), any allocations to subrecipients of funding authorized under 49 (1) The projects it has selected or will select for funding under that program were derived from a public (2) That locally developed, coordinated plan was produced through ap process thati included: (a) Representatives of public, private, andi nonprofit transportation providers, (b) Representatives ofhumans services public, private, and nonprofit providers, and d. As required by 49 U.S.C. 5316(P)(2), before it transfers funds to a project funded under 491 U.S.C. 5336, that project has been or willl have been coordinated with private nonprofit providers ofs services.  U.S.C.: 5317(c)1)(C), (see 49 U.S.C. 5317(d)(2)), U.S.C.. 5317 willl be distributed on ai fair and equitable basis, transit-human services transportation plan that has been:  As required by 49 U.S.C. 5317()(3): (a) Locally developed, and (b) Coordinated,  (c) Participation by the public, and  -40-    State Fiscal Year 2014 Public Transportation Programs Federal and State Assistance Certifications and Assurances  2. As permitted by 49 U.S.C.5317(e)(I), the Federal Transit Administrator has selected certain requirements of 49 U.S.C. 5310 and 49 U.S.C.5307 to be appropriate for the New Freedom Program, ofwhich some require certifications. Therefore, as specified under 491 U.S.C.5307d)(), the Applicant certifies that: a. Asr required by 49 U.S.C. 5307(d)(I)(A), ita and eachs subrecipient has or will have the:  (1) Legal capacity to carry out its proposed projects, (2) Financial capacity to carry out its proposed projects, (3) Technical capacity to carry out its proposed projects, (4) Safety aspects ofi its proposed projects, and (5) Security aspects ofits proposed projects, control over the use ofproject equipment and facilities,  b. As required by 491 US.C.5307())B),. it and each subrecipient has or willl have satisfactory continuing As required by 49 U.S.C. 5307(d)(1)(C), it and each subrecipient will maintain the projectequipment and d. As required by 49 U.S.C. 5307(d)(I)(E), when carrying out aj procurement under thel New Freedom  facilities adequately,  Program authorized by 49 U.S.C. 5317, it and each subrecipient will: (1) Use competitive procurement (as defined or approved by FTA), (2) Not use exclusionary or discriminatory specifications ini its procurements, (3) Comply with applicable Buy America laws, and (4) Comply with the general provisions for FTA programs of4 49 U.S.C. 5323, and (5) Comply with the third party procurement requirements of49 U.S.C.5325, As required by 49 U.S.C. 5307(d)(1)(G), it and each subrecipient: (1) Has or willl have the amount off funds required for thel local share, (3) Will provide the local share funds when needed, and As required by 49 U.S.C. 5307(d)(1)(H), it will comply with: (1) The requirements of49 U.S.C. 5301(a) for public transportation systems that: (a) Maximize the safe, secure, and efficient mobility ofp people, (b) Minimize environmental impacts, and (c) Minimize transportation-related fuel consumption and reliance on foreign oil, (2) The requirements of 491 U.S.C. 5301(d) fors special efforts to: (a) Design public transportation for elderly individuals and individuals with disabilities, and (b) Provide public transportation for elderly individuals and individuals with disabilities, and (3) The requirements of491 U.S.C.: 5303 - 5306 for: (a) Metropolitan and State Planning, and (b) Private enterprise participation.  (2) Will provide the local share funds from approved non-Federal: sources except as permitted by Federal  law, and  ##  Selection and. Signature Pagels).follow  -41-    FEDERAL (FTA). AND STATE (NCDOT) CERTIFICATIONS AND ASSURANCES, FOR  PUBLICT TRANSPORTATION PROGRAMS STATE: FISCALYEAR2014  Legal Name of Applicant:  The Applicant agrees to comply with applicable provisions of Categories 01 -18.  Accept  OR  The Applicant agrees to comply with the applicable provisions of the following Categories it has selected:  Category Description 01. 02. 03. 04. 05. 06. 07. 08. 09. 10. 11. 12. 13. 14. 15. 16. 17. 18.  Accept  Assurances Required For Each Applicant.  Lobbying. Procurement Compliance.  Protections for Private Providers of Public Transportation.  Public Hearing.  Acquisition of Rolling Stock for Usei in Revenue Service. Acquisition of Capital Assets by Lease.  D D D  Bus Testing. Charter Service Agreement. School Transportation Agreement. Demand Responsive Service. Alcohol Misuse and Prohibited Drug Use. Intelligent Transportation Systems. Urbanized Area Formula Program.  Elderly Individuals & Individuals with Disabilities Formula Program & Pilot Program.  D  Nonurbanized Area Formula Program. Job Access and. Reverse Commute (JARC) Program.  New. Freedom Program.  -42-    STATE FISCAL YEAR2014 (Requiredo of all Applicants) AFFIRMATION OF APPLICANT  DERALIETAISTATE (NCDOT) CERTIPICATIONSAND ASSURANCESS SIGNATURE PAGE  Legal Name of Applicant:  Name and Relationship of Authorized Official:  BY SIGNING BELOW, on behalf oft the Applicant, I declare that the Applicant has duly authorized me to make these certifications and assurances and bind the Applicant's compliance. Thus, the Applicant agrees to comply with all Federal/State statutes and regulations, and follow applicable Federal/State directives, and comply with the certifications and assurances as indicated on the foregoing page applicable to each application it makes to North Carolina Department ofTransportation (NCDOT) for FTA (Federal Transit Administration) and for State assistance NCDOT and FTA intend that the certifications and assurances the Applicant selects on the preceding certifications and assurances category selection page, as representative of the certifications and assurances in this document, should apply, as provided, to each project for which the Applicant seeks now, or may later, seek State or (FTA) The Applicant affirms the truthfulness and accuracy oft the certifications and assurances itl has made in the statements submitted herein with this document and any other submission made tol NCDOT, and acknowledges that the Program. Fraud Civil Remedies Act of1986, 31 U.S.C. 3801 et seq., and implementing U.S. DOT regulations, "Program Fraud Civil Remedies," 49 CFR part 31 applyt to any certification, assurance or submission made to the NCDOT and FTA. The criminal provisions of18 U.S.C. 1001 apply to any certification, assurance, or submission made in connection with al Federal public transportation program authorized in 49 U.S.C. chapter 53 or any other Ins signing this document, Ideclare under penalties ofp perjury that the foregoing certifications and assurançes, and  in State Fiscal Year 2014.  Federal assistance during State Fiscal Year 2014.  statute.  any other statements made by me on behalf of the Applicant are true and correct.  Signature of Authorized Official Name/Title of Authorized Official Seal Subscribed and sworn to me (date)  Date Signed  Affix Notary Seal Here  Notary Public  Printed Name and Address My commission expires (date)  -43-    AFFIRMATION OF APPLICANT'S ATTORNEY Reqpuindeal.Appleum,  For (Legal Name of Applicant):  As the undersigned Attorney for the above named Applicant, Ihereby affirm to the. Applicant that itl has authority under State, local, or tribal government law, as applicable, to make and comply with the certifications and assurances as indicated on the foregoing pages. Ifurther affirm that, in my opinion, the certifications and assurances have been legally made and constitute legal and binding obligations on the Applicant. Ifurther affirm to the Applicant that, to the best of my knowledge, there is no legislation or litigation pending or imminent that might adversely affect the validity ofthese certifications and assurances, or of the performance oft the  project.  Signature of Attorney for Applicant Name of Attorney for Applicant Seal Subscribed and sworn to me (date)  Date Signed  Affix Notary, Seal Here  Nolary Public  Printed Name and Address My commission expires (date)  -44-    (Required ofa all Applicants)  CERTIFICATION AND RESTRICTIONS ON LOBBYING  on behalfof  Name of Authorized Official Legal Name of Applicant Hereby certifies that:  No Federal/State appropriated funds have been paid or will be paid, by or on behalfoft the undersigned, to any person for influencing or attempting to influence an officer or employee of any Federal/State agency, a Member ofCongress or State Legislature, an employee ofar member of Congress or State Legislature, or an officer or employee of Congress or State Legislature in connection with the awarding ofa any Federal/State contract, the making of any Federal/State grant, the making ofany Federal/State loan, the enteringi into ofany cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal/State contract, Ifany funds other than Federal/State appropriated funds have been paid or willl be paid to any person influencing or attempting to influence an officer or employee ofa any Federal/State agency, a Member of Congress or State Legislature, an employee of a member of Congress or State Legislature, or an officer or employee of Congress or State Legislature in connection with the Federal/State contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form - LLL, "Disclosure Form to The undersigned shall require that the language oft this certification bei included in the award documents for all sub-awards at all tiers (including sub-contracts, sub-grants and contracts under grants, loans, and cooperative This certification is a material representation offact upon which reliance was placed hen this transaction las made or entered into. Submission ofthis certification is a prerequisite. for making or entering into this transaction imposed by 31 U.S.C. S 1352 (as amended br the Lobbying Disclosure Act of1995). Any person rho. fails to file the required certification shall be subject to a chvil penalty' ofnot less than $10,000 and not The undersigned certifies or affirms the truthfulness and accuracy of the contents of the statements submitted on orwith this certification and understands that the provisions of31 U.S.C. Section 3801, et seq., are applicable  grant, loan, or cooperative agreement.  Report Lobbying," in accordance withi its instructions.  agreements) and that all sub-recipients shall certify and disclose accordingly.  more than SI00,000 foreach such, failure.  thereto.  Signature of Authorized Official Seal Subscribed and sworn to me (dale)  Affi Notary Seal Here  Notary Public  Printed Name and Address My commission expires (date)  -45-    (Required ofall Applicants that plan to procure inaccessible vehicles) CERTIFICATION OF EQUIVALENT SERVICE  (Legal Name of Applicant) certifies that its demand responsive service offered to individuals with disabilities (as defined in 49 CFR 37.3), including individuals who use wheelchairs, is equivalent to the level and quality of service offered to individuals without disabilities. Such service, when viewed in its entirety, is provided in the  most integrated setting feasible and is equivalent with respect to:  1) Response time; 2) Fares; 3) Geographic service area; 4) Hours and days ofservice;  5) Restrictions or priorities based on trip purpose; 6) Availability ofinformation and reservation capability; and 7) Constraints on capacity or service availability.  In accordance with 49 CFR 37.77, public funded entities operating demand responsive systems for the general public which receive financial assistance under section 18 ofthe] Federal Transit Act must file this certification with the appropriate state program office before procuring any inaccessible vehicle. NCDOT also requires state funded entities that do not receive Federal Transit Administration (FTA) funds to file this certification as well. The NCDOT Public Transportation Division requires all participants to certify equivalent service when requesting toj purchase non-ADA accessible vehicles. By signing this certification, the above-named agencyi is certifying that it has a mechanism in place to provide rides toi individuals with disabilities. Thei ride must be provided in a manner equivalent to the service provided by the above-named agency to individuals without  This certification is valid for no longer than one year from its date of filing.  disabilities.  Signature of Authorized Official Seal Subscribed and sworn to me (date)  Affi Notary Seal. Here  Notary Public  Printed Name and Address My commission expires (date)  -46-    SFY2014C Community Transportation Program (CTP) Grant Application  Special Section 5333(b) Warranty  Special Section 5333(b) Warranty  For Application to the Nonurbanized Area Formula Program The following language shall be made part oft the contract of assistance with the State or other public body charged with allocation and administration of funds provided under the  Community Transportation Program (CTP):  A. General Application  The Public Body (The North Carolina Department of Transportation) agrees that the terms and conditions of this waranly, as set forth below. shall apply fort the protection oft the transportation related employees ofa any employer providing transportation services assistedby the (Legal Name of Applicant) and the transportation related employees of any other surface public transportation providers in the transportation service area ofthe project. The Public Body shall provide to the U. S. Department of Labor and maintain at all times during the Project an accurate, up-to-date listing ofall existing transportation providers which are eligible Recipients of transportation assistance funded by the Project, in the transportation service area of the Project, and any labor organizations representing the employees of such Certification by the Public Body to the U. S. Department of Labor that the designated Recipients have indicated in writing acceptance of the terms and conditions of the warranty arrangement will be sufficient to permit the flow of CTP funding in the absence ofa finding  project,  Sampson County  providers.  ofnoncompliance by the Department ofLabor. B. Standard Terms and Conditions  (1) The Project shall be carried out in such a manner and upon such terms and conditions as will not adversely affect employees of the Recipient and of any other surface public transportation provider in the transportation service area of the Project. It shall be an obligation of the Recipient to assure that any and all transportation services assisted by the Project are contracted for and operated in such a manner that they do not impair the rights and interests of affected employees. The term "Project," as used herein, shall not be limited to the particular facility, service, or operation assisted by Federal funds, but shall include any changes, whether organizational, operational, technological, or otherwise, which are a result of the assistance provided. The phrase "as a result of the Project," shall, when used in this arrangement, include events related to the Project occurring in anticipation of, during, and subsequent to the Project and any program of efficiencies or economies related thereto; provided, however, that volume rises and falls of business, or changes in volume and character of employment brought about solely by causes other than the Project (including any economies or efficiencies unrelated to the Project) are not within the purview of this  arrangement.  -47-  NCDOT-PTD SFY2014    SFY2014 Community Transportation Program (CTP) Grant Application  Special Section 5333(b) Warranty  An employee covered by this arrangement, who is not dismissed, displaced or otherwise worsened in his/her position with regard to employment as a result of the Project, but who is dismissed, displaced or otherwise worsened solely because of the total or partial termination of the Project or exhaustion of Project funding shall not be deemed eligible for a dismissal or displacement allowance within the meaning of paragraphs (6) and (7) oft this arrangement. (2) Where employees of a Recipient are represented for collective bargaining purposes, all Project services provided by that Recipient shall be provided under and in accordance with any collective bargaining agreement applicable to such employees which is then in effect. This Arrangement does not create any collective bargaining relationship where one does not already exist or between any Recipient and the employees of another employer. Where the Recipient has no collective bargaining relationship with the Unions representing employees in the service area, the Recipient will not take any action which impairs or interferes with the rights, privileges, and benefits and/or the preservation or continuation of the collective (3) All rights, privileges, and benefits (including pension rights and benefits) of employees covered by this arrangement (including employees having already retired) under existing collective bargaining agreements or otherwise, or under any revision or renewal thereof, shall be preserved and continued; provided, however, that such rights, privileges and benefits which are not foreclosed from further bargaining under applicable law or contract may be modified by collective bargaining and agreement by the Recipient and the Union involved to substitute other rights, privileges and benefits. Unless otherwise provided, nothing in this arrangement shall be deemed to restrict any rights the Recipient may otherwise have to direct the working forces and manage its business as it deemed best, in accordance with the (4) The collective bargaining rights of employees covered by this arrangement, including the right to arbitrate labor disputes and to maintain union security and checkoff arrangements, as provided by applicable laws, policies and/or existing collective bargaining agreements, shall be preserved and continued. Provided, however, that this provision shall not be interpreted sO as to require the Recipient to retain any such rights which exist by virtue of a collective The Recipient agrees that it will bargain collectively with the Union or otherwise arrange for the continuation of collective bargaining, and that it will enter into agreements with the Union or arrange for such agreements to be entered into, relative to all subjects which are or may be proper subjects of collective bargaining. If, at any time, applicable law or contracts permit or grant to employees covered by this arrangement the right to utilize any economic measures, nothing in this arrangement shall be deemed to foreclose the exercise ofsuch right. (5)(a)The Recipient shall provide to all affected employees sixty (60) days' notice ofintended actions which may result in displacements or dismissals or rearrangements of the working forces as a result of the Project. In the case of employees represented by a Union, such notice shall be provided by certified mail through their representatives. The notice shall contain a full and adequate statement of the proposed changes, and an estimate of the number of  bargaining rights ofs such employees.  applicable collective bargaining agreement.  bargaining agreement after such agreement is no longer in effect.  2 -48-  NCDOT-PTD SFV2014    SFY2014 Community Transportation Program (CTP) Grant Application  Special Section 5333(b) Warranty  employees affected by the intended changes, and the number and classifications of any jobs within the jurisdiction and control of the Recipient, including those in the employment ofany entity bound by this arrangement pursuant to paragraph (21), available to be filled by such (5)(b) The procedures of this subparagraph shall apply to cases where notices involve employees represented by a Union for collective bargaining purposes. At the request of either the Recipient or the representatives of such employees, negotiations for the purposes of reaching agreement with respect to the application of the terms and conditions of this arrangement shall commence immediately. These negotiations shall include determining the selection of forces from among the mass transportation employees who may be affected as a result of the Project, to establish which such employees shall be offered employment for which they are qualified or can be trained. Ifno agreement is reached within twenty (20) days from the commencement of negotiations, any party to the dispute may submit the matter to dispute settlement procedures in accordance with paragraph (15) of this arrangement. Unless the parties otherwise mutually agree in writing, no change in operations, services, facilities or equipment within the purview of this paragraph (5) shall occur until after either: 1) an agreement with respect to the application of the terms and conditions of this arrangement to the intended change(s) is reached; 2) the decision oft the arbitrator has been rendered pursuant tot this subparagraph (b); or 3) an arbitrator selected pursuant to Paragraph (15) of this arrangement determines that the intended change(s) may be instituted prior to the finalization (5)(c) In the event of a dispute as to whether an intended change within the purview of this paragraph (5) may be instituted at the end of the 60-day notice period and before an implementing agreement is reached or a final arbitration decision is rendered pursuant to subparagraph (b), any involved party may immediately submit that issue to arbitration under paragraph (15) of this arrangement. In any such arbitration, the arbitrator shall rely upon the standards and criteria utilized by the Surface Transportation Board (and its predecessor agency, the Interstate Commerce Commission) to address the preconsummation" issue in cases involving employee protections pursuant to 49 U.S.C. Section 11326 (ori its predecessor, Section 5(2)() of the Interstate Commerce Act, as amended). If the Recipient demonstrates, as a threshold matter in any such arbitration, that the intended action is a trackagerights, lease proceeding or similar transaction, and not a merger, acquisition, consolidation, or other similar transaction, the burden shall then shift to the involved labor organization(s) to prove that under the standards and criteria referenced above, the intended action should not be permitted to be instituted prior to the effective date ofa negotiated or arbitrated implementing agreement. If the Recipient fails to demonstrate that the intended action is a trackage rights, lease proceeding, or similar transaction, it shall be the burden of the Recipient to prove that under the standards and criteria referenced above, the intended action should be permitted to be instituted prior to the effective date of a negotiated or arbitrated implementing agreement. For purposes of any such arbitration, the time period within which the parties are to respond tot the list of potential arbitrators submitted by the American Arbitration Association Service shall be five (5) days, the notice of hearing may be given orally or by facsimile, the hearing will be held promptly, the award of the arbitrator shall be rendered promptly and, unless otherwise agreed to by the parties, no later than fourteen (14) days from the date of closing  affected employees.  ofimplementing arrangements.  3 -49-  NCDOT-PTD SFY2014    SFY 2014 Community Transportation Program (CTP) Grant Application  Special Section 5333(b) Warranty  the hearings, with five (5) additional days for mailing if posthearing briefs are requested by either party. The intended change shall not be instituted during the pendency of any (5)(d) If an intended change within the purview of this paragraph (5) is instituted before an implementing agreement is reached or a final arbitration decision is rendered pursuant to subparagraph (b), all employees affected shall be kept financially whole, as ifthe noticed and implemented action has not taken place, from the time they are affected until the effective date of an implementing agreement or final arbitration decision. This protection shall be in addition to the protective period defined in paragraph (14) of this arrangement, which period shall begin on the effective date of the implementing agreement or final arbitration decision An employee selecting, bidding on, or hired to fill any position established as a result of a noticed and implemented action prior to the consummation of an implementing agreement or final arbitration decision shall accumulate no benefits under this arrangement as a result thereof during that period prior to the consummation of an implementing agreement or final (6)(a) Whenever an employee, retained in service, recalled to service, or employed by the Recipient pursuant to paragraphs (5), (7)(e), or (18) hereof is placed in a worse position with respect to compensation as a result of the Project, the employee shall be considered a displaced employee", and shall be paid a monthly displacement allowance" to be determined in accordance with this paragraph. Said displacement allowance shall bej paid each displaced employee during the protective period sO long as the employee is unable, in the exercise of his/her seniority rights, to obtain a position producing compensation equal to or exceeding the compensation the employee received in the position from which the employee was displaced, adjusted to reflect subsequent general wage adjustments, including cost of (6)(b) The displacement allowance shall be a monthly allowance determined by computing the total compensation received by the employee, including vacation allowances and monthly compensation guarantees, and his/her total time paid for during the last twelve (12) months in which the employee performed compensated service more than fifty per centum of each such months, based upon the employee's normal work schedule, immediately preceding the date of his/her displacement as a result of the Project, and by dividing separately the total compensation and the total time paid for by twelve, thereby producing the average monthly compensation and the average monthly time paid for. Such allowance shall be adjusted to reflect subsequent general wage adjustments, including cost of living adjustments where provided for. If the displaced employee's compensation in his/her current position is less in anymonth during his/her protective period than the aforesaid average compensation (adjusted to reflect subsequent general wage adjustments, including cost of living adjustments where provided for), the employee shall be paid the difference, less compensation for any time lost on account of voluntary absences to the extent that the employee is not available for service equivalent to his/her average monthly time, but the employee shall be compensated in addition thereto at the rate of the current position for any time worked in excess oft the average  arbitration proceedings under this subparagraph(c).  rendered pursuant to subparagraph (b).  arbitration decision pursuant to subparagraph (b).  living adjustments where provided for.  4 -50-  NCDOT-PTD SFY2014    SFY 2014 Community Transportation: Program (CTP) Grant Application  Special Section 5333(b) Warranty  monthly time paid for. If a displaced employee fails to exercise his/her seniority rights to secure another position to which the employee is entitled under the then existing collective bargaining agreement, and which carries a wage rate and compensation exceeding that oft the position which the employee elects to retain, the employee shall thereafter be treated, for the purposes oft this paragraph, as occupying the position the employee elects to decline. (6)(c) The displacement allowance shall cease prior to the expiration of the protective period in the event of the displaced employee's resignation, death, retirement, or dismissal for cause (7)(a) Whenever any employee is laid off or otherwise deprived of employment as a result of the Project, in accordance with any collective bargaining agreement applicable to his/her employment, the employee shall be considered a "dismissed employee" and shall be paid a monthly dismissal allowance to be determined in accordance with this paragraph. Said dismissal allowance shall first be paid each dismissed employee on the thirtieth (30th) day following the day on which the employee is "dismissed" and shall continue during the  in accordance with any labor agreement applicable tol his/her employment.  protective period, as follow:  Employee's length of Service prior to adverse effect lday to 6 years 6y years or more  Period of protection equivalent period 6y years  The monthly dismissal allowance shall be equivalent to one-twelfth (1/12th) of the total compensation received by the employee in the last twelve (12) months ofhis/her employment in which the employee performed compensation service more than fifty per centum of each such month based on the employee's normal work schedule to the date on which the employee was first deprived of employment as ai result ofthe Project. Such allowance shall be adjusted to reflect subsequent general wage adjustments, including cost ofl living adjustments (7)(b) An employee shall be regarded as deprived of employment and entitled to a dismissal allowance when the position the employee holds is abolished as a result of the Project, or when the position the employee holds is not abolished but the employee loses that position as aresult of the exercise of seniority rights by an employee whose position is abolished as a result of the Project or as a result of the exercise of seniority rights by other employees brought about as a result oft the Project, and the employee is unable to obtain another position, either by the exercise of the employee's seniority rights, or through the Recipient, in accordance with subparagraph (e). In the absence of proper notice followed by an agreement or decision pursuant to paragraph (5) hereof, no employee who has been deprived of employment as a result of the Project shall be required to exercise his/her seniority rights to secure another position in order to qualify for a dismissal allowance hereunder.  where provided for.  5 -51-  NCDOT-PTD SFY2014    SFY: 2014 Community Transportation Program (CTP) Grant Application  Special Section 5333(b) Warranty  (7)(c) Each employee receiving a dismissal allowance shall keep the Recipient informed as to his/her current address and the current name and address of any other person by whom the (7)(d) The dismissal allowance shall be paid to the regularly assigned incumbent of the position abolished. If the position of an employee is abolished when the employee is absent from service, the employee will be entitled to the dismissal allowance when the employee is available for service. The employee temporarily filling said position at the time it was abolished will be given a dismissal allowance on the basis of that position, until the regular employee is available for service, and thereafter shall revert to the employee's previous status and will be given the protections oft the agreement in said position, ifa any are due him/her. (7)(e) An employee receiving a dismissal allowance shall be subject to call to return to service by the employee's former employer; notification shall be in accordance with the terms ofthe then-existing collective bargaining agreement ift the employee is represented by a union. Prior to such call to return to work by his/her employer, the employee may be required by the Recipient to accept reasonably comparable employment for which the employee is physically and mentally qualified, or for which the employee can become qualified after a reasonable training or retraining period, provided it does not require a change in residence or infringe upon the employment rights of other employees under then-existing collective bargaining (7)(f) When an employee who is receiving a dismissal allowance again commences employment in accordance with subparagraph (e) above, said allowance shall cease while the employee is sO reemployed, and the period of time during which the employee is sO reemployed shall be deducted from the total period for which the employee is entitled to receive a dismissal allowance. During the time of such reemployment, the employee shall be entitled to the protections ofthis arrangement to the extent they are applicable. (7)(g) The dismissal allowance of any employee who is otherwise employed shall be reduced to the extent that the employee's combined monthly eamings from such other employment or sell-employment, any benefits received from any unemployment insurance law, and his/her dismissal allowance exceed the amount upon which the employee's dismissal allowance is based. Such employee, or his/her union representative, and the Recipient shall agree upon a procedure by which the Recipient shall be kept currently informed of the eamings of such employee in employment other than with the employee's former employer, including self- (7)(h) The dismissal allowance shall cease prior to the expiration of the protective period in the event oft the failure of the employee without good cause to return to service in accordance with the applicable labor agreement, or to accept employment as provided under subparagraph (e) above, or in the event of the employee's resignation, death, retirement, or dismissal for cause in accordance with any labor agreement applicable to his/her employment. (7)(i) A dismissed employee receiving a dismissal allowance shall actively seek and not refuse other reasonably comparable employment offered him/her for which the employee is  employee may be regularly employed, ori ifthe employee iss self-employed.  agreements.  employment, and the benefits received.  6 -52-  NCDOT-PTD SFY2014    SFY 2014 Community Transportation Program (CTP) Grant Application  Special Section 5333(b) Warranty  physically and mentally qualified and does not require a change in the employee's place of residence. Failure oft the dismissed employee to comply with this obligation shall be grounds for discontinuance of the employee's allowance; provided that said dismissal allowance shall not be discontinued until final determination is made either by agreement between the Recipient and the employee or his/her representative, or by final arbitration decision rendered in accordance with paragraph (15) of this arrangement that such employee did not comply (8) In determining length of service ofa a displaced or dismissed employee for purposes of this arrangement, such employee shall be given full service credits in accordance with the records and labor agreements applicable to him/her and the employee shall be given additional service credits for each month in which the employee receives a dismissal or displacement allowance asi ifthe employee were continuing to perform services in his/her former position. (9) No employee shall be entitled to either a displacement or dismissal allowance under paragraphs (6) or (7) hereof! because of the abolishment ofaj position to which, at some future (10) No employee receiving a dismissal or displacement allowance shall be deprived, during the employee's protected period, of any rights, privileges, or benefits attaching to his/her employment, including, without limitation, group life insurance, hospitalization and medical care, free transportation for the employee and the employee's family, sick leave, continued status and participation under any disability or retirement program, and such other employee benefits as Railroad Retirement, Social Security, Workmen's Compensation, and unemployment compensation, as well as any other benefits to which the employee may be entitled under the same conditions and SO long as such benefits continue to be accorded to other employees of the bargaining unit, in active service or furloughed as the case may be. (11)(a) Any employee covered by this arrangement who is retained in the service of1 his/her employer, or who is later restored to service after being entitled to receive a dismissal allowance, and who is required to change the point ofhis/her employment in order to retain or secure active employment with the Recipient in accordance with this arrangement, and who is required to move his/her place of residence, shall be reimbursed for all expenses of moving his/her household and other personal effects, for the traveling expenses for the employee and members of the employee's immediate family, including living expenses for the employee and the employee's immediate family, and for his/her own actual wage loss during the time necessary for such transfer and for a reasonable time thereafter, not to exceed five (5) working days. The exact extent of the responsibility of the Recipient under this paragraph, and the ways and means of transportation, shall be agreed upon in advance between the Recipient and (11)(b) Ifa any such employee is laid off within three (3) years after changing his/her point of employment in accordance with paragraph (a) hereof, and elects to move his/her place of residence back to the original point of employment, the Recipient shall assume the expenses, losses and costs ofmoving to the same extent provided in subparagraph (a) of this paragraph  with this obligation.  time, the employee could have bid, been transferred, or promoted.  the affected employee or the employee'sr representatives.  (11) and paragraph (12)(a)hereof.  7 -53-  NCDOT-PTD SFY2014    SFY 2014 Community Transportation Program (CTP) Grant Application  Special Section 5333(b) Warranty  (11)(c) No claim for reimbursement shall be paid under the provisions of this paragraph unless such claim is presented to the Recipient in writing within ninety (90) days after the (11)(d) Except as otherwise provided in subparagraph (b), changes in place of residence, subsequent to the initial changes as a result of the Project, which are not a result oft the Project but grow out of the normal exercise of seniority rights, shall not be considered within the (12)(a) The following conditions shall apply to the extent they are applicable in each instance to any employee who is retained in the service of the employer (or who is later restored to service after being entitled to receive a dismissal allowance), who is required to change the point ofhis/her employment as a result of the Project, and is thereby required to move his/her If the employee owns his/her own home in the locality from which the employee is required to move, the employee shall, at the employee's option, be reimbursed by the Recipient for any loss suffered in the sale of the employee's home for less than its fair market value, plus conventional fees and closing costs, such loss to be paid within thirty (30) days of settlement or closing on the sale oft the home. In each case, the fair market value of the home in question shall be determined, as of a date sufficiently prior to the date of the Project, SO as to be unaffected thereby. The Recipient shall, in each instance, be afforded an opportunity to purchase the home at such fair market value before it is sold by the employee to any other person and to reimburse the seller for his/her conventional fees and closing costs. Ifthe employee is under a contract to purchase his/her home, the Recipient shall protect the employee against loss under such contract, and in addition, shall relieve the employee from If the employee holds an unexpired lease of a dwelling occupied as the employee's! home, the Recipient shall protect the employee from all loss and cost in securing the cancellation of said (12)(b) No claim for loss shall be paid under the provisions of this paragraph unless such claim is presented to the Recipient in writing within one year after the effective date of the (12)(c) Should a controversy arise in respect to the value oft the home, the loss sustained in its sale, the loss under a contract for purchase, loss and cost in securing termination ofa a lease, or any other question in connection with these matters, it shall be decided through a joint conference between the employee, or his/her union, and the Recipient. In the event they are unable to agree, the dispute or controversy may be referred by the Recipient or the union to a board of competent real estate appraisers selected in the following manner: one (1) to be selected by the representatives of the employee, and one (1) by the Recipient, and these two, if unable to agree within thirty (30) days upon the valuation, shall endeavor by agreement  date on which the expenses were incurred.  purview oft this paragraph.  place of residence.  any further obligation thereunder.  lease.  change in residence.  8 -54-  NCDOT-PTD SFV 2014    SFY2014 Community Transportation Program (CTP) Grant Application  Special Section 5333(b) Warranty  with ten (10) days thereafter to select a third appraiser or to agree to a method by which a third appraiser shall be selected, and failing such agreement, either party may request the State and local Board of Real Estate Commissioners to designate within ten (10) days a third appraiser, whose designation will be binding upon the parties and whose jurisdiction shall be limited to determination of the issues raised in this paragraph only. A decision ofamajority of the appraisers shall be required and said decision shall be final, binding, and conclusive. The compensation and expenses oft the neutral appraiser including expenses of the appraisal board, shall be borne equally by the parties to the proceedings. All other expenses shall be paid by the party incurring them, including the compensation of the appraiser selected by such party. (12)(d) Except as otherwise provided in paragraph (11)(b) hereof, changes in place of residence, subsequent to the initial changes as a result of the Project, which are not a result of the Project but grow out of the normal exercise of seniority rights, shall not be considered (12)(e) "Change in residence" means transfer to a work location which is either (A) outside a radius of twenty (20) miles of the employee's former work location and farther from the employee's residence than was his/her former work location, or (B) is more than thirty (30) normal highway route miles from the employee's residence and also farther from his/her (13)(a) A dismissed employee entitled to protection under this arrangement may, at the employee's option within twenty-one (21) days ofhis/her dismissal, resign and (in lieu of all other benefits and protections provided in this arrangement) accept a lump sum payment computed in accordance with section (9) ofthe Washington Job Protection Agreement of May  within the purview ofthis paragraph.  residence than was the employee's former work location.  1936:  Length of Service 1 year and less than 2 years 2 years and less than 3 years 3 years and less than 5 years 5 years and less than 10 years 15 years and over  Separation Allowance 3 months' pay 6months' pay 9r months' pay 12 months' pay 12 months' pay  10 years and less than 15 years 12 months' pay  In the case of an employee with less than one year's service, five days' pay, computed by multiplying by 5 the normal daily earnings (including regularly scheduled overtime, but excluding other overtime payments) received by the employee in the position last occupied, for each month in which the employee performed service, will be paid as the lump sum. Length of service shall be computed as provided in Section 7(b) of the Washington Job For the purposes of this arrangement, the length of service of the employee shall be determined from the date the employee last acquired an employment status with the employing carrier and the employee shall be given credit for one month's service for each  Protection Agreement, as follows:  9 -55-  NCDOT-PTD SFY2014    SFY2014 CemmuatyTamgperatin Program (CTP) Grant Application  Special Section 5333(b) Warranty  month in which the employee performed any service (in any capacity whatsoever) and twelve (12) such months shall be credited as one year's service. The employment status of an employee shall not be interrupted by furlough in instances where the employee has a right to and does return to service when called. In determining length ofs service of an employee acting as an officer or other official representative of an employee organization, the employee will be given credit for performing service while sO engaged on leave of absence from the service (13)(b) One month's pay shall be computed by multiplying by 30 the normal daily earnings (including regularly scheduled overtime, but excluding other overtime payments) received by the employee in the position last occupied prior to time ofthe employee's dismissal as a result (14) Whenever used herein, unless the context requires otherwise, the term "protective period" means that period of time during which a displaced or dismissed employee is to be provided protection hereunder and extends from the date on which an employee is displaced or dismissed to the expiration of six (6) years therefrom, provided, however, that the protective period for any particular employee during which the employee is entitled to receive the benefits of these provisions shall not continue for a longer period following the date the employee was displaced or dismissed than the employee's length of service, as shown by the records and labor agreements applicable to his/her employment prior to the date of the (15)(a) In the event that employee(s) are represented by a Union, any dispute, claim, or grievance arising from or relating to the interpretation, application or enforcement of the provisions of this arrangement, not otherwise governed by paragraph 12(c), the Labor- Management Relations Act, as amended, the Railway Labor Act, as amended, or by impasse resolution provisions in a collective bargaining or protective arrangement involving the Recipient and the Union, which cannot be settled by the parties thereto within thirty (30) days after the dispute or controversy arises, may be referred by any such party to any final and binding disputes settlement procedure acceptable to the parties. In the event they cannot agree upon such procedure, the dispute, claim, or grievance may be submitted at the written request of the Recipient or the Union to final and binding arbitration. Should the parties be unable to agree upon the selection of a neutral arbitrator within ten (10) days, any party may request the American Arbitration Association to furnish, from among arbitrators who are then available to serve, five (5) arbitrators from which a neutral arbitrator shall be selected. The parties shall, within five (5) days after the receipt ofs such list, determine by lot the order of elimination and thereafter each shall, in that order, alternately eliminate one name until only one name remains. The remaining person on the list shall be the neutral arbitrator. Unless otherwise provided, in the case of arbitration proceedings, under paragraph (5) of this arrangement, the arbitration shall commence within fifteen (15) days after selection or appointment of the neutral arbitrator, and the decision shall be rendered within forty-five (45) days after the hearing of the dispute has been concluded and the record closed. The decision shall be final and binding. All the conditions of the arrangement shall continue to be effective during the  ofa carrier.  oft the Project.  employee's displacement or dismissal.  arbitration proceedings.  10 -56-  NCDOT-PTD CEV 2A1A    SFY2014 Community Transportation Program (CTP) Grant Application  Special Section 5333(b) Warranty  (15)(b) The compensation and expenses of the neutral arbitrator, and any other jointly incurred expenses, shall be borne equally by the Union(s) and Recipient, and all other (15)(c) In the event that employee(s) are not represented by a Union, any dispute, claim, or grievance arising from or relating to the interpretation, application or enforcement of the provisions of this arrangement which cannot be settled by the Recipient and the employee(s) within thirty (30) days after the dispute or controversy arises, may be referred by any such party to any final and binding dispute settlement procedure acceptable to the parties, or in the event the parties cannot agree upon such a procedure, the dispute or controversy may be (15)(d) In the event of any dispute as to whether or not aj particular employee was affected by the Project, it shall be the obligation of the employee or the representative of the employee to identify the Project and specify the pertinent facts of the Project relied upon, It shall then be the burden oft the Recipient to prove that factors other than the Project affected the employee. The claiming employee shall prevail ifit is established that the Project had an effect upon the employee even if other factors may also have affected the employee. (See Hodgson's (16) The Recipient will be financially responsible for the application of these conditions and will make the necessary arrangements sO that any employee covered by this arrangement may file a written claim ofi its violation, through the Union, or directly if the employee is outside the bargaining unit, with the Recipient within sixty (60) days of the date the employee is terminated or laid off as a result of the Project, or within eighteen (18) months of the date the employee's position with respect to his/her employment is otherwise worsened as a result of the Project. In the latter case, if the events giving rise to the claim have occurred over an extended period, the 18-month limitation shall be measured from the last such event. No benefits shall be payable for any period prior to six (6) months from the date of the filing of any claim. Unless such claims are filed with the Recipient within said time limitations, the Recipient shall thereafter be relieved ofall liabilities and obligations related to the claim. The Recipient will fully honor the claim, making appropriate payments, or will give notice to the claimant or his/her representative of the basis for denying or modifying such claim, giving reasons therefore. Ift the Recipient fails to honor such claim, the Union or non-bargaining unit employee may invoke the following procedures for further joint investigation of the claim by giving notice in writing. Within ten (10) days from the receipt of such notice, the parties shall exchange such factual material as may be requested of them relevant to the disposition oft the claim and shall jointly take such steps as may be necessary or desirable to obtain from any third party such additional factual materials as may be relevant. In the event the Recipient rejects the claim, the claim may be processed to arbitration as hereinabove provided by (17) Nothing in this arrangement shall be construed as depriving any employee of any rights or benefits which such employee may have under existing employment or collective bargaining agreements or otherwise; provided that there shall be no duplication of benefits to  expenses shall be paid by the partyincurring them.  referred to the Secretary ofLabor for a final and binding determination.  Affidavit in Civil Action No. 825-71).  paragraph (15).  11 -57-  NCDOT-PTD SFY2014    SFY2014 Community Transportation Program (CTP) Grant Application  Special Section 5333(b) Warranty  any employee, and, provided further, that any benefit under this arrangement shall be construed to include the conditions, responsibilities, and obligations accompanying such benefit. This arrangement shall not be deemed a waiver of any rights of any Union or of any represented employee derived from any other agreement or provision of federal, state or local (18) During the employee's protective period, a dismissed employee shall, ift the employee sO requests, in writing, be granted priority of employment or reemployment to fill any vacant position within the jurisdiction and control of the Recipient reasonably comparable to that which the employee held when dismissed, including those in the employment of any entity bound byt this arrangement pursuant to paragraph (21). I herein, for which the employee is, orb by training or retraining can become, qualified; not, however, in contravention of collective bargaining agreements related thereto. In the event such employee requests such training or re-training to fill such vacant position, the Recipient shall provide for such training or re- training at no cost to the employee. The employee shall be paid the salary or hourly rate provided for in the applicable collective bargaining agreement or otherwise established in personnel policies or practices for such position, plus any displacement allowance to which the employee may be otherwise entitled. If such dismissed employee who has made such request fails, without good cause, within ten (10) days to accept an offer of a position comparable to that which the employee held when dismissed for which the employee is qualified, or for which the employee has satisfactorily completed such training, the employee shall, effective at the expiration of such ten-day period, forfeit all rights and benefits under As between employees who request employment pursuant to this paragraph, the following (a) Employees in the craft or class of the vacancy shall be given priority over employees (b) As between employees having seniority in the craft or class of the vaçancy, the senior employees, based upon their service in that craft or class, as shown on the appropriate (c) As between employees not having seniority in the craft or class oft the vacancy, the senior employees, based upon their service in the crafts or classes in which they do have seniority as shown on the appropriate seniority rosters, shall prevail over. junior employees. (19) The Recipient will post, in a prominent and accessible place, a notice stating that the Recipient has received federal assistance under the Federal Transit statute and has agreed to comply with the provisions of 49 U.S.C., Section 5333(b). This notice shall also specify the terms and conditions set forth herein for the protection of employees. The Recipient shall maintain and keep on file all relevant books and records in sufficient detail as to provide the basic information necessary to the proper application, administration, and enforcement oft this arrangement and to the proper determination ofany claims arising thereunder.  law.  this arrangement.  order where applicable shall prevail in hiring such employees:  without seniority in such craft or class;  seniority roster, shall prevail over junior employees;  12 -58-  NCDOT-PTD CEV 2n1A    SFY2014 Community Transportation Program (CTP) Grant Application  Special Section 5333(b) Warranty  (20) In the event the Project is approved for assistance under the statute, the foregoing terms and conditions shall be made part of the contract of assistance between the federal government and the applicant for federal funds and between the applicant and any recipient of federal funds; provided, however, that this arrangement shall not merge into the contract of assistance, but shall be independently binding and enforceable by and upon the parties thereto, and by any covered employee or his/her representative, in accordance with its terms, nor shall any other employee protective agreement merge into this arrangement, but each shall be independently binding and enforceable by and upon the parties thereto, in accordance with its (21) This arrangement shall be binding upon the successors and assigns of the parties hereto, and no provisions, terms, or obligations herein contained shall be affected, modified, altered, or changed in any respect whatsoever by reason of the arrangements made by or for the Any person, enterprise, body, or agency, whether publicly or privately-owned, which shall undertake the management, provision and/or operation of the Project services or the Recipient's transit system, or any part or portion thereof, under contractual arrangements of any form with the Recipient, its successors or assigns, shall agree to be bound by the terms of this arrangement and accept the responsibility with the Recipient for full performance of these conditions. As a condition precedent to any such contractual arrangements, the Recipient shall (22) In the event ofthe acquisition, assisted with Federal funds, of any transportation system or services, or any part or portion thereof, the employees of the acquired entity shall be assured employment, in comparable positions, within the jurisdiction and control of the acquiring entity, including positions in the employment of any entity bound by this arrangement pursuant to paragraph (21). All persons employed under the provisions of this paragraph shall be appointed to such comparable positions without examination, other than that required by applicable federal, state or federal law or collective bargaining agreement, and shall be credited with their years of service for purposes of seniority, vacations, and pensions in accordance with the records of their former employer and/or any applicable (23) The employees covered by this arrangement shall continue to receive any applicable coverage under Social Security, Railroad Retirement, Workmen's Compensation, unemployment compensation, and the like. In no event shall these benefits be worsened as a (24) In the event any provision of this arrangement is held to be invalid, or otherwise unenforceable under the federal, state, or local law, in the context ofa particular Project, the remaining provisions of this arrangement shall not be affected and the invalid or unenforceable provision shall be renegotiated by the Recipient and the interested Union representatives, ifany, of the employees involved for purpose of adequate replacement under Section 5333(b). If such negotiation shall not result in mutually satisfactory agreement any party may invoke the jurisdiction of the Secretary of Labor to determine substitute fair and  terms.  Recipient to manage and operate the system.  require such person, enterprise, body or agency to sO agree.  collective bargaining agreements.  result ofthe Project.  13 -59-  NCDOT-PTD SFY2014    SFY 2014 Community Transportation Program (CTP) Grant Application  Special Section 5333(b) Warranty  equitable employee protective arrangements for application only to the particular Project, which shall be incorporated in this arrangement only as applied to that Project, and any other (25) If any employer of the employees covered by this arrangement shall have rearranged or adjusted its forces in anticipation of the Project, with the effect of depriving an employee of benefits to which the employee should be entitled under this arrangement, the provisions of this arrangement shall apply to such employee as of the date when the employee was SO  appropriate action, remedy, or relief.  affected.  C.Acceptance of Special Section 5333(b) Warranty  I, (Name and Title) Edwin Causey,  (Name and" Title)  dol hereby certify that Sampson County (Legal Name of Applican/Recipient)  has agreed to the terms and conditions ofthis Warranty; will accept this agreement as part oft the contract of assistance with the North Carolina Department ofTransportation; and will post, in a prominent and accessible place, the terms and conditions of the Warranty with a notice stating that the Recipient has received federal assistance under the Federal Transit statute and has agreed to comply with these terms.  Signature of Authorized Official Seal Subscribed and sworn to me (date)  Affix Notary: Seall Here  Notary Public  Printed Name and Address My commission expires (date)  14 60-  NCDOT-PTD SFY 2014        DBE GOOD FAITH EFFORTS CERTIFICATION  This is to certify that in all purchase and contract selections (Legal Name of4 Applicant) Sampson County is committed to and shall make good faith efforts toj purchase from and award contracts DBE good faith efforts will include the following items that are: indicated by check mark(s) or  tol Disadvantaged Business Enterprises (DBEs).  narrative: MININUM Check all Effort that apply Required by PTD D  Description  Write al letter to Certified DBEs in the service area to inform them of Document telephone calls, emails and correspondence with or on behalf of Advertise purchase and contract opportunities on local TV Community Request purchase/contract price quotes/bids from DBEs; Monitor newspapers for new businesses that are DBE eligible Encourage interested eligible firms to become NCDOT certified. Interested firms should refer to tp.homuendaisehuinesaslNTTA0IDer. contact the office of contractual services at (919)707-4800 for more Encourage interested firms to contact the Office of Historically Underutilized Businesses at (919) 807-2330 for more information. Consult NCDOT Certified DBE Directory. A DBE company will be listed in the DBE Directory for each work type or area of specialization thatit performs. You may obtain a copy of this directory at tps/pariner.nedotgovVendrDirectory/defaul.htm!  purchase or contract opportunities;    DBEs; Cable Network;  R X  information  Other efforts: Describe: Other efforts: Describe:  You may obtain of copy oft thel USDOTI Disadvantaged Business Enterprise Program Title4 49 Part 26 at htp./ectrgpoesgorlgiglheuedesdtrkp-s2Findextpl Reminder: Documentation of all good faith efforts shalll be retained for a period of five (5) Icertify that, to the best of my knowledge, the abovei information describes the DBE good faith efforts.  years following the end of the fiscal year.  Signature of Authorized Official Edwin' W. Causey Type Name and Title of Authorized Official  Date  -62-    Z. E -  a o Z  -63-    SAMPSON COUNTY POARDOFCOMMIESONERS  ITEMABSTRACT  ITEMNO. 4(b)  Information Only Repor/Presentation Action Item Consent Agenda  Public Comment Closed Session Planning/Zoning Water District Issue  Meeting Date: January 7,2013  SUBJECT: DEPARTMENT: PUBLICHEARING: CONTACTPERSON: PURPOSE,  Acceptance: and Budgeting of Grant Funding and Donations for  Animal Shelter Administration: No  Ed Causey, County Manager  To-considera acceptance of donations and grantfunds with associated grant grement/stpulatons, and approvalof  associated budget amendments Budget amendments grant documents  ATTACHMENTS: BACKGROUND:  Before her departure, Interim Director Lori Baxter worked diligently to solicit donations and grant funding to assist the Sampson County Animal Shelter. The AnimalShelter was fortunate to receive a number of donations from a Twelve Days of Christmas fundraiser, which solicited for the purchase of cages Ina addition to the fundraiser, the Animal Shelter has been offered several grants. The Petfinder Foundation! has offered two grants! a $6,300 grant to fund a kennel cough vaccine program, and a $3,000 grant to fund al FVRCP vaccinationt program, The goal of both programs is to reduce the number of animals euthanized for health reasons.. The enclosed grant agreement sets forth thes stipulations In addition, the Humane Society of the United States has offered a grantofs $7,000 to phase out the use of the gas chamber for animal euthanasia. In the attached email, HSUS State Director Kimberley Accept and budget donations by approval of the enclosed budget  and supplies.  for acceptance of the monies.  Alboum sets out the grant conditions.  RECOMMENDED, ACTIONOR: MOTIONA  amendments  -64-    COUNTY OF SAMPSON BUDGET AMENDMENT  December 18, 2012  MEMO:  FROM: David K. Clack, Finance Officer TO: Sampson County Board of Commissioners VIA: County Manager & Finance Officer SUBJECT: BudgetAmendment for fiscal year 2012-2013  1. Itis is requested that the budget for the Animal Shelter Department be amended as follows:  Expenditure Account Code Description (Object of Expenditure)  Increase 9,300.00  Decrease  11243800-523900  Medical supplies  Revenue Account Code Source of Revenue  Increase 9,300.00  Decrease  11034380-403602  Grant Pet Finder  2. Reason(s) for the above request is/are as follows:  To allocate funds granted to the. Animal Shelter by the PetFinder Foundation for the purchase of  pet vaccines.  Aneel Spyaedbwparmentten  ENDORSEMENT  1. Forwarded, recommending approvaldisapproval.  1hv  20_2  IHa (County Finance Officer)  ENDORSEMENT  Forwarded, recommending approyaldisapproval.  12-18-2012.20  Slo.L  Date of approvaldisapproval by B.O.C.  (County Manager & Bydget Officer)  -65-    Pelfinder FOUNIDATION  December 11, 2012 Sampson County Animal Shelter Attn: Lori Baxter 168 Agriculture Place Clinton, NC28328 Dear Lori Baxter,  Oh behalf of the Petfinder Foundation and Its Board of Directors, lam enclosing a grant in the amount of The Petfinder Foundation is a! 501c3 organization dedicated to ending euthanasia of adoptable pets. Our primary focus is the further assist Petfinder. .com adoption partners through problem solving, This grant is from our Care and Feeding fund which is made possible in partnership with the Animal Rescue Site's click-to-give program and GreaterGood.org andi individual donations. Our belief is that by reducing the outbreak of Bordetella brochispectia (kennel cough) in animal shelters, we canr reduce the number of homeless dogs euthanized for health reasons. Wel know that kennel cough is at treatable illness and protecting the dogs at intake can decrease the chances of it spreading through your facility. The awarding of this grant is conditioned on your organization's agreeing to the following terms and 1. The Sampson County Animal Shelter agrees to track and share with the Petfinder Foundation monthly shelter statistics for the duration oft the grant project (number of incoming dogs, number of dog adoptions, number of animals euthanized, how that number has changed, etc.) These statistics will only! be used to evaluate the impact of the vaccination project. Individual results/reports will not be shared; any report of data will be done in aggregate. The shelter will be sent a monthly email from Toni Morgan, Petfinder Foundation Senior Program Manager asking to complete the online survey. Surveys must be completed within one week. 2. The Sampson County Animal Shelter agrees tot follow all: standard protocols and procedures for monitoring the vaccine inventory, safely handling and storing the vaccines and properly 3. The Sampson County Animal Shelter agrees to provide the Petfinder Foundation with ai final written report on how the grant was used andi the results achieved. This report is due not more than three months after the expiration oft the grant, December 2013. Documentation of the expenses incurred must be included with the report, along with any other documentation and photographs (ifa appropriate). Ifr necessary, an interim progress report may be requested by the 4. The Sampson County Animal Shelter agrees to provide all receipts to the Petfinder Foundation. Copies, of receipts may be sent in as vaçcinations are purchased or once funds have been  $6300t to fund a kennel cough vaccine program at Sampson County Animai Shelter.  fundraising and providing relief in times of stress or disaster.  conditions.  administering the vaccines.  Petfinder Foundation.  4729 E. Sunrise Drive completely 119 used. Arrepepiy HBPace vaccination 85718 purchasés'are honeA aiéhohoiha notr morethant three Montg7-637-16  after the expiration oft thegnant; December2013lnaicon  Visit us online at wW - 66- lerfoundation.com:    Pelfinder FOUNDATION  5. Any funds not used or committed for the specific purpose of the grant after one year must be returned to the Petfinder Foundation, unless otherwise authorized in writing. 6. Also, if Sampson County Animal Shelter decides to publicize this award, please inform the Petfinder Foundation and make sure that the correct name and logo of our Foundation is used in any press releases or articles. We may be able to assist with providing quotes or arranging interviews if needed. The Animal Rescue Site must be included in recognition of this grant along 7. Finally, when appropriate, Sampson County Animal Shelter will communicate to the Petfinder Foundation any questions, concerns or challenges they are having prior to or during the  with Petfinder Foundation.  implementation of this grant project.  On behalf of the Petfinder Foundation, Ewish you andy your staff much success ini implementing the FVRCP vaccine program. Ify you have any questions or concerns about this grant, do not hesitate to let llook forward to hearing more from Sampson County Animal Shelter in the months andy years ahead!  me know.  Truly,    Lisa Robinson Executive Director Petfinder.com Foundation  A729 E. Sunrise Drive #119  Tucson, Arizona 85718  Phone: 520-207-0626  Fax: 877-637-1507  e-mail: oundalonepatinder.con  Visit us online at WW -67- lerfoundation.com    December11,2012 Sampson County Animal Shelter Attn: Lori Baxter 168 Agriculture Place Clinton, NC 28328 Dear Lori Baxter,  Oh behalf of the Petfinder Foundation and its Board of Directors, lam enclosing a grant int the amount of The Petfinder Foundation is a 501c3 organization dedicated to ending euthanasia of adoptable pets. Our primary focus is the further assist Petfinder.com adoption partners through problem solving, This grant is from our Care and Feeding fund which is made possible in partnership with the Animal Rescue Site's click-to-give program and GreaterGood.org and individual donations. Our beliefi is that by reducing the outbreak FVRCP in animal shelters, we can reduce the number of homeless cats euthanized for health reasons. We know that FVRCP is a treatable illness and protecting the cats at intake can The awarding oft this grant is conditioned on your organzationsagreing to the following terms and 1. The Sampson County Animal Shelter agrees to track and share with the Petfinder Foundation monthly shelter statistics for the duration oft the grant project (number ofi incoming dogs, number of dog adoptions, number of animals euthanized, how that number has changed, etc.) These statistics will only be used to evaluate the impact oft the vaccination project. Individual results/reports will not be shared; any report of data will be done in aggregate. The shelter will be sent a monthly email from Toni Morgan, Petfinder Foundation Senior Program Manager asking to complete the online survey. Surveys must be completed within one week. 2. The Sampson County Animal Shelter agrees to follow all standard protocols and procedures for monitoring the vaccine inventory, safely handling and storing the vaccines and properly 3. The Sampson County Animal Shelter agrees to provide the Petfinder Foundation with af final written report on how the grant was used and the results achieved. This report is due not more than three months after the expiration of the grant, December 2013. Documentation of the expenses incurred must bei included with the report, along with any other documentation and photographs (ifa appropriate). Ifnecessary, an interim progress report may be requested byt the 4. The! Sampson County Animal Shelter agrees to provide all receipts to the Petfinder Foundation. Copies of receipts may be senti in as vaccinations are purchased or once funds have been completely used. All receipts of vaccination purchases are due not more than three months  $3,000 to fund a FVRCP vaccine program at Sampson County Animal Shelter.  fundraising and providing relief int times of stress or disaster.  decrease the chances ofi it spreading through your facility.  conditions.  administering the vaccines.  Petfinder Foundation.  after the expiration oft the grant, December: 2013  -68-    5. Any funds not used or committed for the specific purpose oft the grant after one year must be returned to the Petfinder Foundation, unless otherwise authorized in writing. 6. Also, if Sampson County Animal Shelter decides to publicize this award, please inform the Petfinder Foundation and make sure that the correct name and logo of our Foundation is used in any press releases or articles. We may be able to assist with providing quotes or arranging interviews ifneeded. The Animal Rescue Site must be included in recognition of this grant along 7. Finally, when appropriate, Sampson County Animal Shelter will communicate to the Petfinder Foundation any questions, concerns or challenges they are having prior to or during the  with Petfinder Foundation.  implementation oft this grant project.  On behalf of the Petfinder Foundation, I wish you and your staff much success ini implementing the FVRCP vaccine program. Ify you have any questions or concerns about this grant, do not hesitate tol let llook forward to hearing more from Sampson County Animal Shelter in the months and years ahead!  me know.  Truly,  & R  Lisa Robinson Executive Director Petfinder.com Foundation  -69-    COUNTY OF SAMPSON BUDGET AMENDMENT  December 18, 201.  MEMO:  FROM: David K. Clack, Finance Officer TO: Sampson County Board of Commissioners VIA: County Manager & Finance Officer SUBJECT: Budget Amendment for fiscal year 2012-2013  1. Itisr requested that the budget for the Animal Shelter Department be amended as follows:  Expenditure Account Code Description (Object of Expenditure)  Increase 7,000.00  Decrease  11243800-523900  Medical supplies  Revenue Account Code Source of Revenue  Increase 7,000.00  Decrease  11034380-403601  Grant Humane Society  2. Reason(s) for the above request islare as follows:  To allocate funds granted to the Animal Shelter by the Humane Society of the United States to pay for  euthanasia drugs.  AIAAL fsignature-etDeparment-Head) AIN - (County Finance Officer)  NDORSEMENT  1. Forwarded, recommending approvaldisapproval.  ehk 20/2  ENDORSEMENT  I. Forwarded, recommending approvaldisapproval.  12-1- 201220-  Eenko  Date of approvaldisapproval by B.O.C.  (County Manager & Budget Officer)  -70-    Susan Holder 'rom: Sent: To: Subject:  Lori Baxter eaxter@sampsonnccon. Wednesday, December 19,20123:20PM  Susan Holder FW: Grant Letter  Mb bring the PetFinder one over to you: shortly! From: Kimberley Alboum Imalloikalboum@humanesocev/org, Sent: Wednesday, December 19, 20122:36PM To: Lori Baxter (baxteresampsonnc.com) Subject: Grant Letter  Oh behalf oft the Humane Society of the United Stateslwould like to present The Sampson County Animal Shelter witha a $7,000 grant. This grant ist for the phase out of the use of the gas chamber to euthanize companionanimals: at the The awarding of this grant is conditioned on your organizationsagreeing to the following terms and conditions. 1. The Sampson County Animal Shelter agrees phase out the use of the gas chamber in 6 months from receipt of the! $7,000. Ift there are issues with licensing that will take longer than 6r months please notify me or progress 2. The Sampson County Animal Shelter uses the remainder oft the money for shelter repair, shelter upgrades  shelter and also for shelter repairs and upgrades as you see fit.  and expected date.  and/or enrichment for the animals. Kimberley Alboum NC State Director, State. Affairs sbaum@humensipayeg t919.744.5093 f919.388.3827 The Humane Society of the United States 2100L Street NW Washington, DC 20037 humanesociety.org Join Our Email List Façebook Twitter Blog  THE HUMANE SOCIETY OFTHEUNITED: STATES CuketratingA Arimas Confrontinig' Geity  Tos support The Humane. Society of the United. States, please make a! monthlvdonation or give in anotherway via a gift donation or memorial donation ors donating) your vehicle. You can also volunteer for Thel HSUS, and see our 55 ways you can help The HSUS is ratedo a4 4-star charity (the highest possible) by CharityNovigotor, approved by the Better Business Bureauj for all 20 standords for charity accountability, voted by Guidestar's Philonthropedig experts as the #1 high-impact animal protection  animals.  group, and named by! Worth Magazine as one oft the 10 mostj fiscally responsible charities.  -71-    COUNTY OF SAMPSON BUDGET AMENDMENT  December 21, 201..  MEMO:  FROM: David K. Clack, Finance Officer TO: Sampson County Board of Commissioners VIA: County Manager & Finance Officer SUBJECT: Budget Amendment for fiscal year 2012-2013  1. Itisr requested that the budget for the Animal Shelter Department be amended as follows:  Expenditure Account Code Description (Object of Expenditure)  Increase 4,669.00  Decrease  11243800-526200  Department supplies  Revenue Account Code Source of Revenue  Increase 4,669.00  Decrease  11034380-408401  Donations  2. Reason(s) for the above request islare as follows:  To budget funds donated to the Shelter for the purchase of cages and supplies.  AIaL (Signature of Department Head)  ENDORSEMENT  1. Forwarded, recommending approvàlVdisapproval.  M  2012  (County Finance I  Officer)  ENDORSEMENT  1. Forwarded, recommending approvaldisapproval.  20  Date of approvaldisapproval by B.O.C.  (County Manager & Budget Officer)  -72-    SAMPSONICOUNTY BOARDOFCOMMISSIONERS  ITEMABSTRACT  ITEMNO.  4()  Information Only Repor/Presentation ActionI Item Consent Agenda  Public Comment Closed Session Planning/Zoning Water DistrictIssue  Meeting Date: January 7,2013  SUBJECT; DEPARIMENT: PUBLICHEARING: CONTACTPERSON: PURPOSE: ATTACHMENTS: BACKGROUND:  Designation: of Voting Delegate for NCACC Legislative Goals  Conference Governing Body No  Billy Lockamy, Chairman  Todesignated one commissioner to serve as voting delegate att the NCACCI Legislative Goals Conference, January 24-25, 2013 Voting Delegate Designation Form; Proposed Legislative Goals The final stage of the NCACC's Legislative Goals process is the Legislative Goals Conference, to which all Association members arei invited. The conference is spread overa day and a half, assuring time for thorough discussion, deliberation and debate. The, goals conference is conducted according to rules designed to encourage participation, toj provide al balance between inclusiveness and respect for the process and efforts of the committees and the Board up to this point. The Conferencebegins witha pre-luncht non-voting discussion of ther proposed goals. This allows commissioners: not previously involved in the deliberations, particularly newly elected commissioners, toi improve their understanding of thei issues. Every member county appointsa voting delegate to the conference, and every county in attendance has one vote. The voting delegate can be any county official, including non-elected: officials, and a county may choose àn The Board needs to discuss which members wish to be registered to attend the Conference, and selectits voting delegate.  alternate, No proxies are allowed.  RECOMMENDED) ACTION OR MOTION:  Designate voting delegate  73-    NORTH  CAROLINA  ASSOCIATION OF COUNTY COMMISSIONERS  Memorandum  RETURN FORM BY JANUARY11.2013  VOTING DELEGATE DESIGNATION FORM LEGISLATIVE GOALS CONFERENCE January 24-25, 2013 (Thursday - Friday)  Sheraton Imperial - RTP  NOTE: Please place this action on your board meeting agenda.  Each Board of County Commissioners is hereby requested to designate a commissioner or other official as a voting delegate. Each voting delegate should complete and sign the following statement and RETURN IT TO THE ASSOCIATION NO LATER THAN FRIDAY, PLEASE RETURN FORM TO SHEILA SAMMONS, CLERK TO THE BOARD BY  JANUARY 11,2013.  EMAIL: SHBILASAMMONSANCACCORG OR FAX: 919-733-1065.  I,  hereby certify that I am the duly County at the North Carolina  designated voting delegate for  Association ofCounty Commissioners 2013 Legislative Goals Conference.  Signed: Title:  Article VI, Section ofthe Association's Constitution provides:  "On all questions, including the election of officers, each county represented shall be entitled to one vote, which shall be the majority expression oft the delegates of that county. The vote of any county in good standing may be cast by any one ofi its County Commissioners who is present at the time the vote is taken; provided, if no commissioner be present, such vote may be cast by another county official, elected or appointed, who holds elective office or an appointed position in the county whose vote is being cast and who is formally designated by the Board of County Commissioners. These provisions shall likewise govern district meetings oft the Association. A county in good standing is defined as one which has paid the current year's dues." 2151 N. Dawson St., Raleigh, NC: 27603 * Phone: (919) 715-2893 * Fax: (919) 735-106-www.ncicors  -74-    NCACC Core Values NCACC Core Values  The Association recognizes counties' critical partnership with the state of North Carolina and promotes strategies that enhance state and county collaboration, communication, and cooperation. Counties are an integral part of a strong intergovernmental system, along with municipalities, school boards, the state and the federal govemment. Cooperation and communication between all levels of government are essential in order to provide the best and most efficient services to citizens. Counties are the level of government closest to the people. The Association promotes strengthening of local decision- making to respond to local needs. Counties should be free to organize as appropriate for the efficient and effective delivery of services. Flexibility of form, function and finance is critical. A proper balance of service responsibility and revenue-generating authority is imperative. Essential services should be financed through state or federal revenues to ensure statewide availability and consistency. State- mandated services should be funded from state revenue sources; federally mandated services should be financed from federal revenue sources. Policy changes affecting counties should be preceded by fair and equitable negotiations. New initiatives should allow adequate lead time for implementation within the county budget schedule. The State should consider the resource limitations of counties when The Association will provide the Legislature and the public with information necessary for the passage of sound legislation beneficial to the administration of county government affairs, and will oppose  implementing new state and federal programs.  legislation injurious thereto.  1  -75-    Top Five Legislative Goals  Ranked by the NCACC Board of Directors on Dec. 12, 2012 1. Oppose shift of state transportation responsibilities to counties. 2. Reinstate ADM and lottery funds for school construction.  3. Oppose unfunded mandates and shifts of state responsibilities to counties.  4. Preserve the existing local revenue base. 5. Ensure adequate mental health funding.  2  -76-    Agriculture  Guiding Principles  The Association supports local control over land-use decision-making and its impact on the The Association supports state policies providing local options and tools for the preservation of The Association supports research, education and outreach with various public and private partnerships that result in agricultural development opportunities, sustainable initiatives producing low-cost food and energy that will, in turn, create healthy local economies. Agricultural issues related to the environment transcend governmental boundaries and require close coordination of policy and action by federal, state and local governments. Powers delegated to the counties for the protection oft the public health are important for protecting the land and water resources that are vital for agricultural endeavors. The General Assembly should provide funds for any increased county responsibility related to  agricultural community.  farmland, ift they serve the best interest of all counties.  animal control operations and/or facilities.  Agriculture Goals:  Adequately fund agricultural research and extension services.  Support and promote conservation of working lands and farmland preservation.  3  -77-    Environment Guiding Principles  Public policy on environmental protection must recognize that all physical human activities have an impact on the environment, and provide recognition that there must be a balance between Enhancements to the environment laws of North Carolina should be justified by sound science and information and based on a clear rationale and purpose for regulatory change. State agencies responsible for developing administrative rules to implement federal and state policies should involve local governments in the process at the earliest stages of development and should proceed only after thorough analyses ofhealth, environmental and fiscal risks and State agencies issuing permits for activities that affect the environment should give local governments ample opportunity to comment on proposed permits for consistency with local plans Ifstate law delegates responsibility tol local governments for implementing, monitoring and enforcing environmental policy, the state should provide optimum flexibility and discretion in  those activities and the environment.  impacts. and policies.  setting fees at the local level to carry out these responsibilities.  Goals:  Restore state funding and responsibility for river basin monitoring, streamline rulemaking, and Eliminate requirement fora 10-year solid waste management plan and add a requirement in the Solid Waste Management and Facilities annual report for long-term planning. Authorize some county oversight of! bio-solids application. Modify spray irrigation systems classification for volunteer fire departments.  enhance regional cooperation.  Monitor and protect counties from negative fiscal impacts caused by natural resource extraction.  4  -78-    Health and Human Services  Guiding Principles  The Association supports county, regional and state collaboration to improve agency automation and simplify programs, to streamline administration and to improve client interaction. The Association opposes earmarking of block grant funds, and supports increased funding for mandated services, provided the increases do not require additional county expenditures. Counties must be actively engaged in setting health and human services policy and program requirements. Programs should be flexible and recognize the state's changing demographics. Health and human services programs should encourage responsible behavior and should be targeted to those citizens least able to care for themselves. They should encourage families to be responsible supporters of their children and help individuals find sustainable, long-term The State should take the lead in financing, implementing, maintaining, and supporting statewide automated systems; automation efforts undertaken by the State should connect and integrate with Members of county human service agency boards should be appointed by the boards of county  employment.  county automation initiatives. commissioners. Legislative Goals:  Ensure adequate mental health funding. oppose unfunded workload mandates.  Retain county management ofr nonemergency Medicaid transport. Restore local autonomy to LME/MCO governance. structure. Oppose weakening of smoke-free restaurant and bars law.  Preserve federal block grants and state aid to counties for county-administered programs and  Increase Nursing Home Community Advisory Committee membership flexibility. Increase child care subsidies to reduce waiting lists and support funding for Smart Start and NC  Pre-K.  Increase Medicaid rates to cover costs. Support an increase in food and lodging inspection fees to cover costs. Restore state funding of public health accreditation.  5  -79-    Intergovernmental Relations  Guiding Principles  The Association recognizes the importance of the State-County partnership and its unique role in The State should seek input from counties while developing rules and regulations that impact Local general purpose govemments are the building blocks for solving regional problems; regional approaches should be based on the need to strengthen and support local governments. Intergovernmental agreements should be used where appropriate to attain efficient performance,as Encourage public-private partnerships when in the best interest of the citizens. Reserve federal action for those areas where state and local governments are not adequate and where continuing national involvement is necessary, e.g. national defense, provided resources are All local government institutions should be engaged in developing and coordinating services to meet the needs of citizens. Counties will strive to maintain and enhance these partnerships.  providing services to all citizens.  counties, particularly concerning property rights.  determined by local elected officials.  made available by the national government.  Legislative Goals:  Oppose shift ofs state transportation responsibilities to counties. Allow more cost effective methods for second primary and run-off elections. Maintain current requirements for county commission approval of ETJ designations and Implement combined motor vehicle registration and property tax collection system by July 1, Support legislation to grant counties the option to provide notice of public hearings and other legal notices through electronic means in lieu of required publication in any newspaper. Support maintaining local control oft the NC ABC System and preservation ofl local ABC Support release ofl Help America Vote Act (HAVA) funds to assist counties with election costs.  expansions. 2013.  Allow county participation in state health plan.  Increase informal let bid threshold for NCDOT local projects. Oppose collective bargaining for public employees.  revenues.  6  -80-    Justice & Public Safety Guiding Principles  The statewide judicial system, including effective ancillary services and programs, should be adequately funded and staffed in order to provide an efficient environment for judicial process and to instill public  confidence in the justice system.  Adjudication should be swift, in order to minimize overcrowding in county, jails.  Bonds should be reasonable, and effective pre-trial screening and population management efforts Criminals should be held accountable and required toj pay a greater portion of the State and county costs resulting from their crimes through increased jail fees, service of process fees, and court Effective prevention programs, alternatives to incarcerations and other related services should be supported in an effort to help reduce recidivism rates and lower county. jail costs.  should be encouraged. facilities fees.  Legislative Goals:  Seek legislation to limit the amount that providers can charge counties for inmate medical care to no more than what is allowed by the Department of Correction. Seek legislation to expand county governments' use of911 funds, protect and enhance current funding streams and maintain full operational flexibility and autonomy. Oppose legislation that would limit a county's ability to operate a pretrial release program. Support legislation to fully fund the. Justice Reinvestment Act of2011. Preserve current county authority for local electronic offender monitoring. Provide funding for gang prevention, adolescent substance abuse. and domestic violence Request the reduction of detention center space requirements in existing and new detention center facilities in all counties in North Carolina, consistent with the language in N.C. G.S. 153A-221.  Provide greater funding of state crime labs. prevention, intervention and treatment.  7  -81-    Public Education Guiding Principles  The Association strongly urges the General Assembly to support counties' efforts to fund no more than one school system in each county, in order to better utilize school facilities and financial The Association supports efforts to clarify State and county responsibility through legislation that the impact of changing technologies on basic educational needs and the. job market ofthe the need for county commissioners to have the authority to make sure funds appropriated the challenges faced by counties, especially those near metropolitan areas, in balancing Taxing authority for local public education should be vested exclusively with boards of county The State should define and support an adequate sound basic education in all local school systems and should appropriate adequate operating revenue to fully fund its education initiatives. Effective classroom technologies and innovations provide greater choice, improve education, and North Carolina's community colleges are critical components of the state's integrated efforts to prepare youth and adults for constructive participation in a constantly changing economy.  resources.  recognizes the following: future;  thei impact of any changes on the facility needs of local school systems;  for school facility needs are used accordingly; and growth in school populations with stagnant county revenues.  commissioners.  should be available to all public schools and community colleges.  Legislative Goals:  Reinstate ADM and lottery funds for school construction.  Maintain state responsibility for replacement and risk management exposures for operation of Provide sufficient funds for community college workforce training programs.  school buses.  Restore local control ofs school calendar.  8  -82-    Tax & Finance Guiding Principles  The county revenue base should be broad and balanced, with authority to raise revenues from various sources, rather than being overly reliant on any single revenue source or overly The Association opposes the redistribution of existing revenues; distribution of new tax sources Any restructuring of county responsibilities should include restructuring of local revenue sources Counties should have the authority to generate optional revenues to meet public service needs, Ifs statewide policy objectives result in reductions in local tax bases, the Legislature should Existing local revenue base exemptions and exclusions should be evaluated to see whether they have achieved the intended tax policy objectives. New or extended exemptions and exclusions  burdensome on any one, group oftaxpayers.  should assess local needs, local funding efforts, and local funding capability.  to meet those responsibilities.  while being responsive to economic change.  reimburse county and municipal losses from State sources. should include a' "sunset" date in their authorizing legislation.  Legislative Goals:  Preserve the existing local revenue base. Authorize local revenue option.  Oppose unfunded mandates and shifts of state responsibilities to counties.  Protect county revenues in tax reform consideration. Repeal moratorium on contingency fee audits.  Improve and maintain incentive programs, including NÇ's tax credit programs, and increase access Explore and authorize use of alternate, sustainable revenue options and funding sources for beach, Replace current non-profit sales tax refund process with a revenue-neutral exemption. Replace current refund sales tax process for public institutions with a revenue-neutral exemption. Allow counties to provide triple credit toward renewable energy portfolios. Authorize greater county oversight ofe electronic gaming operations. Promote county property tax system modernization. Authorize design build option for all counties. Require payment of manufactured home taxes before transfer. Clarify centralized listing and assessing of cellular and cable companies.  to tax credit financing for smaller economic development projects.  inlet and waterway maintenance. Extend Article 44 hold harmless.  Support local county law enforcement and rehabilitation services through an increase in the Compensate counties for property acquired by the state and removed from the ad valorem tax  beer/wine tax revenues.  Preserve scrap tire disposal tax proceeds.  base.  9  -83-    SAMPSON COUNTY BOARD OF COMMISSIONERS  ITEMABSTRACT  ITEMNO.  4(d)  Information: Only Report/Presentation Action Item Consent Agendà  Public Comment Closed Session Planning/Zoning Water District Issue  Meeting Date: January 7,2013  SUBJECT; DEPARTMENT: PUBLICHEARING: CONTACTI PERSON. PURPOSE: ATTACHMENIS: BACKGROUND:  Designation of Dates for February Planning Session  Governing Body/Administration Ed Causey, County Manager  No  Todesignate dates for the Board's annual planning session  None  Bachyear, the Board holds a planning session to set goals and objectives for the upcoming budget season. Last year, the Board set aside three full days, Tuesday Thursday, starting at 8:00a.m. each day, Last year, the sessions were. held during the third full weekin February, Similar dates for 2013 wouldi be February 19-21, 2013; however Commissioner Strickland would have a conflict on February 20th with a NCACC Board Meeting, Therefore, the dates  of February 12-14 or 26-28 are suggested. Schedule dates for Februaryplanning session  RECOMMENDED ACTIONORMOTION:  -84-    SAMPSONICOUNTY BOARDOFCOMMISSIONERS  ITEMABSTRACT  ITEMNO. 4(e)  Information Only Report/Presentation Action Item Consent. Agenda  Public Comment Closed Session Planning/Zoning Water District Issue  Meeting Date: January7,2 2013  SUBJECT: DEPARTMENT: PUBLICHEARING: CONTACTPERSON: PURPOSE:  Appointments Governing Body No  Jarvis McLamb, Vice Chairman:  Toconsider appointments to various boards and commissions  Board of] Health Dr. Gip Palmer was appointed to the physician seat on the Board of Healthat your December meeting, Dr. Palmerhas declined to serve, and the appointment of Dr. Elizabeth  Byanisrecommended.  185-    SAMPSON COUNTY BOARDOFCOMMISSIONERS  ITEMABSTRACT  ITEMNO,  5  Information: Only Report/Presentation ActionItem Consent Agenda  Public Comment Closed Session Planning/Zoning Water District Issue  Meeting Date: January 7,2013  SUBJECT: DEPARTMENT:  Consent Agenda  Adminsraton/Matpe Departments  ITEM DESCRIPTIONS/ATTACHMENIS  a. b, C, d. e. f. g,  Approve the minutes of the November 5,2012meeting  Adoptar resolution seeking amendment OfNG Session Law 2004-75/Senate Bill1161 Enacted July8,2004regarding: notice of land-use planning changes near military bases Adopt a resolution requesting Mid Carolina Rural Planning Organization (RPO) toinitiate the process to add USHighway 421a as a new corridor on the Strategic Highway Corridors Vision Authorize the submission of an application for 2013 Urgent Repair Grant funding by the Approve a disabled veterans exclusion application from Barney D. Brewington  Plan  Department of Aging Approve tax refunds Approve budget amendments  RECOMMENDED  ACTIONOR: MOTION: Motion to approve Consent Agenda as presented  86-    SAMPSON COUNTY, NORTH CAROLINA  November 5, 2012  The Sampson County Board of Commissioners convened for their regular meeting at 7:00 p.m. on Monday, November. 5, 2012 in the County Auditorium, 435 Rowan Road in Clinton, North Carolina. Members present: Chairman Billy Lockamy, Vice Chairman Jarvis McLamb, and Commissioners John Blanton, Albert D. Kirby, Jr.,  and Jefferson Strickland.  The Chairman convened the meeting and called upon Commissioner Strickland for the invocation. Commissioner Kirby then led the Pledge Allegiance. Chairman Lockamy welcomed back Commissioner Blanton, who had been unable to attend  meetings due to health reasons. Approval of Agenda  Upon a motion made by Commissioner Strickland and seconded by Commissioner Kirby, the Board voted unanimously to approve the agenda with the addition of a special recognition for Commissioner Blanton as item b under Tab2,  Reports and Presentations.  Roads  Monthly Report-NCDOT Keith Eason, NCDOT Highway Engineer, provided Church Road from Hwy 421 to Hwy 13 in Newton Grove and Strawpond School Road/Easy Street from Hwy 421 to Hwy 55 - widening and resurfacing complete, shoulder work complete. These projects were part of last year's Unpaved roads paving work will begin again in late Spring, early Summer next Commissioner Strickland noted that he drove down Church Road the past week and applauded the Department for their good work. He asked that the Department keep Minnie Hall Road on track for widening. Chairman Lockamy noted that he had come through Keener and a Waste Industries truck had been in an accident, and Mr. Eason noted that cleanup was ongoing. Mr. Arnold Sandy spoke from the audience, thanking the Department for the good work on Wash McLamb Road and Easy Street.  updates on secondary roads projects:  secondary roads improvements.  year  -87-    Item No.1: Planning and Zoning Items  RZ-10-12-1 Chairman Lockamy opened the public hearing and called upon Planning Director Mary Rose who reviewed the request toi rezone 1.10. acres at5 57 Three Pines Lane from MRD-Mixed Residential to RA-Residential Agriculture. Ms. Rose reported that adjacent property owners had been duly notified, and the Planning Board had unanimously recommended approval of the rezoning request and the adoption ofa a zoning consistency statement. The floor was opened for comments, and none were received; the hearing was closed. Upon a motion made by Commissioner McLamb and seconded by Commissioner Kirby, the Board voted unanimously to approve rezoning request RZ-10-12-1, accepting the presented findings of fact and making the following zoning consistency statement: Whereas, in accordance with the provisions ofNorth Carolina General Statute 153A-341, the Sampson County Board of Commissioners does hereby) find and determine that the recommendtion of the ordinance amendment RZ-10-12-1 is consistent with the goals and objectives ofthe Sampson County Land Use Plan and other long range planning documents due to the fact this area is located aithin aj portion oft the County designated as a Residential Growth. Area in Section 2 ofthe Sampson County Land Use Plan (Future Land Use Map). This section further identifies appropriates uses for this area would include primarily residential development.  Item 2:  Reports and Presentations  Update on Tax Office Software Improvements (Citizen Self Serve) Tax Administrator Jim Johnson was present and reported on the launch, as of November 1st, of the new Citizen Self Serve website that citizens may utilize to view and pay their tax bills. He noted that prior to the new software, citizens could only access unpaid bills, and now the site offers access to any bill, paid or unpaid, any type, as farl back as twelve years. He reported that the' Tax Office had received positive feedback from local attorneys and banks, and encouraged the Board and citizens to check out the new site, which could be found on the county's webpage under the Quick Links, Tax Office E-  Services.  Mr. Johnson also reported that he and other staff had been meeting with Tyler Technologies in preparation for the new appraisal software to go live in April of next year. This new software will offer citizens access to property record cards online. Recognition of Commissioner Iohn Blanton Commissioner Blanton was present for the last full meeting of his commissioner term, and was lauded by commissioners and staff for his service. Chairman Lockamy called him his hero and friend. Commissioner Jefferson Strickland stated that they went back a long way, serving the citizens of Roseboro, and it had been a pleasure to sit down and work with Mr. Blanton, to put their minds together and come up with a common goal and figure out how they were going to doit. He offered his appreciation for all Mr. Blanton's work. Commissioner McLamb noted that he and Mr. Blanton went back fourteen years and  -88-    stated that he had the utmost respect for his friend. Her noted that he believed there was no other person in Sampson County better known. Commissioner Albert Kirby stated thati it had been a pleasure sitting next to his friend and mentor. He thanked Commissioner Blanton for his many years of service, noting that he had known Mr. Blanton even before he was a commissioner, when he was a principal in Roseboro. He stated that he had admired him then and most certainly had grown to admire him when he became a commissioner and realized how many challenges there were: in sitting in that chair. County Manager Ed Causey recalled that when he applied for his position, Commissioner Blanton was the epitome of what he thought a good commissioner was, and that was one of the reasons he was interested in coming to Sampson County. County Attorney Annette Chancy Starling stated that it had been pleasure tol know Mr. Blanton, and Assistant County Manager Susan Holder added that ithad been an honor and a privilege to work for such a gentleman. Finance Officer David Clack recalled that Commissioner Blanton was someone that anyone could talk to, and he would be missed by employees and staff. Deputy Clerk LeAnn Honeycutt remarked that she had enjoyed working with Mr. Blanton. Mid Carolina Council of Government Executive Director Jim Caldwell noted Mr. Blanton's ten-year service on the COG's Board of Directors, and stated that he had come to rely on his judgment and knowledge. Sheriff Jimmy Thornton noted that Mr. Blanton had served on the) Jail Committee, and offered appreciation on behalf of the men and women of the Sampson County Sheriff's Office. He stated that Mr. Blanton was a fair and reasonable man, going the extra mile to facilitate changes and address needs. He called Mr. Blanton and amazing man who had influenced more. lives through his service to God, country, family, friends and neighbors than anyone else he knew. Health Director Wanda Robinson thanked Commissioner Blanton for being one of her mentors. The Board then jointly presented Mr. Blanton with a silver tray acknowledging his years of service to the citizens of Sampson County. All those assembled then sang Happy Birthday to Commissioner in recognition of his birthday the day before. Mr. Blanton's daughter, speaking on her father's behalf, thanked everyone. She stated that Sampson County had accepted him, allowed him to serve, and motivated him. She quoted scripture as Mr. Blanton's wish for all that "the grace of the Lord Jesus" be with them.  Commissioner Blanton retired from the meeting, with the Board's consent.  Item No. 3: Action Items  Installation, Operation and Maintenance of Equipment to Prohibits Sewer Debris from Sampson County Detention Center County Manager Ed Causey recapped discussions from the Board's October work session where the engineers from Dewberry had offered potential solutions for the problem of debris being flushed from the Detention Center into the City's sanitary sewer system. He noted that the agenda also included the City's original bids for a grit chamber and noted that following the meeting he, Commissioner Kirby, and Public Works Director Lee Cannady had met  -89-    with City Manager John Connet and City Public Works Director Jeff Vreugdenhil to further discuss the City's proposal. He reported that the City was willing to re-bid the planned improvements to obtain updated prices. Commissioner Kirby stated that most oft the options discussed were pennywise and pound foolish when you talked about cost. For most, there would still be materials in the effluent, which would be in violation of the statute. In the end, it seemed to him that the most viable alternative would be to take the City's proposal, and that Mr. Vreugdenhil had spoken to the person who gave the original proposal, who had indicated that it might be a good idea to re-bid. It was noted that there was already $80,000 set aside; therefore if monies had to be appropriated the new bid should require less than an additional $80,000 (original bid was $168,205). The Board also discussed the need to execute an agreement with the City regarding the installation, operation and maintenance of the grit chamber once the new bids were received. Upon a motion by Commissioner Strickland and seconded by Commissioner Kirby, the Board voted unanimously to concur in the City'sre-bidding the project, and if the cost is affordable, advising them of the Board's intention to go  forward with the project.  Consideration of Offer for Acquisition of Right of Way for Highway 24 Road Improvements Assistant County Manager Susan Holder presented a revised offer from the Department of Transportation to acquire approximately 7.35 acres located on Highway 24 near the landfill for right of way for NC24 improvements, noting revisions made to include additional land needed for safety adjustments made as requested by thel Board and Waste Industries. She also noted a consulting opinion from certified appraiser Frank Butler which noted that price offered was reasonable. Upon a motion made by Commissioner Strickland and seconded by Commissioner McLamb, the Board voted unanimously to accept the offer. (Copies of offer and deed filed in Inc. Minute  Book  Page  Animal Shelter Personnel Improvements County Manager Ed Causey discussed the request to advertise the Director position at Grade 68 and to budget additional funds for contracted services for the equivalent of one full-time person. Commissioner McLamb stated he would like to visit the shelter before making a decision on additional monies, but was comfortable with staff proceeding on advertising the position at Grade 68. He asked if the proposed increase in grade would have the Director paid at a salary comparable to surrounding counties, and Finance Officer David Clack explained that the salary had been recommended by The Maps Group based upon salaries in surrounding counties, and the grade was determined based on Sampson County's pay scale grade. Commissioner Kirby noted that he had visited the shelter, and hel had seen incredible improvement. Upon a motion made by Commissioner McLamb and seconded by Commissioner Kirby, the Board voted unanimously to authorize the advertisement of the Animal Shelter Director position at a Grade 68. (See below for  budget amendment.)  -90-    Proposal for Conversion of Vehicles to Propane Auto Gas Finance Officer David Clack explained that local business Parker Gas, in partnership with Alliance Auto Gas, had recently approached the Sheriff's Department regarding a program which converts vehicles from gasoline to propane fuel. Hei reviewed an analysis of twenty-four cars, which reflected that the County could save $24,746 per year by converting the cars to propane, with the net saving including the cost to acquire the conversion equipment through a lease purchase arrangement. Mr. Clack noted that he, the County Manager, and Sheriff's Department representatives had also met with representatives of the Raleigh Police Department whol had successfully converted a number of their vehicles. Raleigh PD had indicated no maintenance issues; the equipment was under warranty for three years, and was transferrable to new vehicles. Commissioner Kirby asked if there were other companies offering the same program, and what was the cost for the gas. Mr. Clack stated that currently it was $1.52 per gallon, based on market; you could conceivably get it cheaper from one company to another, but Parker Gas had indicated that the purchase price could be locked in for a year. Commissioner McLamb stated he preferred to table the issue until he could have conversations with other individuals regarding these services. Commissioner Strickland asked if the equipment had any impact on the vehicle warranty, and Mr. Clack stated that there was no indication of impact to the warranty. Darren Parker of Parker Gas was present and offered additional information on the market rate of the fuel. He noted that two of the conversions were offered free as the company was using this to acquire EPA certification. He also explained that the reduced BTU content reduced the car mileage, but the lower gallon cost offsets the reduced mileage. In response to a question by Commissioner Kirby, he assured the Board there were no enhanced safety risks. He explained further that the cars cranked with gas, but automatically switched to propane. Mr. Parker and a representative of Alliance Auto Gas offered to provide more information on the technology, sOC on a motion made by Commissioner McLamb and seconded by Commissioner Strickland, the Board voted unanimously to table the issue and hold a special work session at 10:00 a.m. on Monday, December: 3, 2012, following the  swearing in ceremonies for new commissioners.  Conveyance of E. Carter Street Lot to City of Clinton County Attorney Annette Chancy Starling reported that the City of Clinton had informed the County that they had discovered that a lot on E. Carter Street they considered abandoned actually belonged the County. She reported that they have provided maintenance of the lot under their nuisance lot procedures at a cost of $1,468.44, and have requested that the bill be paid or thel lot sold sO that thel bill may be satisfied. The County Attorney and Tax Administrator Jim Johnson voiced concerns that the lot, only .262 acres, would not bring enough money to satisfy the City's bill and the costs to advertise pursuant to statute, and it was recommended that the lot be deeded to the City in lieu of payment. Upon a motion made by Commissioner McLamb and seconded by Commissioner Kirby, the Board voted unanimously to table the issue until their December meeting to  give the Tax Administrator the opportunity to visit the property.  -91-    Appointments Upon a motion by Commissioner McLamb and seconded by Commissioner Kirby, consideration of the appointments to the Heritage and Cultural Preservation Committee, the Advisory Board of Older Adults, the Transportation Advocacy Group, the Board of Health, and the Mid Carolina Council of Governments  Board of Directors were tabled. Item No.4: Consent Agenda  Upon a motion made by Commissioner McLamb and seconded by Commissioner Kirby, the Board voted unanimously to approve the Consent Agenda as  follows:  a. Approved the minutes of the September 24, 2012 and October 1, 2012 meetings b. Approved the execution of the Memorandum of Agreement between the Department of the Army and Sampson County Emergency Management Services - Accepted a Department of Justice grant in the amount of $10,350 for purchase of mobile data terminals and laptop computers (Copy filed in Inc. Minute Book d. Approved the revised Records Retention and Disposition Schedule: for Register e. Authorize the purchase of budgeted ambulance and remount of existing ambulance utilizing the piggy-back" bid method authorized by NC General  (Copy filed in Inc. Minute Book  Page  Page.  Budget amendment below with other amendments.)  of Deeds (Copy filed in office of Register of Deeds.)  Statute 143.129(g)  - Adopted the 2013 County Holiday Schedule as follows: New Year's Day - January 1, 2013 Martin Luther King, Jr. Day - January 21, 2013 Good Friday March 29, 2013 Memorial Day May 27,2013 Independence Day -. July 4, 2013 Labor Day September 2, 2013 Veteran's Day November 11, 2013 Thanksgiving- - November 28 &2 29, 2013 Christmas - December 24-26, 2013  g. Adopted the 2013 Board of Commissioners Meeting Schedule as follows (all meetings to be held at 7:00 p.m. in the County Auditorium):  Monday, January 7 Monday, February 4 Monday, March 4  Monday, April 1 Monday, May 6 Monday,June3  -92-    Monday,July: 1 Monday, August 5 Tuesday, September 3 Johnnie Boone Hooper Tart III  Monday, October 7 Monday, November 4 Monday, December 2  h. Approved disabled veterans exclusion applications from Bruce B. Brinkman and Approved late land use applications from Watery Branch LLC and Charles  Approved tax: refunds as follows:  #5524 Harold Woodall #5469 Raeford Daughtry #5523 W.F.Owens #5532 James H. Whitted #5534 The Woodshed #5536 Nathaniel Simmons  $120.75 $827.35 $254.18 $113.27 $153.96 $205.27  k. Approved the following budget amendments:  EXPENDITURE Code Number REVENUE Code Number EXPENDITURE Code Number  Sheriff's Department Description (Object of Expenditure)  Increase Decrease 10,350.00 Increase Decrease 10,350.00  11243100 526201 Dept Supplies Equipment 11034310 402607 US DOJ Grant  Source of Revenue Animals Shelter  Description (Object of Expenditure)  Increase Decrease 2,541.00 158.00 37.00 172.00 65.00  11243800 512100 Salaries 11243800 518100 FICA 11243800 518120 Medicare 11243800 518200 Retirement 11243800 518901 401K 11999000 509700 Contingency  2,973.00  EXPENDITURE Code Number 11243300 REVENUE Code Number  mergencyManaement Description (Object of Expenditure)  Increase Decrease 41,269.00 Increase Decrease 41,269.00  55500 Capital Outlay Other  Source of Revenue  11034330 403674 ST Homeland. Security Grant  -93-    EXPENDITURE Code Number REVENUE Code Number EXPENDITURE Code Number REVENUE Code Number EXPENDITURE Code Number REVENUE Code Number EXPENDITURE Code Number REVENUE Code Number EXPENDITURE Code Number REVENUE Code Number EXPENDITURE Code Number REVENUE Code Number  Social Services  Description (Object of Expenditure)  Increase Decrease 61,200.00 Increase 61,200.00  13554710 536030 Special Adoption Funds 13535310 403384 Special Adoption Funds  Decrease  Source of Revenue Aging  Description (Object of Expenditure)  Increase Decrease 50.00 Increase 50.00  02558670 524100 Home Repairs Materials 02035867 408401 Home Repairs- Donations  Decrease  Source of Revenue Aging  Description (Object of Expenditure)  Increase Decrease 200.00 Increase 200.00  02558680 526200 GSC- Department Supplies 02035868 408403 GSC- Donations  Decrease  Source of Revenue  CES Lagoon Mgmt & Agri Programs Description (Object of Expenditure)  Increase Decrease 1,000.00 Increase 1,000.00  04449560 535100 Maint & Repair Bldgs and Grounds 04034956 409900 Fund Balance Appropriated  Decrease  Source of Revenue EDF Grant  Description (Object of Expenditure)  Increase Decrease 82,000.00 3,400.00 Increase 85,400.00  04549550 555000 Capital Outlay Other 04549550 526201 Dept Supplies Other  Decrease  Source of Revenue Aging  04434955 404012 Environmental Defense Fund  Description (Object of Expenditure)  Increase Decrease 50.00 Increase 50.00  02558670 524100 Home Repairs - Materials  Decrease  Source of Revenue  02035867 408400 Home Repairs Program Income  -94-    EXPENDITURE Code Number REVENUE Code Number EXPENDITURE Code Number  Courts  Description (Obiect of Expenditure)  Increase Decrease 1,549.00 Increase 1,549.00  11141600 551000 Capital Outlay Furniture 11039999 409800 Fund Balance Encumbrances  Decrease  Source of Revenue  Citys Schools Capital Outlay Description (Object of Expenditure)  Increase Decrease 70,000.00 113,326.35 183,326.35 increase 183,326.35 183,326.35  11659110 555030 Category: 1 Capital Outlay 11659110 555031 Category: 2 Capital Outlay 19959110 582096 Transfer to General Fund 11035911 409612 Transfer from School Reserve 19932320 409900 Fund Balance Appropr  REVENUE Code Number  Decrease  Source of Revenue  Approved the Sampson County Schools budget amendments No. 4 (Capital Outlay  Special Projects) as presented. Item No. 5: Board Information  The following items were provided to the Board for information only: Clinton-Sampson Chamber of Commerce Multicultural Business Committee's FEMA 2012 Community Resilience Innovation Challenge Grant Proposal  a. b. C. d.  Annual Martin Luther King, Jr. Business Reception  2013 Essentials of County Government Course Schedule  Clinton-Sampson Chamber of Commerce Junior Leadership Program's Local  Government Day (November 13, 2012)  County Manager Reports  County Manager Ed Causey called the Board's attention to the invitation to the Martin Luther King Jr. Business Reception tol be held Monday, January 21, 2013 and to the announcement of the Chamber Junior Leadership Program Local Government Day on November 13, 2012. He also noted that each member had been given a listing of  events for November and December.  -95-    Public Comments  Deborah Kornegay: Offered the Board several pieces of information including a copy of an article about the health effects of biomass incineration, a resolution adopted by Surry County related to arrondo grass. She stated the Board needed to become familiar with such because of the Chemtex plant. Itisa very aggressive growing plant. She also  offered information on fracking.  Adjournment  Upon a motion made by Commissioner McLamb and seconded by  Commissioner Kirby, the Board voted unanimously to adjourn.  Billy C. Lockamy, Chairman  Susan J. Holder, Clerk to the Board  -96-    Al RESOLUTION TO SEEK THE. AMENDMENT OF NORTH CAROLINA SESSION LAW 2004-75 SENATE BILL 1161 ENACTED JULY 8,2004  WHEREAS, the North Carolina General Assembly adopted Session Law 2004-75 known as "An Act to Require Counties and Cities Near Military Bases to Give Notice of Land-Use Planning WHEREAS, the law continues to be a very effective and important tool in facilitating communication between North Carolina's military bases and the surrounding local governments (cities and counties) concerning proposed zoning changes within five miles of the bases, and WHEREAS, certain provisions of the existing law have proven to be burdensome for both the WHEREAS, certain other potentially incompatible land uses were omitted from the law's  Changes to the Military Bases", and  military and local governments to implement, and  notification requirements.  NOW THEREFORE BE IT RESOLVED, that the Board of Commissioners of the County of Sampson hereby requests the North Carolina General Assembly to adopt the following A. Delete the requirement for a "certified mail" notification to the military base commanders B. Include the additional requirement for base commanders "or their designees" to be notified of proposed subdivisions, telecom towers, and windmills within the five-mile area.  amendments to North Carolina Session Law 2004-75:  [152A-323 (b). and 160A-364 (b)), and  Adopted this 7th day of. January, 2013.  Chairman ATTEST:  Clerk to the Board  -97-    Page I of2  Ed Causey  From: Roland Hall oerchai@embarynatcom, Sent: Friday, December 07,20124:01PM Grove; City of Clinton; Ed Causey  To:  Town of Turkey; Town of Salemburg; Town of Harrells; Town of Garland; Town of Autryville; Newton  Subject: Fw: Local Government Adoption of Attached Resolution 12-6-12  Greetings to All: Please read the attachments and submit the appropriate proposed resolution Board for adoption, at their next scheduled meeting. You may contact me @ 910-525-4183 or. toy Jim your Daughtry @ 910-583-1233, ify you have questions or need assistance presenting the information to  governing board. Thank you and Happy Holidays  your  Roland Hall, Sampson County Board Member Regional Land Use Advisory Commission (RLUAC)  Original Message -n-- From: Jim Dougherty  To: Andrew' Wilkison; Bart Nuckols; Bill Summers : Bill Zell; : BillyKing; : Bob Davis; : Brandi Deese; Jackie Warner; James Armstrong Jean Powell; Jeremy Rust; Mark Locklear;. Michelle Frizzell; ,  Massey; Robert McLaughlin; , Roland Hall; Rora Kellis; :. Tony Buzzard Subject: Local Government Adoption of Attached Resolution 12-6-12  Robert  Sent: Thursday, December 06, 20123 3:26 PM Dear RLUAC Voting Members:  At the quarterly RLUAC meeting held on Thursday, November 15th, the Voting Members present unanimously adopted the attached resolution seeking the support oft the North Carolina General Assembly to amend Session Law 2004-75 entitled "An Act to Require Counties and Cities. Near. Military Bases to Give Notice ofLand-Use Planning Changes to the  Bases".  Military  The amendments RLUAC is seeking include the following items:  1) Eliminate the requirement that the notifications to the base commanders must be "certified 2) Broaden the notification options to include both the base commanders "or their designees". 3) Broaden the law to include (in addition to zoning actions) notification of proposed Please present the appropriate attached resolution to your. Board of Commissions for their consideration and adoption. The support OfRLUAC's twenty member governments will make it much easier for our local legislative delegation to support the proposed amendments in the General Assembly. Please return to me an adopted copy of the resolution once your Board acts Please let me know if you have any questions, or ifyou would like for me to assist youi in  mail".  by  subdivisions, telecom towers, and windmills.  upon it.  -98-  12/18/201?    Page 2of2  presenting the motion to your governing body.  Thanks. Jim  James Dougherty, Executive Director Regional Land Use Advisory Commission  P.O. Box 1510 Fayetteville, NC28302 (910)583-1233 www.rluac.com  -99-    RLVAGT  A RESOLUTION TO SEEK THE. AMENDMENT OF NORTH CAROLINA SESSIONLAW: 2004-75 SENATE BILL 1161 ENACTED JULY 8, 2004  WHEREAS, the North Carolina General Assembly adopted Session Law 2004-75 known as "An Act to Require Counties and Cities Near Military Bases to Give Notice WHEREAS, the law continues to be a very effective and important tool in facilitating communication between North Carolina's military bases and the surrounding local governments (cities and counties) concerning proposed zoning changes within five miles WHEREAS, certain provisions of the existing law have proven to be burdensome WHEREAS, certain other potentially incompatible land uses were omitted from the  Land-Use Planning Changes to the Military. Bases", and  of  ofthe bases, and  both the military and local governments to implement, and  for  law'sn notification requirements.  NOW THEREFORE BE IT RESOLVED, that the Regional Land Use Commission (RLUAC) hereby requests the North Carolina General Assembly Advisory to the following amendments to North Carolina Session Law 2004-75: A. Delete the requirement for a "certified mail" notification to the  adopt base  commanders [152A-323 (b) and 160A-364 (b)), and  military  B. Include the additional requirement for base commanders or their designees to be notified of proposed subdivisions, telecom towers, and windmills within the five mile  area.  Adopted this 15th day of November2012  Jean Powell, Chairperson  -100-    RESOLUTION REQUESTING: MID CAROLINA PLANNING ORGANIZATION TOINITIATE THE PROCESS TO. ADD US HIGHWAY 421 AS. A NEW CORRIDOR ON THE STRATEGIC HIGHWAY CORRIDORS VISION PLAN  WHEREAS, US Highway 421 is a critical highway fostering economic prosperity and efficient WHEREAS, US Highway 421 currently serves as an alternate evacuation route for individuals WHEREAS, the 94.28 miles ofUS Highway 421 between Dunn, NC and Greensboro, NC are WHEREAS, the 88.25 miles ofUS Highway 421 between Dunn, NC and Wilmington, NC NOW THEREFORE BE IT RESOLVED, that the Board of Commissioners of the County of Sampson hereby requests the Mid Carolina Rural Planning Organization (RPO) to initiate the process to add the 88.25 miles of US Highway 421 between Dunn, NC and Wilmington,  movement of people and good between Wilmington, NC: and Dunn, NC; and  leaving the southern coastal areas ofl North Carolina; and part ofthe Strategic Highway Corridors; and not a part of the Strategic Highway Corridors.  are  the Strategic Highway Corridors Vision Plan. Adopted this 7th day of. January, 2013.  NC to  Chairman ATTEST:  Clerk to the Board  -101-    Sampson County Department of Aging  Lorie Sutton Director  Memorandum  Services CAP/DAProgram Family Caregiver Nutrition! Program In-Home Aide Services Information & Relerral Adutz Day! Health Care Transportation Home Repairs Garland Senior Center Butler Court Senior Center  TO: FROM: DATE: RE:  Ed Causey, County Manager  IS  Lorie Sutton, Aging and In-Home Services Director  December 12, 2012  Formal request for Board approval to submit the 2013 Grant for the Home Repairs Program  Urgent Repair  Wel have received notice from the North Carolina Housing Finance Agency ofthe availability of funds under the Urgent Repair Program ("URP"). I would like to request approval from the Board of Commissioners to submit a grant application in the amount of $75,000.00 to further our work in our Housing and Home The goals of the Urgent repair Program are: 1)to alleviate housing conditions which pose an imminent threat to the life or safety of very low-income homeowners with special needs; and 2) to provide accessibility modifications and other repairs necessary to prevent the imminent displacement of very low-income homeowners with special accessibility needs, such as frail elderly and person with Matching funds are not required, but recommended, because oft the competiveness with the grant. We would like to propose a match of $10,000. This will: not be an additional funding request; however, we will use Home and Community Block Grant Funding to make up the match. Both programs working together will allow  Repairs Program.  disabilities.  us to serve many more clients.  Thank you in advance for your consideration.  /Is  405 County Complex Rd. Suite 140 Clinton, NC28328 910-592-4653 Fax 910-590-2142 sutontsampsonnc.om wwwsampsonnc.com:  102-    NORTH CAROLINA HOUSING FINANCE AGENCY Application for Funding 2013 Urgent Repair Program  (URP13)  Program Applicant A. Applicant Organization: 1. Legal Name 2. Street Address 3. Mailing Address 4. City 5. Fax Number 7. DUNS Number 8. Website address B. ChiefAdministrative Official: 1. Name 3. Phone Number 1. Organization Name 2. Mailing Address 3. City 4. Fax Number 5. Chief Operating Officer 1. Name 3. Phone Number E. Type of Applicant: 1. Community Action Agency. 3. Public Housing Authority. 5. Local Government.  Sampson County  405 County Complex Road; Suite 140 405 County Complex Road; Suite 140  Clinton  ZIP  28328 56-6000338  910-590-2142  6. Federal Tax ID (Non Government Organizations ONLI) www.sampsonne.com 2. Title 4. Email  Lorie Sutton 910592-4653  Director Ditton@sampsonnecon  Contracted Administrator Information: Consulting.firm, COG, etc., ifapplicable)  ZIP  D. Project Contact Person: (Who. should NCHFA contact for URP project details?)  Steven Wilson 910-592-4653  2. Title 4. Email  Project hip392@gmail.com Manager  2. Other Nonprofit Corporation. 4. Other Public. Agency. 6. - Regional Council.  X  F. BriefDescription of your Organization (Non Government Organizations ONLY)  G. Funding Requested:  1. Total amount of Program funds requested.  $75,000 20  2. Total number of dwelling units targeted for Program assistance.  THIS SECTION FOR NCHFA USE ONLY  Date received  Ap. No.  Fee enclosed  No. copies Thresh.  Score  Cap.  -103-    URP13 APPLICATION FOR FUNDING  II.  Project Design  A. Service Area: In all cases, "service area" is defined as the geographic area or areas in which homeowners are equally eligible to apply for assistance. Recipients may choose to accept applications on a first-come, first- served basis from throughout the service area, while adhering to section 6 (Eligible households) oft the Application Guidelines, or to allocate equitable portions oft the grant to all eligible localities within the service area, Otherwise homeowners' applications must be rated and prioritized without regard to the applicant's Our service area is Sampson County. We will accept applications on a first-come, first-serve basis from throughout Sampson County for eligible recipients. Applications will be rated and  specific locality within the service area. 1. Please define your service area in specific terms: prioritized according to URP guidelines.  2. Complete the following matrix to define your proposed service area by county, population, number of dwelling units targeted for assistance and amount of Program funds projected to be spent in each county. fthe. service area comprises an entire county or city use the 2011 population estimates from the North Carolina. State Data Center available at hsAsEsNaNAN and iqures/socipeconomic data/population estimates/dem Use the July 2011 population column. Applications for grants exceeding $75,000 must serve  ogmunestbycounty 2011.html multiple counties in their entirety. County(s) in which service area is located  Population of service area 63,746  Proposed #ofunits Program funds 20  a. Sampson County b. C. d. e. f. g. h.  $75,000  - Totals =  63,746  20  $75,000 proposed  3. Ifthe service area contains other than an entire city or county, attach a map clearly delineating the service area boundaries, and service area population. Label the map "Exhibit II A2".  2  -104-    URP13 Application for Funding  II. Project Design (continued) B. Beneficiary Targeting:  Donot submit your proposed project assistance policy with this application for funding. Ifyour project is selected for funding, you will be requested to submit your assistance policy with the post  approval documentation. C. Client Relations:  Linking special needs households to services beyond housing is viewed as an integral part oft the Urgent Repair Program. Explain in detail the system which will be used to screen and refer households for other needed services (list services) and describe the roles of those involved in the process. Be sure to explain the screening/referral roles of any URP project staffi in detail. Please limit the narrative to one -12'xIl-'atuachment (min 11 font) labeled II. Ci in the upper right hand corner. Attachments should be attached in the order that they were requested, at the back of the  application.  D. Proposed procurement and construction:  Indicate which ofthej following will be used to effect your URP-funded work.  Yes No X X X X X X X  1.F Private-sector construction contractors. 2. Competitive sealed bids. 3. Competitive negotiation. 4. Telephone bid solicitation. 5. Non-competitive negotiation.  6. Work crews employed by the applicant organization. 7. Weatherization contractor procured under WAP guidelines. E. Otherresources to be used with URP funds for Hard Costs only: 1. Weatherization Assistance Program (WAP) funds. 3. Independent Living Center funds. 4. Council on Aging funds. 6. Volunteer labor*. 7. Donated materials*. 8. Matching local funds*.  Ves No Value/Amt. X X X X X X X  2. Heating Appliance Repair & Replacement Program (HARRP) funds.  $10,000  5. USDA-Rural Development Section 504 loans.  9.  *Attach documentation of matching contributions listed on lines 6, 7andlor 8, above. Labelas Exhibit IE. Matching contributions on those lines must be used for eligible URP Hard Costs only. Other resources may be usedj for program. support, but those contributions will provide no  competitive advantage in URPapplication: rankings.  3 -105-    URP13 Application for Funding  I. Project Design (continued) F. Project Schedule:  Assuming a maximum of18 months from funding agreement until close-out and a starting date of July 1, 2013, please indicate below your projected project dwelling units repaired or modified with Program assistance All Program funds must be obligated within 18 (45) days to complete all units and submit closeout documentation). Please  hypothetical progress, in terms of  during each calendar quarter. (Note:  months. Recipient will have an additional  forty-five  schedule for your project.  complete aj proposed  Quarter 1.7 7/1/13 - 9/30/13.. 2. 10/1/13-1 12/31/13. 3. 1/1/14 - 3/31/14..  Unit Completions 2 3 5  Quarter  Unit Completions 5 5 20  4. 4/1/14 - 6/30/14.. 5. 7/1/14 - 9/30/14.. 6.1 10/1/14 - 12/31/14..  Total=  mI. Applicant Capacity  A. Rehabilitation/Repair Program Experience and Status:  For each home repair, urgent repair or comprehensive housing rehabilitation grant received the applicant since. July 1, 2007, provide the information indicated below. Ifmore than six by  grants were received during this 5-year period, copy page 6 and attach as tol list here include Community Development Block Grant Partnership Program ('HOME)allocations from a local government or consortium, Rehabilitation Program (SFR) grants, USDA-Rural Development Housing Preservation Single-Family Grant Program ("HPG") funds, Weatherization Assistance Program ("WAP") funds, Urgent Program grants, minor home repair project, local emergency repair programs, etc. Please Repair list  separate  page 6A. Funding sources  ("CDBG"), HOME Investment  oldest grantfirst.  the  B. We prefer that the following tables be used to record the applicants rehab/repair  current status of funding related to units which may be targeted for rehabilitation. experience and some applicants it may be more appropriate toj provide a narrative which speaks to However, the applicant to carry out comprehensive rehabilitation ofowner-occupied units. narrative to one 8-1/2" x 11'attachment (min 11 font) labeled III. B in the Ifso, please limit the  for of the capacity  Attachments should be attached in the order that The narrative should detail the  upper right hand corner.  they were requested, at the back ofthe application.  units  applicants housing rehabilitation experience including the number of  comprehensively rehabilitated in the past five years, (broken out by: year), the of funding per unit (including volunteer labor, materials and donated materials) average amount information relevant to documenting the applicants capacity to affectively  and any other perform comprehensive  housing rehabilitation.  4 -106-    URP13 Application for Funding  mI. Applicant Capacity (continued)  A. Rehabilitation/Repair Program Experience and Status: (continued) 1. Program name (use standard abbreviations as shown above).. a. Funding cycle (2007,2008, etc.).. b. Date ofa award or project commencement date.. Grant/Funding. Agreement number.. d. Project close-out date or deadline.. Total grant allocation amount.. : Matching funds/local contribution.  HCCBG 2007/2008 07/01/07 N/A 06/30/08 $78,763 $7,876 $32,900 60 47 0 $700 URP 2007 04/26/07 URP07 09/16/08 $75,000 $11,933 $73,133 30 35 0 $2,090 SFR 2008-2010 07/01/08 SFR08 06/30/10 $400,000 $0 $323,815 9 9 0 $35,979  Program rehabilitation/repair budget (hard costs only).. h. Number of dwelling units targeted for rehabilitation/repairs. Number of dwelling units completed to date.. Number ofr rehabilitation/repair, jobs under contract at present.. A Average hard cost per unit completed (ali sources).. 2. Program name (use standard abbreviations as shown above).. a. Funding cycle (2007, 2008, etc.)... b. Date ofaward or project commencement date. Grant/Funding Agreement number.. d. Project close-out date or deadline.. Total grant allocation amount.. Matching funds/local contribution..  Current status of grant..  .Closed-out.  X orA Active..  g. Program rehabilitation/repair budget (hard costs only).. h. Number of dwelling units targeted for ehabilitation/repairs. .1 Number of dwelling units completed to date.. Number ofr rehabilitation/repair jobs under contract at present.. k.A Average hard cost per unit completed (all sources).. 3. Program name (use standard abbreviations as shown above). a. Funding cycle (2007, 2008, etc.)... b. Date ofaward or project commencement date.. Grant/Funding Agreement number.. d. Project close-out date or deadline.. e. Total grant allocation amount.. . Matching funds/local contribution..  ( Current status of grant..  .Closed-out.  X or Active..  Program rehabilitation/repair budget (hard costs only).. h. Number ofc dwelling units targeted for rehabilitation/repairs. Number of dwelling units completed to date.. Number ofrehabilitationhepai, jobs under contract at present.. k. Average hard cost per unit completed (all sources)..  Current status of grant..  .Closed-out.. 5 -107-  X or Active..    URP13 Application for Funding  mI. Applicant Capacity (continued)  A. Rehabilitation/Repair Program Experience and Status: (continued) 4. Program name (use standard abbreviations as shown above).. a. Funding cycle (2007, 2008, etc.).. b. Date ofaward or project commencement date.. Grant/Funding Agreement number.. d. Project close-out date or deadline.. Total grant allocation amount., - Matching funds/local contribution.  URP 2011 10/03/11 URP1123 03/16/13 $85,000 $1,000 $75,728 20 15 5 $1,856 or Active.. X HCCBG 2012-2013 07/01/12 N/A 06/30/13 $102,222 $10,222 $58,828 100 35 $1,158 orActive.. X  g. Program rehabilitation/repair budget (hard costs only).. h. Number of dwelling units targeted for rehabilitation/repairs. Number of dwelling units completed to date.. Number ofrehabilitation/repai, jobs under contract at present.. A Average hard cost per unit completed (all sources).. 5. Program name (use standard abbreviations as shown above). a. Funding cycle (2007,2008, etc.)... b. Date ofaward or project commencement date.. c. Grant/Funding Agreement number.. d. Project close-out date or deadline.. e. Total grant allocation amount.. Matching funds/local contribution..  C Current status of grant..  .Closed-out.  g. Program rehabilitation/repair budget (hard costs only).. h. Number of dwelling units targeted for ehabiltation/epairs. Number of dwelling units completed to date.. Number oft rehabilitation/repair, jobs under contract at present.. k. Average hard cost per unit completed (all sources).. 6. Program name (use standard abbreviations as shown above).. a. Funding cycle (2007, 2008, etc.)... b. Date of award or project commencement date.. . Grant/Funding Agreement number.. d. Project close-out date or deadline. Total grant allocation amount.. Matching funds/local contribution.  C Current status of grant..  Closed-out.  Program rehabilitation/repair budget (hard costs only).. h. Number of dwelling units targeted for rehabilitation/repairs. Number of dwelling units completed to date.. Number of rehabilitation/repair, jobs under contract at present.. Average hard cost per unit completed (all sources)..  ( Current status of grant..  .Closed-out. 6 -108-  or Active..    URP13 Application for Funding  mI. Applicant Capacity (continued) C. StaffQualifications and Experience:  Identify key personnel below according to their rolesi ini implementing the URP project. Attach a current resume for each individual listed. Label resumes as "Exhibit III C". Itis especially important that the resumes of technical staff- those responsible for the urgent repair management, work write-ups, etc. - list all relevant training workshops and seminars along with technical credentials such as building inspector certifications, contractor licenses, lead paint certification,  etc.  Project Role  Name/Position Title Lorie Sutton Director of Aging & In Home Svcs Rhonda Smith Senior Admin Support Specialist Steven Wilson Home Improvements Coordinator Steven Wilson Home Improvements Coordinator Steven Wilson Home Improvements Coordinator Steven Wilson Home Improvements Coordinator Angela Faircloth nformation/Referral Specialist Angela Faircloth nformation/Referral Specialist Annette C. Chancey Attorney  1. URP project administration. 2. Financial management. 3. Construction oversight. 4. Work write-ups/cost estimates. 5. Interim inspections ofv work. 6. Final inspections ofwork. 7. Applicant intake/eligibility. 8. Client counselingreterrals. 9. Legal seryices, recording, etc.  Name Title Name Title Name Title Name Title Name Title Name Title Name Title Name Title Name Title  Applicants proposing to act as general contractor and use member-employed work crews and/or volunteers to facilitate the related rehabilitation work must demonstrate satisfactory capacity to fulfill this role. To do this applicants must, inj part, have capable construction supervisory personnel on the job site. Ifapplicable, please identify key construction supervisory personnel below according to their roles. Attach a current resume, including a list ofall relevant training, workshops, seminars, and technical credentials, for each individual listed below.  9. Construction Supervisor. 10.Job Site Volunteer Foreman.  Name Title Name Title 7 -109-    URP13 Application for Funding  IV. Certifications  The applicant hereby certifies that:  A. The information in this application is complete and accurate and the applicant possesses the legal authority to apply for and receive the Program funds and the person signing the application B. The applicant agrees that the Agency may conduct its own independent review oft thei information herein and the attachments, and may verify information from any source; and,  has the proper authority to do so; and,  The applicant understands that the North Carolina Housing Finance Agency will not be responsible for any costs incurred by the applicant in developing and submitting this application, and that all D. The applicant is under no administrative restrictions from federal, state or local sources to receive E. The applicant, ifi funded, will comply with the applicable provisions of General Statute 143-6.1  applications submitted become the property ofthe Agency; and,  funding; and,  related to conflicts of interest.  Attest (signature) Rhonda Smith Typed Name Title Date  Chief Administrative Official (Signature)  Lorie Sutton Typed Name Director Title Date  Senior Administrative Support Specialist  Applications must be received by the North Carolina Housing Finance Agency by 5:00 pm, February 8, 2012.  Mail or deliver to:  The Strategic Investment Group North Carolina Housing Finance Agency 3508 Bush Street Raleigh, NC 27609-7509  Submit one original signature version and one copy ofyour application. All applications must be accompanied by an application fee ($50.00). Make checks payable to the N.C. Housing Finance Agency.  8 -110-    APPLICATION GUIDELINES  For the 2013 cycle oft the  URGENT REPAIR PROGRAM  (URP13)  NORTH CAROLINA HOUSING FINANCE. AGENCY POSTOFFICE BOX: 28066 RALEIGH, NORTH CAROLINA 27611-8066  (919)877-5700  December 2012  -111-    Application Guidelines  CONTENTS  PAGE  1. 2.  Introduction. Background 3. Funding. 4. Schedule. 5.  Eligible applicants. 6. Eligible households. 7. Eligible activities  8.  Eligible forms ofa assistance 9. Application review and ranking process. 9.1 Threshold review. 9.2 Competitive ranking.. 9.3 Agency Board approval 9.5 Funding award..  /  9.4 Post-Approval Documentation and Funding Agreements  10. Special Instructions to the Application. 10.1 Requests for Application forms 10.2 Application deadline 10.3 Application fee. 10.4 Address 10.5 Special instructions.  10 10  -112-    APPLICATION GUIDELINES  For the Urgent Repair Program  1.  Introduction  The North Carolina Housing Finance Agency announces the availability of funds underthe At total of$3.5 million will be made available under the 2013 cycle oft the Urgent Repair Program (URP13) to nonprofit organizations, local governments and regional councils statewide who may apply for funding through a competitive application process. Applicant eligibility and ranking criteria are described under sections 5 and 9, respectively. Last year's URP funding cycle ("URP12"), was very competitive, with 60 applicants requesting a total of$ $5.3 million. With $3.5 million available, 44 projects were funded. With a similar amount of funding available under URP13, we expect 43 to 450 oft the applicants to The goals ofthe Urgent Repair Program are: 1) to alleviate housing conditions which imminent threat to the life or safety of very low-income homeowners with special needs; pose and 2) to provide accessibility modifications and other repairs necessary to prevent the imminent displacement of very low-income homeowners with special accessibility needs, such as frail  Urgent Repair Program ("URP").  receive awards.  an  elderly and persons with disabilities. The Urgent Repair Program objectives are:  1) To assist very low-income and low-income owner-occupant households with one or more fulltime household member with special needs (elderly: > 62 years ofa age, handicapped or disabled, single-parent, large households (five or more), or households with children who have elevated blood lead levels (betweenlOpg/d 2) To serve households with urgent repair needs which cannot be met through other state- or federally-funded housing assistance programs; and, 3) To enable frail elderly homeowners, and others with physical disabilities, to remain in their homes by providing essential accessibility modifications. Under URP13, recipients of funds will be expected to develop and adhere to fair, open and competitive procedures for the procurement of goods and services and for the selection of Program beneficiaries. These Application Guidelines provide a brief overview oft the Program. Additional information on Program and application requirements is contained in the accompanying Application for Funding.  and 19ug/dI), in all areas of the state;  3  -113-    2.  Background  Inl 1994 the North Carolina Housing Finance Agency (NCHFA) initiated the Urgent Repair Program ("URP94") as a one-year demonstration program with funds from the North Carolina Housing Trust Fund. The program was approved by the North Carolina Housing Partnership in response to the frequently expressed need for repair funding to respond to emergency situations and prevent displacement without being required to A total of$1 million ofURP94 funds was allocated to sub-contractors under the U.S. Department of] Energy's Weatherization Assistance Program through a non-competitive application process. An additional $250,000 was available to other non-profit organizations, non-entitlement local governments, public agencies, and regional councils through a competitive application process. A total of 47 organizations received URP94 funding which enabled them to assist more than 6501 households. Ac comprehensive study oft the 1994 demonstration cycle indicated that it had filled a vital niche, and that there was strong, broad-based support for continuing the program. At the same time, the study elicited some thoughtful suggestions which led to. numerous improvements in the design oft the Urgent Repair Program. After many additional program adjustments over the past 18 years, URP is now a very popular tried and true product, filling a vital service niche. Close to $34.5 million in URP funding has been committed to date to assist over 10,600 households with repairs and accessibility From May of 2002, until February of2004 aj portion of recaptured URP funds (from recipients that were unable to use their entire allocation within the allotted time) was dedicated to a special Displacement Prevention Partnership Program fund ("DPP"). Under DPP, very-low income homeowners are referred to NCHFA by either oftwo state agencies (Department of Environment and Natural Resources (DENR) or the Independent Living Rehabilitation Program at the Division of Vocational Rehabilitation Services)if they face imminent displacement due to either lead-paint poisoning or mobility limitations requiring home modifications. Since 2004, over $7.67 million has been set aside for DPP. To date, modifications have been completed on over 2,400 households, Those with experience under the recent cycles ofURP will find some significant changes in the guidelines. The significant changes include raising the maximum eligible hard costs, revising program support expense allowances, changing the form of assistance from grants to loans, and reducing the percentage of assisted households that must fall below 30% oft the area median income. To avoid confusing one cycle with another, we  bring a whole house up to code.  modifications.  all through local offices of! Independent Living Services.  will often refer to the current cycle as URP13.  -114-    3.  Funding  The total amount of funding available under URP13 is $3.5 million. Support for URP13 comes from the State appropriated North Carolina Housing' Trust Fund. Under this program cycle, funding limitations will apply to entitlement counties and cities. The 26 units ofl local government that receive CDBG funds directly from HUD may apply for a maximum of$37,500. Those 'Entitlements" are the cities of Asheville, Burlington, Cary, Chapel Hill, Charlotte, Concord, Durham, Fayetteville, Gastonia, Goldsboro, Greensboro, Greenville, Hickory, High Point, Jacksonville, Kannapolis, Lenoir, Morganton, Raleigh, Rocky Mount, Salisbury, Wilmington and Winston-Salem, The maximum allocation to a non-entitlement recipient organization proposing to serve a multi-county service area (two or more counties in their entirety)is$ $150,000. The maximum allocation to an organization or non-entitlement government entity proposing tos serve an area of less than two entire counties is $75,000. Only applicants proposing to serve areas with populations of5,000 or more are eligible. The minimum allocation is $25,000. Eligible applicants may submit only one application. Funding provided to URP13 assistance provided by Recipients to eligible households cannot exceed $6,000 in hard and soft costs per dwelling unit. There is no minimum amount of Program funds A share of each Recipient's URP13 allocation may be used for program support expenses, but must be accounted for and claimed on a unit-by-unit basis. Eligible program support expenses are those necessary and reasonable costs directly associated with the delivery of program assistance, such as: (1)salaries and benefits for technical staff, or fees to consultants for work write-ups, cost estimates, inspections, etc.; or (2) office supplies and materials consumed in carrying out repairs. The maximum amount available varies with the amount oft the hard costs. All URP assisted units may receive base program support of $200. Units with hard costs exceeding $500 may receive additional soft costs up to 10% oft the hard cost for eligible program support expenses, sO long as the total soft cost  plus Cumberland, Mecklenburg and Wake Counties.  recipient organizations will bei in the form of conditional grants.  that can be spent on any assisted dwelling unit.  for the unit does not exceed $600, as indicated by the table below.  URP13 Hard Costs From $501 to $6,000 Upi to $500  Maximum Program Support  $200 + 10% oft the Hard Cost (not to exceed $600)  $200  For instance, ift the hard costs associated with the repair or modification ofa given unit is $3,250 the Recipient may claim up to $525 for program support expenses ($200 + $325).  5  -115-    4.  Schedule  Applications for Program funding must be received at NCHFA by 5:00 pm, February 8, 2013. Applications will be rated according to the criteria described below. Program awards will be announced by the end of May, 2013. After the implementation workshop for program administrators and technical staff, Funding Agreements will be executed. Successful applicants will be given a maximum of 18 months to complete theirURP  projects, and must report program progress quarterly.  5.  Eligible: applicants  Eligible applicants for URP13 funds include: 1)nonprofit organizations; 2) units of local government; and, 3) regional councils. Applicants for Program funding are directly responsible for the administration of projects being funded, even when contracting with  third parties for administration. Eligible households  6.  Only households with special needs as defined in section 1 (Introduction), paragraph 5 are eligible for assistance under URP. A minimum of 50% ofthe households assisted under al Recipient's URP13 allocation must have incomes which fall below 30% oft the area median income. No URP funds may benefit households with incomes exceeding 50% of the area median. Only owner-occupied housing is eligible for assistance under the Urgent Repair Program. Income limits will be defined using the most recent HUD income estimates, as provided by the NCHFA (see URP income limits at our web site www.nchfa.com under the Urgent Repair Program section).  7.  Eligible activities  URP13 funds may be used exclusively to alleviate housing conditions which pose an imminent threat to the life or safety of very low-income households with special needs, or tot their ability to remain int their! homes independent ofi institutional confinement. Upon completion, housing units repaired/modified under the URP do not have to meet any housing codes or habitability standards, but the work performed under the Program must meet North Carolina State Residential Building Code standards and be performed in accordance with all state and local permitting, inspections, licensing and insurance  requirements.  8.  Eligible forms ofassistance  Assistance provided to owner-occupants by Recipient organizations under URPI3 shall be in the form ofa loan covering the hard and soft costs of the URP funds associated with the repair/modification oft the unit. Homeowners will receive an unsecured deferred,  6  -116-    interest-free loan, forgiven at the rate of$1,000 per year, until the principal balance is reduced to zero. Recipients must use the loan documents provided by the Agency. Recipients will be expected to have adequate project procedures to ensure that  documents are properly processed. Application review and ranking process  Program  9.  Applications for Program funds will be reviewed and ranked on applicant capacity to operate the project, past performance under Agency Programs, ifapplicabie, and the project location (whether they are serving an underserved county). A four-step review process will be used: threshold review, competitive ranking, Agency board approval, and  execution ofF Funding Agreements. 9.1 Threshold review  Applications that do not include an attached resume for each person listed on table IIC on page 7will be considered incomplete. The threshold review will eliminate any applications which are incomplete, were not received by the deadline, are from ineligible entities, or are not accompanied by the required application fee or a copy oft the original application. The threshold review: is also meant to eliminate applicants lacking minimal capacity to operate the project. 1) The experience oft the applicant in undertaking similar projects; 2) The past performance of the applicant, ifapplicable, under housing 3) The capacity of the organization, including staffing support, to complete the project. (Special attention will be given to the avallalillyofgualped technical staff to diagnose repair or modification needs and implement the appropriate measures to address the needs, professionally and efficiently.) The capacity of units of local government or others proposing to administer the project through at third party will be rated based on that party'sg qualifications, experience and past performance under Agency programs, if applicable.  The following factors will be considered:  rehabilitation programs;  9.2 Competitive ranking  The next phase oft the selection process will be to rate and rank applications based on a number of factors related to applicant capacity as determined by (1)staff qualifications and experience, (2) performance under past cycles of the Urgent Repair Program (including the percentage oft targeted units completed under active grants and timeliness of grant completion), ifapplicable, or recent performance under other repair initiatives; and, (3) the accuracy and completeness oft the URPI3 application. A comprehensive and effective system for referring clients to  7  -117-    services other than housing will also be aj positive rating factor. Points will be awarded for matching local funds (for hard costs only) as well as for proposing to serve counties underserved by the URP funds since the Program'si inception (see below). Projects proposing to serve households with urgent repair needs which can be met through other state- or federally-funded housing assistance programs are discouraged and will be at a competitive disadvantage. (URP is designed to be used as funding oft the last resort.) Points will also be awarded to organizations that applied for last year's URP cycle but were not recommended for funding. The. Agency will not fund two applications with overlapping service areas.  Counties Underserved with the Urgent Repair Program  Counties Underserved with the Urgent Repair Program  Alleghany Dare  Iredell Lincoln  Surry  9.3 Agency Board approval  After completion of the application review and ranking process, the final funding decision will be made by the Agency's board of directors. Itist the goal of Agency  staff to take their recommendations to the board in May 2013. 9.4 Post-Approval Documentation and Funding Agreements  Following board approval of the final ranking of applications, Applicants approved by the Agency board will receive conditional award letters and requests for additional documentation (Post Approval Documentation). Funding Agreements will be forwarded to Recipients following receipt by the Agency of  8  -118-    all information requested in the post approval documentation packet and attendance at the mandatory URPI3 Implementation Workshop. Recipients will be given 45 days to execute and return the Funding Agreements to the Agency.  Post approval documentation will include the following: 1) A copy oft the Recipient's Procurement Policy;  2) Bonding/Honesty and Fidelity Insurance documentation. All Recipients must submit evidence that honesty and fidelity insurance coverage is available in an amount not less than 50% oft their URP13 funding Organizational Documents. Recipients which are not units of government may be asked to supply copies oft their organizational documents, including articles ofi incorporation, by-laws and a listing ofa all directors, 4) Conflict of Interest Policy (for private-nonprofit organizations); ;and, 5) The Applicant's proposed URP13 Assistance Policy.  allocation;  3)  officers and staff;  9.5 Funding award  Upon receipt and approval by the Agency oft the Post Approval. Documentation packet, the Agency will forward the Funding Agreement to the Recipient. Once the executed Funding Agreement is returned to the Agency, an initial disbursement of 50% oft the award amount will be sent to the Recipient organization. Project activities may commence upon receipt of the fully executed Funding Agreement. Note: Ifall necessary documentation is not received by the Agency within 45 days ofthe date ofthe conditional award letter, the award  may be canceled and thej funds de-obligated.  10. SPECIAL INSTRUCTIONS TO' THE. APPLICATION  10.1 Requests for Application forms  Program Application forms may be downloaded from the Agency website www.nchfa.com, or requested from the. Agency by calling Amy Elms at (919) 877-5661, or by writing to the address shown below (see section 10.4).  10.2 Application deadline  An original application and one copy per grant request must be received by the  Agency by 5:00 p.m. on February 8, 2013.  9  -119-    10.3 Application fee  The application must be accompanied by a non-refundable application fee. The application fee must be paid by a check made payable to the North Carolina  Housing Finance Agency. The application fee is $50.  10.4 Address  All applications must be mailed or delivered to:  The Strategic Investment Group North Carolina Housing Finance. Agency 3508 Bush Street Raleigh, North Carolina 27609-7509  10.5 Special Instructions  1) Automated. application forms created in MS Excel are available at our website (www.nchfa.com) or via e-mail. Itis highly recommended that applicants use the automated version to take advantage of multiple automated calculations and general ease ofuse. The Excel version is designed such that the applicant tabs through the form, landing only where information is to be entered (the light yellow cells). All totals are automatically calculated (in the bright yellow cells). Ifyou do not use the Excel version, please ensure that your application is typed or printed legibly ini ink. Dollar amounts should be rounded to the nearest dollar. All applications should be signed and dated ini ink on the "Certification" page by the applicant's chief administrative official as listed on the application underI I.B.I. 2). All applications should be submitted on the form provided. Except for requested attachments, please confine your responses to the provided space. 3)Itis preferred that applications be fastened at the upper left corner by a single staple or binder clip. Covers, ring binders, and folders are discouraged, as are attachments or exhibits which are not specifically requested. 4) All attachments should be clearly marked in the upper right hand corner according to the instructions in the application. The attachments should be attached in the order that they were requested, at the back of the application  No applications will be accepted electronically or by Fax.  following the last page.  10  -120-    Sampson County Office ofTax Assessor PO Box 1082 Clinton, NC 28329  Phone 910-592-8146  Fax 910-592-4865  TO: FROM: DATE: SUBJECT:  Ed Causey-County Manager Jim. Johnson-Tax. Administrator December 17, 2012 Disabled Veteran Exclusion (Application GS 105-277.1c)  The attached disabled veteran exclusion application was received after June 1, 2012. After that date, the Board of Commissioners must approve the  application.  The applicant is as follows:  Barney D. Brewington  AI letter is submitted requesting approval of the late application. The application meets the statutory requirements for the disabled veteran Please put on the next Board of Commissioners consent agenda for their  exclusion other than being timely filed.  action.  -121-    126280  Sampson County Board of Commissioners  Rowan Rd Clinton, NC28328  InF Re: Brewington, Barney D. 340 Brewington Rd Clinton, NC28328  Dear Commissioners:  lam an Honorably Discharged Veteran and ihave been awarded 100% service connected compensation for disabilities caused by my military service. lunderstand that my application for Tax exclusion on my County Property Tax is not within the time frame set; however, lam requesting that you please accept  this application and grant me the exclusion.  lapologize for the late date; however, this was not within my control. Thank you for your consideration.  Sincerely,  SonyObugt Barney D. Brewington  -122-    74A4 (Rev 08-09:  01-UIU Lov-uI + 124280 SAMOScA COUNTY  NCDVA-S For Dest oelivery to USDVA, filing this form witny your local veteran's  service office IS recommensed  State of North Carolina for Disabled Veteran's  Certification  Property Tax Exclusion (G.S. 105-277.1C) TO BE COMPLETED BY THE VETERAN OR THE SURVIVING SPOUSE WHO HAS NOT REMARRIED  SECTION1 1  Bainsu D Brasneton 340 Brewmaton Ad  NAME( (Print or Tybei STREET ADDRESS ORI Olinton 00 CITY  BamayD.Beainglaa DISABLED' VÉTERAN'S FULL NAME (PRL OR TYPE; SURVIVING SPOUSES FULL NAMEPRINT OR7 TYPE)  Lan  P.O. ebx NUMBER :  Bceuhnlan (fApplicable  NC 28328 STATE ZIPCODE  U.S. DEPT. OF VETERANS. AFFAIRS FILE! NUMBER VETERAN'SS SOCIAL SECURITY NUMBER conditions and who has a psrmanent of a veteran whose character of servics at disability at death or in support of my separate  iam either (1)a veteran whose character of service at separation was honorable or under honorable and total service-congected disability or (2) the surviving spouse, who has not remarried, separation was honorable or under honorable conditions and who application for the Disabled Veteran's Property Tax Exclusion to the Tax Assessor. lauthorize the U.S. Department of Veterans Affairs to release information regarding my  veteran's SECTION2 ceytification. SECTION 3  had a permaneni and total service-connected  death was the result.of a service-connected condition. I request USDVA complete this certification  Disabled Veteran's Signature  as needed  disability 10-10-2012 DATE my DATE  fori this  buOhaunt  DISABLED VETERAN'S SIGHATURE  Surviving Spouse's (who has not remarried) Signature  lauthorize the U.S. Depariment of Veterans Affairs to release nformation  as needed for this certirication.  regarding spouse's disability or death  SURVIVING SPOUSE'S SIGNATURE  SECTION 4 Please check all C. that apply: D.  To be completed by the U.S. Department of Veterans Affairs Veteran has as service-connected permanent and total disability that existed as of_ 12/1/1999  A. B.  Meteran does notr meete either B, C,D.orEoft the below criteria.  Veteran received benefits on. Veleran died on. Veteran died on/ D Honorable FOFFICIAL  from U.S. Department ofVeterans Affairs for specially and hada a service-connecled permanent and total disability at death. and the death was either (1) the resulto ofa a service-connecied condition  adapted housing under 38 U.S.C. 2101 fort the veteran's permanent residence.  E.  (2)d death occyifedy while on active duty in the lne ofc duty and noto due to service member's own willful misconduct or  Character of Disabled Veteran's Service at Separation: (DD-214) SIGNATURÉOF, JSova PRINTED! ASOFARORCEMIRUKSN TITLE OF USDVA CERTIFYING OFFICIAL  Under Other than Honorable Conditions  Under Honorable Conditions  1018512 DATE  NOTE: Stamped Signature by USDVA Official on this form has been authorized by Director, VA Ragional Office, Winston-Saiem, NC.  NC Division of Veierans Afiairs authorizes tne NC Deparmer -123- and any County Tax Office to uss this form as needed    Sampson County Office ofTax Assessor PO Box 1082 Clinton, NC 28329  Phone 910-592-8146  Fax 910-592-4865  December 19,2 2012 RE: Tax Parcel 12-0031320-01 Sampson County Board of Commissioners,  The above mentioned tax parcel isa. .76 commercial lot located at 600 Beaman Street in Clinton, directly across from Sampson Regional Medical Center. In: 2006 the old buildings were torn down and a new commercial building was constructed in 2007. The owner of the property is Phillip David. On December 3, 2008 a deed was recorded to StarDoc Inc. The deed description stated that StarDoc was purchasing Unit B oft the Beaman Street Condominium further described in Plat Book 65, page! 59. Afterr receivinga call from Mr. David concerning his portion of the taxes it was discovered that the entire property was transferred to Stardoc in error. Both parties have been notified oft this error and are in agreement that Stardoc should have been assessed taxes for their unit only and the front parking area and the remaining portion of the property should have been assessed to Mr. David. Along with the refund isa copy of the deed, plat book and property record card. Mr. David has already been billed fort the taxes to be refunded to StarDoc and the property record cards will be corrected for the 2013 billing year. If you  have any further questions concerning this refund please do not hesitate to call.  ampson CeTax Administrator  ZR  -124-    OFFICE OF THE SAMPSON COUNTY TAX ADMINISTRATOR  P.O.BOX1082 = CLINTON, NORTH CAROLINA 28329-1082  GLENN SPELL Tax Administrator  Telephone 910/592-8146 910/592-8147 5574  SAMPSON EAST ROWAN ROAD CLINTON, NORTH CAROLINA28328 Gentlemen:  COUNTY BOARD OF COMMISSIONERS  Pursuant to North Carolina G.S. 105-381,lhereby demand refyngand: remissionof taxes assessed and collected by  Sampson County against the property the year(s) and in the amount(s) of.  JTRBOC INC  in o7y Cwton  Township, Sampson County, for  YEAR RO!l 2.010 2009  $ $. $. $. $. $  5,58720 562728 4623, 90  TOTAL REFUND  15738,38  These taxes were assessed through clerical error as follows.  County Tax. 935972 541 School Tax. 4,756.97 CoRCIyT Tax #62L69  Fire Tax  TOTAL $ 15738,38  Yours very truly Taxpayer   # ECOWMENPAPPROVAL LA  Mailing address.    RMec INC, POBoK 15237 MtEAEEE  ML  -125-    4838888 MI Bis MALAA nisi  B1  692. DNDOMINIUM BEAMAN. STREET MORINCAK COMDODBg-126-  A1.0  GOODRICH    1727, 0915  FILED SAMPSON COUNTY ELEANOR N. BRADSHAW REGISTER OF DEEDS FILED AT BOOK START PAGE ENDI PAGE INSTRUMENT# 07835  BK:01727 PG:0915  Dec 03, 2008 02:34:14 pm 01727 0915 0917  NORTH Sampson CAROLINA County 12-03-2008 Excise Tax  $1.350.00  Prepared by: ALAN M. SOLANA, 219 N. 2nd Street, Wilmington, NC 28401  NORTH CAROLINA SAMPSON COUNTY  PART OF PARCEL # 12-0031320-01 Excise Tax: _/350.00  WARRANTY DEED  ecemak  THIS DEED, made this_ day of Novemter, 2008, by and  between G. PHILLIP DAVID & wife, ANN M. DAVID, whether one or more, called GRANTOR, and STARDOC, INC., a North Carolina corporation, whose mailing address is 184 Cardins/ Cfhlb.Ac  whether  one or more, called GRANTEE.  286G  WITNESSETH THAT:  The GRANTOR, for and in consideration of the sum of  Ten Dollars ($10.00) and other valuable considerations to them in hand paid by the GRANTEE, the receipt whereof is hereby acknowledged, have bargained and sold, and by these presents do hereby bargain, sell and convey unto GRANTEE, their heirs, successors and assigns forever, all that certain real property located in Sampson County, North Carolina,  described as follows: THIS REFERENCE.  SEE EXHIBIT "A" ATTACHED HERETO AND INCORPORATED HEREIN BY restrictions and easements of record; All local, taxes; Applicable federal laws and regulations relative to county, state and subdivision, usage, construction and development zoning, of the occupancy, described TO HAVE AND TO HOLD the above granted and described  SUBJECT TO 2008 ad valorem real property  property.  property, easements, anywise assigns, executors and heirs,  together with all and singular, the rights, privileges, tenements and appurtenances thereunto belonging, or in appertaining unto the said GRANTEE, their heirs successors and And the GRANTOR, for themselves, their heirs, administrators, do covenant to and with the said GRANTEE, their  in fee simple forever.  -127-    1727. .0916  BK:01727 PG:0916  successors and assigns, that they are seized in fee of the above granted and described property; that they have good right to sell and convey the same in fee simple; that the same is free and clear from any and all restrictions, easements or encumbrances, except those mentioned above; and that they will and their heirs, executors, administrators and successors shall warrant and defend the title to the same against the lawful claims and demands of any and all persons whomsoever. hands and seals as of the day and year first above written.  IN TESTIMONY WHEREOF, the said GRANTOR has hereunto set their  (SEAL) (SEAL)  PHILLIP DAVID Mm2 QwMDao ANN M. DAVIDI  STATE OF NORTH CAROLINA, COUNTY OF brunsuch  I, Mndayiofilcto foregoing instrument.  a Notary Public in and for the state and  County aforesal, do certify Gllsi and wife, Am_M._David personally appeared before me this day and acknowledged the execution of the Witness my hand and official seal this st day of November, 2008.  Decuwbyr  Wtnw.lchn Nordjy Public  My Commission Expires:glo/2on  NOTARY PUBLIC  -128-    1727' 0917  BK:01727 PG:0917  EXHIBIT "A"  BEING A UNIT OWNERSHIP IN REAL PROPERTY AND PURSUANT TO Chapter 47C of the General Statutes of North Carolina, Entitled "Unit Ownership Act", and being known and designated as Unit B of 602 BEAMON STREET CONDOMINIUM, a Condominium project situated upon real property located with the Town of Clinton, State of North Carolina, as said real property is described in Condominium Plat Book 65, - beginning at Page 59 in the Office of the Registry of Deeds of Sampson County, North Carolina, and together with all appurtenances thereto belonging, including, but not limited to, the undivided interest in common areas and facilities of 602 BEAMON STREET CONDOMINIUM as the same are established in the DECLARATION OF CONDOMINIUM, recorded in Book 01708 Page 0297 in said Registry, and  any amendments thereto.  -129-      #ABBY  SBER   3P  DD  PPA FMEES  -130-  E55    OFFICE OF THE SAMPSON COUNTY TAX ADMINISTRATOR  R0.B0X1082-CUNTON, NORTH CAROLINA 28329-1082  GLENN SPELL Tax Administrator  Telephone 910/592-8146 910/592-8147 5305  SAMPSON COUNTY BOARD OF COMMISSIONERS EAST ROWAN ROAD CLINTON, NORTH CAROLINA28328 Gentlemen:  Pursuant to North Carolina G.S. 105-381, Ihereby demand refund andremission oft taxes assessed and collected by Sampson County against the property owned by, Betly Reeves lay/or  in.  Sath Clinfo  Township, Sampson County, for  the year(s) andi in the amount(s) of: 15-0357320-13  YEAR 2010 a009 ao0 2ee7  s_12.63 $_50.33 $_80.2 $ 48.05 $  TOTAL REFUND  242) /93.17  These taxes were assessed through clerical error as follows: Sold all land plr Deeclbk 1330 Pya3  - /  4o  131)01.  County Tax. H69.S 129.80 LeygPe-SchoglTax 456 43.74  60IBASAS02  Fiblax AdwrSiy-TaN  +85 14,74 805 6.04  TOTAL $_ 42 /93.17  Yours very truly, Taxpayer Social  Rs .  (bcot)  Mailing address: LaySAw  707 Cacde Scdltll  NUC 338398  -131-      1375 0986  Fledforregistation  MDamlenco 9:560a AMedagesintes officealtheR Regisler oiDeeds a!Sampson County anhe. 13December 20DbBookNo 1375m98l MAEH. TROUBLEFIELD th, hnnA Recording Time, Book and Page  Depuly V0L175P11986  Excise Tax  Tax Lot No. Verified by by  Parcel Identifier No..  County on the  day of.  Mail after recording to Betty. Tay-lor,- 707.-Claude- Scott Road,-Warsaw,- NCv 28398 This instrument was prepared by. M.LLES.. B. FOWLER, -AITORNEYALLAN.  Brief description for the Index  South Clinton Township  NORTH CAROLINA GENERAL WARRANTY DEED  THIS DEED made this 11. day of. December. GERALD ROBINSON (single) of Sampson County, North Carolina  2000 by and between GRANTEE  GRANTOR  BETTY REEVES TAYLOR of Duplin County, North Carolina  Enter In appropriate block for each parly: name, address, and, I appropriate, character at entity, e.g. corporation or partnership. The designation Grantor and Grantee as used herein shall include said parties, their heirs, successors, and assigns, and WITNESSETH, that the Grantor, for a valuable consideration paid by the Grantee, the receipt of which is hereby acknowledged, has and by these presents does grant, bargain, sell and convey unto the Grantee in fee simple, all that  shall include singular, plural, masculine, feminine or neuter as required by context.  certain lot or parcel of land situated in the City of.  South.Clinton  Township,  Sampson.  County, North Carolina and more particularly described as follows:  SEE EXHIBIT "A" FOR DESCRIPTION OF LAND.  N. C. Har Assne. Form: No. 38 1976. Revisedo 1977 -----w-132-    1375 0988  The property hereinabove described was Ar map showing the above described property is recorded in Plat Book. TO HAVE. AND TO HOLD the aforesaid lot the Grantee in fee simple. And the Grantor covenants with the defend the title against the lawful Title to the property  V0L1375P8:988  acquired by Grantor by instrument recorded in.  page... -  or parcel of land and all privileges and appurtenances thereto  belonging to  the same in fee simple, that title is marketable Grantee, that Grantor is seized of the premises inf fee  has simple, the right to convey  and free and clear ofalle  claims of all persons whomsoever encumbrances, and that Grantor will warrant and  hereinabove described is subject to the following except for the exceptions hereinafter stated.  exceptions:  IN WITNESS name by WHEREOF. As duly authorized the Graptor has hereunto his hand and  abova written. By: ATTEST:  otficers andi its seal BA hereunto affixed seal, s i authority corporate, of has its Board caused this instrument to be signed in  of Directors, the day and year   (Corporate Name) President Secretary (Corporate Seal) NORTH CAROLINA, Samp.son.. 1, Notazy Publie of the Caunty and State aforesaid, certify that Serald..Robinsan. personally appeared before me this day and acknowiedged the execulion oft the foregoing hand and official stamp or seal, this. AL.. day of. -.December. My commission -Asay. 1, Natary Public of the County and Stata atoresaid, certity that personally came before me this day aud acknowtedged that. he is Witness my hand and official stamp or seal, this. day of  Slh GERALD  (SKAL) (SEAL)  Br  County.  Grantor, instrument. Wilness my 2000 Public Secretary ot Secretary, Notazy Public  Kpmi,  SEAL-STAMP  NORTH CAROLINA,  Coanty.  riven and as the act of the corporatton, the foreroing North Carolina rorparation, and that by authority duly  President, sealed with Its Mty commission expires: Rathleen..  instrument was signed in lts name by its.  corporate seat and attested by.  The foregoing Certitieatet,  Sanp.son.. CDy t Igram TLoAK.y. wlsat  H. certlies hereof. to he correet, This instrument and this certiticate are duly Ma.H.Trauhlatiels. ODDna. Sitb  registered at the date and time and in the Book and Page shown on the REGISTER or DEEDS FOR..- Sampsoo.. Aal Register of Deeds  By  COUNTY  N.C. PIACDVA Har Asspe. FommN0.391976. Reriseu * 1977  CBABe 181  -------133-    1380 0023  315 JhDuayy  SAMPSON COUNTY NC 01/31/2001  Flediorn rgttralionon  $12.00 Real Estate Excise Tax  9:2An Mandi ragleisedinthe gliçadhe Fagisier dDeeds oSampeon Courtyo one 3LsyaJanuary 20BLInBoakNo. 1380 PIgINO._23 MAEH.TROUB EFIFLD Heguter aiDeeds Donna Smithy _Depuly Recording Time. Book 13801:023  Excise Tax $12.00  Tax Lot No. Verified by by  Parcel Identifier No. day of.  County on the.  Mail after recording to SHANNON HIGGINBOTHAM  3975.Garland. Highway,.. Clinton,. N. C... 28329.  Thia instrument was prepared by. MILES.B..FOWLER,. ATTORNEY_AL.LAW.  Brief description for the Index  NORTH CAROLINA GENERAL WARRANTY DEED  THIS DEED made this 30th day of. January BETTY REEVES TAYLOR and husband, OTIS ELWOOD TAYLOR of Duplin County, North Carolina  2001, by and between GRANTEE  GRANTOR  SHANNON HIGGINBOTHAM AND WIFE, HOLLY HIGGINBOTHAM, of Sampson County, North Carolina  Enter in approprlate block for each party: name, address, and, it appropriate, characier of entity, e.q. corporation or parinership. The designation Grantor and Grantee as used herein shall include said parties, their shall include singular, plural, masculine, feminine or neuter as required by context. heirs, WITNESSETH, that the Grantor, for a valuable consideration paid by the Grantee, the receipt of acknowledged, has and by these presents does grant, bargain, sell and convey unto the Grantee in fee which simple, is all hereby that BEGINNING at an iron stake in the Easterly edge of the right of way of U.S. Highway 701, which beginning point is located North 48 degrees 46 minutes 59 seconds East 193.97 feet from N.C.Grid Station Pearson",1973 (N.C.Grid Coordinates -437,676.241,k-2,1-2,204,297.576), which grid station is located North 20 degrees 22 minutes 48 seoonds East 811.07 feet from a P.K.Nail in the inter- section of the center line of State Road 1224 with the center of U.S.Highway AND RUNS FROM SAID BEGINNING POINT and with the Easterly edge of the way of U.S.Highway 701 North 30degrees 06 minutes 08 seconds East 136 right feet to an iron stake, a joint corner of the Ned Cottle parcel of land described in deed recorded inBook 1151,at page 642,in the Sampson COuntyRegistry, thence with said Cottle parcel of land South 68 degrees 38 minutes 52 East 210 feet toan iron stake; thence, a new line, South 30 degrees 06 seçonds minutes 08 seconds West 136 feet to an iron stake; thence another new line North 68 degrees 38 minutes 52 seconds West 210 feet to the beginning point, 0.65 acre, more or less, and being a. portion of the land conveyed to containing Robinson by deed from Georgia L. Robinson which is recorded in Book Gerald 1363, at page 393, in the Sampson County Registry. The description in this deed is from _survey and unrecorded map thereof by. Charles L. Matthis, R.L.S., which map is. dated December 1, 2000, and is entitled "Survey for Gerald Roginson". This is the same land as desCrihed in deed dated January 3, 2001 from Gerald Robinson to BettyReeves Taylor and recorded in Book 1377,at page 565,in  successors,  and assigns, and  certain lot or parcel of land situated in the City of  SOUTH. CLINTON. Township,  SAMPSON  County, North Carolina and more particularly described as follows:  of 701,  County Registry.  Sampso  N.C.BAssoc. Form.No.301976, Revisede 1977 amay -134-    OFFICE OF THE SAMPSON COUNTY TAX ADMINISTRATOR  P.O.BOX1082 = CLINTON, NORTH CAROLINA 28329-1082  GLENN SPELL Tax Administrator  Telephone 910/592-8146 910/592-8147 5580  SAMPSON COUNTY BOARD OF COMMISSIONERS EAST ROWAN ROAD CLINTON, NORTH CAROLINA28328 Gentlemen:  Pursuant to North Carolina G.S. 105-381,lhereby demand refund and remission oft taxes assessed and collected by Sampson County against the property owned by. Algernor Dana Brwwn Jr.  in.  Souhh CWhh  Township, Sampson County, for  the year(s) and in the amount(s) of.  YEAR 2012 - -  $ $ $ $ $. $  TOTAL REFUND  82.56  These taxes were assessed through clerical error as follows.  Acck85217 By* 830111 WVY  Gu 2 County Tax. 105.98 S6l School Tax. 19.60 SF2 Fire Tax 76 City Tax  8629  2.94 54.04  RehHuk /Hy trhedin  /Tyt Yours very truly Taxpayer Social Security #  TOTAL $ 182.56  qu/0  (Iigerer  Mailing address. Hgtrnn  Dana Brown Jr.  a  202 Celonicl Arenu Clitu, NC 39329  -135-  -    Sampson County Office ofTax. Assessor PO Box 1082 Clinton, NC28329  Fax 910-592-4865  Phone 910-592-8146  SUBJECT: Vehicle status after tag have been turned into DMV.  Vehicle sold date  tov whom  Vehicle traded date  to whom  Vehicle wrecked (total loss) date Insurance Company:  Other-Explain REMLEO Lw MAME OE InusT  7NIS WAs pvl IM  xe DlA  Signature  6DEC aclR Date  -136-    North Carolina. Division of Motor Vehicles Receipt for Plate and/or Sticker  FS20 (Rev8/96) Plate: WVY8629 Vehicle: 2010 Title: 770133102293011 Reason: PLT TURN IN (FS20) Refund: NO Branch Location: 011 CLINTON #011 Owner's Name ALGERNON DANA BROWN JR Residence Address (Individual) Business Address (Fi) 202 COLONIAL AVE City ands State CLINTON NC  12/05/2012  Expires: 07/31/2013 TOYT  Sticker: 45817559 STDYX3EN3AS018133  Lic. Weight:  MP  Agent: T1C0112  Zip Code 28328-2306  Note: The county requires a copy of this receipt and a copy of the bill ofsale within 1) year in order to process a  possible release or refund of property taxes on this vehicle.  -137-    OFFICE OF THE SAMPSON COUNTY TAX ADMINISTRATOR  P.0.BOX1082- CLINTON, NORTH CAROLINA 28329-1082  GLENN SPELL Tax Administrator  Telephone 910/592-8146 910/592-8147 5579  SAMPSON COUNTY BOARD OF COMMISSIONERS EAST ROWAN ROAD CLINTON, NORTH CAROLINA28328 Gentlemen:  Pursuant to North Carolina G.S. 105-381,lhereby demand refund and remission of taxes assessed and collected by  Sampson County against the property owned by. Ally Erancial  Vautt Kus) Township, Sampson County, for  in  Nhabl.  the year(s) andi in the amount(s) of.  YEAR 201a  $ $. $. $. $. $.  1751  TOTAL REFUND  11.5  These taxes were assessed through cleriçal error as follows.  vehice sold 7194s Fwnedis  acc+ # 44611 Bil # 798348 Roit Gmc TK  Ciz County Tax. 164.97 School Tax F18 Fire Tax City Tax  wym 3176  12.60  Tagt  TOTAL $. 17751  Yours very truly Taxpayer 3  PRGh Eiyr PeprR-kh) Mailing address.  Ally Finaral Po'Bec 9001951   Louvi,knhdy 462A0-1    REFUND REQUEST FOR Ally Financial (formerly known as GMAC)  Date: 11/21/2012 Sampson County PO Box 1082 Clinton, NC 28329 Tax Year: Bill Number: To whom it may concern:  2011 798348  Plate #: VIN#:  WYM3176 GTP2VE30BG158345  We are requesting a refund on the above listed tax bill. The lease on this vehicle has ended and the vehicle was sold. Enclosed, please find the applicable documentation as required for the Please complete the enclosed "Information Request Form" for our records, we. have provideda  refund oft taxes.  return envelope with pre-paid postage for your convenience. Once approved, please forward refund to:  Ally Financial (formerly known as GMAC) Louisville PPC P.O. Box 9001951 Louisville, Kentucky 40290-1951  Due to accounting complications, please do not apply this refund to any tax bills our company has outstanding. Please return this letter (or copy thereof) with the refund Thank you in advance for your efforts to assist us in this matter. Ifyoul have questions please  check.  contact the following individual:  Michelle West 615-514-6410  REF#: 12-005682  3  -139-    Date: 04/17/2012  BILL OF SALE AND ASSIGNMENT  FOR GOOD AND VALUABLE CONSIDERATION. the receipt and sufficiency hereby sells, transfers, and assigns to DORMAN CADILLAC-OMCTRUCK vehicle described below:  Financial (formerly known as GMAC)(the "Seller")  of which is hereby acknowledged, Ally  INC, 1000  INTERSTATE DR, DUNN, NC, 28334 (the "Buyer"), the motor  Model: SIERRA 1500 Make: GMC Year: 2011  VIN: 3GTP2VES0B015845  Ally Financial (formerly known as GMAC)  - hW  By  REF#: 12-005682  EO 3-9933  330h  -140-    VQ18 V312 CUST ID 000021776811 VAUL TRUST UST ID STATUS PLT# WYM3176 WT 5000 FHVUT DT F27 - FCCI INSURANCE COMPANY  TITLE HISTORY DETAIL  09/19/12 13:21:06  367P2VE30BG158345 2011 GMC  FUEL G TK  TITLE NO 774248110738006 TRF DT 030911 PRNT DT  CANCELLED - VEHICLE SOLD  031811Y OWNERS 1  DEALER oS  ISS DT 011112 EXP AUTO P# CA0017013  CAT PRIVATE  DT 013113 CRT DT 011112 TYP FR2  USE LPRO DRAFT N  TATUS PLT TURN IN (FS20) 04/05/2012 CONTROL # 334249110737006  TRANSFORMER MAINTENANCE AND SERVICES INC  LESSEES 1  PLT# WYM3176 WT 5000 FHVUT DT F27 - FCCI INSURANCE COMPANY STATUS STATUS CHANGE TRANSFORMER MAINTENANCE  ISS DT 011112 EXP PRIVATE AUTO P# 04/05/2012 CA0017013 AND SERVICES INC PF3/RETURN  CAT  DT 013113 CRT DT 011112 TYP FR2  USE LPRO DRAFT N  CONTROL # 334249110737006 LESSEES 1  PF1/HELP  PE2/IMAGE  PAGE 1 OF 2 PF5/ADDRESS PF6/OWNERS  PF4/  PE7/BACKWARD PF8/FORWARD PF9/PRINT  PF10/DRAFTS PF11/  PF12/MENU  9  A msn  Çe  916V 02d3SZIBZ DOSDHI  03AI3338  -141-    OFFICE OF THE SAMPSON COUNTY TAX ADMINISTRATOR  R0.80X1062-CINION, NORTH CAROLINA 28329-1082  GLENN SPELL Tax Administrator  Telephone 910/592-8146 910/592-8147 5572  SAMPSON COUNTY BOARD OF COMMISSIONERS EAST ROWAN ROAD CLINTON, NORTH CAROLINA. 28328 Gentlemen:  Pursuant to North Carolina G.S. 105-381, Ihereby demand refund and remission of taxes assessed and collected by  Bradshr Jy < Ekzabth  Sampson County against the property owned by, Donnic Ray  E. Bradsher  in Sat Cinhh  Township, Sampson County, for  the year(s) andi in the amount(s) of.  YEAR 2012  $. $. $ $. $. $.  TOTAL REFUND  160.08  35295  These taxes were assessed through clerical error as follows.  tocy 3114 830048 /WR7531 30Jo Dissan Sold/ las hrhdin  (z County Tax. 146.96 School Tax. F13 Fire Tax 13.12 City Tax  TOTAL $ 14008  Yours verytruly Taxpayer Social Security ECOWMENDAPPROVAY hl  Mailing address. Dnni Rauy 3080  DRs  Bradsher J. Avtnue  Dnoslg  Clinton NL2832.8  -142-x Elizabu E. Byadsls    North Carolina Division ofMotor Vehicles Receipt for Plate and/or Sticker  FS20 (Rev8/96) Plate: VWR7531 Vehicle: 2010 Title: 779880100202011 Reason: PLT TURN IN (FS20) Refund: NO Branch Location: 011 CLINTON #011 Owner's Name DONNIE RAY BRADSHER JR Residence Address (Individual) Business Address (Firm) 3080 MOSELEY AVE Ciy and State CLINTON NC  11/29/2012  Expires: 07/31/2013 NISS  Sticker: 45823852 SWIBADNE4AM606573  Lic. Weight:  MP  Agent: T1C0113  Zip Code 28328-6506  Note: The county requires a copy of this receipt and a copy of the bill ofs sale within 1 year in order to process a  possible release or refund of property taxes on this vehicle.  6  -143-    Sampson County Office of Tax. Assessor PO: Box 1082 Clinton, NC 28329  Fax 910-592-4865  Phone 910-592-8146  SUBJECT: Vehicle status after tag have been turned into DMV.  Vehicle sold date  to whom  Vehicle traded date  to whom  Vehicle wrecked (total loss) date Insurance Company: Other-Explain  l  28/2  Date  -144-    OFFICE OF THE SAMPSON COUNTY TAX ADMINISTRATOR  P.0.BOX1082 - CLINTON, NORTH CAROLINA 28329-1082  GLENN SPELL Tax Administrator  Telephone 910/592-8146 910/592-8147 5570  SAMPSON EAST ROWAN ROAD CLINTON, NORTH CAROLINA28328 Gentlemen:  COUNTY BOARD OF COMMISSIONERS  Pursuant to North Carolina G.S. 105-381,lhereby demand refund and remission of taxes, assessed and collected by  Sampson County against the property owned by. the year(s) and in the amount(s) of.  Sfr Township, Sampsbn County, for  in  E  YEAR 2018  $ $. $ $. $. $  10760  TOTAL REFUND  1A7.60  These taxes were assessed through clerical error as follows.  CudhH 167378 B.llig # 816753 da #YTKI15 aonfclr  GoCounty Tax School Tax. FIl Fire Tax City Tax  95,45 13.15  TOTAL $ 107.66  Yoursyey truly   Mailing address.  B  allel Roancke RD Chstn NC 28328  Social Security #  -145-      North Carolina. Division afMotor Vehicles Receipt for Plate and/or Sticker  FS20 (Rev8 8/96) Plate: YTK1115 Vehicle: 2011 Title: 77214011181224M Reason: PLT TURN IN (FS20) Refund: NO Branch) Location: 006 DUNN #006 Owner's Name DEXTER JULIAN STONE JR Residence Address (indiidual) Business Address (Fin) 2660 ROANOKE RD City and State CLINTON NC  11/26/2012  Expires: 04/30/2013 CHEV  Sticker: 40765322 3GCURSE2986350212  Lic. Weight: 6,000  TK  Agent: T1C0061  Zipo Code 28328-0324  Note: The county requires a copy of this receipt and a copy of the bill of sale within 1 year in order to process a  possible release or refund of property taxes on this vehicle.  -146-    Sampson County Office ofTax Assessor PO Box 1082 Clinton, NC28329  Phone 910-592-8146  Fax 910-592-4865  SUBJECT: Vehicle status after tag have been turned into DMV.  Vehicle sold date  to whom  Vehicle traded date  to whom  Vehicle wrecked (total loss) date Insurance Company:  Other-Explain Veh Repo  OAe  Signature  1-28-12 Date  -147-    COUNTY OF SAMPSON BUDGET AMENDMENT  MEMO:  12/10/2012 Date  FROM: Lorie Sutton, Director of Aging Services TO: Sampson County Board of Commissioners VIA: County Manager & Finance Officer SUBJECT: Budget Amendment for fiscal year 2012-2013  1. Itis requested that the budget for the be amended as follows:  Aging  Department Decrease  Expenditure Account Expenditure Account Description 02558670-524100 Home Repairs - Materials  Increase $ 50.00  Revenue Account Revenue Account Description 02035867-408401 Home Repairs - Donations  Increase $ 50.00  Decrease  2. Reason(s) for the above request islare as follows:  Tol budget donation received from C. Freeman Heath Sunday School Class on 12/10/2012.  Sighature of  Head) :  ENDORSEMENT  daats  1. Forwarded, recommending appfovaldisapproval.  ,2 20/2  (County Finance Officer)  ENDORSEMENT  Ti  1. Forwarded, recommending appfoyaldisapproval.  12-18_,2012  atok (County Manager & Budget Officer)  Date of approvaldisapproval by B.O.C.  -148-    SEEn rily ChncES 512 PINEVIEW RD CLINTON, NC 28328  SE b /or cinils  C.F FREEMAN HEATH SUNDAY SCHOOL CLASS  772 66-30/531  DATE 12-6-12 243  PAY TOTHE ORDER OF  Ayig De  $ 50.00 DOLLARS A  FIRST CITI BANK BCR  02035867- 440840) HR- Dmations  FOR.  PABg  ""OC  J:00 2412506224"  -149-    COUNTY OF SAMPSON BUDGET AMENDMENT  MEMO:  12/11/2012 Date  FROM: Lorie Sutton, Director of Aging Services TO: Sampson County Board of Commissioners VIA: County Manager & Finance Officer SUBJECT: Budget Amendment for fiscal year 2012-2013  1. Itisr requested that the budget for the be amended as follows:  Aging  Department Decrease  Expenditure Account Expenditure Account Description 02558810-526200 FCG- - Departmental Supplies  Increase $ 25.00  Revenue Account Revenue Account Description 02035881-408401 FCG- Donations  Increase $ 25.00  Decrease  2. Reason(s) for the above request is/are as follows:  To budget donation made to the Grandparent's raising Grandchildren Christmas Drive  (Signature of Department Head) Rai-3Sutt  ENDORSEMENT  1. Forwarded, recommending apcroyldisapproval.  k 201  Finance AIW (County Officer) 13-IP-2012.  ENDORSEMENT  1. Forwarded, recommending apetolaldisaproval  Enloc (County Manager & Budger@ficer)  Date of approvaldisapproval by B.O.C.  -150-    COUNTY OF SAMPSON BUDGET AMENDMENT  EMO:  12/17/2012 Date  FROM: Lorie Sutton, Director of Aging Services TO: Sampson County Board of Commissioners VIA: County Manager & Finance Officer SUBJECT: Budget Amendment for fiscal year 2012-2013  1. Itis requested that the budget for the be amended as follows:  Aging  Department Decrease  Expenditure Account Expenditure Account Description 02558810-526200 FCG-D Departmental Supplies  Increase $ 1,260.00  Revenue Account Revenue Account Description 02035881-408401 FCG-D Donations  Increase $ 1,260.00  Decrease  2. Reason(s) for the above request is/are as follows:  To budget donations made to the Grandparent's raising Grandchildren Christmas Drive.  dhohiv 3Sntla (Signature of Department Head)  ENDORSEMENT  1. Forwarded, recommending apéroyaVisapproval.  Lbi (County Finance Officer)  hz  DORSEMENT  1 Forwarded, recommending pprova/disapprova.  20  Date of aPprova/disapproval by B.O.C.  (County Manager & Budget Officer)  -151-    COUNTY OF SAMPSON BUDGET AMENDMENT  MEMO:  December 17,2012  FROM: TO: VIA:  Sampson County Health Department Sampson County Board of Commissioners County Manager & Finance Officer  SUBJECT: Budget Amendment for fiscal year 2012-2013  1. Itisr requested that thel budgets for Family Planning and Child Health be amended as follows:  EXPENDITURE 12551640 512100 Salaries 12551640 518100 FICA 12551640 518120 Medicare FICA 12551640 518200 Retirement 12551640 518901 401K 12551690 512100 Salaries 12551690 518100 FICA 12551690 518120 Medicare FICA 12551690 518200 Retirement 12551690 518901 401K REVENUE 12535164-404000 12535169-404000  CODE NUMBER DESCRIPTION (Object of Expenditure)  INCREASE  DECREASE 9113.93 565.06 132.15 614.28 230.58  9113.93 565.06 132.15 614.28 230.58  CODE NUMBER SOURCE OF REVENUE  INCREASE 10,656.00  DECREASE 10,656.00  Family Planning - State. Assistance Child Health - State. Assistance  2. Reason(s) fort the above request is/are as follows:  Toreallocate State funding Family Planning to Child Health per Agreement Addendum  brd BBw (Signature ofI Department Head) AIC (County Finance Officer) Sclo.k (County Manager & Budget Orfiçer)  ENDORSEMENT 1.  Forwarded, recommending appfovalisapproval  pfo 20/2  ENDORESMENT 1.  Forwarded, recommending aproyalVdisapproval approvaldisapproval by B.O.C.)  12-P 20_/2,  (Date of  -152-    COUNTY OF SAMPSON BUDGET AMENDMENT  MEMO:  October 8, 2012  FROM: TO: VIA:  Sampson County Health Department Sampson County Board ofCommissioners County Manager & Finance Officer  SUBJECT: Budget Amendment for fiscal year 2012-2013 1. Itisrequestedt that the budget for Environmental Health be amended as follows:  EXPENDITURE  CODE NUMBER DESCRIPTION (Object of Expenditure)  12551810 544000 Contracted. Services  INCREASE 2746.00  DECREASE  REVENUE  CODE NUMBER SOURCE OF REVENUE 12535181 404000 State Assistance  INCREASE 2746.00  DECREASE  2. Reason(s): for the above request is/are as follows:  Toreallocate Additional State funding for mosquito control Grant.  Wade Pw (Signature ofl Department LZ  ENDORSEMENT 1.  Head) efr 20_12 Officer) 12-18-20R  Forwarded, recommending apfovaldisapproval  (County  ENDORESMENT I.  Forwarded, recommending approaldisapproval  (Date ofa approvaldisapproval  Scl (County Manager & BudgAyOficer)  by B.O.C.)  -153-    COUNTY OF SAMPSON BUDGET AMENDMENT  PAbre lof2  MEMO: FROM: TO: VIA:  October 15, 2012  Sampson County Health Department Sampson County Board of Commissioners County Manager & Finance Officer  SUBJECT: Budget Amendment for fiscal year 2012-2013 1. Itisre requested that the budget for Bio-Terrorism Preparedness be amended as follows:  EXPENDITURE 12551920 512100 Salaries 12551920 518100 FICA 12551920 518120 Medicare FICS 12551920 518200 Retirement 12551920 518300 Group Insurance 12551920 518400 Dental Insurance 12551920 518901 401K 12551920 522100 Food Provision Contracting 12551920 526200 Departmental Supplies 12551920 531100 Travel 12551920 532100 Telephone & Postage 12551920 533000 Utilities 12551920 543000 Rental Equipment  CODE NUMBER DESCRIPTION (Object of Expenditure)  INCREASE 9404.50 583.08 136.37 633.87 2219.00 97.37 237.94 1513.87 1800.00 2800.00 1000.00 1000.00 1000.00  DECREASE  REVENUE  CODENUMBER SOURCE OF REVENUE 12535192 404000 State Assistance 2. Reason(s) for the above request. is/are as follows:  INCREASE 22426.00  DECREASE  To reallocate Additional State funding for Bio-Terrorism Preparedness  Wida Alw  (Signature of) Department Head) (County Finance Officer) AI Ec (County Manager & BudyetOfficer)  ENDORSEMENT 1.  Forwarded, recommending pproyalVdisapproval  ahe 20_/  ENDORESMENT 1.  Forwarded, recommending bprvaldisapproval (Date of approva/disapproval byl B.O.C.)  12-(  20/R  -154-    COUNTY OF SAMPSON BUDGET AMENDMENT  Pcgye 20f2 October 15, 2012  MEMO:  FROM: David K. Clack, Finance Officer TO: Sampson County Board of Commissioners VIA: County Manager & Finance Officer SUBJECT: Budget Amendment for fiscal year 2012-2013  1. Itis requested that the budget for the Health Bio-Terrorism Preparedness Department be amended  as follows:  Expenditure Account Code Description (Object of Expenditure)  Increase 9,404.50 583.08 136.37 633.87 2,219.00 97.37 237.94  Decrease  12551010-512100 12551010-518100 12551010-518120 12551010-518200 12551010-518300 12551010-518400 12551010-518901 12551020-512100 12551020-518100 12551020-518120 12551020-518200 12551020-518300 12551020-518400 12551020-518901  Salaries FICA Medicare FICA Retirement Group insurance Dental insurance 401K county Salaries FICA Medicare FICA Retirement Group insurance Dental insurance 401K county  9,404.50 583.08 136.37 633.87 2,219.00 97.37 237.94 Decrease  Revenue Account Code Source of Revenue 2. Reason(s) for the above request is/are as follows:  Increase  Page 2  ENDORSEMENT  (Signature of Department Head)  Forwarded, recommending pproval/disapproval.  20  20RSEMENT  (County Finance Officer)  Forwarded, recommending approval/disapproval.  20  ate of poAaldigpoalyBo..  (County Manager & Budget Officer)  -155-    12-13-06 MEMO:  COUNTY OF SAMPSON BUDGET AMENDMENT  December 18, 2012 Date  FROM: Sarah W. Bradshaw  TO: Sampson County Board of Commissioners VIA: County Manager & Finance Officer SUBJECT: Budget Amendment for fiscal year 2012-2013 1. Iti is requested that the budget for the Social Services Expenditure Account Expenditure Account Description 13553100-512400 On-Call Pay 13553100-512600 Part-Time Salaries 13553100-519300 Medical Services 13553100-539300 Contracted Temporary Help 13554810-568413 Crisis Intervention 13554810-568414 LIEAP  Department Decrease  be amended as follows:  Increase 3,671.00 10,000.00 10,500.00 7,000.00 191,362.00 84,529.00  Revenue Account Revenue Account Description 13535310-403376 Energy Administration 13535480-403313 Crisis Intervention 13535480-403314 LIEAP  Increase 31,171.00 191,362.00 84,529.00  Decrease  2. Reason(s) for the above request islare as follows: To record additional funding received for  the Crisis Intervention Program, LIEAP and Energy Administration in December 2012.  RQ (Signature Department Head) IA  ENDORSEMENT  1. Forwarded, recommending appoalisapptoval  20/3  (County Finance Officer)  ENDORSEMENT  1. Forwarded, recommending approva/disaPprova.  20  Date of approvaldisapproval by B.O.C.  (County Manager & Budget Officer)  -156-    COUNTY OF SAMPSON BUDGET AMENDMENT  MEMO:  January 2, 2013  FROM: David K. Clack, Finance Officer TO: Sampson County Board of Commissioners VIA: County Manager & Finance Officer SUBJECT: BudgetAmendment for fiscal year 2012-2013  1. Itis requested that the budget for the Finance Department be amended as follows:  Expenditure Account Code Description (Object of Expenditure),  Increase 1,546.00  Decrease 1,546.00  11141300-529900 11999000-509700  Miscellaneous Contingency  Revenue Account Code Source of Revenue  Increase  Decrease  2. Reason(s) for the above request is/are as follows: To budget funds to pay for grass cutting on the Carter Street lot.  AIbD (Signature of  ENDORSEMENT  DepartmentHead)  Forwarded, recommending appiovaldisapproval.  20/3  (County Finance Officer)  ain  PORSEMENT  Forwarded, recommending pproval/disapprova.  20  ate of approvaldisapproval by B.O.C.  (County Manager & Budget Officer)  -157-    Clinton b AHmericacty 2007  CITY OF CLINTON RO. Box. 199 Clinton,. North Carolina 28329-0199 wwwcigofelimionneuE 910-592-1961  0  December 5, 4 2012  David Clack Sampson County Finance Office PO Box 257 Clinton, NC28329  Mr. Clack,  Please accept this letter as an invoice for the Property Maintenance performed at parcel number 12-0336640-01, W. Carter Street. This property is owned by Sampson County and the amount due for this property is $1,545.48. Ihave included a detail print out of this account. Please remit payment within 30 days of the date of this letter. If you have any questions please feel free to contact me.  Sincerely, tvets Bhatkl Kristin Stafford Accounting Operations Manager City of Clinton salorPebyorimenne.s T:910-299-4901 F:910-592-0221  SCFINDEC 6120x221  -158-    2  -159-    COUNTY OF SAMPSON BUDGET AMENDMENT  December 17, 2014  MEMO:  FROM: David K. Clack, Finance Officer  TO: Sampson County Board of Commissioners VIA: County Manager & Finance Officer SUBJECT: Budget Amendment for fiscal year 2012-2013  1. Itis requested that the budget for the Roseboro Elementary School Construction Department be  amended as follows: 47959146-596000 47959146-558100  Expenditure Account Code Description (Object of Expenditure)  Increase 340,400.53 59,399.47  Decrease  Transfer to school capital reserve Construction costs  Revenue Account Code Source of Revenue  Increase 439,800.00 5,400,000.00  Decrease 5,440,000.00  47035919-402600 47035919-409100 47035919-409101  USDA grant COPs proceeds USDA loan proceeds  2. Reason(s) for the above request is/are as follows:  To allocate funds to pay interest only payment on school debt of $454,146.26, and repay transfer from school capital reserve fund that was used to pay design costs ini fiscal years 2008- 2010.  L (Signature of Departmenth Head)  ENDORSEMENT  1. Forwarded, recommending appfovaldisapproval.  rh  20/2  Thual (County Finance Officer)  ENDORSEMENT  1. Forwarded, recommending appovaldisapproval.  12-12 20_/2  Eenlc (County Manager & Budget Offiser)  Date of approvaldisapproval by B.O.C.  -160-    SAMPSONCOUNTYA BOARD OFCOMMISSIONERS  ITEM ABSTRACT  ITEMNO.  6  Information Only keport/Presentation Action Item Consent Agenda  Public Comment Closed Session Planning/Zoning Water DistrictIssue  Meeting Date: January7,2013  NFORMATIONONLY  The following selected items are available, foryour review. Please contact the County Manager's Office if you wish to have Aafionamjormation on any ofthe/ following.  a. Update on Request for Bids on Carter Street Lot  b. Cumberland Community Action, Inc, Community Block GrantApplication: and NC OEMS Notification and Solicitation of Comments Regarding Wake Hospital's d, Notification: of Filing of Intent to Petition for State Recognition of Tuscarora  Projected Budget for 2012-2013  Trauma Program or Related Delivery of Care Nation of North Carolina, Inc,  -161    ANAGERIS  AFFIDAVIT OF PUBLICATION: STATE OF NORTH CAROLINA COUNTY OF: SAMPSON  2012 m  P  JULES MOLENDA, PUBLISHER, ofthe Sampson Independent, a newspaper pBgHe Sampson County, N.C. being duly sworn, says that at the time the attached notice was published in the SAMPSONI INDEPENDENT, said newspaper met all ofthe requirements and qualifications prescribed by North Carolina General Statue 1-597; that said newspaper had ag general circulation to actual paid subscribers; and was admitted to the United States mail as second class matter: in Sampson County,N.C.; andi further, that the attached: notice was  in MPAMEONINDEPNDNT on  76  2012.  VtaN    PUBLIC NOTICE Noticei is hereby given thatt the I Sampson County Board of - Commissioners is's soliciting of- fers top purchase that parcel of land owned! by Sampson County (Sampson County Par- cell Identification Number 0336640-01), consisting, ofa ap- proximately. .26 acres adjoin- ing and between 400 and 406 West Carter Street, int the City ofc Clinton, and particularly de- scribedin! Deed Book 876, Page 782.and Plat Book-1, Page 68, int the Sampson County Registry as Lots 74,75 and 76 of the Walter. James Faison Property. Thel Boardo of Commissioners has established a minimum bid of$2,00, subject tot the upset bid procedure of G.S. 160A- 269. Bids must be. submittedin writing tot the Clerkt tot the Board, 406 County Complex Road, Clinton NC 28328, Once the Boardp proposes to accept abid, the ofieror must deposit five percent (5%) of his bid with the Clerkt tot the Board who shall publish al notice of the offer. Deposits must be made int the form ofo cash or good check The Board mayat any time reject any and allo of- fers. Clerk,; Sampson County Board ofc Commissioners The Sampson Independent Deçember 16, 2012.c.  Swomp and subscribed before me this the 196 day  2012.  atvonl blwnWw NOTARY PUBLIC My commission  12-  June expires: 20,2015  -162-    CUMBERLAND COMMUNITY ACTION PROGRAM, INC.  December 20, 2012 Commissioner Billy C. Lockamy Sampson County Board ofCommissioners Office of County Manager 435 Rowan Rd Clinton, NC 28382 Dear Commissioner Lockamy:  1965  Chief Executive Officer Cynthia Wilson Board Chairperson Lisa Chance  Cumberland Community Action Program. Inc. has bccn awarded Community Service Block Grant (CSBG) designation t0 provide as self- sufficiency program and other rclated services to Sampson County. While the State ofNC has not yet relcased finding. CCAP has begun screcniny, job applicants and will start the interview proccss in January 2013 for the Sampson County Case Manager II position. Iisalso our desire. to share with you the impact we have had in Cumberland County for program year ending. June 30, 2012. We were: able to remove 26 low-income families from poverty in Cumberland County. Even though the cconomic climate diflers from Cumberland County, we are optimistic that we can assist the low-wealth citizens of Sampson County Enclosed is a copy oft the Community Service Block Grant application. grant application summary and the projected budget for 2013-2014 program year for your revicw. As the designated anti-poverty agency for Cumberland and Sampson Countics, wc are pleased to include the County Commissioners of both counties in the application process through providing a copy oft the grant application (strategy and budgct). Iti is our intent to use thesc funds to assist income eligible residents ofthe Cumberland and Sampson Wc also invite you to tour any ofthey programs operated by Cumberland Community Action Program, Inc. Please call ifyou have any questions,  Major Programs:  reach similar results.  communitics lo reach economic independence.  ASRE  comments or to schedulcav visit at 910-223-0116.  Qa  FOOD BANK L  Program Dircctor Encl. CSBG Budget  AEE  CSBG Grant Application and Summary  -163-  COA  Action  3160 Green: street-rusoxz 2009-Fayetteville, NC28302    Cumberland Community Action Program, Inc.  OFFICE. of  ECONOMIC OPPORTUNITY Community Services Block Grant [CSBG] Documentation of Submission to County Commissioners  Background: Thel North Carolina Administrative Code (10A NCAC 97C.0111 (b)(1)(A)) requires that each CSBG grant recipient submit its Community. Anti-Poverty Plan Igrant application] to each Instructions: This form is tol be completed and notarized by the Clerk tot thei Board.  County Commissioner Board that it serves.  Agency Name: County:  Cumberland Community Action Program, Inc.  Sampson County  Date of Application Submission: Friday, February 1,2013.]  Note: This application should bes submitted to the County Commissioners at least thirty [30] days priorto application: submission to the Office of Economic Opportunity [OEO). The grant application is due OEO  Clerk to the Board should initial alli items below.  The agency submitted a complete grant application for Commissioner review. The Clerk to the Board will be responsible for assuring that the application is Commissioners' comments provided those to the agency. (Ifa applicable)  distributed tot the Commissioners.  Clerk to the Board  Date  Witness/Notary  Date  Fiscal Year 2013-14 Community Services Block Grant Application  -164-    CUMBERLAND COMMUNITY ACTION PROGRAM, INC.  1965  Cumberland Community Action Program, Inc Community Service Block Grant Summary  The projected Community Service Block Grant (CSBG) for FY2013 is $802,090. The grant ycar runs July 1,2 2013 - June 30.2014.  Chief Executive Officer Cynthia Wilson Board, Chairperson Lisa Chance  Project Name: ASPIRE SelfSufficiency Short-Range Goal: To remove 24 low income individuals in Cumberland and Sampson Countics from poverty by Junc 30,2014. Strategy: To provide comprchensive case management services to 170 low wealth participants to become more selfs sullicient. Outcome Measures Expected to Achieve June.  by  30, 2014:  tos serve 170 persons $450  to raise 24 low income families above the poverty guideline to change the average annual income per participant family by to: assist 55 participants to obtain employment to assist 15 participants obtain jobs with medical benefits to assist participants to obtain the average wagc ratc of$7.50 to assist 55 participants with completing education/raining to: assist 13 participants secure standard housing top provide emergency assistance to 35 participants  Major Programs: $  programs  Primary Area of Focus: Employment  AASPRE  CONPHANVES FOOD BANK  -165-  Action  316Green, Mesrvwo:200)-Fyetew1e,C28502    North Carolina Department of Health and  Human Services  OFFICE of  ECONOMIC OPPORTUNITY Community Services Block Grant Program Fiscal Year 2013-14 Application for Funding Project Period July 1,2013-J June 30, 2014 Application Due Date: February 1,2 2013  Agency: Federal I.D. DUNS Number: Administrative Office Address: Mailing Address: Telephone Number: Board Chairperson: Board Chairperson's Address: (where communications should! be sen!) Board Chairperson's Term of Office: Executive Director: Executive Director Email Address: Agency Fiscal Officer: Fiscal Officer Email Address: CSBG Program Director: CSBG Program Director Email Address:  Applicant Information 56-0845795 625279708  Cumberland Community Action Program, Inc.  316 Green Street, Fayetteville, NC 28301 POE Box 2009, Fayetteville, NC28302  910-485-6131 Lisa Chance POBox2 Second Cynthia L. Wison gmhawisonecapncon Kimberly Stafford kinsiaford@crap-ncon Stephanie Ashley 5aeaer@cpengog North Carolina Department of Health and Human Services Office ofE Economic Opportunity Vera P. Best, Director 2420 Mail Service Center Raleigh, North Carolina 27699-2420 venabesi@dhs.ncooy Atplwwnchiscovoe  2009, Fayetteville, NC 28302  -166-    Cumberland Communily Action Program, Inc.  Checklist to Submit a Complete Community Services Block Grant (CSBG). Application Please puta a check marki in the appropriate box tos show that youl have included the completed  document withy your application. Signed Application Certification (bluei ink only) Signed Board Membership Roster (blue ink only) Board of Directors Officers and Committees Planning Process Narative Form 210- - Agency Strategy for Eliminating Poverty Form 212-One Year Work Program Monitoring, Assessment and Evaluation Plan Form 225- - Agency Budget Information Form 225N-Budget Narrative Appendices (to be attached by the Applicant): Organizational Chart  Item  Included( ()OrNIA V  V V V V V  Form 212A-CSBG Administrative Support Worksheet (ifa applicable)  Job Description and Resume fort the Agency's Executive Director Job Description and Resume fort the Agency's Chief Financial Officer  JobD Descriptions for all CSBG employees Affirmative Action Plan  V V V V  Documentation of Public Hearings for Initial Planning Process: Copy off Public Notice(s) from! Newspaper(s) Agenda of Public Meeting(s) Copy of Attendance Sheet(s) Minutes of Public Meeting(s) Documentation for Notice of Intent to Apply: Copy ofa advertisement(s) Documentation of Submission to County Commissioners: Certified document from county clerk Commissioners' comments or minutes (fa applicable) Cognizant-Approved indirect Cost Agreement Cost Allocation Plan Verification of 501/(C)3) Status State Grant Certification- - No Overdue Tax Debts Notarized Confict of Interest Policy Federal Certifications Contracts  V V V V  V V V  Fiscal Year 2013-14 Community Services Block Grant Applicalion  Pane?nf40 -167-    oo  -168-    o  -169-    Board of Directors' Officers and Committees  Note: All committees oft the board shouldf fairly reflect thec  identify the chairperson ando other committeep positions. composition of the board (10AI NCAC 97C. .0109). Be sureto  Name Officers oft the Board Lisa Chance Ann Shipman Terri Thomas Lenwood Edwards Edwin Deaver Ron! McElrath Executive Lisa Chance Ann Shipman Terri Thomas Lenwood Edwards Edwin Deaver Ron McElrath George Jamison Eddie Bray Vacant Lisa Chance Michael Pemberton vacant Committee Name: Lisa Chance Teri Thomas Lenwood Edwards Edwin Deaver Ann Shipman George Jamison Eddie Bray Ron! McElrath Vacant Edwin Deaver Eddie Bray Lynwood Edwards Syvia Wilams Doris Ann Shipman James 0 Garra  Office  Sector Represented Elected Private Public Elected Public Public Elected Privale Public Elected Public Public Elected Private Private Private Elected Public Elected Public Elected Public Private Elected Private Public Private Public Private Elected Elected Private  County Represented" Cumberland Cumberland Cumberland Cumberland Cumberland Cumberland Cumberland Cumberland Cumberland Cumberland Cumberland Cumberland Cumberland Cumberland Cumberland Cumberland Cumberland Cumberland Cumberland Cumberland Cumberland Cumberland Cumberland Cumberland Cumberland Cumberland Cumberland Cumberland Cumberland Cumberland Cumberland Cumberland Cumberland  Chairman Secrelary Vice Chair Parliamentarian Treasurer Chaplain Chairman Secretary Vice Chair Parliamentarian Treasurer Chaplain Al-Large-Member Al-Large-Member Al-Large-Member Commitlee Chairman Committee Member Committee Member Audit Committee Committee Chairman Committee Member Committee Member Committee Member Committee Member Committee Member Committee Member Committee Member Committee Member Committee Chairman Committee Member Commiltee Member Commitee Chairman Committee Member Committee Member  Committee  Committee Name: Board Development Committee  Committee Name: Finance Committee  Committee Name: Nominating Committee  *Tol be completed! bya agencies serving multiple counties. Public  -170-    Community Services Block Grant Program Fiscal Year 2013-14 Application for Funding Planning Process Narrative  ROMA Goals 1,3and5 their capacity to achieve results  DHHSE Excels-Goal2  Lowi income People! Become More Self-Sufficient; Lowi income Expandi  and use  People Owna a Stakei int their Community; Agencies increase health ands understandinga safety of North Carolinians ofi information t06 enhancet the 1. Explaini in detail how each oft thet following was involved ini the planning and development oft this  strategic plan. a. Thel Poor:  The agency's mission is to develop and operate projects that promote the economic and social well-being ofi individuals, children, families, and communities. The processes ofe evaluation and program development orp planning incorporate thei inputa and feedback of former, current and potential clients as well as other concemed community groups. Cumberland County of Social Services and Fayetteville Metropolitan Housing Authority Resource Centers Department were used to collect lowi income residents' views, comments on unmet needs in the community. The agency's planning process for developing ar multi-year and one-year CSBG plani included sending questionnaires toy previous and current clients and potential clients in Cumberland County. Questionnaires asked participants toi identify major barriers that prevent lowi income individuals and families from reaching al level ofs self-sufficiency that couldp propel them out of poverty. Respondents were also asked to prioritize needs in the Cumberland County target community. A public hearing was also scheduled to solicit feedback and comments from the community on the Employees throughout the organization meet regularly to discuss program progress, identify problems impeding goal accomplishment, and develop quality improvement strategies. Unmet needs ofl low wealth residents are documented in minutes andj program assessments. This constructive information is collected and used in the preparation of grant applications and amendments when funding sources are identified. The CSBG: staffi is also afforded the opportunity tor review and discuss the one year work plan and provide any feedback. Goveming and advisory board members, including Head Start's Policy Council use meeting time to acquaint themseives with barriers thati impact the lowi income community. Approaches to resolve problems and remove barriers are recommended, including changing systems that could affect access to services for low wealth residents. These suggestions, collectively with responses from clients and partners, are used to develop andi implement services CCAP will offer. Board members frequently use their dual membership on other boards toj persuade other organizations toj joint the agencyi in an effort toy provide needed services. Members from the elected sector are encouraged  unmet needs. b. The Staff:  C. The Board:  to! bring feedback from theirt neighborhoods on gaps in service.  -171-    Cumberland Community ActionF Program, Inc.  ROMA Goal5  DHHS Excels-Goalsiand2  Agencies increase their capacity toa achieve results  Manager resourcest thatp provide ane elevated! levelo ofe effective ande efficient delivery ofs services and programs tol North Carolinians; Expandi understandinga andu use ofi information to enhancet the health ands safety of North Carolinians  2. Describe your agency's method and criteria fori identifying poverty causes and list causes. Also describe the methods and criteria used to determine priority and selection thei identified of strategies tol bei implemented thaty will address thej poverty causes. Causes of poverty, obstructions to achieving economic self-sufficiency, and related wealth individuals face each day were collected ina as surveyi instrument. The needs problems low was developed for CCAP, Inc. ASPIRE Self-Suficiency Program by Fayetteville State assessment: survey respondents were afforded the opportunity to rate thei mosti important issues individuals ort families in Cumberland County. Thes sampling frame consisted facing ofi individuals County Department of Social Services and Program. survey was administered at the Cumberland ins for CCAP, Inc. and CCAP, Inc. mail outs. Fayetteville Metropolitan Housing Authority as well as walk- Poverty causes facing low wealth individuals in Cumberland County include the following:  low-wealth University. The that had not  been served by the CSBG Self-Sufficiency  Thes  Unemployment and under employment Lack of affordable, standard housing Absence ofa al living wage Lack of affordable health care and prescription medication Lack ofe education orj job skills (training)  Lack ofs support services, ie. gas fort their vehicles, education, qualification for Insufficient resources to manage emergencies, i.e. food, medications, and utlities  assistance High cost ofo child care Criminal background Homelessness  The community needs assessment showed that overwhelming majority oft the thatj job availability is an issue int thel limited wealth community. Although the desire respondents to listed isc common, access toj job training, education, andi increasing marketable skills is crucial be to employed respondents' employability. Inr result, ASPIRE intensifiedi itst focus one employment and implemented strategies that will address this among other poverty causes.  ROMA Goal1 1,2,3and6  DHHS Excels- Provide services Goal4 toi compromised! health and safely.  Lowir income People Become! More Self Sufficient; The conditionsi inv which! lowi income peoplel live arei improved; Low- risk ofo income people own as stakei int their community; Low-income people, especially vulnerable populations, achievet theirp potential bys strengtheningi family and other support systems  individuals and familiesi identified as beinga al  3. Describe activities that your agency has undertaken or plans to advocate for ande income individuals and families to achieve a greater sense of Ther needs ofl lowi income individuals and families are many. CCAP has been an thel local society since 1965 and will continue tos support the wealth community. Some oft the strategies this  over their empower low- own lives and advocate for this sector of  future.  authority  development ofs services that impact the low  agency has undertaken include the following.  Fiscal Year 2013-14 Community Services Block Grant Application  Pace8of49 -172-    Cumberland Community Action Program, Inc.  Offered tax preparation services to low and moderatei income clients to income credit. Deliveredi financial literacy workshops accessible to lowi income individuals tol utilize their limited incomes. Advocated for additionali funds from the Cumberland County services to 4 year old children. opportunities for home ownership for residents.  gain access to eamed help them better for  Partnership Children to improve  Supported the Housing Authority's plani to eliminate 2p public housing developments Established a partnership with Fayetteville Metropolitan Housing Authority to provide self- sufficiency skill training and: support to 50p public housing residents in Advocated fora and received funding from the City and County Community Departments tot train low andi moderate income families on thet finer skills ofh Development Developed and held workshops to strengthen families. Topics included child homeownership. parenting skills, and healtho or nutrition related subjects that fostered Advocated for the need to increase fnancial resources to close self-confidence. income residents and those facing temporary crises Demonstrated the need fors supplemental but nutritious food for children home might not be available or wholesome. Back Pack schools, and other local groups considering  and create  economic security.  preparation forl long term  development,  the gapi in food needs of low top prevent! long term damage from food program generatedi interest from banks, supporting the program and expanding thes service to  insecurity.  on weekends wheni food at  other schools.  CCAP, Inc. will continue to advocate and or sponsor on behalf of lowi income individuals:  Homeownership opportunities Affordable and safe neighborhoods andi rental housing Expanded early childhood development programs Safe affordable after school care Job training programs through the Employment Pilot Nutrition Training andlor Seminars Employment opportunities Higher wages; al living family wage  Program  Availability ofl IDAs for lowi income individuals and families  ROMA Goals 1,2 4,5and6 Lowi income People Become More Self-Sufficient:; The conditions iny which! lowi income people live arei improved; Agencies increaset their capacity to achieve resuits; people are achieved; Low-incomep people, especially vulnerable populations, achieve theirp potential by strengtheningi family ands support systems  DHHS Excels-Goals1a and2  Manager ande resources thal provide ane elevated level ofe effective Carolinians; efficient delivery ofs services andp programs to! North  low-income Partnerships among supporters andp providers ofs servicest to enhancet the! Expandu health understandinga andu usec ofi informationt lo  and safety ofN North Carolinians  4. Describe how your agency plans to make more effective use of, and to coordinate partnerships with other organizations and programs and private resources; religious organizations, charitable including: CCAPis aj partner in the City and County Consolidated Planning  State  and fomm  welfare reforme efforts; public groups, and community organizations. plan the most effective use ofr resources.  opportunity to coordinate with other programs in the community to process, The relationship provides an  Fiscal Year 2013-14 Community Services Block GrantA Application  Paga@fAo 173-    Cumberland Community Action Program, Inc.  Community Services Block Grant Program Fiscal Year 2013-14 Application for Funding Planning Process Narrative (continued)  Collaboration has established a unified visiont for community wide development. CCAP goveming and advisory Board members participate on a wide variety ofp public andy employees, boards etc. Participation provides low wealth families with a voice int the Housing Authority, Partnership for Children, involvement in andi implementation ofr mandated or legislated linkages community. with other Itincreases CCAP's  committees, including Workforce Development, DSS programs, such as the Workforce Development Act of1 1998 and LIHEAP. Coordination and collaboration are: strengthened through recruiting service agencies to sit on agency advisory boards. Contracts with DSS provide TANF recipients  private  and  federally funded programs,  representatives from other human groups to efficiently serve its customers.  clients and provide as service to local organizations Interagency referals help CCAP meet the needs of CCAP coordinates with charitable, public and faith-based seeking resolutions tot their client problems as well. group while perforingi in welfare tov work with payee services to teach financial literacy to this vulnerable 5. Describe how your agency wille establish linkages between govemmental and other programs to assure the effective delivery of such services to low-income duplication of such services and to fili identified gapsi ins services, information, referrals, case management and follow-up consultations. through the provision of  programs.  social services individuals, to avoid the  CCAP, Inc. uses a comprehensive: service delivery approach to enable individuals poverty to ani independent self-sufficient: status. Applicants  andt families movei from  and their willingness toj pursue employment, education, are screened fori income and residency eligibility entry to eaming al living family wage. Basic information job about skils, thei or other supportr mechanisms that will gain supportive services needed is also acquired during intake. Potential individual or family and the types of Fort the CSBG ASPIRE Self Sufficiency Program, Case Managers develop a service primary focus of employment. The case management plan consists of  approach through ai referral.  applicants may apply directly or  plan of action with the enable stafft to share with both  steps required tor resolve the problem. A client authorizationi is secured problemi to identification and specific secure needed benefits through community Appropriate resources: are contacted on the client's behalft to follow upi is required to ensure the client's needs agencies. When referrals are made to other organizations, to track client progress, emergency assistance, and were sufficiently met. Case management: software is used strategic partnerships or linkages with public services, private human: service produced longt term and organizations. Board ands staff representation on local planning boards andi agencies, andi faith-based created opportunities to advocate fort ther needs ofl lowi income individuals andi neighborhood. initiatives! have  intemal and extemal services and programs.  referals.  CCAP's 45 years ofs service to the Cumberland County low wealth community has  generally are used toi identify gaps ins services and unmet needs of the  families. These sessions community served byt this agency  Fiscal Year 2013-14Communiy Services Block GrantA Application  Pane 10nf40 -174-    Cumberland Community Action Program,! Inc.  Community Services Block Grant Program Fiscal Year 2013-14. Application for Funding Planning Process Narrative (continued)  ROMA Goal 2,4and6  DHHS Excels-Goals ande efficient delivery ofs services safely.  Lowi income People Become More Self-Sufficient; Partnerships Manage resources that iand3 provide ane elevated! level ofe people are achieved; Low-income people, especially vunerable Carolinians; Offer outreach ands services andp programs toi toN North  amongs supporters andp providers ofs services to! low-income  effective individuals and  populations, achievet theirp potential bys strengthening family and familiesi identified ast  risk  other support systems  being atr ofd compromised) health and  6. Provide a description of how your agency will supporti innovative community andi based initiatives related tot thep purposes of the Community Services Block Grant neighborhood- initiatives and other initiatives with the goal ofs strengthening families and encouraging (fatherhood effective  parenting).  CCAP continually advocates for new andi improved or expanded services for lowi income individuals families. Both formal andi informal interagency agreements exist thatf fosteri innovative  and the  initiatives.  community based  The Fathers and Friends initiative for Head Start fathers offers parenting skills to reduce The Family Self Sufficiency program, developed and operated as aj jointe effort between CCAP and the Fayetteville Metropolitan Housing Authority, is a multi-year plan to helpf families residingi in public housing prepare themselves for economici independence and homeownership. Workshops are ofered, frequently through Head Start Centers that arel located in lowi income housing areas, Fayetteville Metropolitan Housing Authority, and CSBG. ASPIRE Resource to teachy parenting skills, family health and wellness techniques, child development, and financial Center, The Community Leadership Development course offered through the CSBG ASPIRE cultivates leadership abilities oft the participants who retum to their individual neighborhoods Program to define problematic issues and! bridge the gap! between ther neighborhood residents and public or  incidence of domestic violence and child abuse or neglect.  literacy.  private agencies tor resolve the problem. Organizations currently networking with CCAP, Inc. include the following. Carolina Collaborative Community Care, Inc. Cumberland County Association of Indian People Cumberland County Department of Social Services Cumberland County Department ofH Health Cumberland County Mental Health Department Cumberland County Schools Fayetteville Urban Ministry Operation Blessing United Way Workforce Development Southem Regional AHEC  Cumberland County Partnership for Children (More at Four, Smart Start) Cumberland County Community Development Department Fayetteville Community Development Department  Fiscal Year 2013-14 Community Services Block GrantA Application  Page 11of49 -175-    Cumberland Community Action Program, Inc.  Cumberland Interfaith and Hospitality Network Cumberland County Public Library Catholic Social Ministries Salvation Amy CEED Department of Employment Security NC Cooperative Extension Hispanic/Latino Center Local churches  ROMA Goal5 5and6  DHHS Excels-Goals 1 and 5  Agencies increase their capacity to achieve resulls; Low-income Manager resources thatp provide ane people, especially vulnerabie populations, achieve their potential ande efficient delivery ofs services andp elevatedl level ofe effective  bys strengtheningi family ando cthers support systems  Carolinians; Provide services andp protectiont programs toi toNorth individuals and familles experiencing serious health ands safely needs who are not, at! leastt temporarily, ablet to assist themselves.  7. Describe activities that your agencyl has undertaken or plans to undertake, on an emergency fort the provision of such supplies and services, nutritious foods, and related services, as may basis, be necessary to counteract conditions ofs starvation andi malnutrition among low-income individuals. The Second Harvest Food Bank of Southeast NCI is certified by Feeding America Network, ar national network oft food banks with the goal ofe ending hunger. The Food Bank, developed! by 1982, serves as a clearinghouse: for food products from manufacturers, brokers, CCAP, Inc. in similar resources. Currently, the Food Bank operates in a7 county areal in thes southeastem grocery stores, section and of the state, one of the poorest sections inl North Carolina with 142,203 people at risk ofhunger. Thel Food Bank serves approximately 244 notf for profit private agencies and faith based Eligible entities operate a variety of feeding programs such as on-site meals, emergency organizations. food programs, or food pantries. In2 2012, the Food Bank collected and distributed over 8 food providing nutrition to thousands off families in Cumberland and surrounding counties. million The pounds Mobile Food Pantry was established in 2010 which can deliver to residents that live in very rural and depressed areas where they do noth have ther means toy physically travel to a distribution center relatively to receive food. The Food Bank is certified by thel NCI Department of Agriculture to distribute commodities through The Emergency Food Assistance Program. The Second Harvest Food Bank of Southeast along with its 61 NÇ sister food banks, is a recipient of the State Nutrition Assistance Funds from this source enable the Food Bank to purchase food and distribute. atr no cost Program (SNAP). members. SNAP products are selected for nutritional value andt to supplement other top participating donated The Food Bank does not directly servei individuals andi families but operates through its network membership ofo organizations. Referrals are made to one oft the member agencies withe The Food Banki isa a member of the NC County Emergency Reliefe effort that provides food to disaster victims ine eastem NC. FEMA funds are acquired througha ag grant process offered byt the! local United The ASPIRE Food Pantry, an activity oft the CSBG Self Sufficiency Program, was established food to participants of the ASPIRE Self-Sufficiencyl Program of Cumberland temporary or emergency need and are at risk of hunger or malnutrition. Itwilla County also be whol extend have tot a the  of  NC,  tot the! Food Bank.  products  food emergency  box programs as ther need arises.  Way.  to provide  Fiscal Year 2013-14 Community Services Block GrantApplication  Pane 17nfA0 -176-    Cumberiand Community Action Program, Inc.  Sampson County's participants as well. Supplemental food boxes arei issued as aj preventive measure and tos ensure balanced meals are availablei int thel home. ASPIRE participants are offered opportunities toa attend classes tol leam techniques fort buying, storing and preparing meals. The volunteer instructors are nutritionists from the local Extension Office. Thet focusi is onr nutrition awareness, health education 8. Describe how your agency will coordinate the provision of employment and training activities with entities providing activities through statewide and local workforcei investment systems under the CCAPI has, for 45y years, coordinated with govemmental and: social service organizations ini the Cumberland County community to ensure lowi incomei individuals andi families receive needed services in an efficient and effective manner. This feat has been accomplished through participation of Board and: staff on area planning bodies. Duplication of services has been eliminated in this manner puttingi in place a system for  andy wellness.  Workforce Investment. Act of 1998.  improved delivery ofservices.  Specific methods that have been implemented and will continue include:  Cumberland and Sampson County Commissioners, Public and Private Businesses, City Council members through Cumberland and Sampson Counties, Employment Security Commission, Local Staffing Agencies and' Workforce Developmenti Directors are active members oft the CCAPE Board CCAP's Director of Consumer Credit Counseling Services is a member of the Cumberland County CCAP's CEO is on the Board of Commissioners fort thel Fayetteville Housing Authority and the CCAP's Chaiman of the Boardi is on the management team of the Cumberland County The agency's commitment tot the Workforce Investment Act of 1998 has culminated in welfare-to- work contracts, providing TANF recipients with budgeting, money management andi money mentoring advice and assistance and the development ofap payee service for TANF participants who are suspected of having as substance abuse problem or are having difficulty maintaininga Head Start, CSBG and Second Harvest Food Bank have provided TANF recipients with on thej job Employees receive and make referrals tol human service agencies enabling lowi income individuals to obtain services. Case management: software helps track services provide to avoid duplication. Agency procedures require follow up on all referrals to ensure the client's needs were met. CCAP, Inc. CSBG ASPIRE Self-Sufficiency Program will partner with public and private businesses to create through with the thei incentive ofas stipend where the agency will pay the salary of the employee to the employer for jobs 300 The Case Managers will work closely with the clients and businesses toi insure afit. The continue to offer workshops to participants through the Employee Readiness Program and assess Agencyw thel Train System to provide participants a comprehensive leaming system to acquire common skills Key  of! Directors and sit on agency advisory boards. Workforce Development Board. United Way of Cumberland County. Department of Social Services.  household budget. training.  wil days. required! by  mostj jobs. ROMA Goal4 4and6  DHHS Excels-G Goal5  Partnerships among supporters andp providers ofs serviceslo Provides services andp prolection toi individuals low-income people are: achieved: Low-income people, especally experiencing serious healtha ands needs andf who families vulnerable populations, achieve their potential bys strengthening least lemporarily, able to assislt themselves. safely  are not, at  Fiscal Year 2013-140 Community Services Block Grant Application  P-man -177-    Cumberland Community Action Program, Inc.  family ando others supports systems  9. Describe howy your agency wille ensure coordination with the CCAPis ap partneri int the City and County Consolidated goveming and advisory Board members committees, including Workforce  program under title) XXVI (relating to low-income home emergency energy crisis intervention opportunity to coordinate with other programs int the Planning process. The relationship provides an Collaboration has established a unified vision for community to plan the most effective use of resources. etc. Participation provides low wealth Development, families witha DSS, programs, Housing Authority, Partnership for Children, involvement ina andi implementation of mandated a voice in the community. Itincreases CCAP's such as the Workforce Development Acto of 1998 or! legislated linkages with other federally funded service agencies tos sit on agency advisory boards. through recruiting representatives from other human clients and provide a service to local organizations Interagency referals help CCAP meet ther needs of CCAP coordinates with charitable, public andf faith-based seeking resolutions to their client problems as well. group while perforingi in welfare to work programs. payee services tot teach financial literacyt to this vulnerable  energy assistance).  community wide development. CCAP employees, participate on a wide variety ofp public and private boards and  and LIHEAP.  programs,  Coordination and collaboration are: strengthened Contracts with DSS provide TANF recipients with  groups to efficiently serve its customers.  Fiscaly Year2 2013-14 Community Services Block GrantA Application  Page 140f49 -178-    Cumberland Community Action Program, Inc.  Community Services Block Grant Program Fiscal Year 2013-14 Application for Funding Planning Process Narrative (continued)  ROMA Goals 4and5 capacity toa achieve resulls  DHHS Excels-Goals 1and2  Partnerships amongs supporters and providers ofs servicest to Manage resources thatp provide ane elevated! level ofe effective  low-income people are achieved; Agencies increaset their  ande efficient delivery ofs services andp programs toNorth Carolinians; Expand understanding: andu use ofi information to enhance the health ands safety of North Carolinians  10. Describe the needs ofl low-income youth andy your agency's efforts top promote increased community coordination and collaboration in meeting the needs ofl low-income youth. According to the Cumberland County Schoois 2010-2011 annual report, 53,161 children were enrolledi in Cumberland County schools toi include pre-k, with another 5, 230inFt. Bragg schools. Per thel New Americal Foundation, in 20081 the Cumberland County student poverty level was 20% compared toi the State level at 18.2%. The End of Grade (EOG) scores continue to progress in the! basicj job preparation areas of reading andi math. Lower income and minority students eam lower scores, however. The educational disparity between minority and white students in Cumberland County tendt to validate the hypothesis that Cumberland County Schools had! 52.71% of theire enrollment eligible for free or reduced breakfast and! lunch program in 2011. According tot the 2000 census, 56% of female headed households hadi incomes ator below the Federal poverty level. Children in these homes are more at risk for dropping out of school, becoming homeless, foodi insecurity, and! having noj job skills to meett today's employment market needs. Cumberland County has ay younger population than the State when comparing the percentage or residents less than 18y years ofa age and comparing the percentage of residents overt the age of65. Fayetteville and Cumberland County Parks and Recreation Department offer a wide variety ofl leisure activities, programs and facilities. Youth athletics, sports! lessons, recreational classes, as summer youth program and cheerleading program are among the activities available to county residents. However, many have fees and are not readily accessible to lowy wealth residents without adequate transportation. Cumberland County lacks youth development programs that support the primary role oft thet family and offer preventative measures toj juvenile crime. The! Boys and Giris Club andt the Big! Brother, Big Sister Program ofCumberland County have been making an effort tor reach some oft the! low wealth youthi int the community but have very limited funds tor make al largei impact on thel large number ofy youthi int the county. Few resources are available to developi innovative neighborhood initiatives that would strengthen families and encourage effective parenting. Head Start offers al Fathers and Friends Program tol help men cultivate good CCAP's Second Harvest affiliated Food Bank andi the ASPIRE Food Pantry each offer opportunities for juveniles. Working liaisons with the. JROTC, Cumberland County Transitional Education Program, and youth with member agencies enable youth to perfor required community or volunteer service under adult supervision at the Food Bank. The youth are assigned tasks to complete duringt their time at the Food Bank or with the ASPIRE Food Pantry. These tasks are structured to provide softj job skills, teachs self control, and working respectfullyi in ar mull-generational. environment. The ASPIRE Food Pantryi is operated almost entirely by volunteers. Providing service opportunities for youthi in this selting inspired several oft the young people to retum as at true volunteer after the required community service time was completed.  economics contribute to educational attainment inequalities.  parenting skills. The service is nowi ini its 8h year of operation.  Fiscal Year2 2013-14 Community Services Block GrantA Application  Pcma 4E fAn -179-    Cumberland Community Action Program, Inc.  ROMA Goals 1and5 Low-income People Become More Self-Sufficient; Agencies increaset their capacity toa achiever results  DHHSE Excels-Goal1 Carolinians.  Manager resourcest that provide ane elevated level ofe effective ande efficiento delivery ofs services andp programs tor North  11. Describe activities that your agency! has undertaken orp plans tou undertake unrestricted funds to further the agency's mission andi reduce a. Funds tos support services for low-income persons b.F Funds to support the overall agency  to establish ap pool of dependency on govemmentf funding.  Inj preparation for undertaking fundraising activities for unrestricted CCAPI has taken steps toi increase branda awareness of the the parentcompany. Examples oft this:  fundst tos support the overalla agency agency, to link the well-known programs to Program'. AC Communications Manager position  Common email sufix wasi implemented for all CCAP programs; all literature cards, press releases, web site, implementation of brand awareness (letterhead, business Direct mail companies (hard copy and electronic) have beeni interviewed and selected for programmatic work as well as for agency work. Plans underway to developa an agency solicitation piece. A'Donate Now" button has been placed ont the website with the behind the scenes completed fora accepting electronic payments  Division of Cumberland Community Action has been established to facilitate Email solicitation electronic solicitation.  must state "A  facebook, presentations, letters to the editor.)  lists, based upon owner's consent, are being developed tol be usedin  a company work  To "reduce dependency on govemment funding" CCAP has worked with the The Weatherization team is exploring ways to transition from  Housing Authority to explore options for CCAP managing a7am-6 6p child Fayetteville Metropolitan top providing fee-based service delivery for middle-class providing services forl low-income families  pm care development center.  families.  ROMA Goal 12,4and6 other support systems  Lowi income People Become More Selfs Sufficient; Partherships DHHS Excels-G -Goals 1and3  amongs supporters andp providers ofs services tol low-income  ande Manage efficient resources thatp provide ane elevated leveld ofe effective identified ast beinga atr risk of compromised! healtha and  people are achieved; Low-ncome people, especially vulnerable Carolinians; delivery ofs services and programs to North populations, achieve! theirp potential! bys strengthening! family and familiesi Offer outreach ands services toir individuals and 12. Describe your agency's method fori informing custodial parents ins single-parent families participate in CSBG programming aboutt the avallability of child: describe your method for referring eligible parents to the child support services. Inaddition, Ther number of cases at thee end of the reporting period: 426,020 82.01% of cases currently have ac court order for child support $702.6 million collectedi in SFY 2010 compared to $710.1r millioni in SFY 2009 Ast the ASPIRE Self-Sufficiency Program ençourages economic selfs efforts, allp participants that ares single custodial parents are  safely.  that  Thel North Carolina Child Support Enforcement reported thet  support office/s).  2010:  following statistics fort the NC: State Fiscal Year  sufficiency through employments encouraged tor request additional support  Fiscal Year 2013-14 Community Services Block Grant Application  Pann sefn -180-    Cumberland Community Action Program, Inc.  through Child Support Enforcementi ifs supporti is notr received by ther non-custodial parent ASPIRE'scase management: staffv works closely with the participant as they are referred to, apply for, and wait for approval ofsupport. Thej participant is also educated ont the possible budgetary strained alleviated, ifsupportis received from ther non-custodial parent Case management: staff works with the participant ate entry to the program toe establish al household budget. Then additional budget developmenti is received through partnership with Consumer Credit Counseling Services as the participants income increases. This allows  fort financial literacy and education on properincome management.  13. Does your agency calculate retum oni investment for your CSBG program? Ifso, please explain  and give the calculation.  NIA  Fiscal) Year 2013-14 Community Services Block GrantA Application  Pran: 47-f An -181-    Cumberland Community Action Program, Inc.  Community Services Block Grant Program Fiscal Year2 2013-14 Application for Funding Agency Strategy for Eliminating Poverty  Form 210  Planning Period:  2011to 2014  Section : Identification of the Problem (use additional sheets if  necessary)  1. Give thel Poverty Cause name, rank the poverty cause(s) andi identify which  agency will address.  one(s) the  Poverty Cause: Inability to become Self-Sufficient ability tol become selfs sufficient. There isl limited publict  Lowi income individuals and families in Cumberland County face numerous barriers  that exacerbate their  access toj jobs, jobt training, andi institutions for higher transportation in Cumberland County, restricting care programs are limited, as are afters school care leaming. The availability of quality and affordable day person from attaining economic independence. programs. Numerous factors prevent al lowi income square miles. Sampson County is very rural. Thei families and lowi income Ith has a total area of9 947 8.2% as of May 2012. There is no public transportation which restricts sufficient. The unemployment ratei is income individuals in Sampson Counly. regulations. Affordable and safe housingi is al barrieri faced byl low  Sampson Countyi is the second largest county, in land area, in North Carolina. face numerous barriers that exacerbate their ability to become selfs the local Community College for higher leaming. Although countyi in North County, the work iss seasonal andi thei consumer needs and environmental  individuals of Sampson County access toj jobs, job training andt to Sampson Countyi is the largest agriculture industry faces changes with modem technology,  Many lack education, jobs skills orj job training that would allow them to obtain wage". The deficiency in the areas ofe education ore employability is also lessens their capacity for overcoming crises.  employment providing a lving  community services. Numerous factors prevent al lowi income directly linkedt to an absence of critical independence. These obstacles reduce theira ability tot find person from attaining economic  employment, obtain health care or housing. It  2. Describe the poverly cause(s) in detail in the community with  Explain why the problem exists. Identify the segment oft the appropriate statistical data. number ofp people experiencing the problem. Explain how the population and give the  affected.  persons are adversely  Cumberland County has a population estimated at 315,207 as of 2009 Census County has aj population of 63, 431 as of 2010 (US Census Bureau). In (US for Sampson County is 38. While the 2005-2009 American  Bureau) and Sampson military population and median age  is younger than the State's average at 31 years, duei in large partt tot the Cumberland County the population 18.5% oft the residents in Cumberland County are at or below Community the Survey US Census Bureaur reports Sampson County are at or below the poverty level. African-Americans poverty level and 20.4%0 of the residents in 23.9% followed by the Hispanic or Latino community at 19.2%i in Cumberland. have the highest rate of poverty at community has the highest rate of poverty at 40.2% followed by the African-American The Hispanic orl Latino  communilty at 31.9%.  Fiscal Year 2013-14 Community Services Block GrantA Application  Pana 1Rnf4Q -182-    Cumberland Community AcionProgram, Inc.  Cumberland and Sampson Counties have diverse populations with over 80 cultures in Cumberland Kidscountorg estimate 22.5% of children under the age of 181 livei inj poverty households in (2008) and31.2% is Sampson (2010). The effect of childhood poverty education, lower eamings as an adult, and a continuous cycle ofp poverty. frequently Studies have shown into less ofp poverty, on an average, have lower school tests scores, experience morel health related that victims often livei ins substandard housing. According to Cumberland County School website, problems, and school participatedi int the free or reduced. meal programs in 2009. According to NC Public 54.42% childreni in Sampsoni in 2010 was 56%. The number of children (36.9%) in Cumberland and children receiving Medicaid in from 16.4% reported the same yeari in Cumberland and benefiting 26% of the from childreni Food Stamps increased to 20.6%, up Food Stamps. Child abuse and neglecti in Cumberland County continues in Sampson benefitted from substantiated child maltreatment reports exceeding 5% of the State's incidents to plague the county with Ther median family household income in Cumberland County according to 2009 estimates compared to $43,754 oft the State. The per capitai income was $22,987 in 2009. Cumberland was $41,163, economy is primarilyi in thes service sector whichi is lower paying than skilled these: service jobs pay wages insufficient to support al family. levels andr more skills, generally are hired fort the better more technical with the advent of computers andt telecommunication paying positions. Entry! level positions have become moderate to long term skill training. Unemployment in this area remained technology. near 9% Mostj for jobs require Projections for Cumberland County's future workforce, based on the anticipated and military relatedi industries, call fort technologically skilled workers. The low growth resulting from BRAC CCAP, Inc. will require additional education andj jobt training to meet this new demand. income population served by The median family household income according to 2010 US Census is $35, 740 the State. The per capitai income was $19,086i in 2010. Sampson employment per city-data.com are manufacturing, education, health County's and social primary industries providing agriculture, forestry, fishing, and hunting andi mining. The agriculture insufficient to support a family. Thet manufacturing trade jobs. Mostj jobs requirer moderate to long term jobs skill pay a higher wage than the agriculture andr retail (according to UNC Sheps Center for Health Service training. The top paying jobs in Sampson County dentists, offices of physicians, andi provide longevity and most people dor management. not! leave until Once employed in some of thei industries, thesej jobs  cultures in Sampson representedi in their citizenry.  and 44  translates Cumberland  71% oft the children in Clinton City school system and 74% in Sampson int thef free or reduced meal programs in 2010-2011. Children to 18; population, fewer than reported in 2001  Schoois website,  County schools system participated receiving Medicaid in 2004 was: 31%0 oft the 0  rate for the countyi is 3% whichi is lower than the State rate.  andi in Sampson County, the  County's  orr manufacturingj jobs. Mostof  Military retirees, whoi have higher educational  most of 2009.  compared to $45,570 for services, retail trade, and jobs are seasonal and pay wages  Research) arei in computer systems design, offices of retirement. Unemployment in this area average 8.6in  2011.  Affordable housing contributes to a community's quality of life. However, low  forr many families. Inaddition, their ability to pay the costs of maintenance ift wages limit housing choices County Consolidated Plan prepared byt the Community Development according the 2005 Cumberland population. According to the North Carolinai Housing Coalition, safe and affordable major problem for the low wealth  further restricted by the limited income. Affordable Extremely lowi income households less than 10 years old rented in excess of $758 per month. In Sampson County, affordable housing as well as available. housing is a  is  they ownt their own home is to Department. A2b bedroom apartment  housingi a major problem fort thel low wealth population.  are the 2nd] largest category of renters  housing should noth be  Fiscal Year 2013-14Cemmunity Services Block Grant Application  Page1 19nf49 -183-    Cumberland Community Action Program, Inc. for Sampson County is $35,  more than 30% of the household gross monthly income. Ther median income 740. Monthly affordable housing fora a single person or would be $894. For lowi income household who  who  family eams an annual income of $35,740 extremely lowi income. The median renti is $540 perr month  cost should be $362.50 ande even less for the eams $14,500 annually, the monthly affordable housing  perUSA.com.  As renters, extremely lowi income households have the highest cost burden available income fort housing costs. Fewer homeowners are found excessive rent burden ont the low wealth populationi is Thei inability of lowi income individuals tot be self sufficient ande in unsafe neighborhoods ins substandard  by paying more than 30% of  tied among those with! lowi incomes. The directly tos social ande economici issuesi in economically independent forces them tol live essential prescriptions to retain their health.  Cumberland County.  forego basic human needs such as foods security housing. and Itcreates health homelessness. Individuals andi families must between paying al high energy billt to stay wamm or purchasing care. They are frequently faced with choices that access. Cumberland County ranked 54th and Sampson jobs decline, those with health care benefits lose the State with the number of uninsured individuals from the County ranked 81st out oft the 100 counties in population was uninsured according to the State of the age of0to6 64. 21.1% of Cumberand county's that are paid with tax dollars. 27% of Sampson county's County's Health Report, generating hospital costs than that of the State and 12.5% oft the childreni County, in 14.8% ofc children ages 01 to 17 are uninsured, higher below the Federal poverty level are ata a greater risk Sampson forr notr County. Children withf familyi incomes ator  Access to health care is diminishing ini North Carolina. Asj  alcunpleatvenigsop In Cumberland insurance make better use of preventive care  population was uninsured according to the website receiving medical attention. Children with health  Section I: Resource Analysis (use additional sheets if  necessary)  3. Resources Available: a. Agency Resources: CCAP,Inc  WAP-Standard Recovery CCCS  $742,389 $5,756,541 $6,571,712 $1,270,078 $43,775 $802,090 $113,632 $1,307,600 $742,389 $5,756,541  Head Start-Cumberland County CHDO-Cumberland County CSBG-Standard FSS-Cumberland County Food Bank WAP-Standard Recovery  Fiscal Year 2013-14 Community Services Block GrantA Application  Pane 20nf40 -184-    Cumberland Community Action Program, Inc.  b. Community Resources:  Better Health  Emergency Medical & Financial Assistance  $322,792  Medicai Screenings Emergency Services Child Health Services (-18) Immunization Services School Health Program Weliness Program Dental Health Clinic Health Promotion Adult Health Clinic WIC Nutrition (SchoolLunch) CDBG, HOME Emergency Assistance Emergency Assistance Nutrition (Love Lunches) Emergency Shelter Care Program Home Repairs  Catholic Social Services Cumberland County Health Department  $25,320 $6,150,108  Cumberland County Schools  $8,400,000 $1,626,887 $5,000 $40,000  HUD Local churches Salvation Army  Urban Ministry  $592,462  Workforce Development  Employment TOTAL  $2,718,214 $35,366,105  Additional Community Resources (monelary resource unknown) Veterans Empowering' Veterans Employment, Housing, & VAI Benefits Steps! N' Stages-Jubilee House Housing & Employment Assistance  Application. Assistance for Veterans  for Veterans  Sampson OfSocial Services  Sampson County Department Child Care Subsidize  $4,704,136  Crisis Intervention Food & Nutrition Benefits Lowi Income Energy Assistance TANF Child TANF Domestic' Violence  Fiscal Year 2013-14 Community Services Block Grant Application  Pana?1 nf.40 -185-    Cumberland Community Action Program, Inc.  Work First  Sampson County Health Department  Child Health Services (0-18) Immunization Services School Health. Program Wellness Program Dental Health Clinic Health Promotion Adult Health Clinic Matemity Health Family Planning WIC  $4,033,525  Sampson County Schools Clinton City Schools Local churches Crisis Center UCare  Nutrition (School Lunch) Nutrition (Schooll Lunch) Emergency Assistance Emergency Assistance Nutrition Care Program Domestic Violence  $3,732,743 $1,387,000 $5,000 $500 $500  4. Resources Needed: Agency Resources:  Additional Rental Properties for the Lowl Income Funding for Temporary Childcare Assistant -in-house Certified Technical Training Programs for Participants d. Community Resources: Affordable Rental Properties fort the lowi income An Expanded Public Transportation System -Additional Funding for before and afters school childcare  Additional Funding for Income Medical and Dental Clinics fort thel lowi income  Section Il: Goal and Strategy 5. Long-Range Goal:  Toremove 73 lowi income families in Cumberland and Sampson Counties from the  June 2014  poverty populationb by3 30  6. Strategies for Achieving Long-Range Goal:  Fiscal Year2 2013-14 Community Services Block Grant Application  P-186- n    Cumberiand Community Action Program, Inc.  Provide comprehensive case management: services fork low wealth participants to become  more self sufficient.  Increase employment readiness skill workshops  Have participants obtain thel North Carolina Career Readiness Certificate Seek funding to repair lowi income owner occupied homes.  Encourage faith-based community to collectively poolf funds and offer an emergency relief Collaborate with Care Clinic and other health groups to provide free medical and dental care Encourage financial institutions to make lowi interest loans available to! low wealth community needing funds fore education, home loans, purchase ofc car, etc.  service to intervene when crises arise.  to! lowi income population, including preventive care.  Seek interest int the! Employee Pilot Program Seeki increase in Head Start enrollment. Provide workshops to decrease child maltreatment.  Develop nutrition seminars toi improve health of low wealth population.  Fiscal Year 2013-14 Community Serviçes Block Grant Application  Page23nf49 -187-    Cumberland Community Action Program, Inc.  Community Services Block Grant Program Fiscal Year 2013-14 Application for Funding One-YearWork Program Form 212  Section  Project Identification  1. Project Name: 3. Long-Range Goal: 4. Selected Strategy: 5. Project Period:  Self-Sufficiency Project poverty rolls by 30. June 2014. sufficient. Juy1,2013 To  2.F Poverty Cause Name: Inability tol become self-sufficient  Tor remove 731 lowi incomei individuals in Cumberland and Sampson Counties from the Top provide comprehensive services to 170 lowy wealth participants toi become more self-  June 30, 2014 Plan' Year 3 of  3  6. CSBG. Funds Requested fort this Project: 7. Total Number Expected tol Be Served: a. Expected Number of New Clients b.E Expected Number of Caryover Clients 60  $802,090 170 110  8.N Number expected tol be moved above Federal Poverty Guidelines this) year (Self-Sufficiency 9. Percent ofl Long-Range Goal Expected tol be Mett this Year (For projects other than Self-  Projects): Sufficiency):  24 N/A  Section #: One-Year CSBG Program Objective and Activities  Activities  Position Tite(s)  Implementation Schedule First Second Third Fourth Quarter Quarter Quarter Quarter  Toprovide Objective:  75 75  100 (25) 100 (25)  140 (40) 140 (40)  comprehensive services to 1701 lowy wealth Program Director 1.0 Provide efective and efficient delivery of services. Self-Suficiency Assistant  170 (30) 170 (30)  participants to! become more self-sufficient  Administrative Manager Case! Managers II Case Managers Program Specialist!l Resource Coordinators Communication Manager (PT) Communications Coordinators  1.1 Prepare andi issue PSAS announcing 1.2 Nolify locals service agencies tor make 1.3 Participate in Interagency Council meetings toi inform other agencies of services and remain abreast of other community services available to clients. 1.4 Distribute brochures to clients, faith- based organizations, human service organizations, businesses and communily atl large.  services. referrals.  Fiscal Year 2013-140 Community Services Block Grant Application  Pade 24nf49 -188-    Cumberland Community Action Program, Inc.  2.0F Provide case management: services to low wealth individuals to enable them to achieve self 2.1 Recruit 170 eligible applicants. 2.2 Conduct crientation. 2.3 Assess each client. 2.4 Prepare development plan. 2.61 Follow up on referrals. 2.7 Coordinate services. 2.81 Re-assess needs, ifa appropriate. 2.9F Follow up on progress. 2.10 Coach andr mentor dients, offer informal life skills andp problem solving skills. 2.11 Provide training. 2.12 Facilitate group support. 2.13 Conduct home visits. 2.14 Maintain accurater records 3.0 Provide supportive services tol lowy wealth participants to strengthen families. 3.1 Family crisisi intervention. 3.2 Supplemental food,  Program Director Self-Sufficiency Manager Case! Managers I Case Managers Resource Coordinators Program Specialist!l  75  100 140 (25) (40)  170 (30)  sufficiency.  2.51 Make referrals and advocate for needs. Program Support Aide  Self-Sufliciency Manager Case Managersl II Case Managers Resource Coordinators Warehouse Assistant Customer Relations Specialist (PT) Program Support Aid(PT)  75  100 140 (25) (40)  170 (30)  a) Solicit, collect, pack and distribute Program Specialist!! b) Purchase milk andr nutritional food Administrative Assistant from Food Bank and other sources Warehouse Supervisor  food andp personal carei items. as needed to supplement donations. c) Accurately reçord amount off food received and distributed; maintain inventory. 3.3 Clothing 3.4 Emergency shelter and utilities. 3.5 Emergency medical services and mental health. 4.0 Provides supportive andt transition services to! low wealth participants to enable: them to achieve self sufficiency. 4.1 Transportation 4.2 Child care 4.3 Health care, medical, eye, dental, mental health 4.4 Health services &r nutrition training 4.5 Formal life skills training 4.6 Work clothes andt tools 4.7 Parental training 4.8 Counseling 5.0 Provide income management. services. 5.1 Develop family spending plan and budget. 5.2 Provide money management workshops. 5.3 Refer to Consumer Credit Counseling Service.  Self-Sufficiency Manager Case Managersl! Case Managers Program Specialist!l Resource Coordinators Administrative Assistant Program Support Aid I(PT)  15  40 (25)  75 (35)  110 (35)  15  40 (25)  75 (35)  110 (35)  Self-Sufficiency Manager Resource Coordinators Case Managers I Page2 250f49 -189-  Fiscal Year 2013-140 Community Services Block Grant Application    Cumberland Community Action Program, Inc.  5.4 Offer energy conservation activities. 5.5 Provide income tax assistance and EITCservice.  Case Managers Program Support Aide  6.0 Provide employment training and opportunities for lowy wealth participants to achieve selfs sufficiency. 6.1 Pre-employmentt training 6.2 Vocational educationa and training 6.3 Intemships 6.4 On-the-job training 6.5 Job readiness training to develop soft skills 6.6 Establish working relationships with localj jobp placement providers.  15  30 (15)  50 (20)  70 (20)  Self-Suficiency Manager Resource Coordinators Case Manager II Case Managers Program Support AidI(PT) Program Director Self Sufficiency Manager Resource Coordinator Case Managers! II Case Managers  7.0 Provide job development and placement. 7.1 Conduct job development 7.2 Offer employment counseling 7.3 Provide jobr referrais andp placement. 7.4 Offer Employers top pay partofs salaries up to 201 hours av week al the rate of $7.50p per hour ofp participants upt to4 weeks. 7.5 Provide employment maintenance and support. 8.0 Provide educational services toy participants to lead tos self sufficiency. 8.1 Basic skills 8.2 Residual education andi literacy 8.3 GED program 8.4 High school options 8.5 Community college a) AAd degree ) Medical training (C.N.A, etc.) c) Barerlfosmetologyinal. design d) Other vocational ande educational training opportunities  15  30 (15)  45 (15)  10 (10)  10  Self Sufficiency Resource Manager Coordinator Case Managers!I Casel Managers  20 (10)  38 (18)  55 (17)  8.6 College  9.0 Assist low wealth participants to obtain or maintain safe, decent and affordable housing. 9.1 Assist! low wealth participants toc obtain Program Director safe, decent and affordable housing. 9.2 Offer homeownership counseling, pre- purchase advice, and! foreclosure prevention assistance. 9.3 Obtain repairs ande emergency assistance for participants. 9.4 Refer to Weatherization: andh HARRP programs.  3  6 (3)  10 (4)  13 (3)  Self Sufliciency Manager Case Managers! II Case Managers Program Specialist H  Fiscal Year 2013-14 Community Services Block Grant Application  Pane 26nf49 -190-    Cumberland Community Action Program, Inc.  10.0 Provide micro-enterprise development training to Program Director enable low wealth participants tol become self employer, i.e., child care provider, homel health aide, other businesses, etc. 10.1 Conduct skills trainingo on: a) Start upt basics b) Business plan basics C) Financing Marketing Employees Taxes 9) Legal aspects h) IDAs  0  1 (1)  3 (2)  Self Sufliciency Manager Resource Coordinators Case! Managers Il Case! Managers  5 (2)  11.0 Conduct organizational ande educational programs develop! leadership capabilities lo guide and cultivate neighborhood projects. 11.1 Provide leadershipt training and principles in the areas of: a) CCAP, Inc. Day b) Health Awareness Day c) Transportation Services Day d) Social Services Day e) Business & Economics Day Education Day 9) Media Day Law Enforcement Day Local Govemment Day Neighborhood Issues Day 11.2 Provide youth leadership braining and principles withy youth ages 12-17 inthe areas of. a) WhatisLeadership b) Self-Esteem c) Manhood and Womanhood d) Money Management e) Employment! Readiness College Preparatory ) Physical Fitness and Nutrition Social networking and Bullying  2  2  11  to CSBG participants andt their family members to Program Director  12  CEO Communication Manager (PT) Self Sufficiency Manager Resource Coordinators Administrative Assistant Case Managersll Case Managers Program Specialistll  11.3 Conduct closing activities Graduation Ceremony" for participants successfully completing with 80% attendance. a) Select! location b) Invite! keynote speaker C) Invite graduating participants d) Invite community leaders e) Notify localr media f) Issue graduation certificates 11.4 Continuet to provide advice, information andg guidance to: newi leaders.  Program Director CEO Communication Manager (PT) Self Sufficiency Manager Resource Coordinators Administrative Assistant Case Managers I Case Managers  2  2  Fiscal Year 2013-14 Community Services Block Grant Application  Page 270f49 -191-    Cumberand Community Action Program, Inc. 9/30/2012 12/31/12 3/31/13 6/30/13  12.0N Maintain accurate records of: 12.1Producti inventory 12.2Appraised value off food donations 12.3The AR4CA 12.4Participant's Files.  Program Director Self Sulficiency Manager Resource Coordinators Administrative Assistant Case Managers!l Case Managers Program Specialist! II Administrative Assistant Warehouse Supervisor Warehouse Assistant Customer Relation Specialist (PT) Program Support Aides Program Director Self Sufliciency Manager Resource Coordinators Administrative Assistant Case Managersl! Case Managers Program Specialistil Program Support Aide  13.0N Monitor activities. 13.1 Survey clients for satisfaction. 13.2 Prepare Outcome Measures report 13.3F Review case files 13.41 Review surveys; prepare summaryof responses  9/30/2012 12/31/12  3/31/13 6/30/13  Fiscal Year 2013-14 Community Services Block Grant Application  Pana 2Rnf40 -192-    Cumberland Community Actionl Program, Inc.  14.0 Review anda approve: 14.1 Monthly reports 14.2Quarterly reports 14.3 End of Year report 14.41 IS report 15.0Evaluate Project  Chief Executive Officer 9/30/2012 12/31/12 3/31/13 6/30/13  Program Director CCAP, Inc. Boardo of Directors Chief Executive Officer 9/30/2012 Program Director CCAP, Inc. Boardof Directors Program Director CCAP, Inc. Board of Directors Program Director Program Manager Facilities Manager General Maintenance Worker Program Director Program! Manager Network Administrator Computer Systems Specialist  15.1Number of clients receiving services. 15.2Number of clients successfully completing program.  12/31/12 3/31/13 6/30/13  16.0Delermine progress in achieving outcome goals. Chief Executive Officer 9/30/2012 12/31/12 3/31/13 6/30/13  17.0F Provide assistance withi identifying lease sites and Chief Executive Officer 9/30/2012 12/31/12 3/31/13 6/30/13  reviewing ofl leases as well ast maintenance of buildings with landlords.  18.0F Responsible fort thei implementation of technologically advances of computer networks, telephones, etc.; andf for the purchasing of elecbronic equipment toi include repairing, maintenance andr monitoring oft the equipment.  Chief Executive Officer 9/30/2012 12/31/12 3/31/13 6/30/13  Fiscal Year 2013-14 Community Services Block GrantA Application  Pana 20nf10 -193-    CumberandCommuniy, Action Program, Inc.  Community Services Block Grant Program Fiscal Year 2013-14 Application for Funding One-Year Work Program Form 212 (continued)  10. Use the tables below to entery your agency's projected AIIC CSBG grantees operating self-suficiency  measures will bei includedi in the agency's CSBG contract. outcome results (targets). The outcome grantees operating nons self-suficiency, projects projects are required to complete Table 1. AIIC CSBG Table 2. Ifyoura agency operates more than one arer non required to enter applicable outcomes in the needed. There should be one table of outcome measures self-sufficiency project, please add tables as  per project.  Table1  Project Name: Number of persons served  Outcome Measures for Self-Sufficiency Projects  Expected to Achieve the Outcome in Reporting Period (Target) 170 24 $5500 55 15 $7.50 55 13 35  Outcome Measures  Ther number ofl low-income families rising above the poverty level The average change in annual income per participant The number ofp participants obtaining employment Ther number ofp participants The participant average wage rate The number of participants completing The number ofp participants securing standard housing The number ofp participants provided  (inwholei #s)  family  obtainingj jobs with medical benefits  education/training programs emergency assistance  Table2  Project Name:  Outcome Measures for Non Self-Sufficiency Projects  Expected to Achieve the Outcome in Reporting Period (Target)  Outcome Measures  Number of persons served NA  Fiscal Year 2013-140 Community Services Block GrantA Application  Page3 300f49 -194-    -195-    Community Services Block Grant Program Fiscal Year 2013-14 Application for Funding Monitoring, Assessment and Evaluation Plan  1. Describe the role and responsibilities of the followingi in the assessment and evaluation of  agency programs. a. Board of Directors:  The CCAP, Inc. Board of Directors, as a body or in Committee, is responsible for strategic long term and annual goals oft the agency, allocating human and financial planning resources carry out thep projects effectively ande eficiently; and for assessing and evaluating the services, to programs and operations on a regular basis. Monthly progress reports arep provided Executive Committee at their regular meeting. Quarterly updates of performance achievements tot the against the planned goals and objectives are presented tot thet full board. Members are encouragedi to ask questions ort to visit the program to! leam more about its successes The CEO provides an analysis oft the data. Aquestion and answer periodi is a nomal or problems. and Committee meetings. Suggestions, comments, and concems are addressed part of Board Board may delegate any additional review or evaluation to a Committee or tot the CEOf byt the fort CEO. further The investigation and deterination. A detailed: study with recommendations ist Boardi for final approval. Thel Board of Directors has final approval for all then presented to the As a part of the annual planning process, the lowi income community and clients are evaluate CCAP's services and to recommend modifications or changes improve the programs. Representatives of the elected sector obtain feedback they! believe are needed to constituents regarding the effectiveness of CCAP programs andi identify unmet from their served or underserved populations in the: service area.  the  program evaluations.  b. Low-Income Community:  asked to needs, and un-  C. Program Participants:  Agency clients participate regularly in assessing program services, systems, and through Customer Satisfaction Surveys and program evaluation surveys. Their comments operations concems or recommendations are collated and presented to the Board of Directors action or comment. Responses receiving lows scores require additional  and for further investigation and are  routed to the Program Director ort the CEO.  d. Others:  CCAP's partners and funding sources are frequentlyi involved in assessing outcomes. The quality ofp programs in meeting needs oft the targeted andi indicates ifthe program is within the planned parameters for attainment distribution. CCAP, Inc. also prepares an Annual Report on each ofi its  services program:  and evaluating reporting cycle respective groups for programs tol keept the community  sets standards of performance. Statistical datai is preparedi in accordance community with a scheduled is measured against pre- Thei information is also presented to Board members who take the goal data to their andf financial restrictions.  aware ofi its activities.  Feeding America conducted a review of the Second Harvest Food Bank of Southeast  Carolinai in 2011. The next review willl be scheduled for 2013.  North  -196-    Agency! Name  Office ofh Head Start's review ofk Head Start: Monitor's report, March 2012, CCAP HSisinf full Department of Housing and Urban Development inspects agency client files to ensure compliance withs standard and grant specifications of CCCS. Recertification is granted upon satisfactory Department of Agriculture, both North Carolina and United States offices, conductu unannounced inspections and evaluations of CCAP services and of our partnering agencies. The Fayetteville Metropolitan Housing Authority conducts an annual review of service delivery against grants requirements and duet to the outgrowth of 2011; we were asked to continue services Council on Accreditation for Children and Family Services, Inc. evaluates the agency against best practice standards every three years. CCAP was award COAI recertification December 2009. North Carolina Day Care Licensing Agency conducts compliance reviews on an unannounced City of Fayetteville Community Development and the NC Housing Finance agency conduct annual on site reviews to re-certify agency as a Community Housing Development Organization. The office oft the Govemor contracted the Brownstone Group to evaluate programs and accounting procedures. The five days, fiffy-sixi item reviews was completed with not findings. The Department ofE Energy and the State Energy Office conduct quarterly monitor visits of the 2. Describe how administrative policies andp procedures are monitored by the Board of Directors. The Board of Directors, as ar matter ofp policy, has accurately distinguished between Board and management policies. The Board establishes upperost policies and delegates thei implementation of them tot the CEO. Board policies establish the broad parameters within which Board, management and staff will conduct operations. Management policies are developed and carried out byt the CEO. These clearly outine the specifics ofl howt the organization and staff will operate within the Board's policy. Policies are regularly reviewed byt the Board fora appropriateness and continuity with other agency practices. The CEO prepares reports for thel Board or Executive Committee ensuringa administrative or management policies and procedures are covered for Board consideration 3. Describe how the Board acts on monitoring, assessment and evaluation reports. The CCAP, Inc. Board of Directors, ori its Executive Committee, receives in-depth reports to review prior toti their meetings. Theyr may call orv visit the office to obtain clarification or to observe program operations. The CEO makes recommendations. as needed to ensure programs are operating as The Board accepts monitoring, assessment and evaluation reports when the program or service isi in compliance with agency poliçies and procedures. Ifthe report contains negative consequences, the Board may appoint a Committee to investigate and make recommendations for corrective action. Both  compliance of all OHS rules and regulations. performance andi ity was grantedi in 2012.  until 2013.  basis to ensure compliance with regulations.  Weatherization Assistance Program for Recovery.  prescribed and achieving objectives.  Fiscal' Year 2013-14 Communily Services Block Grant Application  P---4n -197-    Agency Name  intemal driven ande extemally prepared reports are treated int thes same manner. Qualityi yimprovement plans (QIPs) may ber required tor rectify identified problems. QIPs will necessitate additional reporting and as secondary review once completed. The Board has thet final approval for all evaluation reports.  4. Describe the Board's procedure for conducting the agency self-evaluation.  The Board of Directors delegates the responsibility fori implementing evaluations ofp programs to the Chief Executive Officer. The CEO ensures programs are evaluated on a regular basis andi findings to the Board. The Head Start sell-assessment: is an example. Anyi identified deficiencies reports are discussed at both Board andr management levels to determine appropriate steps for bringing the program backi into compliance. The program will be closely monitored for 1 to: 3 months andi  the regular  reports submitted for Board approval  5. Summarize the results oft the Board's most recent self-evaluation. Describe how the information has been or will be used to develop the agency's next Strategy for Eliminating Poverty. Indicate when the next evaluation will begin and be completed. The Executive Committee is looking at selfevaluation tools. The evaluations will be completed ini the second quarter. Upon completion of thee evaluations, a strategic planning session willl be held.  Fiscal Year 2013-14 Community Services Block Grant Application  n---4-EAA -198-    Revised: 11/26/2012 BUDGET INFORMATION  OEO Form 225  COMMUNITY SERVICES BLOCK GRANT PROGRAM  Please Note: Information should only! be entered int the highlighted sections oft this form. Thet tabs att the bottom indicate the different sections oft the budget. As amounts are enteredi int the various sections oft thet automatically displays totalsi int the appropriate Object Category areas oft thel Budget Summaryi in the budget, Cover thef Tab. form Check" "Annual Application" ift this budget is being submitted with the CSBG Application. Check Amendment" #fthis budgeti ist being submittedy with an amendment tot the CSBG contract. Check "Budget Change" ifthis budgeti is being submitted with a Budget Change Request (OEO Form: 225)  oft the form  Budget Type  Section I. Identification: Entert the agency name and contract period. Section II. Contract Summary: documentation is necessary. ADMIN. SUPPORT: Support Our Students Section HI, Budget Summary: into each tab oft the form. Indirect Costs. Indirect Costs: Approved Rate: 16.8% Base: Salaries/Wages  The onlye entries required in Section lla are for Administrative Support. Entert the name of the supported with CSBG funds and the amount(s) budgeted (see sample below). Entries must be program(s) consistent being information enteredi into the CSBG Administrative Support Worksheet (OEOF Form2  with  212A). Support  $10,000 (Insert Program Name)  $0  Proiect Names. Agencies budgeting more than one CSBG project should identify each project byi in the columns. Once CSBG project administering names are entered in Section I, the names willp Agencies chargingi indirect costs (pursuantt to an approved Indirect Cost Rate Agreement), shoulde enter the Rate, the! base and the amount charged int the indicated spaces (see sample below).  appropriate populate int the same locations  Indirect Cost  44,748  01  IMPORTANT The Budget Narrative Form 225N is required to provide detail and  tot  line  instructions and the Form 225N arei included Int the application instructions. TheF support Form budgeted items. The additional information on any section oft the Budget 225. See, page 9oft the application 225N instructions. can be used top provide  Section IV. Salaries and Fringe:  AUF Fringe Benefits must! bei itemized and entered on a per employee basis, regardiess ify Position Titles must be statede exactly as they appear on the One-Year Work plan Portions partially orf fullyf funded by CSBG should be listed.  has  beneftr rate" agreement. Two pages for Salaries & Fringe arei includedi in the 2251 form. your agency has a' cognizant-approyed fringe these two pages, please e-mail OEO Fiscal Analyst Steve Fowler at See.owerpcnsnsgoy lfyoura agency more staff than will fit on which have been assigned project activities ont the corresponding OEO Form 212 (OEO and Form: 212). List onlyt those positions The actual Annual Salary for each position must be listed; combined salaries of positions with the same are Enter Position Title, Annual Salary, Number of Months and CSBG Share. Then enter thei itemized columns (sees sample on next page). Total Salaries and' TotalF Fringes fort the  additional pages.  and he will provide your agency with  charged directly tot the grant.  acceplablei int this column. Cover! Page.  title not  fort the Fringe. The amount ofs salary and every itemized fringe benefit charged to each Position Fringe Type and the Computation  columns Titler must be enteredi int the program are automatically captured ont the  program  -199-    SECTION IV.- SALARIES AND FRINGE Position Title Salary Annual & No.of CSBG %CSBG  Wages Months Salary Share Fringe Type Fringe Benefit Computation Program Program Program Program  1  2 2  (Itemize) eg. Benefit Amountx x No. of Unemployment 520,400x03966 Retirement $45,000x6% Workers Comp $45,000/100x.33 Unemployment 520,400x0396% Retirement $35,000x6% Workers Comp $35.000/100x.33 FICA 2.00  Months eg. Salary> x benefit Amount/%  FTE's s0J $0 $0 $0 s0 $0 $0  CSBG Manager $45,000 12 $45,000 100.00% Case Worker1 $35,000 12 $35,000 $0 100.00% FICA  Fringes Salary Fringes Salary  $404 $1,350 $74 $3,443 5404 $1,050 $58 $1,339 $14,122  Health Ins. $500 per monthx1 12 months $3,000 $22,500 $404 $22,500 Health Ins. $500 per month x1 12 months $3,000 $17,500 $404 $17,500  $3,000 $74 $1,350 $1,721 $3,000 $1,050 $58 $1,339 $12,400 $40,000  $45,000x7.659 $35,000x7.65%  TOTAL SALARIES $80,000 TOTALI FRINGES $26,522 TOTALF FTE's  $40,000  Note: In the Budget Narrative Form 225N please provide staffr names and position titles. Note:. Justification fort total costs must be providedi int the appropriate spaces for detailed description of anticipated! Equipment (as definedi inf [Attachment of the  the ctherp Program/percentages the employee works. Budget Support Data (Sections IVa. -IVd):  Ifthe employee is less than 100%, include  Supplies/Materials, Contractual, Client Services and! Other. Additionali information Communications, will ber requestedi Space int the Costs, Travel,  Form 225N.  Section IVa  1e number ofi items to be purchased, the actual cost peri item and the total G]C cost thei CSBG contract) purchasesi ist required along with on! the need for new equipment. Include planned office equipment with a useful oft life of1 item(s). Int the Form 225N provide justification  exceed the capitalization threshold of $500.00.  or more years in this area even ifito does not  Section IVb  The Space Costs category shouldi include facilities rent, maintenance costs, etc.  The Travel category shouldi include localr mileage, per diem, lcdging, transportation and other relatedi items whilei int travels status on The Supplies/Materials category shouldi include: such items as office supplies, brochures, training materials, etc. The Contractual category shouldi include, in addition to audit costs, a detailed description note that CSBG funds can only be contractually obligated during the contract agreements priort to OEO's confirmation ofa an executed contract. The Client Services category should Include a detailed description ofs services tol be services should support the services identified in the One Year Work plan.  Section IVc  through a professional orp personal consultant services contract. Detailed information of any goods or services tot be provided the Accountable Results for Community Action (AR4CA) database: system should include is requested int the Form: 225N. Agencies utilizing  and Grantees related expenses under contractual. Please should not enteri into subcontract provided to clients ine each project. Budgeted  period  Section IVd  The Other category shouldi include a detailed description ofa any items not covered inp previous cost categories. Support documents  may be required.  Per County Budget  The County Budget is requlred for CAA's administering CSBG ina a multi-county service area. The Spreadsheeti indicates thet total agency allocation as well as the county allocations residents by county. Entert these figures into the Per County Allocation Line The County Totals enteredi int the County Budget will populate ont the Cover undert the Thel TotalA Agency Budget (TAB)i is included fori informational purposes and is required. The TAB separately from the OEO Form: 225. Budget figures entered1 for OEO-funded  FY2013-14 CSBG Allocation  which arel based ont the percentage ofpoor (Line 9)p provided within the County Budget Tab.  the County" Totals column and the Program Totals column on the Covers should County Totals column. The figures on cover sheet oft this form. Information should also be entered for all agency programs should be consistent with amounts ont the the: actual or anticipated amount for the current funding cycle. Please dor not programs. abbreviate Allp program budgeted amounts should reflect  agree.  otal Agency Budget  is a two-page form, numbered  program names.  -200-    - EEEE D8 80  201    8  00    DB  I    8 6A 8888 B B 8 6A 6A  8 8 6 B 6A  0  204    B  DE  205-    B de 8 9 B  e e AI 6 6A  De  06    A  A 988 10 de  8  D0  -207-    6  De  a  0  D8 0  08    De  s  9  De    -210-    TINIR DEC 2012 R  COUN  North Carolina DepartmentofHealh: and Human Services Division ofHealth Service Regulation Office ofl EmergencyMedical Services 2707 Mail Service Center Raleigh, North Carolina 27699-2707 pladhhagwla Drexdall Pratt, Director  Beverly Eaves Perdue, Govemor Albert A. Delia, Acting Secretary December 14, 2012 Mr. Edwin Causey Sampson County Manager 406 County Complex Road Clinton, NC28328 Dearl Mr. Causey:  Regina Godett-Orawiord, Chief Phone: 919-855-3935 Fax:919-733-7021  The North Carolina Office of Emergency Medical Services (OEMS) oft the North Carolina Department of Health and Human Services will be conducting a site visit at Wake Med Health and Hospitals to consider its application for renewal designation as a Level Itrauma center. The visit will be conducted at the Pursuant to state rule 10A1 NCAC 13P. .0905 (b)(1), this letter serves to apprise your. Board of County Commissioners, whose county is either completely or partially in Wake Med Health and Hospitals' primary trauma catchment area, oft this process. Thej purpose ofthis notification is to seek locali input on any concerns: relating to the hospital's trauma care or related services prior to making ai recommendation Ify your county has specific concerns: regarding any aspect of Wake Med Health and Hospitals' trauma program or related delivery of care, please advise: me: in writing no. later than February 22, 2013. Any concerns submitted to us willl be shared with the survey team members and followed up during the site visit. Should we not receive any correspondence from you by this date, we will assume there areno Ifyou or your staff should have any questions, please feel free to contact me at (919)855-3953.  hospital on March 26, 2013.  on the renewal.  particular concerns., Sincerely,  Geafps Amy Douglas, RN  Trauma Manager, NCOffice ofEmergency Medical Services  cc: Regina Godette-Crawford, Chief Tom Mitchell,. Assistant Chief, Administration Doug Calhoun, Regional Specialist  Location: 1201 Umstead Drive B Dorothea: Dix Hospital Campus m Raleigh, N.C. 27603  Anl Equal Opportunin/Afmatiw, Action Employer  -211-    MANAG 9 DECI 2012 E  ONCOURT  North Carolina  Department of Administration  Beverly Eaves Perdue, Governor Moses Carey,Jr., Secretary November 15, 2012 Mr. Edwin Causey County Manager Sampson County Government 406 County Complex Rd. Clinton, North Carolina 28328 Dear Mr. Causey:  N.C. Commission ofI Indian Affairs Gregory A. Richardson, Executive Director  The North Carolina Commission ofIndian Affairs was created in 1971 by the North Carolina General Assembly to study Indian needs, to deal effectively with Indian issues, and tol bring local, state, and federal resources into focus for the implementation or continuation ofr meaningful programs for Indian citizens oft the state, and to assist in social and economic development of Native American communities (N.C. General Statutes 143B- 406). As part ofits mandate, the N.C. Commission ofIndian Affairs administers the state's procedures for the. recognition ofp previously unrecognized American Indian groups in The state recognition procedures are codified as administrative rules in the North Carolina Administrative Code at Title 1, Chapter 15, Section .0200 "Legal Recognition of American Indian Groups." A copy of1NCAC15.02001 is available on the internetat Atp/hmmdancewaiasaAislssind: In accordance with 1 NCAC 15.0209 (3)(b), the Commission ofIndian Affairs is required to notify local and county governments within a 25 mile radius oft the Petitioner's geographic area when we. have received a "Notice ofIntent To Petition" for state recognition asan American Indian tribe in North Carolina. A "Notice of Intent' To Petition" has been received from the group calling itselfthe Tuscarora Nation of! North Carolina, Inc." located in Weare hereby notifying the Sampson County Government, as a municipality within a 25 mile radius of the Petitioner's geographic: area, that the group callingi itselfthe' Tuscarora Nation ofNorth Carolina, Inc." has filed its Notice ofIntent to Petition for state recognition  North Carolina.  Maxton, NC.  with the N.C. Commission ofl Indian Affairs.  Mailing Address: 13171 Mail Service Center Raleigh, N.C. 27699-1317  Telephone (919) 807-4440 Fax (919) 807-4461 State Coarier #56-20-51 w-212-: :ia  Location: 116 W. Jones Street. Suite 3054 Raieigh, North Caroiina 27603    Sampson County November 15,2012, page 2  Matters regarding tribal recognition are: initially handled through the Commission's Recognition Committee, which is comprised of one member from each oft the state's American Indian tribes and urban Indian center organizations. The committee meets quarterly -and otherwise, asi is necessary-and reports to the full Commission ofI Indian For furtherinformation regarding tribal recognition matters, please contact me at the commission'sofice (919-807-4444) or via email elk.richardson@doa.nc.gov),  Affairs regarding recognition matters.  Sincerely, E Elk Richardson :ECR  Staff to the Recognition Committee  CC; Paul Brooks, Chairman -N.C. Commission ofI Indian Affairs G. Mark Teague (Office oft the Attorney General)  Recognition Committee  -213-    POLICIES AND PROCEDURES REGARING: PUBLIC COMMENT  Aperiod reserved for comments from the public ont topics not otherwise included on that eveningsagendà" will bei included as an item of business on all agendas of regularly-scheduled Board of Commissioners meetings and shall be deemed the "Public Comment' segment of the agenda. The Public Comment segment of the agenda will be placed at the end oft the agenda,following the conclusion: of all other open session Aswith Public Hearings, the Chair (or presiding officer) will determine and announce: limits on speakers at the start of the Public Comment period. Generally,each: speaker will be allocated five (5) minutes. Speakers may not allocatetheir time to another speaker. The Chairman (or presiding officer) may, at his discretion, decrease this time allocation, if the number ofpersons wishing to speak would unduly prolong the meeting. The Public Comment period shall not exceed a total of thirty (30) minutes unless the Board An individualwishing to address the Board during the Public Comment period shall register with the Clerk to the Board prior to the opening of the meeting by signing his or her name, address and a short description of his or her topic on a sign-up sheet stationed in the lobby of Iftime allows, those who fail to register before the meeting may speak during the Public Comment period. heseindividuals: will speak following those who registered in advance, At this time in the agenda, an individual should raise his orherhand and ask to be recognized by the Board Chair (or presiding officer); and then state his or her name, address and introduce the Items of discussion during the Public Comment segment of the meeting will be only those approprate: to Open Meetings. Closed Meeting topics include, butare not limited to, such subjects as personnel, acquisition ofreal property, and information protected by the client- Because subjects of Special and Emergency Meetings are often regulated by General Statutes, there will be no Public Comments segment reserved on agendas of these meetings; however, The Public Comments segment of the agenda isi intended to providea a forum for the Board of Community to listen to citizens; there shall be no expectation that the Board will answer impromptu questions. However, Board members, through the presiding officer, may ask the speaker questions for clarificationt purposes. The Board will not take action on an item brought upduring the Public Comments segment of the agenda and, when appropriate, items will be  business.  entertains a successful majority vote to extend this period.  the County Auditorium:  topic tol be addressed.  attorney privilege. Closed Meeting subjects will not be entertained.  Special and Emergency Meetings are open for public attendance.  referred to the Manager or the proper Department Head.  -214-