062713a Agenda PackageHARNETT COUNTY BOARD OF COMMISSIONERS
County Administration Building
102 East Front Street
Lillington, North Carolina
Special Meeting
June 27, 2013 7:00pm
1. Call to order -Chairman Jim Burgin
2. Pledge of Allegiance and Invocation-Commissioner Gordon Springle
3. Consider additions and deletions to the published agenda
4. Consent Agenda
A. Budget Amendments
B. Airport Administrator requests approval of the Block Grant 36237.25.14.1 funding
agreement with the NC Department of Transportation/Division of Aviation for the
Runway, Apron & Taxiway Rehabilitation Project at Harnett Regional Jetport.
C. Cooperative Extension requests approval of a time extension of current contract with
the Pesticide Container Recycling Program scheduled to end June 30, 2013. The
Amendment will allow our Pesticide Container Recycling program to continue until
August 31, 2013 in order to spend remainder of funds to purchase paint to be applied
to the deck, framing, doors and metal siding attached to the rear side of the Pesticide
Container Unit.
D. Finance Officer requests approval of a lease purchase agreement with US Bank in the
amount of $739,763 for the purchase of a wheel loader and compactor for the landfill.
5. Period of up to 30 minutes for informal comments allowing 3 minutes for each presentation
6. Public Hearing on FY 2013-2014 Proposed Budget Plan
7. County Manager's report-Tommy Bums, County Manager
8. New Business
9. Closed Session
10. Adjourn
Page 1
Agenda Item ------
BUDGET ORDINANCE AMENDMENT
BE IT ORDAINED by the Governing Board of the County of Harnett, North Carolina, that the following
amendment be made to the annual budget ordinance for the fiscal year ending June 30, 2013:
Section 1. To amend the Dunn Erwin Corrective Project Fund, the appropriations are to be changed as
follows:
EXPENDITURE AMOUNT AMOUNT
CODE NUMBER DESCRIPTION OF CODE INCREASE DECREASE
583-8300-461.45-74 Capital Outlay 30,000
REVENUE AMOUNT AMOUNT
CODE NUMBER DESCRIPTION OF CODE INCREASE DECREASE
583-0000-370.82-13 Special Obligation Bonds 30,000
EXPLANATION: To correct par amount of Special Obligation Bonds issued on January 23, 2013.
APPROVALS:
Section 2. Copies of this budget amendment shall be furnished to the Clerk to the Board, and to the
Budget Officer and the Finance Officer for their direction.
Adopted this
Margaret Regina Wheeler
Clerk to the Board
day of
Jim Burgin, Chairman
Harnett County Board of Commissioners
l.:rl'lL. l.J l.J .L l.J':t
Fiscal Year 2013
<..:.LV:J.'.Y Ul!' HARNETT
Account Balance Inquiry
Account number 583-0000-370.82-13
Fund ...
Department
Division .
Activity basic
Sub activity
Element
Object ..
Estimated revenue
583
00
00
37
0
82
13
Estimated revenue -revised
Actual receipts -current
Actual receipts -ytd
Unposted receipts
Total receipts . .
Unrealized revenue
DUNN-ERWIN CORRECTIVE
OTHER FINANCING SOURCES
OTHER FINANCING SOURCES
OTHER FINANCING SOURCES
SPECIAL OBLIGATION BONDS
0
1, 720,000
.00
1, 750,000.00
.00
1,750,000.00
30,000.00-
02/04/20~3
9-0 10~.7
~.7-%
6/05jl3
16:42:19
F7=Project data
F11=Acct activity list
FB=Misc inquiry
F12=Cancel
F9=Misc update
Fl3=Misc Budget
FlO=Detail trans
F24=More keys
BUDGET ORDINANCE AMENDMENT
BE IT ORDAINED by the Governing Board of the County of Harnett, North Carolina, that the following
amendment be made to the annual budget ordinance for the fiscal year ending June 30, 2013:
Section 1. To amend the General Fund, the appropriations are to be changed as follows:
EXPENDITURE AMOUNT AMOUNT
CODE NUMBER DESCRIPTION OF CODE INCREASE DECREASE
110-8702-470.86-25 2012B QSCB $629,507
110-8702-470.86-26 2012A LOB/Limited Obligation $12,750
REVENUE AMOUNT AMOUNT
CODE NUMBER DESCRIPTION OF CODE INCREASE DECREASE
110-0000-356.80-05 Federal Reimb-2012 QSCB Debt $525,907
110-0000-3 99.00-00 Fund Balance Appropriated $116,350
EXPlANATION: To budget debt payments and Federal reimbursement for QSCB's and LOBS issued in November
2012.
APPROVAlS:
Department Head (date}
Section 2. Copies of this budget amendment shall be furnished to the Clerk to the Board, and to the
Budget Officer and the Finance Officer for their direction.
Adopted this
Margaret Regina Wheeler
Clerk to the Board
day of
Jim Burgin, Chairman
Harnett County Board of Commissioners
BUDGET ORDINANCE AMENDMENT
BE IT ORDAINED by the Governing Board of the County of Harnett, North Carolina, that the following arnendrnent be
made to the annual budget ordinance for the fiscal year ending June 30, 2013:
Section 1. To amend the AIRPORT OVER LAY ZONING DISTRICT CP1004, the appropriations are to be
changed as follows:
EXPENDITURE AMOUNT AMOUNT
CODE NUMBER DESCRIPTION OF CODE INCREASE DECREASE
398-8360-465-45-20 Legal $2,172
398-8360-465-45-30 Engineering $107,700
398-8360-465-46-01 Residual Equity $5
398-8360-465-45-01 Construction $34,370
398-8360-465-7 4-71 Capitol Outlay $75,497
REVENUE AMOUNT AMOUNT
CODE NUMBER DESCRIPTION OF CODE INCREASE DECREASE
EXPLANATION: To modify budget due to expiring grant for the Airport Overlay Zoning 2009 Vision 100 Project.
36237.25.11.1
APPROVALS:
?{'~ tfo/f7J
-Depa rnent Head (date) Finance Offic (d te) Cou Manager (dote)
(g r ::J tf -r~
Section 2. Copies of this budget amendment shall be furnished to the Clerk to the Boord, and to the BJG'get
Officer and the Finance Officer for their direction.
Adopted __________________________________ __
Margaret Regina Wheeler,
Clerk to the Boord
Jim Burgin, Chairman
Harnett County Boord of Comm
BUDGET ORDINANCE AMENDMENT
BE IT ORDAINED by the Governing Board of the County of Harnett] North Carolina] that the following
amendment be made to the annual budget ordinance for the fiscal year ending June 301 2013:
Section 1. To amend the Employee Clinic Fundi the appropriations are to be changed as follows:
EXPENDITURE AMOUNT AMOUNT
CODE NUMBER DESCRIPTION OF CODE INCREASE DECREASE
9Dtf Contracted Services-Miscellaneous-$2251000
---9m-9802 -410.33-50 Employee Clinic
REVENUE AMOUNT AMOUNT
CODE NUMBER DESCRIPTION OF CODE INCREASE DECREASE
....902-0000-353.98-05 Employee Clinic $2251000
EXPLANATION: To move the budget for the Employee Clinic to a separate fund to facilitate the tracking of
activity.
APPROVALS:
Department Head (date) anager (date) . 1 b(;;l.'IJJ~
Section 2. Copies of this budget amendment shall be furnished to the Clerk to the Board1 and to the
Budget Officer and the Finance Officer for their direction.
Adopted this
Margaret Regina Wheeler
Clerk to the Board
day of
Jim Burgin 1 Chairman
Harnett County Board of Commissioners
BUDGET ORDINANCE AMENDMENT
BE IT ORDAINED by the Governing Board of the County of Harnett, North Carolina, that the following
amendment be made to the annual budget ordinance for the fiscal year ending June 30, 2013:
Section 1. To amend the Group Insurance Fund, the appropriations are to be changed as follows:
EXPENDITURE AMOUNT AMOUNT
CODE NUMBER DESCRIPTION OF CODE INCREASE DECREASE
902-9802-410.21-05 Employee Clinic $225,036
902-9802-410.21-02 HRA $18,797
902-9802-410.21-04 HAS $127,140
REVENUE AMOUNT AMOUNT
CODE NUMBER DESCRIPTION OF CODE INCREASE DECREASE
902-0000-353.98-05 Employee Clinic $265,036
902-0000-353.98-02 Group Insurance $20,037
902-0000-353.98-03 HRA $165,262
902-0000-351.00-00 Miscellaneous Expense $638
EXPLANATION: To adjust the Group Insurance Fund budget to reflect current year activity.
APPROVAlS:
Department Head (date) Finance · er (date) Cou anager (date) I /
&r;J.I.f;ls
Section 2. Copies of this budget amendment shall be furnished to the Clerk to the Board, and to the
Budget Officer and the Finance Officer for their direction.
Adopted this
Margaret Regina Wheeler
Clerk to the Board
day of
Jim Burgin, Chairman
Harnett County Board of Commissioners
BUDGET ORDINANCE AMENDMENT
BE IT ORDAINED by the Governing Board of the County of Harnett, North Carolina that the following
amendment be made to the annual budget ordinance for the fiscal year ending June 30, 2013:
Section 1. To amend the General Fund, Social Services Department, the appropriations are to be
changed as follows:
EXPENDITURE AMOUNT AMOUNT
CODE NUMBER DESCRIPTION OF CODE INCREASE DECREASE
110-7710-441.80-25 Medical Transportation 50,000
110-7710-441.89-50 Elderly Assistance Donations 272
110-7710-441.80-65 Title IV-E Foster Care 24,800
110-7710-441.80-70 State Foster CareR & B 30,000
110-7710-441.80-85 Progress Energy Neighbors 683
REVENUE AMOUNT AMOUNT
CODE NUMBER DESCRIPTION OF CODE INCREASE DECREASE
110-0000-330.77-08 Medical Transportation 50,000
110-0000-353.06-00 Social Services Donations 272
110-0000-330.77-01 Social Services Administration 683
110-0000-330.77-03 Foster Care IV-E 20,336
110-0000-334.77-02 Foster Care SFHF 15,000
110-0000-399.00-00 Fund Balance Appropriated 19,464
EXPLANATION:
To budget donations received for the elderly & disabled and additional funding allocated by the State from
Progress Energy for the Energy Neighbor Program. Increase in budgets for foster care services and medical
transportation provided by HARTS is requested for estimated year-end expenditures.
APPROVALS:
partment Head (date} Finance 0 c r (date} Coun Manager (date} I . I
(Qj)'IJ/3
Section 2. Copies of this budget amendment shall be furnished to the Clerk to the Board, and to the
Budget Officer and the Finance Officer for their direction.
Adopted this_ day of _____ 2 __
Margaret Regina Wheeler,
Clerk to the Board
Jim Burgin, Chairman
Harnett County Board of Commissioners
Board Meeting
Agenda Item
Agenda Item Lf. _ f3
MEETING DATE: Jtttte 17, 2013
Sp.<-tN< XSS'/ .. JJ :::r <-4.41"--:L 7 ,I 2..111~
TO: HARNETT COUNTY BOARD OF COMMISSIONERS
SUBJECT: NC Dept of Transportation I Division of Aviation -Runway Rehab Project
Funding Agreement
REQUESTED BY: Barry Blevins, Director, General Services
REQUEST:
Airport administration requests the Harnett County Board of Commissioners consider and
approve the Block Grant 36237.25.14.1 funding agreement for the Runway, Taxiway &
Aproon Rehabilitation Project at Harnett Regional Jetport. Project Ordinance for $4,304,928
approved on May 20, 2013 pending grant funding agreement.
COUNTY MANAGER'S RECOMMENDATION:
http:: /www.hamett. org/boc/downloadsiagendafonn20 13 .doc
I ofl
Page
STATE OF NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION
PAT MCCRORY
GOVERNOR
Mr. Barry Blevins, Administrator
June 17, 2013
Harnett County General Services Department
P.O. Box 940
Lillington, NC 27546
Dear Blevins:
ANTHONY J. TATA
SECRETARY
Enclosed are state airport aid grant agreements for the funding of your Block Grant
Project 36237.25.14.1 (Rehabilitate & Strengthen Runway 5/23, Taxiway & Apron
(Construction & CA). The appropriate governmental body must execute these
agreements. Upon completion, all two original copies ofthe agreement must be returned
to this office. Please remember that all signatures and seals must be original and not
reproduced copies. The Department will fill in the date on the first page of the agreement
once the Secretary of Transportation signs the documents.
Please note that the signature pages are pages 3 and 4 of the Agreement. Once the
Department has executed the grant agreements, one copy will be returned to you for your
files.
Should you have any questions, please do not hesitate to contact me or your Airport
Project Manager Kathy Vollert.
NCS/cae
Enclosures
MAILING ADDRESS:
NC DEPARTMENT OF TRANSPORTATION
DIVISION OF AVIATION
1560 MAIL SERVICE CENTER
RALEIGH NC 27699-1560
Sincerely,
~~~;g~
Grants Administrator
TELEPHONE: 919-814·0550
FAX 919-840-9267
NCDOT.GOV/AVIATION
LOCATION:
RDUAIRPORT
1 050 MERIDIAN DRIVE
RDU NC 27623
BLOCK GRANT AGREEMENT
STATE AID TO AIRPORTS BLOCK GRANT
BETWEEN
THEN. C. DEPARTMENT OF TRANSPORTATION,
AN AGENCY OF THE STATE OF NORTH CAROLINA
AND
COUNTY OF HARNETT
HARNETT REGIONAL JETPORT
PROJECT NO: 36237.25.14.1
THIS AGREEMENT made and entered into this the ___ day of , 20 , by and between
the NORTH CAROLINA DEPARTMENT OF TRANSPORTATION (hereinafter referred to as "Department") and
HARNETT COUNTY, the owner of the HARNETT REGIONAL JETPORT (hereinafter referred to as "Sponsor").
WITNESSETH
WHEREAS, Chapter 63 of the North Carolina General Statutes authorizes the Department to administer a program of
State Aid to Airports, subject to the limitations stated in that Chapter; and
WHEREAS, the Department has received the approval of the Federal Aviation Administration to administer certain
Airport Improvement Program Funds in North Carolina under the provisions of the State Block Grant Program in accordance
with Chapter 63-71; and
WHEREAS, the Department has approved a grant of funds to the Sponsor for State Block Grant Program funds.
NOW THEREFORE, the Department and the Sponsor do hereby mutually agree as follows:
I) That the approved scope of this project shall consist of:
REHABILITATE & STRENGTHEN RUNWAY 5/23, TAXIWAY & APRON
(Construction & CA)
2) That the Grant of funds shall include maximum funding obligations for federal funds which shall be:
State Block Grant Program: $3,874,435 (not to exceed 90% of the final total costs)
3) That the funding obligations referenced in (2) above shall be the maximum obligations based on the final cost of eligible
work items in the approved project, as certified by the Sponsor
4) That the Sponsor shall promptly undertake the Project and complete all work on the Project no later than the 1st day of
JULY 2016, unless a written extension of time is granted by the Department.
DOA FORM (12/10)
5) That all work perfonned on the Project shall confonn to the approved scope of work referenced in this Agreement. Any
amendments or modifications to the approved scope of work, approved grant amounts, or this Agreement shall not be
authorized by the Department unless they are contained in a written modification to this Agreement and fully executed by
both the Sponsor and the Department.
6) Debannent and Suspension: The Grantee agrees to comply, and assures the compliance by each of its third party
contractors and subrecipients at any tier, with the provisions of Executive Orders Nos. 12549 and 12689, "Debannent and
Suspension," 31 U.S.C. § 6101 note, and U.S. DOT regulations on Debannent and Suspension at 49 C.F.R. Part 29.
7) The Sponsor certifies that it has adhered to all applicable laws, regulations, and procedures in the application for and
Sponsor's approval of this Grant.
8) For a material breach of this Agreement or the Sponsor's Assurances, the Sponsor shall be liable to the Department for the
return of all grant monies received.
9) The Sponsor agrees to adhere to the standards and procedures contained in the State Aid to Airports Program Guidance
Handbook (third edition, dated January 1997), unless the Department issues a written waiver to the contrary.
1 O) The Sponsor agrees to adhere to and be bound by the Grant Assurances of the Federal Aviation Administration, said
Grant Assurances contained in Appendix I of this Grant Agreement. Further, the Sponsor agrees that it shall be responsible to
the Federal Aviation Administration, or its designated agent, for enforcement of such Grant Assurances including any
penalties, sanctions, or other actions which may be legally enforceable for lack of compliance with said Grant Assurances.
11) The Sponsor agrees to comply with the "Sponsor Assurances" contained as part of this Agreement.
12) N.C.G.S. § 133-32 and Executive Order 24 prohibit the offer to, or acceptance by, any State Employee of any gift from
anyone with a contract with the State, or from any person seeking to do business with the State. By execution of any response
in this grant agreement, you attest, for your entire organization and its employees or agents that you are not aware that any
such gift has been offered, accepted, or promised by any employees of your organization.
DOA FORM (12/10)
Page 2 of 11
IN WITNESS WHEREOF, THE PARTIES HERETO EXECUTED THIS GRANT AGREEMENT THEDA Y AND YEAR
FIRST WRITTEN ABOVE:
NORTH CAROLINA DEPARTMENT OF TRANSPORTATION:
NCDOTSEAL BY: ------------------------------------
Deputy Secretary for Transit
ATTEST: --------------------------------
SPONSOR: Signed: ------------------------------------
Title: ------------------------------------
SPONSOR SEAL
Attest: ------------------------------
STATE OF NORTH CAROLINA, COUNTY OF------------------------
I,-------------------------------' a Notary Public in and for the County and State aforesaid, do
hereby certifY that _______________________________________ __personally came before me this day and
acknowledged that he is _______________________________ of the---------------------------
(Title) (Sponsor)
(hereinafter referred to as "Sponsor" and by authority duly given and as an act of said Sponsor, the foregoing instrument was
signed by him, attested by--------------------------------------------------of the Sponsor, and
(Name and Title)
Seal ofthe Sponsor affixed hereto.
WITNESS my hand and Notarial Seal, this the ______ day of ___________________________ .20
My Commission expires: ____________________ _
DOA FORM (12/10)
Page 3 of 11
Notary Public (Signature)
SEAL
RESOLUTION
A motion was made by _______________________ and seconded by
(Name and Title)
____________________ for the adoption of the following resolution, and upon being put to a
(Name and Title)
vote was duly accepted:
WHEREAS, a Grant in the amount of$3,874,435 has been approved by the Department based on total estimated
cost of $4,304,928; and
WHEREAS, an amount equal to or greater than ten percent (10%) ofthe total estimated project cost has been
appropriated by the Sponsor for this Project.
NOW THEREFORE, BE AND IT IS RESOLVED THAT THE----------------
(Title)
of the Sponsor be and he hereby is authorized and empowered to enter into a Grant Agreement with the Department, thereby
binding the Sponsor to the fulfillment of its obligation incurred under this Grant Agreement or any mutually agreed upon
modification thereof.
--------------------------------------------------------of the
(Name and Title)
-------------~-=----~--------------------------do hereby certifY that
(Sponsor)
the above is a true and correct copy of an excerpt from the minutes of the
---------------::---------:--------------------------------of a meeting
(Sponsor)
duly and regularly held on the ___ day of ________ , 20 __ _
This, the ___ day of ________________ ,20 __ _
SPONSOR SEAL
THIS 1~4STRUMENT HAS BEEf'/
DOA FO~'f~lTED IN THE MANNER REQUIA::-:c
BY THE LOCAL GOVERNM~NT BUDGET
A. . FISCAL CONTR~L ACT
Signed: -------------------
Title:
OfThe: ----------------
Page 4 of 11
SECTION A: SPONSOR'S ASSURANCES: GENERAL CONDITIONS
A-I. The Sponsor certifies that it holds fee simple title to the property on which this project is to be constructed. In the
event any work is proposed on property which has an easement or lease in the Sponsor's name, the Sponsor agrees that it will
comply with the Department's conditions and receive V.Titten approval prior to any construction on such lease or easements.
This condition does not apply to planning projects.
A-2. The Sponsor agrees to operate the Airport for the use and benefit of the general public and shall not deny reasonable
access to public facilities by the general public.
A-3. The Sponsor agrees to operate, maintain, and control the Airport in a safe and serviceable condition for a minimum
of twenty (20) years following the date of this Agreement and shall immediately undertake, or cause to be undertaken, such
action to correct safety deficiencies as may be brought to its attention by the Department.
A-4. The Sponsor agrees that any land purchased, facilities constructed, or equipment acquired under this Agreement shall
not be sold, swapped, leased or otherwise transferred from the control of the Sponsor without written concurrence of the
Department.
A-5. The Sponsor agrees that the state share of any land purchased, facilities constructed, or equipment acquired under
this Agreement shall be credited to the Department in a manner acceptable to the Department in the event such land, facilities
or equipment are subsequently disposed of through sale or lease.
A-6. Insofar as it is within its power and reasonable, the Sponsor shall, either by the acquisition and retention of property
interest, in fee or easement, or by appropriate local zoning action, prevent the construction of any object which may constitute
an obstruction to air navigation under the appropriate category of Federal Air Regulation Part 77, 14 CFR 77.
A-7. Insofar as it is within its power and reasonable, the Sponsor shall, restrict the use of land adjacent to or in the
immediate vicinity of the airport to activities and purposes compatible with normal airport operations, including landing and
taking off of aircraft and the noise produced by such operations by adoption of zoning laws, by acquisition and the retention
of property interest, in fee or easement.
A-8. Terminal building spaces constructed under this Grant Agreement shall be for the use of the general public. The
Sponsor agrees that it will not use any space so constructed for private use, or charge fees for the use of such space, without
the v.Titten approval ofthe Department.
Page 5 of 11
SECTIO~ B: SPONSOR'S ASSURANCES: PROJECT ADMINISTRATION
B-1. The Airport shall comply with all requirements of the State Aid to Aimorts Program Guidance Handbook (third edition,
January 1997).
B-2. It is the policy of this State, to encourage and promote participation by disadvantaged minority owned and women
owned businesses (MBE and WBE) in contracts let by the Department pursuant to GS 136-28.4 for the planning, design,
preconstruction, construction, alteration, or maintenance of State transportation infrastructure construction, and in the
procurement of materials for these projects. All State agencies, institutions, and political subdivisions shall cooperate with the
Department of Transportation and among themselves in all efforts to conduct outreach and to encourage and promote the use
of disadvantaged minority owned and women owned businesses in these contracts. This is designed to ensure minority MBEs
and WBEs have maximum opportunity to participate in performance of NCDOT contracts let using state funding. The
sponsor assures and certifies with respect to this grant that they will pursue these requirements as stipulated by the Department
in the advertising, award and administration of all contracts, and require the same for all contractors, sub recipient or
subcontractors.
MBE\WBE program is governed by G.S. 136-28.4 and administered in accordance with Title 19A Chapter 02 SubChapter D
Section .II 0 I -.1112 of North Carolina Administrative Code (19A NCAC 02D.ll 0 I).
B-3. The Sponsor shall submit draft plans and specifications, or approved alternate, for the project for review by the
Department prior to advertising for bids on the Project. Should bids not be required on the project, the Sponsor shall submit a
detailed scope of work and estimated costs prior to requesting "Project Concurrence and Notice to Proceed" form
(A V-CONCUR/AV-503) for undertaking the project. All plans (and alternate) shall be supported by engineer's report. A list
of deliverable(s) from the Sponsor to the Department is as follows:
Planning Projects
1. Interim Planning Submittals ~ All Airport Layout Plan Sheets, Reports, Projections, Construction Cost
Estimate, drawings, sketches and all other pertinent information ~ electronic copy: PDF format. Paper
copy, if requested: bond copy~ true half-size.
2. Final Submittal -All Airport Layout Plan Sheets, Reports, Projections, Construction Cost Estimate,
drawings, sketches and all other pertinent information ~ electronic copies: PDF format and AutoCAD or
MicroStation format-Paper copy: bond~ true half-size for plan sheets I sketches
a. All reports, projections ~ PDF Format. Any element of the documents shall be delivered in its
original electronic format (i.e. MSWord, Excel, AutoCAD ... ) if requested by the Department
b. Sketches and drawings ~ electronic copies: PDF format and AutoCAD or MicroStation format -
Paper copy: bond~ true half-size for plan sheets I sketches.
Page 6 of II
Construction Projects
I. Interim Design Submittals (i.e. 30%, 60%, 90% .... ) -Plan Sheets, Technical Specifications, Itemized
Construction Cost Estimate and Engineers Report-electronic copy: PDF format. Paper copy, if requested:
bond true half-size for plan sheets.
2. 100% Design and Issue for Bid Submittals -Plan Sheets, Technical Specifications, Itemized Construction
Cost Estimate, Engineer's Report, and Bid Tab Any element of the documents shall be delivered in
electronic format (i.e. MS Excel and PDF format) and AutoCAD or MicroStation fonnat and Paper copy:
bond-true half-size for plan sheets.
3. As-built I Record Drawings
a. Contract Documents (Plan and Detail Sheets, Technical Specifications)-electronic copies: PDF
format and AutoCAD or MicroStation format and Paper copy: bond-true half-size for plan sheets.
b. Technical Specifications-electronic copies: MS Word File and PDF format
c. Final Engineers Report-electronic copies: PDF format unless otherwise requested.
B-4. Bids will be taken in accordance with N. C. General Statute 143-129. Following bid opening or final contract
negotiations, the Sponsor shall submit the "Project Concurrence and Notice to Proceed" (AV-CONCUR/AV-503) request
along with the bid tabulations to the Department for review. The Department will take action on the request including the
approval or disapproval ofthe Sponsor's Employment of specific contractors within ten (10) days of receipt. Approval will be
communicated via a Contract Goal Requirements Letter sent directly to the Sponsor.
B-5. All contractor(s) who bid or submit proposals for contracts in connection with this project must submit a statement of
non-collusion to the Sponsor.
B-6. The Sponsor shall not commence construction or award construction contracts on the project until a written "Project
Concurrence and Notice to Proceed" (AV-CONCUR/AV-503) is co-signed by the Sponsor's Representative and the
Department or alternate written approval is provided by the Department.
B-7. The Sponsor shall submit quarterly status reports (A V -STATUS/ A V -502) to the Department, unless otherwise
instructed, and will immediately notify the Department of any significant problems which are encountered in the completion
of the project.
B-8. The Sponsor shall notify the Department of any significant meetings or inspections involving the Sponsor, his
contractor(s), consultant(s), and/or federal funding agencies concerning Project.
B-9. The Sponsor shall notify the Department within thirtv (30) days of completion of all work performed under this
agreement for the purpose of final acceptance inspection and completion of audit requirements by the Department.
Page 7 of II
B-1 0. The Sponsor has full responsibility for assuring the completed Project meets the requirements of the Department and
appropriate federal funding agencies. The Sponsor further certifies that all local, state, and federal requirements for the
conduct of this Project shall be met.
B-1 I. It is the policy of the Department not to award contracts to contractors who have been removed from the
Department's list of pre-qualified bidders without subsequent reinstatement. Therefore, no State funds will be provided for
any work performed by the contractor(s), or sub-contractor(s) which had been removed from the Department's list of pre-
qualified bidders without subsequent reinstatement as of the date of the signing of the construction contract. It shall be the
responsibility of Sponsor to insure that only properly qualified contractors are given construction contracts for work.
SECTION C: SPONSOR'S ASSURANCES: PROJECT ACCOUNTING AND PAYMENT
C-1. The Sponsor shall record all funds received under this Agreement and shall keep the same in an identifiable Project
account. The Sponsor, and his contractor(s) and/or consultant(s), shall maintain adequate records and documentation to
support all Project costs incurred under this Grant. All records and documentation in support of the Project costs must be
identifiable as relating to the Project and must be acceptable costs only. Acceptable costs are defined as those costs which are
acceptable under "Federal Acquisition Regulations 1-31.6, 48 CFR (OMC Circular A-87)". Acceptable items of work are
those referenced in the State Aid to Airports Program Guidance Handbook and North Carolina General Statutes. The
Sponsor's accounting procedures which were established for work as set out in this Agreement must be reviewed and accepted
by the Department prior to the final execution of this Agreement and payment of State funds, except for Sponsor reporting
under OMB Circular A-133.
C-2. The Sponsor and his contractor(s) and/or consultant(s) shall permit free access to its accounts and records by official
representatives ofthe State of North Carolina. Furthermore, the Sponsor and contractor(s) and/or consultant(s) shall maintain
all pertinent records and documentation for a period of not less than five (5) years from the date of final payment.
C-3. In accordance with OMB Circular A-133, "Audits of States, Local Governments and Non-Profit Organizations"
(wv:w.whitehouse.gov/wh/eop/omb), the Airport shall arrange for an independent financial and compliance audit of its fiscal
operations. The Airport shall furnish the Department with a copy of the independent audit report within thirty (30) days of
completion of the report, but not later than nine (9) months after the Airports fiscal year ends.
The Airport shall maintain all books, documents, papers, accounting records, and such other evidence as may be
appropriate to substantiate costs incurred under this Agreement. Further, the Airport shall make such materials available at its
office at all reasonable times during the contract period, and for five (5) years from the date of final payment under this
agreement, for inspection and audit by the Department's Fiscal Section
Page 8 of 11
C-4. Payment of the funds obligated under this Grant Agreement shall be made in accordance with the followina
"'
schedule, unless otherwise authorized by the Department:
A. Payments from NCDOT to the Sponsor are made on a reimbursement basis. The Sponsor must pay all
contractors/vendors prior to or within 3 business days of receipt of the Department's reimbursement.
B. Payments will be made on the basis of progress payments which may be requested by the Sponsor as costs are
incurred, but not more frequently than monthly. Progress payments will be made provided the following requirements
have been met.:
(I) The Grant Agreement has been executed and a Project Concurrence (AV-CONCUR/AV-503) issued.
(2) The Project has received an appropriate environmental finding.
(3) The Sponsor has submitted a Proposed Project Budget (AV-BUDGET/AV-504) accurately reflecting costs to date.
The initial and revised AV-BUDGET/AV-504 shall be approved by the Department. With each AV-BUDGET/AV-
504, the Sponsor shall provide the following documentation:
a) Scope of Services for the project, Consultant Fee -Man-hours Breakdown by task with hourly rates,
Breakdown of Sub-consultant and I or Vendor Cost, Schedule of Deliverables, Estimated Construction Cost, Plan
Sheet List
b) Actual Bidding Cost (once a project is bid) -Bid Tabulation I Bid Schedule, Recommendation for
Award.
( 4) Additional information shall be provided as requested.
(5) The Sponsor has submitted an executed Interim Payment Request (AV-PA YIAV-505) accurately reflecting costs
incurred to date.
(6) The Sponsor has complied with all applicable conditions of the State Aid to Airports Program Guidance Handbook
C. The submission of progress payments is expected to parallel the value of work actually completed and costs incurred.
At such point the Sponsor has requested payments equaling I 00% of the State Grant, it is expected that the approved
Project will be 100% complete.
D. Upon receipt of 100% of the State Grant, the Sponsor will promptly complete Project acceptance and submit the
Project Completion and Final Payment Request (AV-FINAL/AV-506).
C-5. If after the acceptance ofthe Project by the Department, the final State share of approved eligible items is less than
the amount of State funds actually disbursed for the Project, the Sponsor shall reimburse the Department in an amount equal
to the difference between the amount of State funds actually disbursed and the final State share of the final, audited, approved
eligible Project costs within thirty (30) days of notification by the Department of the amount due.
Page 9 of 11
C-6. If after the acceptance of the Project by the Department, the final State share of approved eligible Project costs shall
be more than the amount of State funds obligated for the Project, the Sponsor may make application to the Department for a
corresponding increase which will be considered for funding in accordance with their relative priority versus other
applications for available State funds.
C-7. Under certain conditions, projects originally involving only state and local funds may subsequently be eligible for
reimbursement from federal funding agencies. In such cases, the Sponsor shall notifY the Department of its intent to apply for
federal reimbursement and shall keep the Department informed of the status of such application. In the event federal funds
are obtained for all or a portion of the Project, the Sponsor shall refund to the Department an amount equal to the difference
between State funds originally disbursed for the work item(s) subsequently receiving federal funds and the final State share of
the costs of the affected item(s) of work. Reimbursement will be made within ninety (90) days of the date of the final
execution ofthe FAA Grant Agreement affecting the work elements in the approved Project.
C-8. For the purpose of calculating the State share of the Project, federal funds are defined as funds provided by an
agency of the federal government for the specific purpose of undertaking the Project, including Block Grant funds
administered by the Department.
SECTION D: SPONSOR'S ASSURANCES: REAL PROPERTY ACQUISITION
D-1. The acquisition of land, buildings, and other real property involving the use of State Airport Aid funds shall be in
compliance with the provisions of this Section.
D-2. The Sponsor shall depict each parcel to be acquired on an airport property map containing the identity of the parcel
and its metes and bounds.
D-3. The acquisition cost of each parcel, building, or other real property acquired with State financial assistance shall be
based on the fair market value of the property as determined by an appraisal process acceptable to the Department.
D-4. For each parcel or building with an estimated cost of $100,000 or less, fair market value shall be established by a
single original appraisal and a review appraisal. For complex acquisitions, fair market value shall be established by two
original appraisals and one review appraisal.
D-5. All original and review appraisals shall be conducted by qualified appraisers who have no financial or other interest
in the property to be acquired.
D-6. The fair market value of a parcel will be established by the review appraiser based upon the information contained in
the original appraisal or appraisals.
Page 10 of 11
D-7. No negotiation for property acquisition shall be commenced between the Sponsor and the property owner until the
fair market value of the property has been established. Initial negotiations shall be based upon the fair market value.
D-8. Negotiated values above the fair market value shall not be eligible for State funds unless, prior to the final agreement
for acquisition, the Sponsor has received the concurrence of the Department for paying such negotiated values in lieu of the
appraised fair market value.
D-9. Sponsors who adhere to the federal "Uniform Guidelines for the Acquisition of Property" shall be deemed to have
conformed to the Department's guidelines, except that Paragraph 8 above shall also be applicable under such acquisitions.
D-1 0. In the event the Project is a low value, non-complex acquisition, the Department, at its option, may accept the
original appraisal without the review appraisal. In such cases, all other provisions ofthis Section shall apply.
D-11. Failure to follow the requirements of this Section shall disqualifY the property from State participation for any parcel
which has not been acquired in accordance with such standards.
SECTION E: Sponsor's Acknowledgement of Executive Order 24, issued by Governor Perdue, and N.C. G.S.§ 133-32
E-1 Sponsor acknowledges and agrees that it is unlawful for any vendor or contractor ( i.e. architect, bidder, contractor,
construction manager, design professional. engineer, landlord, offeror, seller, subcontractor, supplier, or vendor), to make
gifts or to give favors to any State employee of the Governor's Cabinet Agencies (i.e., Administration, Commerce,
Correction, Crime Control and Public Safety, Cultural Resources, Environment and Natural Resources, Health and Human
Services, Juvenile Justice and Delinquency Prevention, Revenue, Transportation, and the Office of the Governor). This
prohibition covers those vendors and contractors who:
(I) have a contract with a governmental agency; or
(2) have performed under such a contract within the past year; or
(3) anticipate bidding on such a contract in the future.
For additional information regarding the specific requirements and exemptions, vendors and contractors are encouraged to
review Executive Order 24 and G.S. Sec. 133-32.
Revised 12/10
Page 11 of 11
. -
U. S. Department
of Transportation
Federal Aviation
Administration
Terms and Conditions
January 9, 2013
of Accepting Airport Improvement Program Grants
This document was compiled from multiple government source documents.
This document contains the terms and conditions of accepting Airport Improvement Program (AlP) grants
from the Federal Aviation Administration (FAA) for the purpose of carrying out the provisions of Title 49,
United States Code. These terms and conditions become applicable when the Sponsor accepts a Grant
Offer from the FAA that references this document. The FAA may unilaterally amend the terms and
conditions by notification in writing, and such amendment will only apply to grants accepted after
notification.
I. DEFINITIONS
A. Sponsor-An agency that is legally, financially, and otherwise able to assume and carry out the
certifications, representations, warranties, assurances, covenants and other obligations required
in this document and in the accepted Grant Agreement.
B. Project-Work as identified in this grant Agreement.
C. Primary Airport-A commercial service airport the Secretary of Transportation determines to have
more than 10,000 passengers boarding each year.
D. "this grant"-In this document the term "this grant" refers to the applicable grant agreement or
grant agreements that incorporate(s) these Terms and Conditions as part of the grant agreement.
II. CERTIFICATIONS
Title 49, United States Code, section 47105(d), authorizes the Secretary to require certification from
the Sponsor that it will comply with statutory and administrative requirements in carrying out a project
under the AlP. The following list of certified items includes major requirements for this aspect of
project implementation. However, the list is not comprehensive, nor does it relieve sponsors from
fully complying with all applicable statutory and administrative standards. In accepting this grant, the
Sponsor certifies that each of the following items was or will be complied with in the performance of
grant agreements. If a certification cannot be met for a specific project, the Sponsor must fully
explain in an attachment to the project application.
A. Sponsor Certification for Selection of Consultants. General standards for selection of
consultant services within Federal grant programs are described in Title 49, Code of Federal
Regulations (CFR), and Part 18.36. Sponsors may use other qualifications-based procedures
provided they are equivalent to specific standards in 49 CFR 18 and Advisory Circular 150/51 00-
14, Architectural, Engineering, and Planning Consultant Services for Airport Grant Projects.
1. Solicitations were (will be) made to ensure fair and open competition from a wide area of
interest.
2. Consultants were (will be) selected using competitive procedures based on qualifications,
experience, and disadvantaged enterprise requirements with the fees determined through
negotiations.
1
Terms and Conditions of Accepting Airport Improvement Program Grants January 9, 2013
9. The project was (will be) physically completed without Federal participation in costs due to
errors and omissions in the plans and specifications that were foreseeable at the time of
project design.
C. Sponsor Certification for Equipment/Construction Contracts. General standards for
equipment and construction contracts within Federal grant programs are described in Title 49,
CFR, Part 18.36. AlP standards are generally described in FAA Advisory Circular (AC)
150/5100-6, Labor Requirements for the Airport Improvement Program; 150/5100-15, Civil Rights
Requirements for the Airport lm provement Program; and 150/5100-16, Airport Grant Assurance
One-General Federal Requirements. Sponsors may use State and local procedures provided
procurements conform to these Federal standards.
1. A code or standard of conduct is (will be) in effect governing the performance of the
Sponsor's officers, employees, or agents in soliciting and awarding procurement contracts.
2. Qualified personnel are (will be) engaged to perform contract administration, engineering
supervision, construction inspection, and testing.
3. Unless the FAA approved (has approved) otherwise, the procurement was (will be) publicly
advertised using the competitive sealed bid method of procurement.
4. The bid solicitation clearly and accurately describes (will describe):
a. The current Federal wage rate determination for all construction projects; and
b. All other requirements of the equipment and/or services to be provided.
5. Concurrence was (will be) obtained from FAA prior to contract award under any of the
following circumstances:
a. Only one qualified person/firm submits a responsive bid;
b. The contract is to be awarded to other than the lowest responsible bidder;
c. Life cycle costing is a factor in selecting the lowest responsive bidder; or
a. Proposed contract prices are more than 10 percent over the Sponsor's cost estimate.
6. All contracts exceeding $100,000 require (will require) the following provisions:
a. A bid guarantee of 5 percent, a performance bond of 1 00 percent, and a payment bond of
1 00 percent;
b. Conditions specifying administrative, contractual, and legal remedies, including contract
termination, for those instances in which contractors violate or breach contact terms; and
c. Compliance with applicable standards and requirements issued under Section 306 of the
Clean Air Act (42 USC 1857(h)), Section 508 of the Clean Water Act (33 USC 1368), and
Executive Order 11738.
7. All construction contracts contain (will contain) provisions for:
a. Compliance with the Copeland "Anti-Kick Back" Act; and
b. Preference given in the employment of labor (except in executive, administrative, and
supervisory positions) to honorably discharged Vietnam-era veterans and disabled
veterans.
8. All construction contracts exceeding $2,000 contain (will contain) the following provisions:
a. Compliance with the Davis-Bacon Act based on the current Federal wage rate
determination; and
b. Compliance with the Contract Work Hours and Safety Standards Act (40 USC 327-330),
Sections 103 and 107.
9. All construction contracts exceeding $10,000 contain (will contain) appropriate clauses from
41 CFR Part 60 for compliance with Executive Orders 11246 and 11375 on Equal
Employment Opportunity.
3
Terms and Conditions of Accepting Airport Improvement Program Grants January 9, 2013
b. Supporting documents for settlements are (will be) included in the project files.
11. If a negotiated settlement is not reached, the following procedures were (will be) used:
a. Condemnation was (will be) initiated and a court deposit not less than the just
compensation was (will be) made prior to possession of the property; and
b. Supporting documents for awards were (will be) included in the project files.
12. If displacement of persons, businesses, farm operations, or non-profit organizations is
involved, a relocation assistance program was (will be) established, with displaced parties
receiving general information on the program in writing, including relocation eligibility, and a
90-day notice to vacate.
13. Relocation assistance services, comparable replacement housing, and payment of
necessary relocation expenses were (will be) provided within a reasonable time period for
each displaced occupant in accordance with the Uniform Act.
E. Sponsor Certification for Construction Project Final Acceptance. General requirements for
final acceptance and closeout of Federally funded construction projects are in Title 49, CFR, Part
18.50. The Sponsor shall determine that project costs are accurate and proper in accordance
with specific requirements of this grant Agreement and contract documents.
1. The personnel engaged in project administration, engineering supervision, construction
inspection, and testing were (will be) determined to be qualified as well as competent to
perform the work.
2. Daily construction records were (will be) kept by the resident engineer/construction inspector
as follows:
a. Work in progress
b. Quality and quantity of materials delivered
c. Test locations and results
d. Instructions provided the contractor
e. Weather conditions
f. Equipment use
g. Labor requirements
h. Safety problems
i. Changes required.
3. Weekly payroll records and statements of compliance were (will be) submitted by the prime
contractor and reviewed by the Sponsor for Federal labor and civil rights requirements
(Advisory Circulars 150/5100-6 and 150/51 00-15).
4. Complaints regarding the mandated Federal provisions set forth in the contract documents
have been (will be) submitted to the FAA.
5. All tests specified in the plans and specifications were (will be) performed and the test results
documented as well as made available to the FAA.
6. For any test results outside of allowable tolerances, appropriate corrective actions were (will
be) taken.
7. Payments to the contractor were (will be) made in compliance with contract provisions as
follows:
a. Payments are verified by the Sponsor's internal audit of contract records kept by the
resident engineer; and
b. If appropriate, pay reduction factors required by the specifications are applied in
computing final payments; and a summary of pay reductions are made available to the
FAA.
5
_.
Terms and Conditions of Accepting Airport Improvement Program Grants January 9, 2013
~-
d. The penalties that may be imposed upon employees for drug abuse violations occurring
in the workplace.
3. Each employee to be engaged in the performance of the work has been (will be) given a copy
of the statement required within item 1 above.
4. Employees have been (will be) notified in the statement required by item 1 above that, as a
condition of employment under this grant, the employee will:
a. Abide by the terms of the statement; and
b. Notify the employer in writing of his or her conviction for a violation of a criminal drug
statute occurring in the workplace no later than five calendar days after such conviction.
5. The FAA will be notified in writing within ten calendar days after receiving notice under item
4b above from an employee or otherwise receiving actual notice of such conviction.
Employers of convicted employees must provide notice, including position title of the
employee, to the FAA. Notices shall include the project number of each affected grant.
6. One of the following actions will be taken within 30 calendar days of receiving a notice under
item 4b above with respect to any employee who is so convicted:
a. Take appropriate personnel action against such an employee, up to and including
termination, consistent with the requirements of the Rehabilitation Act of 1973, as
amended; or
b. Require such employee to participate satisfactorily in a drug abuse assistance or
rehabilitation program approved for such purposes by a Federal, State, or local health,
law enforcement, or other appropriate agency.
7. A good faith effort will be made to continue to maintain a drug-free workplace through
implementation of items 1 through 6 above.
llL GENERALCONDITIONS
A. The allowable costs of the project shall not include any costs determined by the FAA to be
ineligible for consideration under Title 49 U.S. C.
B. Payment of the United States' share of the allowable project costs will be made pursuant to and
in accordance with the provisions of such regulations and procedures as the Secretary shall
prescribe. Final determination of the United States' share will be based upon the final audit of the
total amount of allowable project costs, and settlement will be made for any upward or downward
adjustments to the Federal share of costs.
C. The Sponsor shall carry out and complete the Project(s) without undue delays and in accordance
with the terms hereof, and such regulations and procedures as the Secretary shall prescribe.
D. The FAA reserves the right to unilaterally terminate this grant if the Sponsor does not make at
least one draw down of funds under their Letter of Credit or submit at least one written Request
for Reimbursement, as applicable, in each twelve month period after grant acceptance.
E. The Sponsor agrees to monitor progress on the work to be accomplished by this grant. For
engineering services, the Sponsor agrees to make payment only for work that has been
satisfactorily completed and that ten percent (1 0%) of the total value of the engineering services
contract will not be paid to the Engineer until acceptable final project documentation is provided.
F. The Sponsor agrees to submit final grant closeout documents to the FAA within 60 days after
physical completion of the project(s), but no greater than four (4) years from the date of the grant,
unless otherwise agreed to by the FAA.
G. The FAA reserves the right to amend or withdraw this grant offer at any time prior to its
acceptance by the Sponsor.
7
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Terms and Conditions of Accepting Airport Improvement Program Grants January 9, 2013
system and require the grantee to complete two forms. The grantee will complete a web
based DOT registration form and download the Proof of Identification form to verify the
grantee's identity.
b. The grantee must complete the Proof of Identification form, and present it to a Notary
Public for verification. The grantee will return the notarized form to:
DOT Enterprise Services Center
FAA Accounts Payable, AMZ-100
PO Box 25710
Oklahoma City, OK 73125
c. The DOT will validate the both forms and email a user ID and password to the grantee.
Grantees should contact the FAA Airports District/Regional Office with any changes to
their system information.
Note: Additional information, including access forms and training materials, can be
found on the DOT elnvoicing website (http://www.dot.gov/cfo/delphi-einvoicing-
system.html).
3. Waivers.
a. DOT Financial Management officials may, on a case by case basis, waive the
requirement to register and use the electronic grant payment system based on user
requests and concurrence of the FAA. Waiver request forms can be obtained on the
DOT elnvoicing website (http://www.dot.gov/cfo/delphi-einvoicing-system .html) or by
contacting the FAA Airports District/Regional Office. Recipients must explain why they
are unable to use or access the Internet to register and enter payment requests.
b. All waiver requests should be sent to the FAA Airports District/Regional Office for
concurrence, prior to sending to the Director of the Office of Financial Management,
US Department of Transportation, Office of Financial Management, B-30, room W93-
431, 1200 New Jersey Avenue SE, Washington DC 20590-0001,
DOTEiectroniclnvoicing@dot.gov~ The Director of the DOT Office of Financial
Management will confirm or deny the request within approximately 30 days.
c. If a grantee is granted a waiver, the grantee should submit all hard-copy invoices
directly to:
DOT/FAA
PO Box 25082
AMZ-110
Oklahoma City, OK 73125
M. Unless otherwise approved by the FAA, it will not acquire or permit any contractor or
subcontractor to acquire any steel or manufactured products produced outside the United States
to be used for any project for airport development or noise compatibility for which funds are
provided under this grant. The Sponsor will include in every contract a provision implementing
this condition.
N. Central Contractor Registration and Universal Identifier Requirements
1. Requirement for Central Contractor Registration (CCR)
Unless you are exempted from this requirement under 2 CFR 25.110, you as the recipient
must maintain the currency of your information in the CCR until you submit the final financial
report required under this award or receive the final payment, whichever is later. This
requires that you review and update the information at least annually after the initial
registration, and more frequently if required by changes in your information or another award
term.
9
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:
Terms and Conditions of Accepting Airport Improvement Program Grants January 9, 2013
provisions and tests required by the Federal specifications. The program shall include as a
minimum:
a. The name of the person representing the Sponsor who has overall responsibility for
contract administration for the project and the authority to take necessary actions to
comply with the contract.
b. Names of testing laboratories and consulting engineer firms with quality control
responsibilities on the project, together with a description of the services to be provided.
c. Procedures for determining that testing laboratories meet the requirements of the
American Society of Testing Materials standards on laboratory evaluation, referenced in
the contract specifications (03666, C1 077).
d. Qualifications of engineering supervision and construction inspection personnel.
e. A listing of all tests required by the contract specifications, including the type and
frequency of tests to be taken, the method of sampling, the applicable test standard, and
the acceptance criteria or tolerances permitted for each type of test.
f. Procedures for ensuring that the tests are taken in accordance with the program, that
they are documented daily, that the proper corrective actions, where necessary, are
undertaken.
2. Submit at completion of the project, a final test and quality control report documenting the
results of all tests performed, highlighting those tests that failed or did not meet the applicable
test standard. The report shall include the pay reductions applied and reasons for accepting
any out-of-tolerance material. An interim test and quality control report shall be submitted, if
requested by the FAA.
3. Failure to provide a complete report as described in paragraph 2, or failure to perform such
tests, shall, absent any compelling justification, result in a reduction in Federal participation
for costs incurred in connection with construction of the applicable pavement. Such reduction
shall be at the discretion of the FAA and will be based on the type or types of required tests
not performed or not documented and will be commensurate with the proportion of applicable
pavement with respect to the total pavement constructed under this grant agreement.
4. The FAA, at its discretion, reserves the right to conduct independent tests and to reduce
grant payments accordingly if such independent tests determine that Sponsor tests results
are inaccurate.
P. For a project to replace or reconstruct pavement at the airport, the Sponsor shall implement an
effective airport pavement maintenance management program as is required by Airport Sponsor
Assurance Number 11. The Sponsor shall use such program for the useful life of any pavement
constructed, reconstructed, or repaired with Federal financial assistance at the airport. As a
minimum, the program must conform with the following provisions:
Pavement Maintenance Management Program
An effective pavement maintenance management program is one that details the procedures to
be followed to assure that proper pavement maintenance, both preventive and repair, is
performed. An airport sponsor may use any form of inspection program it deems appropriate.
The program must, as a minimum, include the following:
1. Pavement Inventory. The following must be depicted in an appropriate form and level of
detail:
a. Location of all runways, taxiways, and aprons;
b. Dimensions;
c. Type of pavement, and;
d. Year of construction or most recent major rehabilitation.
11
Terms and Conditions of Accepting Airport Improvement Program Grants January 9, 2013
accomplished by the Sponsor, the Sponsor shall maintain as a portion of the cost records
covering this project, separable cost records pertaining to the above-identified work excluded
from Federal participation under this project, which records shall be made available for inspection
and audit by the FAA to the end that the cost of the excluded work may be definitely determined.
It is further understood and agreed that the Sponsor will submit a Program StatemenUcost
estimate depicting the excluded costs or a cost estimate depicting only those costs eligible for
Federal participation in this project.
T. Utility Relocation in Project. It is understood and agreed by and between the parties hereto
that the United States shall not participate in the cost of any utility relocation unless and until the
Sponsor has submitted evidence satisfactory to the FAA that the Sponsor is legally responsible
for payment of such costs. FAA participation will be limited to those utilities located on private
right-of-way or utilities that exclusively serve the Airport.
U. Revenue from Real Property -Land in Project. The Sponsor agrees that all net revenues
produced from real property purchased in part with Federal funds in this grant shall be used on
the airport for airport planning, development or operating expenses, except that all income from
real property purchased for noise compatibility purposes or for future aeronautical use be used
only to fund projects which would be eligible for grants under the Act. Income from noise or
future use property may not be used for the Sponsor's matching share of any airport grant.
Airport fiscal and accounting records shall clearly identify actual sources and uses of these funds.
V. Future Development Land. If this grant includes acquisition of land for future development, the
Sponsor agrees to implement within five years of such grant the airport development that requires
this land acquisition, unless the FAA agrees to a different duration. Furthermore, the Sponsor
agrees not to dispose of the land by sale or lease without prior consent and approval of the FAA.
In the event the land is not used within ten years for the purpose for which it was acquired, the
Sponsor will refund the Federal share of acquisition cost or the current fair market value of the
land, whichever is greater, unless the FAA agrees to a different duration.
w. Runway Protection Zones. The Sponsor agrees to take the following actions to maintain and/or
acquire a property interest, satisfactory to the FAA, in the Runway Protection Zones:
1. Existing Fee Title Interest in the Runway Protection Zone: The Sponsor agrees to prevent
the erection or creation of any structure or place of public assembly in the Runway Protection
Zone, except for NAVAIDS that are fixed by their functional purposes or any other structure
approved by the FAA. Any existing structures or uses within the Runway Protection Zone will
be cleared or discontinued unless approved by the FAA.
2. Existing Easement Interest in the Runway Protection Zone: The Sponsor agrees to take any
and all steps necessary to ensure that the owner of the land within the designated Runway
Protection Zone will not build any structure in the Runway Protection Zone that is a hazard to
air navigation or which might create glare or misleading lights or lead to the construction of
residences, fuel handling and storage facilities, smoke generating activities, or places of
public assembly, such as churches, schools, office buildings, shopping centers, and
stadiums.
3. Future Interest ih the Runway Protection Zone: The Sponsor agrees that it will acquire fee
title or less-than-fee interest in the Runway Protection Zones that presently are not under its
control under an agreed schedule with the FAA. Said interest shall provide the protection
noted in above Subparagraphs 1 and 2.
X. Noise Projects on Privately Owned Property. No payment shall be made under the terms of
this grant agreement for work accomplished on privately owned land until the Sponsor submits
the agreement with the owner of the property required by Assurance 5d of the ASSURANCES
Airport Sponsors, and such agreement is determined to be satisfactory. As a minimum, the
agreement with the private owner must contain the following provisions:
1. The property owner shall subject the construction work on the project to such inspection and
approval during the construction or installation of the noise compatibility measures and after
13
Terms and Conditions of Accepting Airport Improvement Program Grants January 9, 2013
IV. ASSURANCES
The following FAA document titled ASSURANCES Airport Sponsors, dated April 2012, is
incorporated as part of these Terms and Conditions:
A. General.
Assurances
Airport Sponsors
April2012
1. These assurances shall be complied with in the performance of grant agreements for airport
development, airport planning, and noise compatibility program grants for airport sponsors.
2. These assurances are required to be submitted as part of the project application by sponsors
requesting funds under the provisions of Title 49, U.S.C., subtitle VII, as amended. As used
herein, the term "public agency sponsor" means a public agency with control of a public-use
airport; the term "private sponsor" means a private owner of a public-use airport; and the term
"Sponsor" includes both public agency sponsors and private sponsors.
3. Upon acceptance of this grant offer by the Sponsor, these assurances are incorporated in and
become part of this grant agreement.
B. Duration and Applicability.
1. Airport development or Noise Compatibility Program Projects Undertaken by a Public
Agency Sponsor. The terms, conditions and assurances of this grant agreement shall remain in
full force and effect throughout the useful life of the facilities developed or equipment acquired for
an airport development or noise compatibility program project, or throughout the useful life of the
project items installed within a facility under a noise compatibility program project, but in any
event not to exceed twenty (20) years from the date of acceptance of a grant offer of Federal
funds for the project. However, there shall be no limit on the duration of the assurances
regarding Exclusive Rights and Airport Revenue so long as the airport is used as an airport.
There shall be no limit on the duration of the terms, conditions, and assurances with respect to
real property acquired with federal funds. Furthermore, the duration of the Civil Rights assurance
shall be specified in the assurances.
2. Airport Development or Noise Compatibility Projects Undertaken by a Private Sponsor.
The preceding paragraph 1 also applies to a private sponsor except that the useful life of project
items installed within a facility or the useful life of the facilities developed or equipment acquired
under an airport development or noise compatibility program project shall be no less than ten (1 O)
years from the date of acceptance of Federal aid for the project.
3. Airport Planning Undertaken by a Sponsor. Unless otherwise specified in this grant
agreement, only Assurances 1, 2, 3, 5, 6, 13, 18, 30, 32, 33, and 34 in section C apply to
planning projects. The terms, conditions, and assurances of this grant agreement shall remain in
full force and effect during the life of the project.
C. Sponsor Certification. The Sponsor hereby assures and certifies, with respect to this grant that:
1. General Federal Requirements. It will comply with all applicable Federal laws, regulations,
executive orders, policies, guidelines, and requirements as they relate to the application,
acceptance and use of Federal funds for this project including but not limited to the following:
Federal legislation
a. Title 49, U.S.C., subtitle VII, as amended.
b. Davis-Bacon Act-40 U.S.C. 276(a), et seg.1
15
Terms and Conditions of Accepting Airport Improvement Program Grants January 9, 2013
e. 29 CFR Part 3 -Contractors and subcontractors on public building or public work financed in
whole or part by loans or grants from the United States.1
f. 29 CFR Part 5 -Labor standards provisions applicable to contracts covering federally
financed and assisted construction (also labor standards provisions applicable to non-
construction contracts subject to the Contract Work Hours and Safety Standards Act).1
g. 41 CFR Part 60 -Office of Federal Contract Compliance Programs, Equal Employment
Opportunity, Department of Labor (Federal and federally assisted contracting requirements).1
h. 49 CFR Part 18 -Uniform administrative requirements for grants and cooperative agreements
to state and local governments.3
i. 49 CFR Part 20 -New restrictions on lobbying.
j. 49 CFR Part 21 -Nondiscrimination in federally-assisted programs of the Department of
Transportation -effectuation of Title VI of the Civil Rights Act of 1964.
k. 49 CFR Part 23 -Participation by Disadvantage Business Enterprise in Airport Concessions.
I. 49 CFR Part 24 -Uniform relocation assistance and real property acquisition for Federal and
federally assisted programs.1 2
m. 49 CFR Part 26 -Participation By Disadvantaged Business Enterprises in Department of
Transportation Programs.
n. 49 CFR Part 27 -Nondiscrimination on the basis of handicap in programs and activities
receiving or benefiting from Federal financial assistance.1
o. 49 CFR Part 29 -Government wide debarment and suspension (nonprocurement) and
government wide requirements for drug-free workplace (grants).
p. 49 CFR Part 30 -Denial of public works contracts to suppliers of goods and services of
countries that deny procurement market access to U.S. contractors.
q. 49 CFR Part 41 -Seismic safety of Federal and federally assisted or regulated new building
construction.1
Office of Management and Budget Circulars
a. A-87 -Cost Principles Applicable to Grants and Contracts with State and Local Governments.
b. A-133-Audits of States, Local Governments, and Non-Profit Organizations
1 · These laws do not apply to airport planning sponsors.
2 These laws do not apply to private sponsors.
3 49 CFR Part 18 and OMB Circular A-87 contain requirements for State and Local Governments
receiving Federal assistance. Any requirement levied upon State and Local Governments by this
regulation and circular shall also be applicable to private sponsors receiving Federal assistance under
Title 49, United States Code.
Specific assurances required to be included in grant agreements by any of the above laws, regulations or
circulars are incorporated by reference in this grant agreement.
17
Terms and Conditions of Accepting Airport Improvement Program Grants January 9, 2013
against the local government if there is substantial non-compliance with the terms of the
agreement.
d. For noise compatibility program projects to be carried out on privately owned property, it will
enter into an agreement with the owner of that property which includes provisions specified
by the Secretary. It will take steps to enforce this agreement against the property owner
whenever there is substantial non-compliance with the terms of the agreement.
e. If the Sponsor is a private sponsor, it will take steps satisfactory to the Secretary to ensure
that the airport will continue to function as a public-use airport in accordance with these
assurances for the duration of these assurances.
f. If an arrangement is made for management and operation of the airport by any agency or
person other than the Sponsor or an employee of the Sponsor, the Sponsor will reserve
sufficient rights and authority to insure that the airport will be operated and maintained in
accordance Title 49, United States Code, the regulations and the terms, conditions and
assurances in this grant agreement and shall insure that such arrangement also requires
compliance therewith.
g. Sponsors of commercial service airports will not permit or enter into any arrangement that
results in permission for the owner or tenant of a property used as a residence, or zoned for
residential use, to taxi an aircraft between that property and any location on airport.
Sponsors of general aviation airports entering into any arrangement that results in permission
for the owner of residential real property adjacent to or near the airport must comply with the
requirements of Sec. 136 of Public Law 112-95 and the sponsor assurances.
6. Consistency with Local Plans. The project is reasonably consistent with plans (existing at the
time of submission of this application) of public agencies that are authorized by the State in which
the project is located to plan for the development of the area surrounding the airport.
7. Consideration of local Interest. It has given fair consideration to the interest of communities in
or near where the project may be located.
8. Consultation with Users. In making a decision to undertake any airport development project
under Title 49, United States Code, it has undertaken reasonable consultations with affected
parties using the airport at which project is proposed.
9. Public Hearings. In projects involving the location of an airport, an airport runway, or a major
runway extension, it has afforded the opportunity for public hearings for the purpose of
considering the economic, social, and environmental effects of the airport or runway location and
its consistency with goals and objectives of such planning as has been carried out by the
community and it shall, when requested by the Secretary, submit a copy of the transcript of such
hearings to the Secretary. Further, for such projects, it has on its management board either voting
representation from the communities where the project is located or has advised the communities
that they have the right to petition the Secretary concerning a proposed project.
10. Air and Water Quality Standards. In projects involving airport location, a major runway
extension, or runway location it will provide for the Governor of the state in which the project is
located to certify in writing to the Secretary that the project will be located, designed, constructed,
and operated so as to comply with applicable air and water quality standards. In any case where
such standards have not been approved and where applicable air and water quality standards
have been promulgated by the Administrator of the Environmental Protection Agency, certification
shall be obtained from such Administrator. Notice of certification or refusal to certify shall be
provided within sixty days after the project application has been received by the Secretary.
19
Terms and Conditions of Accepting Airport Improvement Program Grants January 9, 2013
17. Construction Inspection and Approval. It will provide and maintain competent technical
supervision at the construction site throughout the project to assure that the work conforms to the
plans, specifications, and schedules approved by the Secretary for the project. It shall subject the
construction work on any project contained in an approved project application to inspection and
approval by the Secretary and such work shall be in accordance with regulations and procedures
prescribed by the Secretary. Such regulations and procedures shall require such cost and
progress reporting by the sponsor or sponsors of such project as the Secretary shall deem
necessary.
18. Planning Projects. In carrying out planning projects:
a. It will execute the project in accordance with the approved program narrative contained in the
project application or with the modifications similarly approved.
b. It will furnish the Secretary with such periodic reports as required pertaining to the planning
project and planning work activities.
c. It will include in all published material prepared in connection with the planning project a
notice that the material was prepared under a grant provided by the United States.
d. It will make such material available for examination by the public, and agrees that no material
prepared with funds under this project shall be subject to copyright in the United States or
any other country.
e. It will give the Secretary unrestricted authority to publish, disclose, distribute, and otherwise
use any of the material prepared in connection with this grant.
f. It will grant the Secretary the right to disapprove the Sponsor's employment of specific
consultants and their subcontractors to do all or any part of this project as well as the right to
disapprove the proposed scope and cost of professional services.
g. It will grant the Secretary the right to disapprove the use of the Sponsor's employees to do all
or any part of the project.
h. It understands and agrees that the Secretary's approval of this project grant or the
Secretary's approval of any planning material developed as part of this grant does not
constitute or imply any assurance or commitment on the part of the Secretary to approve any
pending or future application for a Federal airport grant.
19. Operation and Maintenance.
a. The airport and all facilities which are necessary to serve the aeronautical users of the
airport, other than facilities owned or controlled by the United States, shall be operated at all
times in a safe and serviceable condition and in accordance with the minimum standards as
may be required or prescribed by applicable Federal, state and local agencies for
maintenance and operation. It will not cause or permit any activity or action thereon which
would interfere with its use for airport purposes. It will suitably operate and maintain the
airport and all facilities thereon or connected therewith, with due regard to climatic and flood
conditions. Any proposal to temporarily close the airport for non-aeronautical purposes must
first be approved by the Secretary. In furtherance of this assurance, the Sponsor will have in
effect arrangements for-
1) Operating the airport's aeronautical facilities whenever required;
2) Promptly marking and lighting hazards resulting from airport conditions, including
temporary conditions; and
3) Promptly notifying airmen of any condition affecting aeronautical use of the airport.
Nothing contained herein shall be construed to require that the airport be operated for
aeronautical use during temporary periods when snow, flood or other climatic conditions
interfere with such operation and maintenance. Further, nothing herein shall be construed as
requiring the maintenance, repair, restoration, or replacement of any structure or facility
21
Terms and Conditions of Accepting Airport Improvement Program Grants January 9, 2013
g. In the event the Sponsor itself exercises any of the rights and privileges referred to in this
assurance, the services involved will be provided on the same conditions as would apply to
the furnishing of such services by commercial aeronautical service providers authorized by
the Sponsor under these provisions.
h. The Sponsor may establish such reasonable, and not unjustly discriminatory, conditions to be
met by all users of the airport as may be necessary for the safe and efficient operation of the
airport.
i. The Sponsor may prohibit or limit any given type, kind or class of aeronautical use of the
airport if such action is necessary for the safe operation of the airport or necessary to serve
the civil aviation needs of the public.
23. Exclusive Rights. It will permit no exclusive right for the use of the airport by any person
providing, or intending to provide, aeronautical services to the public. For purposes of this
paragraph, the providing of the services at an airport by a single fixed-based operator shall not be
construed as an exclusive right if both of the following apply:
a. It would be unreasonably costly, burdensome, or impractical for more than one fixed-based
operator to provide such services, and
b. If allowing more than one fixed-based operator to provide such services would require the
reduction of space leased pursuant to an existing agreement between such single fixed-
based operator and such airport. It further agrees that it will not, either directly or indirectly,
grant or permit any person, firm, or corporation, the exclusive right at the airport to conduct
any aeronautical activities, including, but not limited to charter flights, pilot training, aircraft
rental and sightseeing, aerial photography, crop dusting, aerial advertising and surveying, air
carrier operations, aircraft sales and services, sale of aviation petroleum products whether or
not conducted in conjunction with other aeronautical activity, repair and maintenance of
aircraft, sale of aircraft parts, and any other activities which because of their direct
relationship to the operation of aircraft can be regarded as an aeronautical activity, and that it
will terminate any exclusive right to conduct an aeronautical activity now existing at such an
airport before the grant of any assistance under Title 49, United States Code.
24. Fee and Rental Structure. It will maintain a fee and rental structure for the facilities and services
at the airport which will make the airport as self-sustaining as possible under the circumstances
existing at the particular airport, taking into account such factors as the volume of traffic and
economy of collection. No part of the Federal share of an airport development, airport planning or
noise compatibility project for which a grant is made under Title 49, United States Code, the
Airport and Airway Improvement Act of 1982, the Federal Airport Act or the Airport and Airway
Development Act of 1970 shall be included in the rate basis in establishing fees, rates, and
charges for users of that airport.
25. Airport Revenues.
a. All revenues generated by the airport and any local taxes on aviation fuel established after
December 30, 1987, will be expended by it for the capital or operating costs of the airport; the
local airport system; or other local facilities which are owned or operated by the owner or
operator of the airport and which are directly and substantially related to the actual air
transportation of passengers or property; or for noise mitigation purposes on or off the airport.
The following exceptions apply to this paragraph:
1) If covenants or assurances in debt obligations issued before September 3, 1982, by the
owner or operator of the airport, or provisions enacted before September 3, 1982, in
governing statutes controlling the owner or operator's financing, provide for the use of the
revenues from any of the airport owner or operator's facilities, including the airport, to
support not only the airport but also the airport owner or operator's general debt
obligations or other facilities, then this limitation on the use of all revenues generated by
the airport (and, in the case of a public airport, local taxes on aviation fuel) shall not
apply.
23
.
'
Terms and Conditions of Accepting Airport Improvement Program Grants January 9, 2013
would unduly interfere with use of the landing areas by other authorized aircraft, or during any
calendar month that-
a. Five (5) or more Government aircraft are regularly based at the airport or on land adjacent
thereto; or
b. The total number of movements (counting each landing as a movement) of Government
aircraft is 300 or more, or the gross accumulative weight of Government aircraft using the
airport (the total movement of Government aircraft multiplied by gross weights of such
aircraft) is in excess of five million pounds.
28. Land for Federal Facilities. It will furnish without cost to the Federal Government for use in
connection with any air traffic control or air navigation activities, or weather-reporting and
communication activities related to air traffic control, any areas of land or water, or estate therein,
or rights in buildings of the Sponsor as the Secretary considers necessary or desirable for
construction, operation, and maintenance at Federal expense of space or facilities for such
purposes. Such areas or any portion thereof will be made available as provided herein within four
months after receipt of a written request from the Secretary.
29. Airport Layout Plan.
a. It will keep up to date at all times an airport layout plan of the airport showing (1) boundaries
of the airport and all proposed additions thereto, together with the boundaries of all offsite
areas owned or controlled by the Sponsor for airport purposes and proposed additions
thereto; (2) the location and nature of all existing and proposed airport facilities and structures
(such as runways, taxiways, aprons, terminal buildings, hangars and roads), including all
proposed extensions and reductions of existing airport facilities; (3) the location of all existing
and proposed non-aviation areas and of all existing improvements thereon; and (4) all
proposed and existing access points used to taxi aircraft across the airport's property
boundary. Such airport layout plans and each amendment, revision, or modification thereof,
shall be subject to the approval of the Secretary which approval shall be evidenced by the
signature of a duly authorized representative of the Secretary on the face of the airport layout
plan. The Sponsor will not make or permit any changes or alterations in the airport or any of
its facilities which are not in conformity with the airport layout plan as approved by the
Secretary and which might, in the opinion of the Secretary, adversely affect the safety, utility
or efficiency of the airport.
b. If a change or alteration in the airport or the facilities is made which the Secretary determines
adversely affects the safety, utility, or efficiency of any federally owned, leased, or funded
property on or off the airport and which is not in conformity with the airport layout plan as
approved by the Secretary, the owner or operator will, if requested, by the Secretary (1)
eliminate such adverse effect in a manner approved by the Secretary; or (2) bear all costs of
relocating such property (or replacement thereof) to a site acceptable to the Secretary and all
costs of restoring such property (or replacement thereof) to the level of safety, utility,
efficiency, and cost of operation existing before the unapproved change in the airport or its
facilities, except in the case of a relocation or replacement of an existing airport facility due to
a change in the Secretary's design standards beyond the control of the airport sponsor.
30. Civil Rights. It will comply with such rules as are promulgated to assure that no person shall, on
the grounds of race, creed, color, national origin, sex, age, or handicap be excluded from
participating in any activity conducted with or benefiting from funds received from this grant. This
assurance obligates the Sponsor for the period during which Federal financial assistance is
extended to the program, except where Federal financial assistance is to provide, or is in the form
of personal property or real property or interest therein or structures or improvements thereon in
which case the assurance obligates the Sponsor or any transferee for the longer of the following
periods: (a) the period during which the property is used for a purpose for which Federal financial
assistance is extended, or for another purpose involving the provision of similar services or
benefits, or (b) the period during which the Sponsor retains ownership or possession of the
property.
25
Terms and Conditions of Accepting Airport Improvement Program Grants January 9, 2013
foreign country is listed by the United States Trade Representative as denying fair and equitable
market opportunities for products and suppliers of the United States in procurement and
construction.
34. Policies, Standards, and Specifications. It will carry out the project in accordance with policies,
standards, and specifications approved by the Secretary including but not limited to the advisory
circulars listed in the "Current FAA Advisory Circulars Required for Use in AlP Funded and PFC
Approved Projects", dated (the latest approved version as of this grant offer) and included in this
grant, and in accordance with applicable state policies, standards, and specifications approved by
the Secretary.
35. Relocation and Real Property Acquisition. (1) It will be guided in acquiring real property, to the
greatest extent practicable under State law, by the land acquisition policies in Subpart 8 of 49
CFR Part 24 and will pay or reimburse property owners for necessary expenses as specified in
Subpart B. (2) It will provide a relocation assistance program offering the services described in
Subpart C and fair and reasonable relocation payments and assistance to displaced persons as
required in Subpart D and E of 49 CFR Part 24. (3) It will make available within a reasonable
period of time prior to displacement, comparable replacement dwellings to displaced persons in
accordance with Subpart E of 49 CFR Part 24.
36. Access By Intercity Buses. The airport owner or operator will permit, to the maximum extent
practicable, intercity buses or other modes of transportation to have access to the airport;
however, it has no obligation to fund special facilities for intercity buses or for other modes of
transportation.
37. Disadvantaged Business Enterprises. The recipient shall not discriminate on the basis of race,
color, national origin or sex in the award and performance of any DOT -assisted contract or in the
administration of its DBE program or the requirements of 49 CFR Part 26. The Recipient shall
take all necessary and reasonable steps under 49 CFR Part 26 to ensure non discrimination in
the award and administration of DOT -assisted contracts. The recipient's DBE program, as
required by 49 CFR Part 26, and as approved by DOT, is incorporated by reference in this
agreement. Implementation of this program is a legal obligation and failure to carry out its terms
shall be treated as a violation of this agreement. Upon notification to the recipient of its failure to
carry out its approved program, the Department may impose sanctions as provided for under Part
26 and may, in appropriate cases, refer the matter for enforcement under 18 U.S.C. 1001 and/or
the Program Fraud Civil Remedies Act of 1986 (31 U.S.C. 3801).
38. Hangar Construction. If the airport owner or operator and a person who owns an aircraft agree
that a hangar is to be constructed at the airport for the aircraft at the aircraft owner's expense, the
airport owner or operator will grant to the aircraft owner for the hangar a long term lease that is
subject to such terms and conditions on the hangar as the airport owner or operator may impose.
39. Competitive Access.
a. If the airport owner or operator of a medium or large hub airport (as defined in section 47102
of title 49, U.S.C.) has been unable to accommodate one or more requests by an air carrier
for access to gates or other facilities at that airport in order to allow the air carrier to provide
service to the airport or to expand service at the airport, the airport owner or operator shall
transmit a report to the Secretary that-
1) Describes the requests;
2) Provides an explanation as to why the requests could not be accommodated; and
3) Provides a time frame within which, if any, the airport will be able to accommodate the
requests.
b. Such report shall be due on either February 1 or August 1 of each year if the airport has been
unable to accommodate the request(s) in the six month period prior to the applicable due
date.
27
Agenda Item 4 -C
Board Meeting
Agenda Item
MEETINGDAT~~
TO: HARNETT COUNTY BOARD OF COMMISSIONERS
SUBJECT: Pesticide Container Recycling Grant
REQUESTED BY: Tyrone L Fisher, County Extension Director~
REQUEST:
Harnett County Cooperative Extension request approval on a time extension of current
contract with the Pesticide Container Recycling Program scheduled to end June 30, 2013.
The amendment will allow our Pesticide Container Recycling project to continue until
August 31, 2013 in order to spend remainder of funds to purchase paint to be applied to the
deck, framing, doors and metal siding attached to the rear side of the Pesticide Container
Unit.
COUNTY MANAGER'S RECOMMENDATION:
C:\Users\swilliams\Desktop\County forms\agendaform20 12-20 13.doc
1 of1
Page
Brian Parrish
From:
Sent:
To:
Subject:
Attachments:
Importance:
Wade, Henry F [Henry.Wade@ncagr.gov]
Monday, June 03, 2013 2:45 PM
Brian Parrish
Harnett container recycling grant contract amendment
2012 Harnett Amendment Att B Signature Card Form.pdf; 2012 Harnett Amendment Offer
LOT June 2013.pdf; 2012 Harnett Contract Check Off list amd 01-2013.pdf; 2012 Harnett
Contract Cover-amd 01-2013.pdf; 2012 Harnett Budget Amendment Att A.doc
High
Brian,
Here/s the documents for your container recycling grant time extension. Please print 2 copies of
the Contract Check Off list, Contract Cover, Att A, & Att B. You need to read these documents
and have them signed in BLUE INK. Please mail all these originals to me. If you have any
questions, contact me.
Thanks.
Henry
Henry Wade, PhD 1 Environmental Programs Manager I 919-733-3556 I Structural Pest Control and Pesticides
Division 1 North Carolina Department of Agriculture and Consumer Services I 1090 MSC I Raleigh, NC 27699-
1090
North Carolina has a verv broad public records law. Most written communications to and from state officials a1·e public records
available to the public and media upon request.
1
Steve Troxler
Commissioner
June 3, 2013
North Carolina Department of Agriculture
and Consumer Services
Brian Parrish, Agricultural Agent
Harnett County Cooperative Extension
126 Alexander Drive, Suite 300
Lillington, NC 27546
Dear Mr. Parrish:
CONTRACT NUMBER: G401 00005413PET
AMENDMENT NUMBER: 01-2013
N. David Smith
Chief Deputy Commissioner
On behalf of the North Carolina Department of Agriculture and Consumer Services and Commissioner Steve
Troxler, please be advised that your request for a time extension on your current contract for your Harnett County
Pesticide Container Recycling Program has been considered and is being offered. The amendment will allow your
project to continue until August 31, 2013 to purchase paint to be applied to the deck, framing, doors, and metal
siding that is attached to the rear of a van trailer.
By completing these documents, you are agreeing to the specific stipulations, the general terms and conditions,
and specific reporting requirements. Two original Contract Amendment packets must be completed and returned to
the NCDA&CS. The Contract Amendment document must be signed, dated and witnessed. Please return these two
original Contract Amendment packets to the address provided on page 4 of your Contract cover document.
All Authorized Representative Signatures MUST be in BLUE INK.
Upon final execution by the Department, one original Contract Amendment documents will be returned to you for
your records. If you have any questions about your Contract or any of the forms contained in your offer packet,
please call Dr. Henry Wade at 919-733-3556, or feel free to send an email to Henry.Wade@ncagr.gov.
Sincerely,
N. David Smith
Chief Deputy Commissioner
Cc: Kathryn Caler, M.L.S., Grants Administrator
Dr. Henry Wade, Environmental Programs Manager
Email: David.Smith@ncagr.gov
1001 Mail Service Center, Raleigh, North Carolina, 27699-1001
(919) 707-3033 e Fax (919) 715-0026
An Equal Opportunity Affirmative Action Employer
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STATE OF NORTH CAROLINA
COUNTY OF WAKE
Departmental Use Only
Center: 6137 Account:~""=s:::-36::-:4701:------
CFDA#/Other: PETF
Amount: $1,8""'9:-::-5.-==.00.!...!._ ___ _
North Carolina Department of Agriculture and Consumer Services
Structural Pest Control and Pesticides Division
Harnett County Pesticide Container Recycling Program -Governmental
Amendment Number: 01-2013
Contract Number: G40100005413PET
This document amends the Contract bearing the effective date of July 1, 2013, between the North Carolina
Department of Agriculture and Consumer Services, hereinafter referred to as the "Agency" and the County of
Harnett, hereinafter referred to as the "Grantee."
The Grantee's tax ID number is 56-6000306. The congressional district number is ~llii. The Grantee's DUNS
number is 091565986.
As provided for under the terms of the original Contract, the Agency and the Grantee agree to amend the
Contract provisions as outlined below.
1. Section I. Contract Documents: Project Timeline and/or Revised Budget.
2. Section Ill. Effective Period: The termination date of June 30. 2013 is changed to August 31,
2013.
Also, this Amendment shall serve as notification to the Grantee that it shall submit to the Agency the
documents outlined below:
1. Revised Project Timeline and/or Revised Budget (Attachment A)
2. Signature Card (Attachment B)
All other terms and conditions as set forth in the original Contract document shall remain in effect for the
duration of this Amendment.
NCDA&CS -Contract Cover-Amendment-Gov't
Rev 9112, 10/12
Page 1 of2
Signature Warranty:
The undersigned represent and warrant that they are authorized to bind their principals to the terms of this
Contract.
IN WITNESS WHEREOF, the Grantee and the Agency execute this Contract Amendment in two (2) originals,
one (1) of which is retained by the Grantee and one (1) which is retained by the Agency.
Grantee: County of Harnett
Signature of Authorized Representative Date
Printed Name Title
Witness:
Signature Date
Printed Name Title
North Carolina Department of Agriculture and Consumer Services
Signature of Authorized Representative
N. David Smith. Chief Deputy Commissioner
Printed Name of Authorized Representative
NCDA&CS -Contract Cover -Amendment-Gov't
Rev 9/12, 1 0/12
Date
Page 2 of2
Attachme~t ~·
Signature C~rtl
CONTRACT & FINANCIAL DOCUMENTS
INSTRUCTIONS: Please read and fill in the required information to the right of each field where applicable.
Provide the requested printed and written signatures (in Blue Ink) of agency representatives in the designated
areas. In the event the affixed signature(s) are no longer valid, a revised form must be submitted prior to
processing any contractual documents or submitting "Request for Payments" or any other financial
documents.
SECTION I.
Date:
Legal Applicant Organization/Agency Name:
Federal Tax Identification Number:
SECTION II.
Certification:
By affixing my signature below, I certify that person(s) identified are designated having legal authorization to
sign on behalf of the organization named in Section 1., above, for purposes of executing contractual
documents and preparing, approving and executing all financial documents; including "Requests for
Payments". I understand the legal implications of any and all misrepresentation of a sole purpose of
defrauding the State of North Carolina.
NON-PROFIT ORGANIZATIONS ONLY
Chairman of the Board of Directors (Contract Documents) Financial R~esentative Signature
Print Name: Print Name & Title:
Signature: Signature:
GOVERNMENTAL ENTITIES
Appropriate Governmental Official (Secretary,
Commissioner, etc.)
Print Name & Title:
Signature:
Signature Card-NPO & Governmental
NCDA&CS: Rev 7/11, 2/12, 5/12, 7/12, 8/12, 10/12
Chief Fiscal Officer Signature
~~~. h~if lN1e21HR~EOP1
~U,n.L~~~ull
..........
( " ~
l
~
Attachment A
REVISED GRANTEE'S NARRATIVE BUDGET
NAME OF RECIPIENT: County of Harnett
APPROVED AMOUNT: No new funding
The Grantee shall use money remaining from the grant contract that was effective from
May 22, 2012 through June 30, 2013 for the purchase of paint to be applied to the deck,
framing, doors, and metal siding that is attached to the rear of a van trailer.
APPROVED BY:
SIGNATURE: ___________ _
DATE:
Agenda Item 4 -D
Board Meeting
Agenda Item
MEETING DATE: '3"~.~.1'\e :;) 7-, aoc3
TO: HARNETT COUNTY BOARD OF COMMISSIONERS
SUBJECT: Approval of Lease Purchase Agreement with US Bank
REQUESTED BY: Kimberly A. Honeycutt, Interim Finance Officer
REQUEST:
Respectfully requests that the Harnett County Board of Commissioners approve a lease
purchase agreement with US Bank in the amount of$739,763 for the purchase of a wheel
loader and compactor for the landfill. The interest rate for the transactin is 1.1 9%.
COUNTY MANAGER'S RECOMMENDATION:
http://www.harnett.org/boc/downloads/agendafonn2013.doc
1 of 1
Page
DOCUMENT CHECKLIST
PLEASE EXECUTE TWO (2) ORIGINALS OF ALL DOCUMENTS
RETURN ALL ORIGINALS TO:
U.S. BANCORP GOVERNMENT LEASING AND FINANCE, INC.
FRANCINE NEVILLE
950 17TH STREET, 7TH FLOOR
DENVER, CO 80202
303-585-4077
~ Master Tax-Exempt Lease Purchase Agreement -This document must be executed in the presence of a
witness/attestor. The attesting witness does not have to be a notary, just present at the time of execution.
~ Addendum/Amendment to Master Tax-Exempt Lease Purchase Agreement -This document must be
executed in the presence of a witness/attestor. The attesting witness does not have to be a notary, just present at
the time of execution.
).> Property Schedule No. 1 -This document must be executed in the presence of a witness/attestor. The attesting
witness does not have to be a notary, just present at the time of execution.
~ Property Description and Payment Schedule -Exhibit 1
~ Lessee's Counsel's Opinion -Exhibit 2. This exhibit will need to be executed by your attorney, dated and
placed on their letterhead. Your attorney will likely want to review the agreement prior to executing this opinion.
~ Lessee's Certificate-Exhibit 3. 1) Please fill in the person's title who will be executing the certificate in the first
paragraph (note: the person who signs this exhibit cannot be the same person as the executing official(s) for all
other documents); 2) Please fill in the date that the governing body met in Line 1; 3) In the middle set of boxes,
please print the name of the executing official(s) in the far left box, print their title(s) in the middle box and have
the executing official(s) sign the line in the far right hand box; 4) Include in your return package a copy of the
board minutes or resolution for our files; and 5) The exhibit should be executed by someone other than the
executing official(s) named in the center box.
~ Payment of Proceeds Instructions -Exhibit 4. This is for the vendor payment information. If more than one
vendor is being paid please make copies of this exhibit and fill out as many as are needed.
~ Acceptance Certificate-Exhibit 5. The date that all equipment is delivered, installed and accepted is the date
that should be placed on the "DATE" line. If moneys are being deposited into escrow this exhibit should be held
and returned with the final disbursement from the escrow account.
~ Bank Qualification and Arbitrage Rebate -Exhibit 6.
~ Insurance Authorization and Verification -To be filled out by the Lessee and sent to your insurance carrier. A
valid insurance certificate, or self-insurance letter if the Lessee self-insures, is required prior to funding.
~ Notification of Tax Treatment-Please provide your State of Sales/Use tax Exemption Certificate, if applicable.
);> Form 8038-G -Blank form provided to Lessee. Please consult your local legal/bond counsel to fill out.
);> Escrow Agreement-This document needs to be executed by the Executing Official defined in the Lessee's
Certificate-Exhibit 3.
o Investment Direction Letter-Exhibit 1. This document needs to be executed by the Executing Official.
o Schedule of Fees-Exhibit 2.
o Requisition Request-Exhibit 3. This document should be retained by Lessee and utilized to request
disbursements from the escrow account. Please make copies and fill out as many as are needed.
o Acceptance Certificate -Exhibit 4. This document should be retained by Lessee and provided to
Lessor once all the proceeds have been disbursed from the escrow account.
o Class Action Negative Consent Letter-Exhibit 6.
o IRS Form W-9. This document should be retained by Lessee and submitted with the Requisition
Request(s) for each vendor being paid. Please make copies and fill out as many as are needed.
);> First Payment Invoice-Invoice included for your convenience.
Between:
And:
Dated:
Master Tax-Exempt Lease/Purchase Agreement
U.S. Bancorp Government Leasing and Finance, Inc. (the "Lessor")
13010 SW 68th Parkway, Suite 100
Portland, OR 97223
County of Harnett (the "Lessee")
P.O. Box 760
Lillington, NC 27546
Attention: Sylvia S. Blinson
Telephone: 910-814-6090
June 14, 2013
ARTICLE I
DEFINITIONS
The following terms will have the meanings indicated below unless the context clearly requires otherwise:
• Agreement" means this Master Tax-Exempt Lease/Purchase Agreement, including all exhibits and schedules attached hereto.
"Code" is defined in Section 3.01(f}.
"Commencement Date" is the date when the term of a Property Schedule and Lessee's obligation to pay rent thereunder commences, which date shall be set forth in such
Property Schedule.
"Event of Default'' is defined in Section 13.01.
"Lease Payments" means the Lease Payments payable by Lessee under Article VI of this Agreement and each Property Schedule, as set forth in each Property Schedule.
"Lease Payment Dates" means the Lease Payment dates for the Lease Payments as set forth in each Property Schedule.
"Lease Term" means, with respect to a Property Schedule, the Original Term and all Renewal Terms. The Lease Term for each Property Schedule executed hereunder
shall be set forth in such Property Schedule, as provided in Section 4.02.
"Lessee" means the entity identified as such in the first paragraph hereof, and its permitted successors and assigns.
"Lessor" means the entity identified as such in the first paragraph hereof, and its successors and assigns.
"Nonappropriation Event" is defined in Section 6.06.
"Original Term" means, with respect to a Property Schedule, the period from the Commencement Date until the end of the budget year of Lessee in effect at the
Commencement Date.
"Property" means, collectively, the property lease/purchased pursuant to this Agreement, and with respect to each Property Schedule, the property described in such
Property Schedule, and all replacements, repairs, restorations, modifications and improvements thereof or thereto made pursuant to Section 8.01 or Article IX.
"Property Schedule" means a Property Schedule in the form attached hereto for Property Schedule 1. Subsequent Property Schedules pursuant to this Agreement shall be
numbered consecutively, beginning with Property Schedule 2.
"Purchase Price" means the amount that Lessee may, in its discretion, pay to Lessor to purchase the Property under a Property Schedule, as provided in Section 11.01 and
as set forth in the Property Schedule.
"Renewal Tenms" means the renewal terms of a Property Schedule, each having a duration of one year and a term coextensive with Lessee's budget year.
"State" means the state where Lessee is located.
"Vendor" means the manufacturer or contractor of the Property as well as the agents or dealers of the manufacturer or contractor from whom Lessor or Lessee purchased or
is purchasing all or any portion of the Property.
ARTICLE II
2.01 Property Schedules Separate Financings. Each Property Schedule executed and delivered under this Agreement shall be a separate financing, distinct from
other Property Schedules. Without limiting the foregoing, upon the occurrence of an Event of Default or a Nonappropriation Event with respect to a Property Schedule,
Lessor shall have the rights and remedies specified herein with respect to the Property financed and the Lease Payments payable ~nder such Property Schedule, and except
as expressly provided in Section 12.02 below, Lessor shall have no rights or remedies with respect to Property financed or Lease Payments payable under any other Property
Schedules unless an Event of Default or Nonappropriation Event has also occurred under such other Property Schedules.
ARTICLE Ill
3.01 Covenants of Lessee. As of the Commencement Date for each Property Schedule executed and delivered hereunder, Lessee shall be deemed to represent,
covenant and warrant for the benefit of Lessor as follows:
(a)
(b)
(c)
Lessee is a public body corporate and politic duly organized and existing under the constitution and laws of the State with full power and authority to enter
into this Agreement and the Property Schedule and the transactions contemplated thereby and to perform all of Jts obligations thereunder.
Lessee will do or cause to be done all things necessary to preserve and keep in full force and effect its existence as a body corporate and politic. To the
extent Lessee should merge with another entity under the laws of the State, Lessee agrees that as a condition to such merger it will require that the
remaining or resulting entity shall be assigned Lessee's rights and shall assume Lessee's obligations hereunder.
Lessee has been duly authorized to execute and deliver this Agreement and the Property Schedule by proper action by its governing body, or by other
appropriate official approval, and all requirements have been met and procedures have occurred in order to ensure the validity and enforceability of this
Agreement and the Property Schedule, and Lessee has complied with such public bidding requirements as may be applicable to this Agreement and the
Property Schedule and the acquisition by Lessee of the Property thereunder. On or before the Commencement Date for the Property Schedule, Lessee
shall cause to be delivered an opinion of counsel in substantially the form attached to the form of the Property Schedule as Exhibit 2.
(d) During. the Lease Term for the Property Schedule, the Property thereunder will perform and will be used by Lessee only for the purpose of performing
essential governmental uses and public functions within the permissible scope of Lessee's authority.
(e) Lessee will provide Lessor with current financial statements, budgets and proof of appropriation for the ensuing budget year and other financial information
relating to the ability of Lessee to continue this Agreement and the Property Schedule in such form and containing such information as may be requested by
Lessor.
(f) Lessee will comply with all applicable provisions of the Internal Revenue Code of 1986, as amended (the "Code"), including Sections 103 and 148 thereof,
and the regulations of the Treasury Department thereunder, from time to time proposed or in effect, in order to maintain the excludability from gross income
for federal income tax purposes of the interest component of Lease Payments under the Property Schedule and will not use or permit the use of the
Prop~rty. in such a manner as to cause a Property Schedule to be a "private activity bond" under Section 141 (a) of the Code. Lessee covenants and agrees
that 11 will use the proceeds of the Property Schedule as soon as practicable and With all reasonable dispatch for the purpose for which the Property
Schedule has been entered 1nto, and that no part of the proceeds of the Property Schedule shall be Invested m any securities, obligations or other
investments except for the temporary period pending such use nor used, at any time, directly or indirectiy, in a manner which, if such use had been
reasonably anticipated on the date of issuance of the Agreement, would have caused any portion of the Property Schedule to be or become "arbitrage
bonds" within the meaning of Section 103{b){2) or Section 148 of the Code and the regulations of the Treasury Department thereunder proposed or in effect
at the time of such use and applicable to obligations issued on the date of issuance of the Property Schedule.
(g) The execution, delivery and performance of this Agreement and the Property Schedule and compliance with the provisions hereof and thereof by Lessee
does not conflict with or result in a violation or breach or constitute a default under, any resolution, bond, agreement, indenture, mortgage, note, lease or
other instrument to which Lessee is a party or by which it is bound by any law or any rule, regulation, order or decree of any court, governmental agency or
body having jurisdiction over Lessee or any of its activities or properties resulting in the creation or imposition of any hen, charge or other security interest or
encumbrance of any nature whatsoever upon any property or assets of Lessee or to which it is subject.
(h) Lessee's exact legal name is as set forth on the first page of this Agreement. Lessee will not change its legal name in any respect without giving thirty (30)
days prior notice to Lessor.
ARTICLE IV
4.01 Lease of Property. On the Commencement Date of each Property Schedule executed hereunder, Lessor will be deemed to demise, lease and let to Lessee, and
Lessee will be deemed to rent, lease and hire from Lessor, the Property described in such Property Schedule, in accordance with this Agreement and such Property
Schedule, for the Lease Term set forth in such Property Schedule.
4.02 Lease Tenn. The term of each Property Schedule shall commence on the Commencement Date set forth therein and shall terminate upon payment of the final
Lease Payment set forth in such Property Schedule and the exercise of the Purchase Option described in Section 11.01, unless terminated sooner pursuant to this
Agreement or the Property Schedule.
4.03 Delivery, Installation and Acceptance of Property. Lessee shall order the Property, shall cause the Property to be delivered and installed at the locations
specified in the applicable Property Schedule and shall pay all taxes, delivery costs and installation costs, if any, in connection therewith. To the extent funds are deposited
under an escrow agreement or trust agreement for the acquisition of the Property, such funds shall be disbursed as provided therein. When the Property described in such
Property Schedule is delivered, installed and accepted as to Lessee's specifications, Lessee shall immediately accept the Property and evidence said acceptance by
executing and delivering to Lessor the Acceptance Certificate substantially in the form attached to the Property Schedule.
ARTICLE V
5.01 Enjoyment of Property. Lessee shall during the Lease Term peaceably and quietly have, hold and enjoy the Property, without suit, trouble or hindrance from
Lessor, except as expressly set forth in this Agreement. Lessor shall not interfere with such quiet use and enjoyment during the Lease Term so long as Lessee is not in
default under the subject Property Schedule.
5.02 Location: Inspection. The Property will be initially located or based at the location specified in the applicable Property Schedule. Lessor shall have the right at
all reasonable times during business hours to enter into and upon the property of Lessee for the purpose of inspecting the Property.
ARTICLE VI
6.01 Lease Payments to Constitute a Current Expense of Lessee. Lessor and Lessee understand and intend that the obligation of Lessee to pay Lease Payments
hereunder shall const~ute a current expense of Lessee and shall not in any way be construed to be a debt of Lessee in contravention of any applicable constitutional,
statutory or charter limitation or requirement concerning the creation of indebtedness by Lessee, nor shall anything contained herein constitute a pledge of the faith and credit
or taxing power of Lessee. Upon the appropriation of Lease Payments for a fiscal year, the Lease Payments for said fiscal year, and only the Lease Payments for said
current fiscal year, shall be a binding obligation of Lessee; provided that such obligation shall not include a pledge of the taxing power of Lessee.
6.02 Payment of Lease Pavments. Lessee shall promptly pay Lease Payments under each Property Schedule, exclusively from legally available funds, in lawful
money of the United States of America, to Lessor in such amounts ~nd on such dates as described in the applicable Property Schedule, at Lessor's address set forth on the
first page of this Agreement, unless Lessor instructs Lessee otherwise. Lessee shall pay Lessor .a charge on any delinquent Lease Payments under a Property Schedule in
an amount sufficient to cover all additional costs and expenses mcurred by Lessor from such delinquent Lease Payment. In add ilion, Lessee shall pay a late charge of five
cents per dollar or the highest amount permitted by applicable law, whichever is lower, on all delinquent Lease Payments and mterest on said delinquent amounts from the
date such amounts were due until paid at the rate of 12% per annum or the maximum amount permitted by law, whichever is less ..
6.03 Interest Component. A portion of each Lease Payment due under each Property Schedule is paid as, and represents payment of, interest, and each Property
Schedule hereunder shall set forth the interest component (or method of computation thereof) of each Lease Payment thereunder during the Lease Term.
6.04 Lease Payments to be Unconditional. SUBJECT TO SECTION 6.06, THE OBLIGATIONS OF LESSEE TO PAY THE LEASE PAYMENTS DUE UNDER THE
PROPERTY SCHEDULES AND TO PERFORM AND OBSERVE THE OTHER COVENANTS AND AGREEMENTS CONTAINED HEREIN SHALL BE ABSOLUTE AND
UNCONDITIONAL IN ALL EVENTS WITHOUT ABATEMENT, DIMINUTJON, DEDUCTION, SET-OFF OR DEFENSE, FOR ANY REASON, INCLUDING WITHOUT
LIMITATION, ANY DEFECTS, MALFUNCTIONS, BREAKDOWNS OR INFIRMITIES IN THE PROPERTY OR ANY ACCIDENT, CONDEMNATION OR UNFORESEEN
CIRCUMSTANCES. THIS PROVISION SHALL NOT LIMIT LESSEE'S RIGHTS OR ACTIONS AGAINST ANY VENDOR AS PROVIDED IN SECTION 10.02.
6.05 Continuation of Lease by Lessee. Lessee intends to continue all Property Schedules entered into pursuant to this Agreement and to pay the Lease Payments
thereunder. Lessee reasonably believes that legally available funds in an amount sufficient to make all Lease Payments during the term of all Property Schedules can be
obtained. Lessee agrees that its staff will provide during the budgeting process for each budget year to the governing body of Lessee notification of any Lease Payments due
under the Property Schedules during the following budget year. Notwithstanding this covenant, if Lessee fails to appropriate the Lease Payments for a Property Schedule
pursuant to Section 6.06, such Property Schedule shall terminate at the end of the then current Original Term or Renewal Term. Although Lessee has made this covenant, in
the event that it fails to provide such notice, no remedy is provided and Lessee shall not be liable for any damages for 1ts failure to so comply.
6.06 Nonappropriation. If during the then current Original Tenm or Renewal Term, sufficient funds are not appropriated to make Lease Payments required under a
Property Schedule for the following fiscal year, Lessee shall be deemed to not have renewed such Property Schedule for the following fiscal year and the Property Schedule
shall terminate at the end of the then current Original Term or Renewal Term and Lessee shall not be obligated to make Lease Payments under said Property Schedule
beyond the then current fiscal year for which funds have been appropriated. Upon the occurrence of such nonappropriation (a "Nonappropriation Event") Lessee shall, no
later than the end of the fiscal year for which Lease Payments have been appropriated, deliver possession of the Property under said Property Schedule to Lessor. If Lessee
fails to deliver possession of the Property to Lessor upon termination of said Property Schedule by reason of a Nonappropriation Event, the temnination shall nevertheless be
effective but Lessee shall be responsible for the payment of damages in an amount equal to the portion of Lease Payments thereafter coming due that is attributable to the
number of days aft~r the termination during which the Lessee fails to deliver possession and for any other loss suffered by Lessor as a result of Lessee's failure to deliver
possess1on as reqUired. In addrt1on, Lessor may, by written instructions to any escrow agent who is holding proceeds of the Property Schedule, instruct such escrow agent to
release all such proceeds and any eammgs thereon to Lessor, such sums to be credited to Lessee's obligations under the Property Schedule and this Agreement Lessee
shall notify Lessor in writing within seven (7) days after the failure of the Lessee to appropriate funds sufficient for the payment of the Lease Payments, but failure to provide
such notice shall not operate to extend the Lease Term or result in any liability to Lessee.
6.07 Defeasance of Lease Payments. Lessee may at any time irrevocably deposit in escrow with a defeasance escrow agent for the purpose of paying all of the
principal component and interest component accruing under a Property Schedule, a sum of cash and non-callable securities consisting of direct obligations of, or obligations
the principal of an interest on which are unconditionally guaranteed by, the United States of America or any agency or instrumentality thereof, in such aggregate amount,
bearing interest at such rates and maturing on such dates as shall be required to provide funds sufficient for this purpose. Upon such defeasance, all right, title and interest
of Lessor in the Property under said Property Schedule shall terminate. Lessee shall cause such investment to comply with the requirements of federal tax law so that the
exclusion from gross income of the interest component of Lease Payments on said Property Schedule is not adversely affected.
ARTICLE VII
7.01 Title to the Property. Upon acceptance of the Property by Lessee and unless otherwise required by the laws of the State, title to the Property shall vest in
Lessee, subject to Lessor's interests under the applicable Property Schedule and this Agreement
7.02 Personal Property. The Property is and will remain personal property and will not be deemed to be affixed to or a part of the real estate on which it may be
situated, notwithstanding that the Property or any part thereof may be or hereafter become in any manner physically affixed or attached to real estate or any building thereon.
If requested by Lessor, Lessee will, at Lessee's expense, furnish a waiver of any interest in the Property from any party having an interest in any such real estate or building.
7.03 Security Interest. To the extent permitted by law and to secure the performance of all of Lessee's obligations under this Agreement with respect to a Property
Schedule, including without limitation all Property Schedules now existing are hereafter executed, Lessee grants to Lessor, for the benefit of Lessor and its successors and
assigns, a security interest constituting a first lien on Lessee's interest in all _of the Property under the Property Schedule, whether now owned or hereafter acquired, all
additions, attachments, alterations and accessions to the Property, all substitutions and replacements for the Property, ~nd on any pr?ceeds of any of the foregoing, including
insurance proceeds. Lessee shall execute any add1t1onal documents, mcludmg financmg statements, aff1dav1ts, not1ces and s1m1lar Instruments, in form and substance
satisfactory to Lessor, which Lessor deems necessary or appropriate to establish, maintain and perfect a security interest in the Property in favor of Lessor and its
successors and assigns. Lessee hereby authorizes Lessor to file all financing statements which Lessor deems necessary or appropriate to establish, maintain and perfect
such security interest
ARTICLE VIII
8.01 Maintenance of Property by Lessee. Lessee shall keep and maintain the Property in good condition and working order and in compliance with the
manufacturer's specifications, shall use, operate and maintain the Property in conformity with all laws and regulations concerning the Property's ownership, possession use
and maintenance, and shall keep the Property free and clear of all liens and claims, other than those created by this Agreement Lessee shall have sole responsibility to
maintain and repair the Property. Should Lessee fail to maintain, preserve and keep the Property in good repair and working order and in accordance with manufacturers
specifications, and if requested by Lessor, Lessee will enter into maintenance contracts for the Property in form approved by Lessor and with approved providers.
8.02 Liens. Taxes, Other Governmental Charges and Utility Charges. Lessee shall keep the Property free of all levies, liens and encumbrances, except for the
interest of Lessor under this Agreement The parties to this Agreement contemplate that the Property will be used for a governmental or proprietary purpose of Lessee and
therefore, that the Property will be exempt from all property taxes. The Lease Payments payable by Lessee under this Agreement and the Property Schedules hereunde;
have been established to reflect the savings resulting from this exemption from taxation. Lessee will take such actions necessary under applicable law to obtain said
exemption. Nevertheless, if the use, possession or acquisition of the Property is determined to be subject to taxation or later becomes subject to such taxes, Lessee shall
pay when due all taxes and governmental charges lawfully assessed or levied against or with respect to the Property. Lessee shall pay all gas, water, steam, electricity, heat,
power, telephone, utility and other charges incurred in the operation, maintenance, use, occupancy and upkeep of the Property. Lessee shall pay such taxes or charges as
the same may become due; provided that, with respect to any such taxes or charges that may lawfully be paid in installments over a period of years, Lessee shall be
obligated to pay only such installments as accrue during the then current fiscal year of the Lease Term for such Property.
8.03 Insurance. At its own expense, Lessee shall maintain (a) casualty insurance insuring the Property against loss or damage by fire and all other risks covered by
the standard extended coverage endorsement then in use in the State and any other risks reasonably required by Lessor in an amount equal to at least the outstanding
principal component of Lease Payments, and (b) liability insurance that protects Lessor from liability in all events in an amount reasonably acceptable to Lessor, and (c)
worker's compensation insurance covering all employees working on, in, near or about the Property; prov1ded that Lessee may self-insure against all such risks. All
insurance proceeds from casualty losses shall be payable as hereinafter provided in this Agreement All such insurance shall be with insurers that are authorized to issue
such insurance in the State. All such liability insurance shall name Lessor as an additional insured. All such casualty insurance shall contain a provision making any losses
payable to Lessor and Lessee as their respective interests may appear. All such insurance shall contain a provision to the effect that such insurance shall not be canceled or
modified without first giving written notice thereof to Lessor and Lessee at least thirty (30) days in advance of such cancellation or modification. Such changes shall not
become effective without Lessors prior written consent Lessee shall furnish to Lessor, on or before the Commencement Date for each Property Schedule, and thereafter at
Lessor's request, certificates evidencing such coverage, or, if Lessee self-insures, a written description of its self-insurance program together with a certification from
Lessee's risk manager or insurance agent or consultant to the effect that Lessee's self-insurance program provides adequate coverage against the risks listed above.
8.04 Advances. In the event Lessee shall fail to either maintain the insurance required by this Agreement or keep the Property in good repair and working order,
Lessor may, but shall be under no obligation to, purchase the required insurance and pay the cost of the premiums thereof or maintain and repair the Property and pay the
cost thereof. All amounts so advanced by Lessor shall constitute additional rent for the Lease Term for the applicable Property Schedule and shall be due and payable on
the next Lease Payment Date and Lessee covenants and agrees to pay such amounts so advanced by Lessor with interest thereon from the date such amounts are
advanced until paid at the rate of 12% per annum or the maximum amount permitted by law, whichever is less.
ARTICLE IX
9.01 Damage or Destruction. If (a) the Property under a Property Schedule or any portion thereof is destroyed, in whole or in part, or is damaged by fire or other
casualty, or (b) title to, or the temporary use of, the Property under a Property Schedule or any part thereof shall be taken under the exercise or threat of the power of eminent
domain by any governmental body or by any person, firm or corporation acting pursuant to governmental authority, Lessor and Lessee will cause the Net Proceeds (as
hereinafter defined) of any insurance claim, condemnation award or sale under threat of condemnation to be applied to the prompt replacement, repair, restoration,
modification or improvement of the Property, unless Lessee shall have exercised its right to defease the Property Schedule as provided herein, or unless Lessee shall have
exercised its option to purchase Lessor's interest in the Property if the Property Schedule so provides. Any balance of the Net Proceeds remaining after such work has been
completed shall be paid to Lessee. For purposes of Section 8.03 and this Article IX, the term "Net Proceeds" shall mean the amount remaining from the gross proceeds of
any insurance claim, condemnation award or sale under threat of condemnation after deducting all expenses, including attorneys' fees, incurred in the collection thereof.
9.02 Insufficiency of Net Proceeds. If the Net Proceeds are insufficient to pay in full the cost of any repair, restoration, modification or improvement referred to in
Section 9.01, Lessee shall (a) complete such replacement, repair, restoration, modification or improvement and pay any costs thereof in excess of the amount of the Net
Proceeds and, if Lessee shall make any payments pursuant to this Section, Lessee shall not be entitled to any reimbursement therefor from Lessor nor shall Lessee be
entitied to any diminution of the amounts payable under Section 6.02, or (b) defease the Property Schedule pursuant to Section 6.07, or (c) exercise its option to purchase
Lessor's interest in the Property pursuant to the optional purchase provisions of the Property Schedule, if any. The amount of the Net Proceeds, if any, remaining after
completing such repair, restoration, modification or improvement or after such defeasance or purchase may be retained by Lessee.
ARTICLE X
10.01 Disclaimer of Warranties. LESSOR MAKES NO (AND SHALL NOT BE DEEMED TO HAVE MADE ANY) WARRANTIES, EXPRESS OR IMPLIED, AS TO ANY
MATTER WHATSOEVER, INCLUDING, WITHOUT LIMITATION, THE DESIGN, OPERATION OR CONDITION OF, OR THE QUALITY OF THE MATERIAL, EQUIPMENT
OR WORKMANSHIP IN, THE PROPERTY, ITS MERCHANTABILITY OR ITS FITNESS FOR ANY PARTICULAR PURPOSE, THE STATE OF TITLE THERETO OR ANY
COMPONENT THEREOF, THE ABSENCE OF LATENT OR OTHER DEFECTS (WHETHER OR NOT DISCOVERABLE), AND LESSOR HEREBY DISCLAIMS THE SAME·
IT BEING UNDERSTOOD THAT THE PROPERTY IS LEASED TO LESSEE "AS IS" ON THE DATE OF THIS AGREEMENT OR THE DATE OF DELIVERY, WHICHEVER
IS LATER, AND ALL SUCH RISKS, IF ANY, ARE TO BE BORNE BY LESSEE. Lessee acknowledges that it has made (or will make) the selection of the Property from the
Vendor based on its own JUdgment and expressly disclaims any reliance upon any statements or representations made by Lessor. Lessee understands and agrees that (a)
neither the Vendor nor any sales representative or other agent of Vendor, is (i) an agent of Lessor, or (ii) authorized to make or alter any terrn or condition of this Agreement,
and (b) no such waiver or alteration shall vary the terms of this Agreement unless expressly set forth herein. In no event shall Lessor be liable for any incidental, indirect,
special or consequenti~l damage in connection with or arising out of this Agreement, the Property Schedules, or the existence, furnishing, functioning or use of any item,
product or service prov1ded for 1n th1s Agreement or the Property Schedules.
10.02 Vendor's Warranties. Lessor hereby irrevocably assigns to Lessee all rights that Lessor may have to assert from time to time whatever claims and rights
(including without limitation warranties) related to the Property against the Vendor. Lessee's sole remedy for the breach of such warranty. indemnification or representation
shall be against the Vendor of the Property, and not against Lessor, nor shall such matter have any effect whatsoever on the rights and obligations of Lessor with respect to
this Agreement, including the right to receive full and timely payments hereunder. Lessee expressly acknowledges that Lessor makes, and has made, no representations or
warranties whatsoever as to the existence or the availability of such warranties of the Vendor of the Property.
10.03 Use of the Property. Lessee will not install, use, operate or maintain the Property improperly, carelessly, in violation of any applicable law or in a manner
contrary to that contemplated by this Agreement and the applicable Property Schedule. Lessee shall provide all permits and licenses, if any, necessary for the installation
and operation of the Property. In addition, Lessee agrees to comply in all respects with all laws of the jurisdiction in which its operations involving any item of Property may
extend and any legislative, executive, administrative or judicial body exercising any power or jurisdiction over the items of the Property; provided that Lessee may contest in
good faith the validity or application of any such law or rule in any reasonable manner that does not, in the opinion of Lessor, adversely affect the interest of Lessor in and to
the Property or its interest or rights under this Agreement. Lessee shall promptly notify Lessor in writing of any pending or threatened investigation, inquiry, claim or action by
any governmental authority which could adversely affect this Agreement, any Property Schedule or the Property thereunder.
10.04 Modifications. Subject to the provisions of this Section, Lessee shall have the right, at its own expense, to make alterations, additions, modifications or
improvements to the Property. All such alterations, additions, modifications and improvements shall thereafter comprise part of the Property and shall be subject to the
provisions of this Agreement. Such alterations, additions, modifications and improvements shall not in any way damage the Property, substantially alter its nature or cause it
to be used for purposes other than those authorized under the provisions of state and federal law; and the Property, on completion of any alterations, additions, modifications
or improvements made pursuant to this Section, shall be of a value which is equal to or greater than the value of the Property immediately prior to the making of such
alterations, additions, modifications and improvements. Lessee shall, at its own expense, make such alterations, additions, modifications and improvements to the Property
as may be required from time to time by applicable law or by any governmental authority.
ARTICLE XI
11.01 Option to Purchase. Lessee shall have the option to purchase Lessor's entire interest in all of the Property subject to a Property Schedule and to terminate any
restrictions herein on the Property under such Property Schedule on the last day of the Lease Term for a Property Schedule, If the Property Schedule is still in effect on such
day, upon payment in full of the Lease Payments due thereunder plus payment of One (1) Dollar to Lessor. Lessee shall give written notice to Lessor of its intent to purchase
Lessor's interest in the Property at least sixty (60) days prior to the last day of the Lease Term for applicable Property Schedule. Upon exercise of the purchase option as set
forth in this Section 11.01 and payment of the purchase price under the applicable Property Schedule, and performance by Lessee of all other terms, conditions and
provisions hereof, Lessor shall deliver to Lessee all such documents and instruments as Lessee may reasonably require to evidence the transfer, without warranty by or
recourse to Lessor, of all of Lessors right, title and interest in and to the Property subject to such Property Schedule to Lessee.
11.02 Option to Prepay. Lessee shall have the option to prepay in whole the Lease Payments due under a Property Schedule, but only if the Property Schedule so
provides, and on the terms set forth in the Property Schedule.
ARTICLE XII
12.01 Assignment by Lessor. Lessors right, title and interest in, to and under each Property Schedule and the Property under such Property Schedule may be
assigned and reassigned in whole or in part to one or more assignees or subassignees by Lessor without the necessity of obtaining the consent of Lessee; provided that any
assignment shall not be effective until Lessee has received written notice, signed by the assignor, of the name, address and tax identification number of the assignee.
Lessee shall retain all such notices as a register of all assignees and shall make all payments to the assignee or assignees designated in such register. Lessee agrees to
execute all documents, including notices of assignment and chattel mortgages or financing statements that may be reasonably requested by Lessor or any assignee to
protect its interests in this Agreement and the Property Schedules.
12.02 Property Schedules Separate Financings. Assignees of the Lessor's rights in one Property Schedule shall have no rights in any other Property Schedule
unless such rights have been separately assigned ..
12.03 Assignment and Subleasing by Lessee. NONE OF LESSEE'S RIGHT, TITLE AND INTEREST IN, TO AND UNDER THIS AGREEMENT AND IN THE
PROPERTY MAY BE ASSIGNED, SUBLEASED OR ENCUMBERED BY LESSEE FOR ANY REASON, WITHOUT THE PRIOR WRITIEN CONSENT OF LESSOR.
12.04 Release and Indemnification Covenants. To the extent permitted by applicable law, Lessee shall indemnify, protect, hold harmless, save and keep harmless
Lessor from and against any and all liability, obligation, loss, claim and damage whatsoever, regardless of cause thereof, and all expenses in connection therewith, including,
without limitation, counsel fees and expenses, penalties and interest (collectively, "Losses") arising out of or resulting from the entering into this Agreement, any Property
Schedules hereunder, the ownership of any item of the Property, the loss of federal tax exemption of the interest on any of the Property Schedules, the ordering, acquisition,
use, operation, condition, purchase, delivery, rejection, storage or return of any item of the Property or any accident in connection with the operation, use, condition,
possession, storage or return of any item of the Property resulting in damage to property or injury to or death to any person; provided, however, that Lessee shall not be
required to indemnify Lessor for Losses arising out of or resulting from Lessor's own willful or negligent conduct, or for Losses arising out of or resulting from Lessor'
preparation of disclosure material relating to certificates of participation in this Agreement and any Property Schedule (other than disclosure material provided to Lessor by
Lessee). The indemnification arising under this Section shall continue in full force and effect notwithstanding the full payment of all obligations under this Agreement, or the
applicable Property Schedule, or the termination of the Lease Term for such Property Schedule for any reason.
ARTICLE XIII
13.01 Events of Default Defined. Any of the following shall constitute an "Event of Default" under a Property Schedule:
(a)
(b)
(c)
(d)
Failure by Lessee to pay any Lease Payment under the Property Schedule or other payment required to be paid with respect thereto at the time specified
therein;
Failure by Lessee to observe and perform any covenant, condition or agreement on its part to be observed or performed with respect to the Property
Schedule, other than as referred to in subparagraph (a) above, for a period of thirty (30) days after written notice specifying such failure and requesting that
it be remedied is given to Lessee by Lessor, unless Lessor shall agree in writing to an extension of such time prior to its expiration; provided that, if the
failure stated in the notice cannot be corrected within the applicable period, Lessor will not unreasonably withhold its consent to an extension of such time if
corrective action is instituted by Lessee within the applicable period and diligently pursued until the default is corrected;
Any statement, representation or warranty made by Lessee in or pursuant to the Property Schedule or its execution, delivery or performance shall prove to
have been false, incorrect, misleading or breached in any material respect on the date when made;
Lessee shall (i) apply for or consent to the appointment of a receiver, trustee, custodian or liquidator of Lessee, or of all or a substantial part of the assets of
Lessee, (ii) be unable, fail or admit in writing its inability generally to pay its debts as they become due, (iii) make a general assignment for the benefit of
creditors, (iv) have an order for relief entered against it under applicable federal bankruptcy law, or (v) file a voluntary petition in bankruptcy or a petition or
an answer seek1ng reorganization or an arrangement with creditors or taking advantage of any insolvency law or any answer admitting the material
allegations of a petition filed against Lessee in any bankruptcy, reorganization or insolvency proceeding; or
(e) An order, judgment or decree shall be entered by any court of competent jurisdiction, approving a petition or appointing a receiver, trustee, custodian or
liquidator of Lessee or of all or a substantial part of the assets of Lessee, in each case without its application, approval or consent, and such order,
judgment or decree shall continue unstayed and in effect for any period of 60 consecutive days.
The foregoing provisions of Section 13.01 are subject to the following limitation: if by reason of force majeure Lessee is unable in whole or in part to perform its
agreements under this Agreement and the Property Schedule (other than the obligations on the part of Lessee contained in Article VI hereof) Lessee shall not be in default
during the continuance of such inability. The term "force majeure" as used herein shall mean the following: acts of God; strikes, lockouts or other industrial disturbances; acts
of public enemies; orders or restraints of any kind of the government of the United States or of the State or any of their departments, agencies or officials, or any civil or
military authority; insurrections, riots, landslides, earthquakes, fires, storms, droughts, floods, explosions, breakage or accident to machinery, transmission pipes or canals· or
any other cause or event not reasonably within the control of Lessee. '
A Nonappropriation Event is not an Event of Default.
13.02 Remedies on Default. Whenever any Event of Default exists with respect to a Property Schedule, Lessor shall have the right, at its sole option without any
further demand or notice, to take one or any combination of the following remedial steps:
(a)
(b)
(c)
(d)
Without terminating the Property Schedule, and by written notice to Lessee, Lessor may declare all Lease Payments and other amounts payable by Lessee
thereunder to the end of the then-current budget year of Lessee to be due, including without limitation delinquent Lease Payments under the Property
Schedule from prior budget years, and such amounts shall thereafter bear interest at the rate of 12% per annum or the maximum rate permitted by
applicable law, whichever is less;
Lessor may terminate the Property Schedule, may enter the premises where the Property subject to the Property Schedule is located and retake possession
of the Property, or require Lessee, at Lessee's expense, to promptly return any or all of the Property to the possession of Lessor at such place within the
United States as Lessor shall specify, and Lessor may thereafter dispose of the Property in accordance with Article 9 of the Uniform Commercial Code in
effect in the State; provided, however, that any proceeds from the disposition of the property in excess of the sum required to (i) pay off any outstanding
principal component of Lease Payments, (ii) pay any other amounts then due under the Property Schedule, and (iii) pay Lessor's costs and expenses
associated with the disposition of the Property (including attorneys fees), shall be paid to Lessee or such other creditor of Lessee as may be entitied thereto,
and further provided that no deficiency shall be allowed against Lessee except with respect to unpaid costs and expenses incurred by Lessor in connection
with the disposition of the Property;
By written notice to any escrow agent who is holding proceeds of the Property Schedule, Lessor may instruct such escrow agent to release all such
proceeds and any earnings thereon to Lessor, such sums to be credited to payment of Lessee's obligations under the Property Schedule;
Lessor may take any action, at law or in equity, that is permitted by applicable law and that may appear necessary or desirable to enforce or to protect any
of its rights under the Property Schedule and this Agreement.
Notwithstanding the foregoing, if the proceeds are insufficient to pay items (i) to (iii) in Section 13.02(b) in whole, Lessee shall remain obligated after application of
proceeds to items (i) and (ii), to pay in whole the amounts for item (iii).
13.03 No Remedy Exclusive. No remedy herein conferred upon or reserved to Lessor is intended to be exclusive and every such remedy shall be cumulative and shall
be in addition to every other remedy given under this Agreement now or hereafter existing at law or in equity. No delay or omission to exercise any right or power accruing
upon any default shall impair any such right or power or shall be construed to be a waiver thereof, but any such right or power may be exercised from time to time and as
often as may be deemed expedient. In order to entiHe Lessor to exercise any remedy reserved to it in this Article it shall not be necessary to give any notice, other than such
notice as may be required in this Article.
13.04 Costs and Attorney Fees. Upon the occurrence of an Event of Default by Lessee in the performance of any term of this Agreement, Lessee agrees to pay to
Lessor or reimburse Lessor for, in addition to all other amounts due hereunder, all of Lessor's costs of collection, including reasonable attorney fees, whether or not suit or
action is filed thereon. Any such costs shall be immediately due and payable upon written notice and demand given to Lessee, shall be secured by this Agreement until paid
and shall bear interest at the rate of 12% per annum or the maximum amount permitted by law, whichever is less. In the event suit or action is instituted to enforce any of the
terms of this Agreement, the prevailing party shall be entitied to recover from the other party such sum as the court may adjudge reasonable as attorneys' fees at trial or on
appeal of such suit or action or in any bankruptcy proceeding, in addition to all other sums provided by law.
ARTICLE XIV
14.01 Notices. All notices, certificates or other communications hereunder shall be sufficiently given and shall be deemed given when delivered or mailed by certified
mail, postage prepaid, to the parties hereto at the addresses as specified on the first page of this Agreement (or at such other address as either party hereto shall designate
in writing to the other for notices to such party), to any assignee at its address as it appears on the registration books maintained by Lessee.
14.02 Arbitrage Certificates. Unless a separate Arbitrage Certificate is delivered on the Commencement Date, Lessee shall be deemed to make the following
representations and covenants as of the Commencement Date for each Property Schedule:
(a) The estimated total costs, including taxes, freight, installation, cost of issuance, of the Property under the Property Schedule will not be less than the total
principal amount of the Lease Payments.
(b)
(c)
(d)
(e)
(f)
The Property under the Property Schedule has been ordered or is expected to be ordered within six months after the Commencement Date and the Property
is expected to be delivered and installed, and the Vendor fully paid, within eighteen months from the Commencement Date. Lessee will pursue the
completion of the Property and the expenditure of the net proceeds of the Property Schedule with due diligence.
Lessee has not created or established, and does not expect to create or establish, any sinking fund or other similar fund (i) that is reasonably expected to be
used to pay the Lease Payments under the Property Schedule, or (ii) that may be used solely to prevent a default in the payment of the Lease Payments
under the Property Schedule.
The Property under the Property Schedule has not been and is not expected to be sold or otherwise disposed of by Lessee, either in whole or in major part,
prior to the last maturity of the Lease Payments under the Property Schedule.
There are no other obligations of Lessee which (i) are being sold within 15 days of the Commencement Date of the Property Schedule; (ii) are being sold
pursuant to the same plan of financing as the Property Schedule; and (iii) are expected to be paid from substantially the same source of funds.
The officer or official who has executed the Property Schedule on Lessee's behalf is familiar with Lessee's expectations regarding the use and expenditure
of the proceeds of the Property Schedule. To the best of Lessee's knowledge, information and belief, the facts and estimates set forth in herein are
accurate and the expectations of Lessee set forth herein are reasonable.
14.03 Further Assurances. Lessee agrees to execute such other and further documents, including, without limitation, confirmatory financing statements, continuation
statements, certificates of titie and the like, and to take all such action as may be necessary or appropriate, from time to time, in the reasonable opinion of Lessor, to perfect,
confirm, establish, reestablish, continue, or complete the interests of Lessor in this Agreement and the Property Schedules, to consummate the transactions contemplated
hereby and thereby, and to carry out the purposes and intentions of this Agreement and the Property Schedules.
14.04 Binding Effect. This Agreement shall inure to the benefit of and shall be binding upon Lessor and Lessee and their respective successors and assigns.
14.05 Severability. In the event any provision of this Agreement shall be held invalid or unenforceable by any court of competent jurisdiction, such holding shall not
invalidate or render unenforceable any other provision hereof.
14.06 Waiver of Jury Trials. Lessee and Lessor hereby irrevocably waive all right to trial by jury in any action, proceeding or counterclaim (whether based on contract,
tort or otherwise) arising out of or relating to this Agreement or the actions of Lessor or Lessee in the negotiation, administration, perfonnnance or enforcement hereof.
14.07 Amendments, Changes and Modifications. This Agreement may be amended in writing by Lessor and Lessee to the extent the amendment or modification
does not apply to outstanding Property Schedules at the time of such amendment or modification. The consent of all assignees shall be required to any amendment or
modification before such amendment or modification shall be applicable to any outstanding Property Schedule.
14.08 Execution in Counterparts. This Agreement and the Property Schedules hereunder may be simultaneously executed in several counterparts, each of which
shall be an original and all of which shall constitute but one and the same instrument.
14.09 Applicable Law. This Agreement shall be governed by and construed in accordance with the laws of the State.
14.10 Captions. The captions or headings in this Agreement are for convenience only and in no way define, limit or describe the scope or intent of any provisions or
sections of this Agreement.
IN WITNESS WHEREOF, Lessor and Lessee have caused this Agreement to be executed in their names by their duly authorized representatives as of the date
first above written.
Lessor: u.s. Bancorp Government Lessee: County of Harnett
Leasing and Finance, Inc.
By: By:
Name: Name:
Title: Title:
Attest:
By:
Name:
Title:
ADDENDUM (NORTH CAROLINA)
Master Tax-Exempt Lease/Purchase Agreement
THIS ADDENDUM, which is entered into as of June 14, 2013 between U.S. Bancorp Government Leasing and Finance, Inc. ("Lessor'') and
County of Harnett ("Lessee"), is intended to modify and supplement Property Schedule No. 1 (the "Property Schedule") to the Master Tax-
Exempt Lease/Purchase Agreement between Lessor and Lessee dated as of June 14, 2013 (the "Master Agreement"). Capitalized terms
not otherwise defined herein shall have the meanings set forth in the Master Agreement.
In addition to the representations, warranties and covenants set forth in the Master Agreement, Lessee represents, warrants and
covenants for the benefit of Lessor that (i) Lessee has reviewed the Property Schedule with legal counsel regarding the need to obtain
approval of the Local Government Commission, and if determined that such approval is needed, has so obtained such approval, and (ii)
if Lessee is a school district, Lessee has reviewed Section 115C-528 of the General Statutes of North Carolina with its legal counsel for
compliance with all of the terms and conditions set forth therein for lease-purchase contracts, and has complied with all said terms and
conditions with respect to the Property Schedule.
IN WITNESS WHEREOF, Lessor and Lessee have caused this Addendum to be executed in their names by their duly authorized
representatives as of the date first above written.
Lessor: U.S. Bancorp Government Leasing and Lessee: County of Harnett
Finance, Inc.
By: By:
Name: Name:
Title: Title:
Attest:
By
Name:
Title:
!Property Schedule No. 1\
Master Tax-Exempt Lease/Purchase Agreement
This Property Schedule No. 1 is entered into as of the Commencement Date set forth below, pursuant to that certain Master Tax-
Exempt Lease/Purchase Agreement (the "Master Agreement"), dated as of June 14, 2013, between U.S. Bancorp Government Leasing
and Finance, Inc., and County of Harnett.
1. 1 nteroretation. The terms and conditions of the Master Agreement are incorporated herein by reference as if fully set forth herein.
Reference is made to the Master Agreement for all representations, covenants and warranties made by Lessee in the execution of this
Property Schedule, unless specifically set forth herein. In the event of a conflict between the provisions of the Master Agreement and
the provisions of this Property Schedule, the provisions of this Property Schedule shall control. All capitalized terms not otherwise
defined herein shall have the meanings provided in the Master Agreement.
2. Commencement Date. The Commencement Date for this Property Schedule is June 14,2013.
3. Property Description and Payment Schedule. The Property subject to this Property Schedule is described in Exhibit 1 hereto. Lessee
shall not remove such property from the locations set forth therein without giving prior written notice to Lessor. The Lease Payment
Schedule for this Property Schedule is set forth in Exhibit 1.
4. Opinion. The Opinion of Lessee's Counsel is attached as Exhibit 2.
5. Lessee's Certificate. The Lessee's Certificate is attached as Exhibit 3.
6. Proceeds. Lessor shall disburse the proceeds of this Property Schedule in accordance with the instructions attached hereto as Exhibit
4.
7. Acceptance Certificate. The form of Acceptance Certificate is attached as Exhibit 5.
8. Additional Purchase Option Provisions. In addition to the Purchase Option provisions set forth in the Master Agreement, Lease
Payments payable under this Property Schedule shall be subject to prepayment in whole at any time by payment of the applicable
Termination Amount set forth in Exhibit 1 (Payment Schedule) and payment of all accrued and unpaid interest through the date of
prepayment.
9. Bank Qualification and Arbitrage Rebate. Attached as Exhibit 6.
10. Expiration. Lessor, at its sole determination, may choose not to accept this Property Schedule if the fully executed, original Master
Agreement (including this Property Schedule and all ancillary documents) is not received by Lessor at its place of business by June 30,
2013.
IN WITNESS WHEREOF, Lessor and Lessee have caused this Property Schedule to be executed in their names by their duly authorized
representatives as of the Commencement Date above.
Lessor: U.S. Bancorp Government Leasing and
Finance, Inc.
Bv:
Name:
Title:
Lessee: County of Harnett
By:
Name:
Title:
Attest:
By
Name:
Title:
!EXHIBIT 11
!Property Description and Payment Schedule!
Re: Property Schedule No. 1 to Master Tax-Exempt Lease/Purchase Agreement U.S. Bancorp Government Leasing
and Finance, Inc. and County of Harnett.
THE PROPERTY IS AS FOLLOWS: The Property as more fully described in Exhibit A incorporated herein by reference
and attached hereto. It includes all replacements, parts, repairs, additions, accessions and accessories incorporated
therein or affixed or attached thereto and any and all proceeds of the foregoing, including, without limitation, insurance
recoveries.
PROPERTY LOCATION:
Address
City, State Zip Code
USE: Wheel Loader and Compactor-This use is essential to the proper, efficient and economic functioning of Lessee or
to the services that Lessee provides; and Lessee has immediate need for and expects to make immediate use of
substantially all of the Property, which need is not temporary or expected to diminish in the foreseeable future.
Lease Payment Schedule
Total Principal Amount: $739,763.00
Termination
Payment No. Due Date Lease Principal Interest Amount
Payment Portion Portion (After Making Payment
for said Due Date)
1 14-Jul-2013 12,914.79 12,181.50 733.29 749,408.95
2 14-Aug-2013 12,914.79 12,193.57 721.22 736,849.57
3 14-Sep-2013 12,914.79 12,205.66 709.13 724,277.74
4 14-0ct-2013 12,914.79 12,217.76 697.03 711,693.45
5 14-Nov-2013 12,914.79 12,229.87 684.92 699,096.69
6 14-Dec-2013 12,914.79 12,241.99 672.80 686,487.44
7 14-Jan-2014 12,914.79 12,254.13 660.66 673,865.69
8 14-Feb-2014 12,914.79 12,266.27 648.51 661,231.43
9 14-Mar-2014 12,914.79 12,278.43 636.36 648,584.65
10 14-Apr-2014 12,914.79 12,290.60 624.18 635,925.33
11 14-May-2014 12,914.79 12,302.79 612.00 623,253.46
12 14-Jun-2014 12,914.79 12,314.98 ~ r-599.81 610,569.03
13 14-Jul-2014 12,914.79 12,327.19 587.60 597,872.03
14 14-Aug-2014 12,914.79 12,339.41 575.38 585,162.44
15 14-Sep-2014 12,914.79 12,351.64 563.15 572,440.25
16 14-0ct-2014 12,914.79 12,363.88 550.90 559,705.45
17 14-Nov-2014 12,914.79 12,376.14 538.65 546,958.03
18 14-Dec-2014 12,914.79 12,388.41 526.38 534,197.97
19 14-Jan-2015 12,914.79 12,400.69 514.10 521,425.27
20 14-Feb-2015 12,914.79 12,412.98 501.81 508,639.90
21 14-Mar-2015 12,914.79 12,425.28 489.50 495,841.86
22 14-Apr-2015 12,914.79 12,437.60 477.19 483,031.13
23 14-May-20 15 12,914.79 12,449.93 464.86 470,207.71
24 14-Jun-2015 12,914.79 12,462.27 452.52 457,371.57
25 14-Jul-2015 12,914.79 12,474.62 440.16 444,522.71
26 14-AuQ-20 15 12,914.79 12,486.99 427.80 431,661.11
27 14-Sep-2015 12,914.79 12,499.36 415.42 418,786.77
28 14-0ct-2015 12,914.79 12,511.75 403.03 405,899.66
29 14-Nov-2015 12,914.79 12,524.16 390.63 392,999.78
30 14-Dec-2015 12,914.79 12,536.57 378.21 380,087.11
31 14-Jan-2016 12,914.79 12,549.00 365.79 367,161.64
32 14-Feb-2016 12,914.79 12,561.44 353.35 354,223.36
33 14-Mar -2016 12,914.79 12,573.89 340.90 341,272.26
34 14-Apr-2016 12,914.79 12,586.35 328.43 328,308.31
35 14-May-2016 12,914.79 12,598.83 315.96 315,331.52
36 14-Jun-2016 12,914.79 12,611.32 303.47 302,341.86
37 14-Jul-2016 12,914.79 12,623.82 290.97 289,339.33
38 14-Aug-2016 12,914.79 12,636.33 278.45 276,323.91
39 14-Sep-2016 12,914.79 12,648.86 265.93 263,295.58
40 14-0ct-2016 12,914.79 12,661.40 253.39 250,254.34
41 14-Nov-2016 12,914.79 12,673.95 240.84 237,200.18
42 14-Dec-2016 12,914.79 12,686.51 228.28 224,133.07
43 14-Jan-2017 12,914.79 12,699.09 215.70 211,053.02
44 14-Feb-2017 12,914.79 12,711.67 203.11 197,959.99
45 14-Mar-2017 12,914.79 12,724.27 190.51 184,853.99
46 14-Apr-2017 12,914.79 12,736.89 177.90 171,735.00
47 14-Mav-2017 12,914.79 12,749.51 165.27 158,603.00
48 14-Jun-2017 12,914.79 12,762.15 152.64 145,457.99
49 14-Jul-2017 12,914.79 12,774.80 139.99 132,299.94
50 14-AuQ-2017 12,914.79 12,787.46 127.32 119,128.85
51 14-Sep-2017 12,914.79 12,800.14 114.65 105,944.71
52 14-0ct-2017 12,914.79 12,812.83 101.96 92,747.50
53 14-Nov-2017 12,914.79 12,825.53 89.26 79,537.21
54 14-Dec-2017 12,914.79 12,838.24 76.54 66,313.82
55 14-Jan-2018 12,914.79 12,850.97 63.82 53,077.32
56 14-Feb-2018 12,914.79 12,863.71 51.08 39,827.70
57 14-Mar-2018 12,914.79 12,876.46 38.33 26,564.95
58 14-Apr-2018 12,914.79 12,889.22 25.57 13,289.06
59 14-May-2018 12 914.79 12 902.00 12.79 0.00
TOTALS: 761,972.38 739,763.00 22,209.38
Interest Rate: 1.19%
Lessee: County of Harnett
By:
Name:
Title:
\EXHIBIT A
!Property Description!
One (1) new CAT Wheel Loader
One (1) new CAT Compactor
!EXHIBIT 21
!Lessee's Counsel's Opinion!
[To be provided on letterhead of Lessee's counsel.}
June 14,2013
U.S. Bancorp Government Leasing and Finance, Inc.
13010 SW68th Parkway, Suite 100
Portland, OR 97223
County of Harnett
P.O. Box 760
Lillington, NC 27546
Attention: Sylvia S. Blinson
RE: Property Schedule No. 1 to Master Tax-Exempt Lease/Purchase Agreement between U.S. Bancorp Government
Leasing and Finance, Inc. and County of Harnett.
Ladies and Gentlemen:
We have acted as special counsel to County of Harnett ("Lessee"), in connection with the Master Tax-Exempt
Lease/Purchase Agreement, dated as of June 14, 2013 (the "Master Agreement"), between County of Harnett, as lessee,
and U.S. Bancorp Government Leasing and Finance, Inc. as lessor ("Lessor"), and the execution of Property Schedule No. 1
(the "Property Schedule") pursuant to the Master Agreement. We have examined the law and such certified proceedings
and other papers as we deem necessary to render this opinion.
All capitalized terms not otherwise defined herein shall have the meanings provided in the Master Agreement and
Property Schedule.
As to questions of fact material to our opinion, we have relied upon the representations of Lessee in the Master
Agreement and the Property Schedule and in the certified proceedings and other certifications of public officials furnished to
us without undertaking to verify the same by independent investigation.
Based upon the foregoing, we are of the opinion that, under existing law:
1. Lessee is a public body corporate and politic, duly organized and existing under the laws of the State, and
has a substantial amount of one or more of the following sovereign powers: (a) the power to tax, (b) the power of eminent
domain, and (c) the police power.
2. Lessee has all requisite power and authority to enter into the Master Agreement and the Property Schedule
and to perform its obligations thereunder.
3. The execution, delivery and performance of the Master Agreement and the Property Schedule by Lessee
has been duly authorized by all necessary action on the part of Lessee.
4. All proceedings of Lessee and its governing body relating to the authorization and approval of the Master
Agreement and the Property Schedule, the execution thereof and the transactions contemplated thereby have been
conducted in accordance with all applicable open meeting laws and all other applicable state and federal laws.
5. Lessee has acquired or has arranged for the acquisition of the Property subject to the Property Schedule,
and has entered into the Master Agreement and the Property Schedule, in compliance with all applicable public bidding laws.
6. Lessee has obtained all consents and approvals of other governmental authorities or agencies which may
be required for the execution, delivery and performance by Lessee of the Master Agreement and the Property Schedule.
7. The Master Agreement and the Property Schedule have been duly executed and delivered by Lessee and
constitute legal, valid and binding obligations of Lessee, enforceable against Lessee in accordance with the terms thereof,
except insofar as the enforcement thereof may be limited by any applicable bankruptcy, insolvency, moratorium,
reorganization or other laws of equitable principles of general application, or of application to municipalities or political
subdivisions such as the Lessee, affecting remedies or creditors' rights generally, and to the exercise of judicial discretion in
appropriate cases.
8. As of the date hereof, based on such inquiry and investigation as we have deemed sufficient, no litigation is
pending, (or, to our knowledge, threatened) against Lessee in any court (a) seeking to restrain or enjoin the delivery of the
Master Agreement or the Property Schedule or of other agreements similar to the Master Agreement; (b) questioning the
authority of Lessee to execute the Master Agreement or the Property Schedule, or the validity of the Master Agreement or the
Property Schedule, or the payment of principal of or interest on, the Property Schedule; (c) questioning the constitutionality of
any statute, or the validity of any proceedings, authorizing the execution of the Master Agreement and the Property Schedule;
or (d) affecting the provisions made for the payment of or security for the Master Agreement and the Property Schedule.
This opinion may be relied upon by Lessor, its successors and assigns, and any other legal counsel who provides an
opinion with respect to the Property Schedule.
Very truly yours,
By: ________________________ ___
Dated:-----------
!EXHIBIT 3!
!Lessee's Certificate!
Re: Property Schedule No. 1 to Master Tax-Exempt Lease/Purchase Agreement U.S. Bancorp Government Leasing
and Finance, Inc. and County of Harnett. .
The undersigned, being the duly elected, qualified and acting of the County of Harnett ("Lessee")
do hereby certify, as of June 14, 2013, as follows:
1. Lessee did, at a meeting of the governing body of the Lessee held by resolution or
ordinance duly enacted, in accordance with all requirements of law, approve and authorize the execution and delivery of
the above-referenced Property Schedule (the "Property Schedule") and the Master Tax-Exempt Lease/Purchase
Agreement (the "Master Agreement") by the following named representative of Lessee, to wit:
NAME TITLE SIGNATURE
OF EXECUTING OFFICIAL OF EXECUTING OFFICIAL OF EXECUTING OFFICIAL
And/Or
2. The above-named representative of the Lessee held at the time of such authorization and holds at the
present time the office set forth above.
3. The meeting(s) of the governing body of the Lessee at which the Master Agreement and the Property
Schedule were approved and authorized to be executed was duly called, regularly convened and attended throughout by
the requisite quorum of the members thereof, and the enactment approving the Master Agreement and the Property
Schedule and authorizing the execution thereof has not been altered or rescinded. All meetings of the governing body of
Lessee relating to the authorization and delivery of Master Agreement and the Property Schedule have been: (a) held
within the geographic boundaries of the Lessee; (b) open to the public, allowing all people to attend; (c) conducted in
accordance with internal procedures of the governing body; and (d) conducted in accordance with the charter of the
Lessee, if any, and the laws of the State.
4. No event or condition that constitutes, or with the giving of notice or the lapse of time or both would
constitute, an Event of Default or a Nonappropriation Event (as such terms are defined in the Master Agreement) exists at
the date hereof with respect to this Property Schedule or any other Property Schedules under the Master Agreement.
5. The acquisition of all of the Property under the Property Schedule has been duly authorized by the
governing body of Lessee.
6. Lessee has, in accordance with the requirements of law, fully budgeted and appropriated sufficient funds
for the current budget year to make the Lease Payments scheduled to come due during the current budget year under the
Property Schedule and to meet its other obligations for the current budget year and such funds have not been expended
for other purposes.
7. As of the date hereof, no litigation is pending, (or, to my knowledge, threatened) against Lessee in any
court (a) seeking to restrain or enjoin the delivery of the Master Agreement or the Property Schedule or of other
agreements similar to the Master Agreement; (b) questioning the authority of Lessee to execute the Master Agreement or
the Property Schedule, or the validity of the Master Agreement or the Property Schedule, or the payment of principal of or
interest on, the Property Schedule; (c) questioning the constitutionality of any statute, or the validity of any proceedings,
authorizing the execution of the Master Agreement and the Property Schedule; or (d) affecting the provisions made for the
payment of or security for the Master Agreement and the Property Schedule.
County of Harnett
By:
Title:
SIGNER MUST NOT BE THE SAME AS THE EXECUTING OFFICIAL(S) SHOWN ABOVE.
!EXHIBIT 4!
!Payment of Proceeds Instructions!
U.S. Bancorp Government Leasing and Finance, Inc.
1301 0 SW 68th Parkway, Suite 100
Portland, OR 97223
Re: Property Schedule No. 1 (the "Property Schedule") to Master Tax-Exempt Lease/Purchase Agreement
between U.S. Bancorp Government Leasing and Finance, Inc. ("Lessor'') and County of Harnett
("Lessee").
Ladies and Gentlemen:
The undersigned, an Authorized Representative of the Lessee hereby requests and authorizes Lessor to disburse the net
proceeds of the Property Schedule as follows:
NameofPayee: ---------------------------------
By check ____ _ By wire transfer ____ __
If by check, Payee's address:
If by wire transfer, instructions as follows:
Pay to Bank Name:
Bank Address:
Bank Phone#:
For Account of:
Account No.:
ABA No.:
Lessee: County of Harnett
Bv:
Name:
Title:
!EXHIBIT sj
!Acceptance Certificate!
U.S. Bancorp Government Leasing and Finance, Inc.
13010 SW68th Parkway, Suite 100
Portland, OR 97223
Re: Property Schedule No. 1 to Master Tax-Exempt Lease/Purchase Agreement between U.S. Bancorp
Government Leasing and Finance, Inc. and County of Harnett
Ladies and Gentlemen:
In accordance with the above-referenced Master Tax-Exempt Lease/Purchase Agreement (the "Master Agreement"), the
undersigned ("Lessee") hereby certifies and represents to, and agrees with, U.S. Bancorp Government Leasing and
Finance, Inc. ("Lessor''), as follows:
(1)
(2)
(3)
The Property, as such terms are defined in the above-referenced Property Schedule, has been acquired,
made, delivered, installed and accepted on the date indicated below.
Lessee has conducted such inspection and/or testing of the Property as it deems necessary and
appropriate and hereby acknowledges that it accepts the Property for all purposes.
No event or condition that constitutes, or with notice or lapse of time, or both, would constitute, an Event of
Default or a Nonappropriation Event (as such terms are defined in the Master Agreement) exists at the date
hereof.
Acceptance Date: --------------
Lessee: County of Harnett
By:
Name:
Title:
IEXHIBIT61
!Bank Qualification And Arbitrage Rebatel
U.S. Bancorp Government Leasing and Finance, Inc.
1301 0 SW 68th Parkway, Suite 100
Portland, OR 97223
Re: Property Schedule No. 1 to Master Tax-Exempt Lease/Purchase Agreement U.S. Bancorp Government Leasing
and Finance, Inc. and County of Harnett
Bank Qualified Tax-Exempt Obligation under Section 265
Not applicable.
Arbitrage Rebate
Eighteen Month Exception:
Pursuant to Treasury Regulations Section 1.148-?(d), the gross proceeds of this Property Schedule will be expended
for the governmental purposes for which this Property Schedule was entered into, as follows: at least 15% within six months
after the Commencement Date, at least 60% within 12 months after the Commencement Date, and 1 00% within 18 months
after the Commencement Date. If Lessee is unable to comply with Section 1.148-?(d) of the Treasury Regulations, Lessee
shall compute rebatable arbitrage on this Agreement and pay rebatable arbitrage to the United States at least once every five
years, and within 60 days after payment of the final Lease Payment due under this Agreement.
Lessee: County of Harnett
By:
Name:
Title:
Language for UCC Financing Statements
Schedule 1
SECURED PARTY: U.S. Bancorp Government Leasing and Finance, Inc.
DEBTOR: County of Harnett
This financing statement covers all of Debtor's right, title and interest, whether now owned or hereafter acquired, in and to
the equipment leased to Debtor under Property Schedule No. 1 dated June 14, 2013 to that certain Master Tax-Exempt
Lease Purchase Agreement dated as of June 14, 2013, in each case between Debtor, as Lessee, and Secured Party, as
Lessor, together with all accessions, substitutions and replacements thereto and therefore, and proceeds (cash and non-
cash), including, without limitation, insurance proceeds, thereof, including without limiting, all equipment described on
Exhibit A attached hereto and made a part hereof.
Debtor has no right to dispose of the equipment.
INSURANCE AUTHORIZATION AND VERIFICATION
Date: June 14, 2013 Property Schedule No: 1
From: U.S. Bancorp Government Leasing and Finance, Inc. (the
"Lessor")
To: County of Harnett (the "Lessee")
13010 SW 68th Parkway, Suite 100
Portland, OR 97223
Attn: Francine Neville
TO THE LESSEE: In connection with the above-referenced Property Schedule, Lessor requires proof in the form of this document
executed by both Lessee* and Lessee's agent, that Lessee's insurable interest in the financed property (the "Property") meets Lesso'r·s
requirements as follows, with coverage including, but not limited to, fire, extended coverage, vandalism, and theft:
Lessor, AND ITS SUCCESSORS AND ASSIGNS, shall be covered as both ADDITIONAL INSURED and LENDER'S LOSS
PAYEE with regard to all equipment financed or leased by policy holder through or from Lessor. All such insurance
shall contain a provision to the effect that such insurance shall not be canceled or modified Without first giving
written notice thereof to Lessor and Lessee at least thirty (30) days in advance of such cancellation or modification.
Lessee must carry GENERAL LIABILITY (and/or, for vehicles, Automobile Liability) in the amount of no less than
$1,000,000.00 (one million dollars).
Lessee must carry PROPERTY Insurance {or, for vehicles, Physical Damage Insurance) in an amount no less than the
'Insurable Value' $739,763.00, with deductibles no more than $10,000.00.
*Lessee: Please execute this form and return with your document package. Lessor will fax this form to your insurance agency for
endorsement. In lieu of agent endorsement, Lessee's agency may submit insurance certificates demonstrating compliance with all
requirements. If fully executed form (or Lessee-executed form plus certificates) is not provided within 15 days, we have the right to
purchase such insurance at your expense. Should you have any questions, please contact Francine Neville at 303-585-4077.
By signing, Lessee authorizes the Agent named below: 1) to complete and return this form as indicated; and 2) to endorse the
policy and subsequent renewals to reflect the required coverage as outlined above.
Agency/Agent: I
Address:
Phone/Fax: 1
Email:
Lessee: County of Harnett
Bv:
Name:
Title:
TO THE AGENT: In lieu of providing a certificate, please execute this form in the space below and promptly fax it to
Lessor at 303-585-4732. This fully endorsed form shall serve as proof that Lessee's insurance meets the above
requirements.
Agent hereby verifies that the above requirements have been met in regard to the Property listed below.
Print Name of Agency: X. _______________ _
By: x·------~~--~~-------(Agent's Signature)
Print Name: X'--------------
Insurable Value: $739,763.00
ATTACHED: PROPERTY DESCRIPTION FOR PROPERTY SCHEDULE NO.: 1
Date: X. _____________ _
Notification of Tax Treatment to Tax-Exempt Lease/Purchase Agreement
This Notification of Tax Treatment is pursuant to the Master Tax-Exempt Lease/Purchase Agreement
dated as of June 14, 2013 and the related Property Schedule No.1 dated June 14, 2013, between Lessor
and Lessee (the "Agreement").
X
Lessee agrees that this Property Schedule SHOULD be subject to sales/use taxes
Lessee agrees that this Property Schedule should NOT be subject to sales/use taxes and
Lessee has included our tax-exemption certificate with this document package
Lessee agrees that this Property Schedule should NOT be subject to sales/use taxes and no
tax-exemption certificate is issued to us by the State
Lessee agrees that this Property Schedule is a taxable transaction and subject to any/all
taxes
Lessee agrees that this Property Schedule is subject to sales/use taxes and will pay those
taxes directly to the State or Vendor
IN WITNESS WHEREOF, Lessee has caused this Notification of Tax Treatment to be executed by their duly
authorized representative.
. Lessee: County of Harnett
By:
Name:
Title:
Instructions for Form
8038-G
(Rev. September 2011)
~<Ji\ Department of the Treasury
~&/JJ Internal Revenue Service
Information Return for Tax-Exempt Governmental Obligations
Section references are to the Internal
Revenue Code unless otherwise noted.
General Instructions
Purpose of Form
Form 8038-G is used by issuers of
tax-exempt governmental obligations to
provide the IRS with the information
required by section i49(e) and to monitor
the requirements of sections i41 through
150.
Who Must File
IF the issue price THEN, for tax-exempt
(line 21, column (b)) governmental
is... obligations issued
after December 31,
1986, issuers must
file ...
$100,000 or more A separate Form
8038-G for each issue
Less than $100,000 Form 8038-GC,
Information Return for
Small Tax-Exempt
Governmental Bond
Issues, Leases, and
Installment Sales
For all build America bonds and
recovery zone economic
development bonds use Form
8038-B, Information Return for Build
America Bonds and Recovery Zone
Economic Development Bonds. For tax
credit bonds and specified tax credit
bonds use Form 8038-TC, Information
Return for Tax Credit Bonds and
Specified Tax Credit Bonds.
When To File
File Form 8038-G on or before the 15th
day of the 2nd calendar month after the
close of the calendar quarter in which the
bond is issued. Form 8038-G may not be
filed before the issue date and must be
completed based on the facts as of the
issue date.
Late filing. An issuer may be granted an
extension of time to file Form 8038-G
under Section 3 of Rev. Proc. 2002-48,
2002-371.R.B. 531, if it is determined that
the failure to file timely is not due to willful
neglect. Type or print at the top of the
form "Request for Relief under section 3
of Rev. Proc. 2002-48" and attach a letter
explaining why Form 8038-G was not
submitted to the IRS on time. Also
indicate whether the bond issue in
question is under examination by the IRS.
Do not submit copies of the trust
Sep 20,2011
indenture or other bond documents. See
Where To File next.
Where To File
File Form 8038-G, and any attachments,
with the Department of the Treasury,
Internal Revenue Service Center, Ogden,
UT 84201.
Private delivery services. You can use
certain private delivery services
designated by the IRS to meet the "timely
mailing as timely filing/paying" rule for tax
returns and payments. These private
delivery services include only the
following:
• DHL Express (DHL): DHL Same Day
Service.
• Federal Express (FedEx): FedEx
Priority Overnight, FedEx Standard
Overnight, FedEx 2Day, FedEx
International Priority, and FedEx
International First.
• United Parcel Service (UPS): UPS Next
Day Air, UPS Next Day Air Saver, UPS
2nd Day Air, UPS 2nd Day Air A.M., UPS
Worldwide Express Plus, and UPS
Worldwide Express.
The private delivery service can tell
you how to get written proof of the mailing
date.
Other Forms That May Be
Required
For rebating arbitrage (or paying a
penalty in lieu of arbitrage rebate) to the
Federal government, use Form 8038-T,
Arbitrage Rebate, Yield Reduction and
Penalty in Lieu of Arbitrage Rebate.
For private activity bonds, use Form
8038, Information Return for Tax-Exempt
Private Activity Bond Issues.
For build America bonds (Direct Pay),
build America bonds (Tax Credit), and
recovery zone economic development
bonds, complete Form 8038-B,
Information Return for Build America
Bonds and Recovery Zone Economic
Development Bonds.
For qualified forestry conservation
bonds, new clean renewable energy
bonds, qualified energy conservation
bonds, qualified zone academy bonds,
qualified school construction bonds, clean
renewable energy bonds, Midwestern tax
credit bonds, and all other qualified tax
credit bonds (except build America
bonds), file Form 8038-TC, Information
Return for Tax Credit Bonds and
Specified Tax Credit Bonds.
Cat. No. 637740
Rounding to Whole Dollars
You may show amounts on this return as
whole dollars. To do so, drop amounts
less than 50 cents and increase amounts
from 50 cents through 99 cents to the
next higher dollar.
Questions on Filing Form
8038-G
For specific questions on how to file Form
8038-G send an email to the IRS at
TaxExemptBondQuestions @irs.gov
and put "Form 8038-G Question" in the
subject line. In the email include a
des~ription of your question, a return
ema1l address, the name of a contact
person, and a telephone number.
Definitions
TaJ_C·e~em~t obligation. This is any
obligation, Including a bond, installment
purchase agreement, or financial lease
on which the interest is excluded from '
income under section 103.
Tax-exempt governmental obligation.
A tax-exempt obligation that is not a
private activity bond (see below) is a
tax-exempt governmental obligation. This
includes a .bond issued by a qualified
volunteer f1re department under section
150(e).
Private activity bond. This includes an
obligation issued as part of an issue in
which:
• More than 1 0% of the proceeds are to
be used for any private activity business
use, and
• More than 1 0% of the payment of
principal or interest of the issue is either
(a) secured by an interest in property to
be used for a private business use (or
payments for such property) or (b) to be
derived from payments for property (or
borrowed money) used for a private
business use.
It ~lso includes a bond, the proceeds
?f ~h1ch (a) are to be used directly or
md1rectly to make or finance loans (other
than loans described in section 141(c)(2))
to persons other than governmental units
and (b) exceeds the lesser of 5% of the
proceeds or $5 million.
lss.ue 1_3ric~. The issue price of
obligations 1s generally determined under
Regul~t1ons section 1.148-1(b). Thus,
whe~ 1ssu~d for cash, the issue price is
the f1rst pnce at which a substantial
amount of the obligations are sold to the
public. To determine the issue price of an
obli~ation issued for property, see
sections 1273 and 127 4 and the related
regulations.
Issue. Generally, obligations are treated
as part of the same issue if they are
issued by the same issuer, on the same
date, and in a single transaction, or a
series of related transactions. However,
obligations issued during the same
calendar year (a) under a loan agreement
under which amounts are to be advanced
periodically (a "draw-down loan") or (b)
with a term not exceeding 270 days, may
be treated as part of the same issue if the
obligations are equally and ratably
secured under a single indenture or loan
agreement and are issued under a
common financing arrangement (for
example, under the same official
statement periodically updated to reflect
changing factual circumstances). Also, for
obligations issued under a draw-down
loan that meet the requirements of the
preceding sentence, obligations issued
during different calendar years may be
treated as part of the same issue if all of
the amounts to be advanced under the
draw-down loan are reasonably expected
to be advanced within 3 years of the date
of issue of the first obligation. Likewise,
obligations (other than private activity
bonds) issued under a single agreement
that is in the form of a lease or installment
sale may be treated as part of the same
issue if all of the property covered by that
agreement is reasonably expected to be
delivered within 3 years of the date of
issue of the first obligation.
Arbitrage rebate. Generally, interest on
a state or local bond is not tax-exempt
unless the issuer of the bond rebates to
the United States arbitrage profits earned
from investing proceeds of the bond in
higher yielding nonpurpose investments.
See section 148(f).
Construction issue. This is an issue of
tax-exempt bonds that meets both of the
following conditions:
1. At least 75% of the available
construction proceeds are to be used for
construction expenditures with respect to
property to be owned by a governmental
unit or a section 501 {c)(3) organization,
and
2. All the bonds that are part of the
issue are qualified 501 {c){3) bonds,
bonds that are not private activity bonds,
or private activity bonds issued to finance
property to be owned by a governmental
unit or a section 501 (c)(3) organization.
In lieu of rebating any arbitrage that
may be owed to the United States, the
issuer of a construction issue may make
an irrevocable election to pay a penalty.
The penalty is equal to 1112% of the
amount of construction proceeds that do
not meet certain spending requirements.
See section 148(f){4){C) and the
Instructions for Form 8038-T.
Specific Instructions
Part !-Reporting Authority
Amended return. An issuer may file an
amended return to change or add to the
information reported on a previously filed
return for the same date of issue. If you
are filing to correct errors or change a
previously filed return, check the
Amended Return box in the heading of
the form.
The amended return must provide all
the information reported on the original
return, in addition to the new or corrected
information. Attach an explanation of the
reason for the amended return and write
across the top, "Amended Return
Explanation." Failure to attach an
explanation may result in a delay in
processing the form.
Line 1. The issuer's name is the name of
the entity issuing the obligations, not the
name of the entity receiving the benefit of
the financing. For a lease or installment
sale, the issuer is the lessee or the
purchaser.
Line 2. An issuer that does not have an
employer identification number (EIN)
should apply for one on Form SS-4,
Application for Employer Identification
Number. You can get this form on the IRS
website at IRS.gov or by calling
1-800-TAX-FORM (1-800-829-3676). You
may receive an EIN by telephone by
following the instructions for Form SS-4.
Line 3a. If the issuer wishes to authorize
a person other than an officer or other
employee of the issuer (including a legal
representative or paid preparer) to
communicate with the IRS and whom the
IRS may contact about this return
(including in writing or by telephone),
enter the name of such person here. The
person listed in line 3a must be an
individual. Do not enter the name and title
of an officer or other employee of the
issuer here (use line 1 Oa for that
purpose).
Note. By authorizing a person other than
an authorized officer or other employee of
the issuer to communicate with the IRS
and whom the IRS may contact about this
return, the issuer authorizes the IRS to
communicate directly with the individual
entered on line 3a and consents to
disclose the issuer's return information to
that individual, as necessary, to process
this return.
Lines 4 and 6. If you listed an individual
on line 3a to communicate with the IRS
and whom the IRS may contact about this
return, enter the number and street (or
P.O. box if mail is not delivered to street
address), city, town, or post office, state,
and ZIP code of that person. Otherwise,
enter the issuer's number and street {or
P.O. box if mail is not delivered to street
address), city, town, or post office, state,
and ZIP code.
Note. The address entered on lines 4
and 6 is the address the IRS will use for
all written communications regarding the
processing of this return, including any
notices.
Line 5. This line is for IRS use only. Do
not make any entries in this box.
Line 7. The date of issue is generally the
date on which the issuer physically
-2-
exchanges the bonds that are part of the
issue for the underwriter's (or other
purchaser's) funds. For a lease or
installment sale, enter the date interest
starts to accrue in a MM/DD/YYYY
format.
Line 8. If there is no name of the issue
please provide other identification of the'
issue.
Line 9. Enter the CUSIP {Committee on
Uniform Securities Identification
Procedures) number of the bond with the
latest maturity. If the issue does not have
a CUSIP number, write "None."
Line 10a. Enter the name and title of the
officer or other employee of the issuer
whom the IRS may call for more
information. If the issuer wishes to
designate a person other than an officer
or other employee of the issuer {including
a legal representative or paid pre parer)
whom the IRS may call for more
information about the return enter the
name, title, and telephone n'umber of
such person on lines 3a and 3b.
Complete lines 10a and 10b even
if you complete lines 3a and 3b.
Part II-Type of Issue
Elections referred to in Part II are
made on the original bond
documents, not on this form.
ldent~fy the type of obligations issued
by entenng t~e corresponding issue price
(see Issue pnce under Definitions earlier).
Attach a schedule listing names and EINs
of organizations that are to use proceeds
of these obligations, if different from those
of the issuer, include a brief summary of
the use and indicate whether or not such
user is a governmental or
nongovernmental entity.
Line 18. Enter a description of the issue
in the space provided.
Line 19. If the obligations are short-term
tax anticipation notes or warrants (TANs)
or short-term revenue anticipation notes
or warrants (RANs), check box 19a. If the
obligations are short-term bond
anticipati.on notes (BANs), issued with the
expectation that they will be refunded with
the proceeds of long-term bonds at some
future date, check box 19b. Do not check
both boxes.
Line 20. s;heck this box if property other
than cash IS exchanged for the obligation,
for example, acquiring a police car, a fire
tru~k, or telephone equipment through a
ser.1es ?f n:'onthly payments. (This type of
obligatiOn IS sometimes referred to as a
"municipal lease.") Also check this box if
real property is directly acquired in
exchange for an obligation to make
periodic payments of interest and
principal. Do not check this box if the
proceeds of the obligation are received in
the form of cash, even if the term "lease"
is used in the title of the issue.
Part Ill-Description of
Obligations
Line 21. For column (a), the final
maturity date is the last date the issuer
must redeem the entire issue.
For column (b), see Issue price under
Definitions earlier.
For column (c), the stated redemption
price at maturity of the entire issue is the
sum of the stated redemption prices at
maturity of each bond issued as part of
the issue. For a lease or installment sale,
write "N/A" in column (c).
For column (d), the weighted average
maturity is the sum of the products of the
issue price of each maturity and the
number of years to maturity (determined
separately for each maturity and by taking
into account mandatory redemptions),
divided by the issue price of the entire
issue (from line 21, column (b)). For a
lease or installment sale, enter instead
the total number of years the lease or
installment sale will be outstanding.
For column (e), the yield, as defined in
section 148(h), is the discount rate that,
when used to compute the present value
of all payments of principal and interest to
be paid on the obligation, produces an
amount equal to the purchase price,
including accrued interest. See
Regulations section 1.148-4 for specific
rules to compute the yield on an issue. If
the issue is a variable rate issue, write
"VR" as the yield of the issue. For other
than variable rate issues, carry the yield
out to four decimal places (for example,
5.3125%). If the issue is a lease or
installment sale, enter the effective rate of
interest being paid.
Part IV-Uses of Proceeds of
Bond Issue
For a lease or installment sale, write "N/A"
in the space to the right of the title for Part
IV.
Line 22. Enter the amount of proceeds
that will be used to pay interest from the
date the bonds are dated to the date of
issue.
Line 24. Enter the amount of the
proceeds that will be used to pay bond
issuance costs, including fees for trustees
and bond counsel. If no bond proceeds
will be used to pay bond issuance costs,
enter zero. Do not leave this line blank.
Line 25. Enter the amount of the
proceeds that will be used to pay fees for
credit enhancement that are taken into
account in determining the yield on the
issue for purposes of section 148(h) (for
example, bond insurance premiums and
certain fees for letters of credit).
Line 26. Enter the amount of proceeds
that will be allocated to such a fund.
Line 27. Enter the amount of the
proceeds that will be used to pay
principal, interest, or call premium on any
other issue of bonds within 90 days of the
date of issue.
Line 28. Enter the amount of the
proceeds that will be used to pay
principal, interest, or call premium on any
other issue of bonds after 90 days of the
date of issue, including proceeds that will
be used to fund an escrow account for
this purpose.
Part V-Description of
Refunded Bonds
Complete this part only if the bonds are to
be used to refund a prior issue of
tax-exempt bonds. For a lease or
installment sale, write "N/A" in the space
to the right of the title for Part V.
Lines 31 and 32. The remaining
weighted average maturity is determined
without regard to the refunding. The
weighted average maturity is determined
in the same manner as on line 21, column
(d).
Line 34. If more than a single issue of
bonds will be refunded, enter the date of
issue of each issue. Enter the date in an
MM/DD/YYYY format.
Part VI-Miscellaneous
Line 35. An allocation of volume cap is
required if the nonqualified amount for the
issue is more than $15 million but is not
more than the amount that would cause
the issue to be private activity bonds.
Line 36. If any portion of the gross
proceeds of the issue is or will be
invested in a guaranteed investment
contract (GIG), as defined in Regulations
section 1.148-1 (b), enter the amount of
the gross proceeds so invested, as well
as the final maturity date of the GIG and
the name of the provider of such contract.
Line 37. Enter the amount of the
proceeds of this issue used to make a
loan to another governmental unit, the
interest of which is tax-exempt.
Line 38. If the issue is a loan of
proceeds from another tax-exempt issue,
check the box and enter the date of issue,
EIN, and name of issuer of the master
pool obligation.
Line 40. Check this box if the issue is a
construction issue and an irrevocable
election to pay a penalty in lieu of
arbitrage rebate has been made on or
before the date the bonds were issued.
The penalty is payable with a Form
8038-T for each 6-month period after the
date the bonds are issued. Do not make
any payment of penalty in lieu of arbitrage
rebate with this form. See Rev. Proc.
92-22, 1992-1 G.B. 736 for rules
regarding the "election document."
Line 41a. Check this box if the issuer
has identified a hedge on its books and
records according to Regulations sections
1.148-4(h)(2)(viii) and 1.148-4(h)(5) that
permit an issuer of tax-exempt bonds to
identify a hedge for it to be included in
yield calculations for computing arbitrage.
Line 42. In determining if the issuer has
super-integrated a hedge, apply the rules
of Regulations section 1.148-4(h)(4). If
the hedge is super-integrated, check the
box.
Line 43. If the issuer takes a "deliberate
action" after the issue date that causes
-3-
the conditions of the private business
tests or the private loan financing test to
be met, then such issue is also an issue
of private activity bonds. Regulations
section 1.141-2(d)(3) defines a deliberate
action as any action taken by the issuer
that is within its control regardless of
whether there is intent to violate such
tests. Regulations section 1.141-12
ex~lains the conditions to taking remedial
act1on that prevent an action that causes
an issue to meet the private business
tests or private loan financing test from
being treated as a deliberate action.
Check the box if the issuer has
established written procedures to ensure
timely remedi~l action for all nonqualified
bonds accordmg to Regulations section
1.141-12 or other remedial actions
authorized by the Commissioner under
Regulations section 1.141-12(h).
Line 44. Check the box if the issuer has
established written procedures to monitor
compli<;mce with the arbitrage, yield
restnct1on, and rebate requirements of
section 148.
Line 45a. Check the box if some part of
the proceeds was used to reimburse
expenditures. Figure and then enter the
amount of proceeds that are used to
reimb~~se the issuer for amounts paid for
a qualified purpose prior to the issuance
of the bonds. See Regulations section
1.150-2.
Li':l~ 4~b. An issuer must adopt an
off1c1al mtent to reimburse itself for
preissuance expenditures within 60 days
after payment of the original expenditure
unless excepted by Regulations section
1.150-2(f). Enter the date the official
inte~t was adopted. See Regulations
sect1on 1 .150-2( e) for more information
about official intent.
Signature and Consent
An authorized representative of the issuer
mus~ sign Forn: _80~8-G and any
applicable ~ert1f1catJOn. Also print the
name and t1tle of the person signing Form
8038-G. The authorized representative of
the issuer signing this form must have the
authority to consent to the disclosure of
the issuer's return information, as
necessary to process this return, to the
person(s) that have been designated in
Form 8038-G.
Note. If t_he issuer in Part 1 , lines 3a and
3b authonzes the IRS to communicate
(i~cluding in writing and by telephone)
With a person other than an officer or
ot~er employ~e of the issuer, by signing
th1s form, the Issuer's authorized
representative consents to the disclosure
of the issuer's return information, as
necessary to process this return, to such
person.
Paid Preparer
If an authorized officer of the issuer filled
in this return, the paid preparer's space
should remain blank. Anyone who
prepares ~he _return but does not charge
the orgamzat1on should not sign the
return. Certain others who prepare the
return should not sign. For example, a
regular, full-time employee of the issuer,
such as a clerk, secretary, etc., should
not sign.
Generally, anyone who is paid to
prepare a return must sign it and fill in the
other blanks in the Paid Preparer Use
Only area of the return.
The paid preparer must:
e Sign the return in the space provided
for the preparer's signature (a facsimile
signature is acceptable),
• Enter the preparer information, and
e Give a copy of the return to the issuer.
Paperwork Reduction Act Notice. We
ask for the information on this form to
carry out the Internal Revenue laws of the
United States. You are required to give us
the information. We need it to ensure that
you are complying with these laws.
You are not required to provide the
information requested on a form that IS
subject to the Paperwork Reduction Act
unless the form displays a valid OMS
control number. Books or records relating
to a form or its instructions must be
retained as long as their contents may
become material in the administration of
any Internal Revenue law. Generally, tax
returns and return information are
confidential, as required by section 6103.
The time needed to complete and file
this form varies depending on individual
circumstances. The estimated average
time is:
-4-
Learning about the law or
the form ............ .
Preparing, copying,
assembling, and sending
the form to the IRS ..... .
2 hr., 41 min.
3 hr., 3 min.
If you have comments concerning the .
accuracy of these time estimates or
suggestions for making this form simpler,
we would be happy to hear from you. You
can write to the Internal Revenue Service,
Tax Products Coordinating Committee,
SE:W:CAR:MP:T:M:S, 1111 Constitution
Ave. NW, IR-6526, Washington, DC
20224. Do not send the form to this
office. Instead, see Where To File.
Form8038•G Information Return for Tax-Exempt Governmental Obligations
(Rev. September 2011) II-Under Internal Revenue Code section 149(e) OMB No. 1545-0720
Department of the Treasury II-See separate instructions.
Internal Revenue Service Caution: If the issue price is under $100,000, use Form 8038-GC. . . Reporting Authority If Amended Return, check here 111>-0
1 Issuer's name 2 Issuer's employer identification number (EIN)
3a Name of person (other than issuer) with whom the IRS may communicate about this return (see instructions) 3b Telephone number of other person shown on 3a
4 Number and street (or P.O. box if mail is not delivered to street address) I Room/suite 5 Report number (For IRS Use Only)
!31 .• , ..
6 City, town, or post office, state, and ZIP code 7 Date of issue
8 Name of issue 9 CUSIP number
10a Name and title of officer or other employee of the issuer whom the IRS may call for more information (see 10b Telephone number of officer or other
instructions) employee shown on 1 Oa
II:F.T'iHIIIII Type of Issue (enter the issue price). See the instructions and attach schedule.
11 Education. 11
12 Health and hospital 12
13 Transportation 13
14 Public safety . 14
15 Environment (including sewage bonds) 15
16 Housing 16
17 Utilities 17
18 Other. Describe Ill>-18
19 If obligations are TANs or RANs, check only box 19a ..... 0
If obligations are BANs, check only box 19b ..... 0
20 If obligations are in the form of a lease or installment sale, check box ..... 0
ll:.m'iiiilll II Description of Obligations. Complete for the entire issue for which this form is being filed.
(a) Final maturity date (b) Issue price (c) Stated redemption (d) Weighted
(e) Yield price at maturity average maturity
21 $ $ vears %
l::lmiilll ~'AI Uses of Proceeds of Bond Issue (including underwriters' discount)
22 Proceeds used for accrued interest 22
23 Issue price of entire issue (enter amount from line 21, column (b)) 23
24 Proceeds used for bond issuance costs (including underwriters' discount) . 24
25 Proceeds used for credit enhancement 25
26 Proceeds allocated to reasonably required reserve or replacement fund 26
27 Proceeds used to currently refund prior issues 27
28 Proceeds used to advance refund prior issues 28
29 Total (add lines 24 through 28) . 29
30 Nonrefunding proceeds of the issue (subtract line 29 from line 23 and enter amount here) 30
II:F.ml'll Description of Refunded Bonds. Complete this part only for refunding bonds. .. 31 Enter the remammg weighted average matunty of the bonds to be currently refunded . 111>-years
32 Enter the remaining weighted average maturity of the bonds to be advance refunded 111-years
33 Enter the last date on which the refunded bonds will be called (MM/DDIYYYY) 111-
34 Enter the date(s) the refunded bonds were issued Ill>-(MM/DD!YYYYJ
For Paperwork Reduction Act Notice, see separate instructions. cat. No. 63773S Form 8038-G (Rev. 9-2011)
Form 8038-G (Rev 9-2011) P ge2 a
l:.l;'!iiill'll Miscellaneous
35 Enter the amount of the state volume cap allocated to the issue under section 141 (b)(5) 35
36a Enter the amount of gross proceeds invested or to be invested in a guaranteed investment contract
(GIG) (see instructions) 36a
b Enter the final maturity date of the GIG~
c Enter the name of the GIG provider~
37 Pooled financings: Enter the amount of the proceeds of this issue that are to be used to make loans
to other governmental units 37
38a If th1s 1ssue IS a loan made from the proceeds of another tax-exempt issue, check box ~ 0 and enter the following information:
b Enter the date of the master pool obligation~ ---------------------
c Enter the EIN of the issuer of the master pool obligation~-----------------
d Enter the name of the issuer of the master pool obligation ~ --------------:-:------:---
39 If the issuer has designated the issue under section 265(b)(3)(8)(i)(lll) (small issuer exception), check box
40 If the issuer has elected to pay a penalty in lieu of arbitrage rebate, check box .
41a
b
If the issuer has identified a hedge, check here~ 0 and enter the following information:
Name of hedge provider~
c Type of hedge~ ------------------
d Term of hedge~ ------------------
0
0
42 If the issuer has superintegrated the hedge, check box ~ 0
43 If the issuer has established written procedures to ensure that all nonqualified bonds of this issue are remediated
according to the requirements under the Code and Regulations (see instructions), check box . ~
44 If the issuer has established written procedures to monitor the requirements of section 148, check box . . ~
45a If some portion of the proceeds was used to reimburse expenditures, check here~ 0 and enter the amount
of reimbursement . . ~
b Enter the date the official intent was adopted ~ --------------------
0
0
Signature
and
Consent
Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge
and belief, they are true, correct, and complete. I further declare that I consent to the IRS's disclosure of the issuer's return information, as necessary to
process this return, to the person that I have authorized above.
Paid
Pre parer
Use Only
~ Signature of issuer's authorized representative Date
PrinVType preparer's name I Preparer's signature
Firm's name .,.
Firm's address .,.
~ Type or print name and title
I Date I Check 0 if I PTIN
self-employed I
I Firm's EIN ..,.
I Phone no.
Form 8038-G {Rev. 9-2011)
ESCROW AGREEMENT
THIS EscRow AGREEMENT ("Escrow Agreement') is made as of June 14, 2013 by and among U.S.
Bancorp Government Leasing and Finance, Inc. ("Lessor'}, County of Harnett ("Lessee') and U.S. BANK
NATIONAL ASSOCIATION, as escrow agent ("Escrow Agent').
Lessor and Lessee have heretofore entered into that certain Master Tax-Exempt Lease/Purchase
Agreement dated as of June 14, 2013 (the "Master Agreement') and a Property Schedule No. 1 thereto
dated June 14, 2013 (the "Schedule" and, together with the terms and conditions of the Agreement
incorporated therein, the "Agreement'}. The Schedule contemplates that certain personal property
described therein (the "Equipment') is to be acquired from the vendor(s) or manufacturer(s) thereof (the
"Vendor'}. After acceptance of the Equipment by Lessee, the Equipment is to be financed by Lessor to
Lessee pursuant to the terms of the Agreement.
The Master Agreement further contemplates that Lessor will deposit an amount equal to the
anticipated aggregate acquisition cost of the Equipment (the "Purchase Price'}, being $739,763.00, with
Escrow Agent to be held in escrow and applied on the express terms set forth herein. Such deposit,
together with all interest and other additions received with respect thereto (hereinafter the "Escrow Fund")
is to be applied to pay the Vendor its invoice cost (a portion of which may, if required, be paid prior to final
acceptance of the Equipment by Lessee); and, if applicable, to reimburse Lessee for progress payments
already made by it to the Vendor of the Equipment.
The parties desire to set forth the terms on which the Escrow Fund is to be created and to
establish the rights and responsibilities of the parties hereto.
Now, THEREFORE, in consideration of the sum of Ten Dollars ($1 0.00) in hand paid, and other
good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the
parties agree as follows:
1. Escrow Agent hereby agrees to serve as escrow agent upon the terms and conditions set forth
herein. The moneys and investments held in the Escrow Fund are irrevocably held in trust for the benefit
of Lessee and Lessor, and such moneys, together with any income or interest earned thereon, shall be
expended only as provided in this Escrow Agreement, and shall not be subject to levy or attachment or
lien by or for the benefit of any creditor of either Lessee or Lessor. Lessor, Lessee and Escrow Agent
intend that the Escrow Fund constitute an escrow account in which Lessee has no legal or equitable right,
title or interest until satisfaction in full of all conditions contained herein for the disbursement of funds by
the Escrow Agent therefrom. However, if the parties' intention that Lessee shall have no legal or
equitable right, title or interest until all conditions for disbursement are satisfied in full is not respected in
any legal proceeding, the parties hereto intend that Lessor have a security interest in the Escrow Fund,
and such security interest is hereby granted by Lessee to secure payment of all sums due to Lessor
under the Master Agreement. For such purpose, Escrow Agent hereby agrees to act as agent for Lessor
in connection with the perfection of such security interest and agrees to note, or cause to be noted, on all
books and records relating to the Escrow Fund, the Lessor's interest therein.
2. On such day as is determined to the mutual satisfaction of the parties (the "Closing Date'),
Lessor shall deposit with Escrow Agent cash in the amount of the Purchase Price, to be held in escrow by
Escrow Agent on the express terms and conditions set forth herein.
On the Closing Date, Escrow Agent agrees to accept the deposit of the Purchase Price by
Lessor, and further agrees to hold the amount so deposited together with all interest and other additions
received with respect thereto, as the Escrow Fund hereunder, in escrow on the express terms and
conditions set forth herein.
3. Escrow Agent shall at all times segregate the Escrow Fund into an account maintained for
that express purpose, which shall be clearly identified on the books and records of Escrow Agent as
being held in its capacity as Escrow Agent. Securities and other negotiable instruments comprising the
Escrow Fund from time to time shall be held or registered in the name of Escrow Agent (or its nominee).
The Escrow Fund shall not, to the extent permitted by applicable law, be subject to levy or attachment or
lien by or for the benefit of any creditor of any of the parties hereto (except with respect to the security
interest therein held by Lessor).
4. The cash comprising the Escrow Fund from time to time shall be invested and reinvested
by Escrow Agent in one or more investments as directed by Lessee. Absent written direction from
Lessee, the cash will be invested in the U.S. Bank National Association Money Market Deposit Fund. See
Exhibit 1 Investment Direction Letter. Lessee represents and warrants to Escrow Agent and Lessor that
the investments selected by Lessee for investment of the Escrow Fund are permitted investments for
Lessee under all applicable laws. Escrow Agent will use due diligence to collect amounts payable under
a check or other instrument for the payment of money comprising the Escrow Fund and shall promptly
notify Lessee and Lessor in the event of dishonor of payment under any such check or other instruments.
Interest or other amounts earned and received by Escrow Agent with respect to the Escrow Fund shall be
deposited in and comprise a part of the Escrow Fund. Escrow Agent shall maintain accounting records
sufficient to permit calculation of the income on investments and interest earned on deposit of amounts
held in the Escrow Fund. The parties acknowledge that to the extent regulations of the Comptroller of
Currency or other applicable regulatory entity grant a right to receive brokerage confirmations of security
transactions of the escrow, the parties waive receipt of such confirmations, to the extent permitted by law.
The Escrow Agent shall furnish a statement of security transactions on its regular monthly reports.
Attached as Exhibit 6 is the Class Action Negative Consent Letter to be reviewed by Lessee.
5. Upon request by Lessee and Lessor, Escrow Agent shall send monthly statements of
account to Lessee and Lessor, which statements shall set forth all withdrawals from and interest earnings
on the Escrow Fund as well as the investments in which the Escrow Fund is invested.
6. Escrow Agent shall take the following actions with respect to the Escrow Fund:
(a) Upon Escrow Agent's acceptance of the deposit of the Purchase Price, an
amount equal to Escrow Agent's set-up fee, as set forth on Exhibit 2 hereto, shall be disbursed
from the Escrow Fund to Escrow Agent in payment of such fee.
(b) Escrow Agent shall pay costs of the Equipment upon receipt of a duly executed
Requisition Request (substantially in the format of Exhibit 3) signed by Lessor and Lessee.
Lessor's authorized signatures are provided in Exhibit 5. Lessee's authorized signatures will be
provided in Exhibit 3 of Master Lease Purchase Agreement. Escrow Agent will use best efforts to
process requests for payment within one (1) business day of receipt of requisitions received prior
to 2:00 p.m. Central Time. The final Requisition shall be accompanied by a duly executed
Acceptance Certificate form attached as Exhibit 4 hereto.
(c) Upon receipt by Escrow Agent of written notice from Lessor that an Event of
Default or an Event of Nonappropriation (if provided for under the Master Agreement) has
occurred under the Agreement, all funds then on deposit in the Escrow Fund shall be paid to
Lessor for application in accordance with the Master Agreement, and this Escrow Agreement
shall terminate.
(d) Upon receipt by Escrow Agent of written notice from Lessor that the purchase
price of the Equipment has been paid in full, Escrow Agent shall pay the funds then on deposit in
the Escrow Fund to Lessor to be applied first to the next Lease Payment due under the Master
Agreement, and second, to prepayment of the principal component of Lease Payments in inverse
order of maturity without premium. To the extent the Agreement is not subject to prepayment,
Lessor consents to such prepayment to the extent of such prepayment amount from the Escrow
Fund. Upon disbursement of all amounts in the Escrow Fund, this Escrow Agreement shall
terminate.
(e) This Escrow Agreement shall terminate eighteen (18) months from the date of
this Escrow Agreement. It may, however, be extended by mutual consent of Lessee and Lessor
in writing to Escrow Agent. All funds on deposit in the Escrow Fund at the time of termination
under this paragraph, unless otherwise directed by Lessee in writing (electronic means
acceptable), shall be transferred to Lessor.
7. The fees and expenses, including any legal fees, of Escrow Agent incurred in connection
herewith shall be the responsibility of Lessee. The basic fees and expenses of Escrow Agent shall be as
set forth on Exhibit 2 and Escrow Agent is hereby authorized to deduct such fees and expenses from the
Escrow Fund as and when the same are incurred without any further authorization from Lessee or
Lessor. Escrow Agent may employ legal counsel and other experts as it deems necessary for advice in
connection with its obligations hereunder. Escrow Agent waives any claim against Lessor with respect to
compensation hereunder.
8. Escrow Agent shall have no liability for acting upon any written instruction presented by Lessor in
connection with this Escrow Agreement, which Escrow Agent in good faith believes to be genuine.
Furthermore, Escrow Agent shall not be liable for any act or omission in connection with this Escrow
Agreement except for its own negligence, willful misconduct or bad faith. Escrow Agent shall not be liable
for any loss or diminution in value of the Escrow Fund as a result of the investments made by Escrow
Agent.
9. Escrow Agent may resign at any time by giving thirty (30) days' prior written notice to
Lessor and Lessee. Lessor may at any time remove Escrow Agent as Escrow Agent under this Escrow
Agreement upon written notice. Such removal or resignation shall be effective on the date set forth in the
applicable notice. Upon the effective date of resignation or removal, Escrow Agent will transfer the
Escrow Fund to the successor Escrow Agent selected by Lessor.
10. Lessee hereby represents, covenants and warrants that pursuant to Treasury Regulations
Section 1.148-?(d), the gross proceeds of the Agreement will be expended for the governmental
purposes for which the Agreement was entered into, as follows: at least 15% within six months after the
Commencement Date, such date being the date of deposit of funds into the Escrow Fund, at least 60%
within 12 months after the Commencement Date, and 100% within 18 months after the Commencement
Date. If Lessee is unable to comply with Section 1.148-?(d) of the Treasury Regulations, Lessee shall, at
its sole expense and cost, compute rebatable arbitrage on the Agreement and pay rebatable arbitrage to
the United States at least once every five years, and within 60 days after payment of the final rental or
Lease Payment due under the Agreement.
11. In the event of any disagreement between the undersigned or any of them, and/or any
other person, resulting in adverse claims and demands being made in connection with or for any moneys
involved herein or affected hereby, Escrow Agent shall be entitled at its option to refuse to comply with
any such claim or demand, so long as such disagreement shall continue, and in so refusing Escrow
Agent may refrain from making any delivery or other disposition of any moneys involved herein or
affected hereby and in so doing Escrow Agent shall not be or become liable to the undersigned or any of
them or to any person or party for its failure or refusal to comply with such conflicting or adverse
demands, and Escrow Agent shall be entitled to continue so to refrain and refuse so to act until:
(a) the rights of the adverse claimants have been finally adjudicated in a court assuming
and having jurisdiction of the parties and the moneys involved herein or affected hereby; or
(b) all differences shall have been adjusted by Master Agreement and Escrow Agent
shall have been notified thereof in writing signed by all of the persons interested.
12. All notices (excluding billings and communications in the ordinary course of business)
hereunder shall be in writing, and shall be sufficiently given and served upon the other party if delivered
(a) personally, (b) by United States registered or certified mail, return receipt requested, postage prepaid,
(c) by an overnight delivery by a service such as Federal Express or Express Mail from which written
confirmation of overnight delivery is available, or (d) by facsimile with a confirmation copy by regular
United States mail, postage prepaid, addressed to the other party at its respective address stated below
the signature of such party or at such other address as such party shall from time to tirne designate in
writing to the other party, and shall be effective from the date of mailing.
13. This Escrow Agreement shall inure to the benefit of and shall be binding upon the parties
hereto and their respective successors and assigns. No rights or obligations of Escrow Agent under this
Escrow Agreement may be assigned without the prior written consent of Lessor.
14. This Escrow Agreement shall be governed by and construed in accordance with the laws in
the state of the Escrow Agent's location. This Escrow Agreement constitutes the entire Agreement
between the parties hereto with respect to the subject matter hereof, and no waiver, consent, modification
or change of terms hereof shall bind any party unless in writing signed by all parties.
15. This Escrow Agreement and any written direction may be executed in two or more
counterparts, which when so executed shall constitute one and the same agreement or direction.
IN WITNESS WHEREOF, the parties hereto have caused this Escrow Agreement to be duly
executed as of the day and year first above set forth.
U.S. Bancorp Government Leasing and
Finance, Inc., as Lessor
By:
Name:
Title:
Address: 13010 SW 68tr Parkway, Suite 100
Portland, OR 97223
County of Harnett, as Lessee
By:
Name:
Title:
Address: P.O. Box 760
Lillinqton, NC 27546
U.S. BANK NATIONAL ASSOCIATION, as Escrow
Agent
By:
Name:
Title:
Address: U.S. Bank National Association
950 17th Street, 1ih Floor
Denver, CO 80202
U.S. Bank National Association
950 17th Street, 12th Floor
Denver, CO 80202
EXHIBIT 1
INVESTMENT DIRECTION LETTER
Re: Escrow Agreement dated as of June 14, 2013, U.S. Bancorp Government Leasing and
Finance, Inc. as Lessor, County of Harnett as Lessee, and U.S Bank National Association as
Escrow Agent
Ladies and Gentlemen:
Pursuant to the above-referenced Escrow Agreement, $739,763.00 will be deposited in escrow
with you on or about June 14, 2013. Such funds shall be invested in one or more of the following
qualified investments in the amounts indicated:
U.S. Bank Money Market Deposit Account
Agent is hereby directed to deposit and invest funds in the U.S. Bank Money Market Deposit Savings
Account. Depositors acknowledge that the U. S. Bank Money Market Deposit Account is a U. S. Bank
National Association ("U.S. Bank") interest-bearing money market deposit account designed to meet the
needs of U.S. Bank's Corporate Trust Services Escrow Group and other Corporate Trust customers of
U.S. Bank. Selection of this investment includes authorization to place funds on deposit with U.S. Bank.
U. S. Bank uses the daily balance method to calculate interest on this account (actual/365 or 366). This
method applies a daily periodic rate to the principal balance in the account each day. Interest is accrued
daily and credited monthly to the account. Interest rates currently offered on the accounts are determined
at U. S. Bank's discretion and may be tiered by customer deposit amount. The owner of the accounts is
U. S. Bank as Agent for its trust customers. U.S. Bank's trust department performs all account deposits
and withdrawals. Each customer's deposit is insured by the Federal Deposit Insurance Corporation as
determined under FDIC Regulations, up to applicable FDIC limits. Any and all interest earned on the
Assets after the deposit shall be added to the Assets and shall become a part thereof. Agent shall
thereafter hold, maintain and utilize the Assets pursuant to the terms and conditions of this Agreement.
Depositors shall provide Agent with a W-9 or original W-8 IRS tax form prior to the disbursement of
interest and Agent will file the appropriate 1099 or other required forms pursuant to Federal and North
Carolina laws. A statement of citizenship will be provided if requested by Agent. Agent shall not be
responsible for maximizing the yield on the Assets. Agent shall not be liable for losses, penalties or
charges incurred upon any sale or purchase of any such investment.
Very truly yours,
County of Harnett, as Lessee
By:
Name:
Title:
EXHIBIT2
Schedule of Fees for Services as
Escrow Agent
For
County of Harnett
Equipment Lease Purchase Escrow
CTS01010A Acceptance Fee The acceptance fee includes the administrative review of WAIVED
documents, initial set-up of the account, and other reasonably required
services up to and including the closing. This is a one-time, non-refundable
fee, payable at closing.
CTS04460 Escrow Agent Annual fee for the standard escrow agent services WAIVED
associated with the administration of the account. Administration fees are
payable in advance.
Direct Out of Pocket Expenses Reimbursement of expenses associated
with the performance of our duties, including but not limited to publications,
legal counsel after the initial close, travel expenses and filing fees.
Extraordinary Services Extraordinary Services are duties or
responsibilities of an unusual nature, including termination, but not provided
for in the governing documents or otherwise set forth in this schedule. A
reasonable charge will be assessed based on the nature of the services and
the responsibility involved. At our option, these charges will be billed at a flat
fee or at our hourly rate then in effect.
At Cost
Account approval is subject to review and qualification. Fees are subject to change at our
discretion and upon written notice. Fees paid in advance will not be prorated. The fees set
forth above and any subsequent modifications thereof are part of your agreement.
Finalization of the transaction constitutes agreement to the above fee schedule, including
agreement to any subsequent changes upon proper written notice. In the event your
transaction is not finalized, any related out-of-pocket expenses will be billed to you directly.
Absent your written instructions to sweep or otherwise invest, all sums in your account will
remain uninvested and no accrued interest or other compensation will be credited to the
account. Payment of fees constitutes acceptance of the terms and conditions set forth.
IMPORTANT INFORMATION ABOUT PROCEDURES FOR OPENING A NEW
ACCOUNT:
To help the government fight the funding of terrorism and money laundering
activities, Federal law requires all financial institutions to obtain, verify and record
information that identifies each person who opens an account.
For a non-individual person such as a business entity, a charity, a Trust or other legal
entity we will ask for documentation to verify its formation and existence as a legal
entity. We may also ask to see financial statements, licenses, identification and
authorization documents from individuals claiming authority to represent the entity or
other relevant documentation.
EXHIBIT 3
REQUISITION REQUEST
The Escrow Agent is hereby requested to pay from the Escrow Fund established and maintained under
that certain Escrow Agreement dated as of June 14, 2013 (the "Escrow Agreement") by and among U.S. Bancorp
Government Leasing and Finance, Inc. (the "Lessor"), County of Harnett (the "Lessee''), and U.S. Bank National
Association (the "Escrow Agent"), the amount set forth below to the named payee(s). The amount shown is due
and payable under a purchase order or contract (or has been paid by and not previously reimbursed to Lessee)
with respect to equipment being financed under that certain Master Tax-Exempt Lease Purchase Agreement
dated as of June 14, 2013 (the "Master Agreement'') and Property Schedule No.1 thereto dated June 14, 2013
(the "Schedule" and, together with the terms and conditions of the Master Agreement incorporated therein, the
"Master Agreement"), by and between the Lessor and the Lessee, and has not formed the basis of any prior
requisition request.
PAYEE AMOUNT INVOICE NO. EQUIPMENT
Total requisition amount $ _____ _
The undersigned, as Lessee under the Master Agreement, hereby certifies:
1. The items of the Equipment being acquired with the proceeds of this disbursement have been delivered and
installed at the location(s) contemplated by the Master Agreement. The Lessee has conducted such inspection
and/or testing of the Equipment being acquired with the proceeds of this disbursement as it deems necessary and
appropriate, and such Equipment has been accepted by Lessee.
2. The costs of the Equipment to be paid from the proceeds of this disbursement have been properly incurred,
are a proper charge against the Escrow Fund and have not been the basis of any previous disbursement.
3. No part of the disbursement requested hereby will be used to pay for materials not yet incorporated into the
Equipment or for services not yet performed in connection therewith.
4. The Equipment is covered by insurance in the types and amounts required by the Agreement.
5. No Event of Default or Event of Nonappropriation (if applicable), as each such term is defined in the Master
Agreement, and no event which with the giving of notice or lapse of time, or both, would become such an Event of
Default or Event of Nonappropriation has occurred and is continuing on the date hereof.
6. If Lessee paid an invoice prior to the commencement date of the Master Agreement, and is requesting
reimbursement for such payment, Lessee has satisfied the requirements for reimbursement set forth in Treas.
Reg. §1.150-2.
Request Date:
Lessor: U.S. Bancorp Government Leasing
and Finance, Inc.
By:
Name:
Title:
Lessee: County of Harnett
By:
Name:
Title:
Exhibit 4
Acceptance Certificate
U.S. Bancorp Government Leasing and Finance, Inc.
13010 SW68th Parkway, Suite 100
Portland, OR 97223
Re: Property Schedule No.1 to Master Tax-Exempt Lease/Purchase Agreement between U.S. Bancorp
Government Leasing and Finance, Inc. and County of Harnett
Ladies and Gentlemen:
In accordance with the above-referenced Master Tax-Exempt Lease/Purchase Agreement (the "Master
Agreement"), the undersigned ("Lessee") hereby certifies and represents to, and agrees with, U.S. Bancorp
Government Leasing and Finance, Inc. ("Lessor"), as follows:
(1) The Property, as such terms are defined in the above-referenced Property Schedule, has been
acquired, made, delivered, installed and accepted on the date indicated below.
(2) Lessee has conducted such inspection and/or testing of the Property as it deems necessary and
appropriate and hereby acknowledges that it accepts the Property for all purposes.
(3) No event or condition that constitutes, or with notice or lapse of time, or both, would constitute, an
Event of Default or a Nonappropriation Event (as such terms are defined in the Master Agreement)
exists at the date hereof.
Acceptance Date: --------------
Lessee: County of Harnett
By:
Name:
Title:
June14,2013
County of Harnett
P.O. Box760
Lillington, NC 27546
Exhibit 6
Class Action Negative Consent Letter
RE: USBGLF/County of Harnett--Class Action Litigation Claims
Dear Sylvia S. Blinson:
U.S. Bank National Association ("U.S. Bank") has established its policies and procedures relative to class action
litigation claims filed on behalf of its clients' accounts. This policy may impact future claims filed by U.S. Bank on
behalf of the above-referenced account. Listed below are the policies regarding class action litigation claims:
1. U.S. Bank will file class action litigation claims, at no charge, on behalf of open, eligible agency or custody
accounts upon receipt of proper documented authorization. This notice, with your ability to opt out as
further described below, constitutes such documented authorization.
2. U.S. Bank will not file claims for agency or custody accounts that were open during the class action period
but were closed prior to receipt of any notice of the class action litigation.
3. Assuming requisite information is provided by the payor to identify the applicable account, settlement
proceeds of the class action litigation will be posted within a reasonable time following receipt of such
proceeds to the entitled accounts that are open at such time. If entitled accounts are closed prior to
distribution and receipt of settlement proceeds, they will be remitted to entitled beneficiaries or successors
of the account net of any research and filing fees. Proceeds, less any research and filing fees, will be
escheated if the entitled beneficiaries or successors of the account cannot be identified /located.
If you wish U.S. Bank to continue to file class action litigation proofs of claim on behalf of your account, you do not
need to take any further action. However, if you do not wish U.S. Bank to file class action proofs of claim on behalf of
your account, you may notify us of this election by returning this letter with your signature and date provided below
within 30 days or by filing a separate authorization letter with your Account Manager by the same date.
The authorization and understanding contained in this communication constitutes an amendment of any applicable
provisions of the account document for the above-referenced account.
If you have any questions, please contact me at the below number.
Sincerely,
Shawna Hale
Vice President
919-424-3944
D No, U.S. Bank is not authorized to file class action litigation proofs of claim on behalf of the above-referenced
account(s). By making this election, I acknowledge that U.S. Bank is not responsible for forwarding notices received
on class action or litigation claims.
Authorized Signer Date
FIRST PAYMENT INVOICE
Government Leasing and Finance, Inc.
PLEASE RETURN THIS PORTION WITH YOUR PAYMENT
SCHEDULE NUMBER: 077-0019215-001
CREATE DATE: June 12, 2013
DUE DATE: July 14,2013
AMOUNT DUE: $12,914.79
County of Harnett
P.O. Box 760
Lillington, NC 27546
U.S. Bancorp Government Leasing and Finance, Inc.
A TIN: Francine Neville
Attention: Accounts Payable Dept.
Customer Phone Number: 910-814-6090
950 17th Street, 7th Floor
Denver, CO 80202
»»»» PLEASE RETAIN THIS PORTION FOR YOUR RECORDS <<<<<<«
All payments MUST be sent to this address:
U.S. Bancorp Government Leasing and Finance, Inc.
PO BOX 959067
ST. LOUIS, MO 63179-9067
U.S. Bancorp Government Leasing and Finance, Inc.
ATTN: Francine Neville
ACCOUNT: 077-0019215-001
AMOUNT DUE: $12,914.79
950 17th Street, 7th Floor DUE DATE: July 14, 2013
Denver, CO 80202 CREATE DATE: June 12, 2013
QUESTIONS? PLEASE CALL (303-585-4077)
INVOICE SUMMARY
Current Charges [Payment #1 J
Total Due
TOTAL AMOUNT DUE THIS INVOICE MUST
BE PAID WITHIN TEN (10) DAYS OF DUE DATE TO AVOID LATE CHARGES
$12,914.79
$12,914.79