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HomeMy WebLinkAbout101518a Agenda PackageHARNETT COUNTY BOARD OF COMMISSIONERS
County Administration Building
420 McKinney Parkway
Lillington, North Carolina
Regular Meeting
October 15, 2018
1. Call to order -Chairman Gordon Springle
7:00 pm
2. Pledge of Allegiance and Invocation -Vice Chairman Howard Penny
3. Consider additions and deletions to the published agenda
4. Consent Agenda
A. Minutes
B. Budget Amendments
C. Tax rebates, refunds and releases
D. Proclamation Recognizing Dan Honeycutt for his Dedicated Service to Harnett
County and its Citizens
E. Proclamation Celebrating Harnett County Resident Hubert Edwards on the Occasion
of his 100th Birthday
F. Harnett County General Services, HARTS, requests approval of the NC Department
of Transportation/Public Transportation Division FYl 9 5311 grant agreement in the
amount of $488,449 with a county match of$62,768. This grant provides funding for
both capital and administrative expenses associated with providing public
transportation for the citizens of Harnett County.
G. Harnett County General Services/ Airport requests approval of the grant agreement
with the NC Department of Transportation/Division of Aviation to provide
professional services for the design/permitting of the terminal site improvement and
related work to replace the existing terminal at the Harnett Regional Jetport. The
County of Hamett will receive a 90% federally funded grant under the State Block
Grant Non-Primary Entitlement (NPE) Program with a 10% local match funded by
the current budget.
H. Harnett County Senior Staff Attorney requests Public Disclosure of Settlement
Agreement -Wanda Carolyn Tart v. County of Harnett
I. Harnett County Sheriffs Office requests approval to purchase new 9MM weapons for
deputies from Craig's Firearm Supply Inc. at a net cost of approximately $36,951.
The Sheriffs Office proposes trading-in present weapons (handguns -40 caliber and
9MM) to offset the cost of the new weapons and will use Asset Forfeiture Funds to
purchase the new weapons if approved.
J. Harnett County Cooperative Extension requests approval to accept $31,603.70 from
Chatham County Partnership for Children for the Child Care Resource Core Services
Program. This Family Resource Program provides program administration and
delivers services and training to childcare centers and childcare homes.
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101518a HCBOC Page 1
K. Hamett County Engineer, Solid Waste Division, requests approval of the Household
Hazardous Waste Collection (HHW) contract with the NC Department of
Environmental Quality for a grant in the amount of $46,129 to establish a permanent
Household Hazardous Waste Collection Site at the Anderson Creek Landfill. There
is a local match of $14,720.
L. Hamett County Health Director requests approval to increase the following fees:
CPT CODE DESCRIPTION RECOMMENDED PRICE
90621 Trumenba $180
90662 Fluzone High Dose $78
90670 Prevnar 13 $210
90674 Flucelvax Quad $49
90681 Rotarix $1 I 6
90698 Pentacel $88
90710 Proquad $225
90732 Pneumovax 23 $105
M. Hamett County Emergency Services, on behalf of Benhaven Emergency Services,
requests approval to purchase a new compressor for $$21,387.13 ($19,999.10 plus
$1,388.03 sales tax) to replace their 2006 compressor that is no longer operational. If
approved, Benhaven Emergency Services will make the purchase out of their Capital
Outlay Reserve Fund.
N. Hamett County G1S/E9I 1 requests approval of a joint resolution adopting the
location of the boundary line between Hamett County and Wake County in
accordance with the plat prepared by the North Carolina Geodetic Survey. Staff also
requests that the Board direct the Hamett County Tax Administrator to assess parcels,
or portions thereof, that have previously been assessed in Wake County but will now
be in Hamett County in accordance with the plat prepared by the North Carolina
Geodetic Survey and mutually agreed to by this Board and the Wake County Board of
Commissioners.
0. Hamett County Parks and Recreation requests consideration of an amendment to the
contract between the County of Hamett and the YMCA of the Sandhills to open a
YMCA facility in Hamett County. The amendment includes a five-month extension
of the 50 percent completion date from April 30, 2019 to September 30, 2019.
5. Special Presentations
6. Period of up to 30 minutes for informal comments allowing 3 minutes for each
presentation
7. Appointments
8. Public Hearing -Proposed Zoning Change: Case# PLAN 1808-0001 Landowner/ Applicant:
Moses & Melanie Farmer/ Par 5 Development Group, LLC; 2.5 +/-acres; Pin #0518-91-
0268.000; From RA-30 to Commercial Zoning District; Intersection of NC Hwy 27 West &
SR# 1238 (Springhill Church Road); Upper Little River Township.
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9. Public hearing regarding the issuance of Public Finance Authority Assisted Living
Revenue Bonds not to exceed $8 ,500,000 -Senter's Memory Care, Jeffrey Poley,
Parker Poe
Following the public hearing commissioners will consider a resolution regarding the
issuance by the Public Finance Authority of its assisted living revenue bonds, in one
or more series, in the principal amount not to exceed $8,500,000, for the purpose of
financing or refinancing the acquisition and construction of certain assisted living
facilities located in the county; and other related matters.
10. Public Hearing -5311 Community Transportation Program application FY 2020 to be
submitted to the North Carolina Department of Transportation, Division on Public
Transportation. The Section 5311 Program intends to enhance the access of people in non-
urbanized areas to health care, shopping, education, employment, public services and
recreation. Section 5311 assists in the maintenance, development, improvement and use of
public transportation systems in non-urbanized areas.
Following the public hearing, staff requests approval of the application and resolution for FY
2020 funding for the HARTS program. Matching funds total $59,343.
11. Harnett County General Service requests approval of the Project Ordinance to demolish the
former Benhaven Elementary School's cafeteria/classrooms and renovate the remaining
facilities to meet North Carolina Building Codes. Anticipated expenses for the project is
$1 ,900,000 with portions of this project funded with the proceeds from the 2017 General
Obligation School Bond.
12. Breast Cancer Awareness Campaign, Morgan Sills, American Cancer Society, Inc.
13. County Manager's Report-Paula Stewart, County Manager
14 . New Business
15. Closed Session
16. Adjourn
Harnett County Veteran Services Activities -September 2018
Harnett County Public Health Activities -September 2018
Invitations and upcoming meetings
Proposed Add-on: The Town of Coats requests assistance in offsetting the tipping fees totaling
$9,093 associated with debris disposal from a powerful storm in July 2018. Between July 22 ,
2018 and August 21, 2018, the Town of Coats collected and disposed of a total of 303 tons of
debris at the County landfill.
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Agenda Item __ 4 __ -=A=----
HARNETT COUNTY BOARD OF COMMISSIONERS
Minutes of Regular Meeting
October 1, 2018
The Hamett County Board of Commissioners met in regular session on Monday, October 1,
2018, in the Commissioners Meeting Room, County Administration Building, 420 McKinney
Parkway, Lillington, North Carolina.
Members present:
Staff present:
Gordon Springle, Chairman
Howard Penny, Vice Chairman
Barbara McKoy, Commissioner
Joe Miller, Commissioner
Abe Elmore, Commissioner
Paula Stewart, County Manager
Dwight Snow, County Attorney
Kimberly Honeycutt, Finance Officer
Margaret Regina Wheeler, Clerk
Chairman Springle called the meeting to order at 9:00 am. Vice Chairman Penny led the Pledge
of Allegiance and invocation.
Chairman Springle called for additions and/or deletions to the published agenda. Mrs. Stewart
requested the addition of a discussion regarding mosquito control measures. Commissioner
Miller moved to approve the agenda as amended. Vice Chairman Penny seconded the motion,
which passed unanimously.
Vice Chairman Penny moved to approve items on the consent agenda . Commissioner
Elmore seconded the motion, which passed unanimously.
1. Tax rebates, refunds and releases (Attachment 1)
2. Hamett County Department of Public Utilities (HCDPU) requested approval of a
Memorandum of Agreement between the US Army Garrison (USAF) Fort Bragg and
HCDPU to use two existing wastewater basins at the decommissioned Fort Bragg
Waste Water Treatment Plant for emergency storage .
3. The Hamett County Sheriffs Office requested permission to accept funding for the
second year of a three-year Governor's Highway Safety Grant in the amount of
$51,199. Funding for Year 2 is 70% of one deputy position's salary and benefits and
other indirect cost.
4. Resolution of the Hamett County Board of Commissioners to Set Hamett County's
Next Reappraisal Schedule to January 1, 2021 and to establish a Four Year
Reappraisal Cycle. (Attachment 2)
October 1, 2018 Regular Meeting Minutes
Hamett County Board of Commissioners
Page 1 of 3
101518a HCBOC Page 4
Chairman Springle opened the floor for informal comments by the public, allowing up to
3 minutes for each presentation up to 30 minutes.
Jerry Rivas of 364 Twin Ponds Road in Sanford addressed the Board.
Marty Clayton with Progress Energy also addressed the Board. Mr. Clayton
thanked the Harnett County team for their tremendous support throughout
Hurricane Florence.
Commissioner Miller moved to approve the appointments listed below. Commissioner Elmore
seconded the motion that passed unanimously.
Local Firefighters Relief Fund Board of Trustees -Spout Springs Emergency Service
Eric Hartman (filling Robert Doberstein's seat) and Steven Bond, Sr., (replacing
George Williams) were appointed as trustees to the Spout Springs Emergency Service
Local Relief Fund Board.
Regarding mosquito control measures, Harnett County Health Director John Rouse said Hamett
County has received $296,500 in funding from the State, which will allow about one third of the
county to be aerial sprayed. He noted it would cost approximately $900,000 to spray the entire
county for mosquitos. Mr. Rouse said staff must conduct a mosquito count and then consider
population density to determine where to spray. Mr. Rouse said he would need to declare a
Public Health Emergency and accept bids for the contract. He also mentioned the possibility of
FEMA funding.
Interim Harnett County Cooperative Extension Director Bill Stone introduced Selena McKoy as
Harnett County's new Horticulture Agent. Ms. McKoy talked about some side effects of
spraying for mosquitos on agriculture in the county; mentioning both organic growers and
beekeepers. She said typically if something will kill a mosquito, it would also kill a honeybee.
The American Mosquito Control Association and the Hamett County Beekeepers Association
recommend spraying late in the evening or at night to limit the effects of application on
honeybees. Mrs. McKoy said it is important to give beekeepers some forewarning of when the
sprays will be applied as well as the areas of application so that they may do some preparation to
protect the hives. Staff will communicate and coordinate efforts. Mrs. Stewart noted we are also
talking to surrounding counties to see what they are doing.
Paula Stewart presented the following report:
Harnett County DSS Monthly Report -August 2018
Mr. Stewart noted Probation and Parole are settled into their new office space in Dunn. She
noted the entrance to the Ponderosa convenient site has been paved. Last, Mrs. Stewart reported
the demolition at Shawtown is proceeding.
Under new business, Chairman Springle said the CCCC Board of Trustees has asked if the Board
of Commissioners will consider extending Jim Burgin's appointment on the CCCC Board of
Trustees. In March 2017, Jim Burgin was appointed to serve a four-year term on the CCCC
Board of Trustees expiring June 30, 2021. Commissioner Elmore moved to appoint Mr. Burgin
October 1, 2018 Regular Meeting Minutes
Harnett County Board of Commissioners
Page 2 of 3
101518a HCBOC Page 5
to serve an additional four-year term on the CCCC Board of Trustees, which will expire June 30,
2025. Vice Chairman Penny seconded the motion that passed unanimously.
Vice Chairman Penny, on behalf of the Hamett County Soil and Water Board, thanked staff for
their efforts during Hurricane Florence. Chairman Springle said farmers are also very
appreciative of how responsive the County has been.
Vice Chairman Penny moved that the Board go in to closed session to assist in the formulation of
plans by the Harnett County Board of Education relating to the emergency response to incidents
of school violence. This motion is made pursuant to N .C. General Statute Section 143-
3 l 8. l 1 ( a)(8 ). Commissioner Elmore seconded the motion, which passed unanimously.
Commissioner Elmore moved that the Board come out of closed session. Commissioner McKoy
seconded the motion that passed unanimously.
Commissioner Elmore moved to adjourn the meeting at I 0:26 am. Commissioner Miller
seconded the motion, which passed unanimously.
Gordon Springle, Chairman Margaret Regina Wheeler, Clerk
October 1, 2018 Regular Meeting Minutes
Harnett County Board of Commissioners
Page 3 of 3
101518a HCBOC Page 6
A 1 1 ALttlVJJ!,J'llj l .l ~ ~~~""'"------~r,-,--. -· -,.....,,_., : ---.,~-~p~~roved Hffio C / 0 -I -{ </ Date 10/01/2018 To: Harnett County Board of Commissioners Re: Consideration of Refund for Taxes, Interest and Penalities for all Muncipalities Duplication S. Keith Faulkner Tax Administrator 0001985208-2018-2018-0000-00 , Type BUS ..-Recei~eci'Anwunt···R~fundAmou.nt-Name -. 491.28 324.09 BLUE TRACK HOLDINGS LLC \ .. ·. ·~-.. .: 101518a HCBOC Page 7
ATTACHMENT2
~/F :;_~. Harnett ,,=~))1(:··' _c....;o;;.....;u;....;.N.;...,..;.T_Y.;,._ __________________________ _
~ ~~-· NORT H CARO LIN A
RESOLUTION OF THE HARNETT COUNTY BOARD OF COMMISSIONERS
TO SET HARNETT COUNTY'S .NEXT REAPPRAISAL SCHEDULE
TO JANUARY 1, 2021 AND TO ESTABLISH A FOUR YEAR
REAPPRAISAL CYCLE
WHEREAS, Harnett County completed and implemented its most recent
reappraisal ofreal property on January 1, 2017 , utilizing its own staff and personneJ, and
augmenting with contract appraisal staff as need; and
WHEREAS, North Carolina General Statute § 105-286(a) requires each county to
reappraise all real property every eighth year; and
WHEREAS, North Carolina General Statute § 105-286(a)(3) authorizes a county
to conduct a reappraisal of real property earlier than required and may designate a new
reappraisal cycle that is more frequent than the octennial cycle if the board of
commissioners adopts a resolution providing for advancement of the reappraisal ; and
WHEREAS, Hamett County desires to conduct a reappraisal of real property
earlier than required by North Carolina General Statute § 105-286(a), to be effective
January 1, 2021 , and to perform subsequent reappraisals every four years thereafter; and
WHEREAS , the reappraisal work will be conducted by the staff of the Harnett
County Tax Assessor's Office as part of its program of work each year, or an independent
appraisal consultant, or a combination of the two, as deemed necessary and appropriate
by the Harnett County Board of Commissioners (hereinafter "Board");
NOW, THEREFORE BE IT RESOLVED by the Hamett County Board of
Commissioners that in the annual budget ordinance each fiscal year, the Board shall
include in the special reserve fund established for the reappraisal an appropriation for Tax
Administration in the amount required for reappraisal work during that fiscal year
consistent with a plan established for the reappraisal of real property, as required by
North Carolina General Statute§ 153A-150; and
BE IT FURTHER RESOLVED, that when the County budget for each s ucceeding
fisca l year is in preparation, the Board , with the County Manager and Tax Assessor, shall
review the progress of the reappraisal work, and the Board shall appropriate to the special
reappraisal reserve fund such funds for reappraisal work during that year as may be
necessary to continue the reappraisal work and to assure the completion of the reappraisal
work on schedule.
Page 1 of 2
strong root s • new growth
www.harne tt.org
101518a HCBOC Page 8
BE IT FURTHER RESOLVED that a copy of this resolution be forwarded
promptly by the Clerk to the Board to the Department of Revenue as required by North
Carolina General Statute § I 05-286(a)(3).
Adopted this I st day of October 2018.
HARNETT COUNTY BOARD OF COMMISSIONERS
Attest:
Page 2 of2
www.harnett.org
101518a HCBOC Page 9
Agenda Item __ 4 ...... -.... B ___ __
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, 2019;
Section 1. To amend the General Fund, Health Department, the appropriations are to be changed as follows:
EXPENDITURE AMOUNT AMOUNT
CODE NUMBER DESCRIPTION OF CODE INCREASE DECREASE
1105110-544000 Contracted Services $ 393,000.00
REVENUE AMOUNT AMOUNT
CODE NUMBER DESCRIPTION OF CODE INCREASE DECREASE
1105110-330310 State Revenues $ 296,505.00
1103900-390990 Fund Balance $ 96,495.00
EXPLANATION: To budget State funds received ($296,S05) and County funds for Mosquito Abatement.
Department Head (date) County Manager (D~te) / o -10-nr
Section 2. Copies of this budget amendment shall be furnished to the Clerk of the Board, and to the Budget Officer and
the Finance Officer for their direction.
Adopted th is
Margaret Regina Wheeler,
Clerk to the Board
day of ,2018
Gordon Springle, Chairman
Harnett County Board of Commissioners
101518a HCBOC Page 10
Date run: 10/5/2018 2:23:20 PM Data as of: 10/4/2018 7:59:05 PM TR-304 Bill Release Report Report Parameters: Release Date Start: 9/1/2018 Release Date End: 9/30/2018 Tax District: ALL Default Sort-By: Grouping: Bill #,Taxpayer Name,Release Date,Billing Date,Operator ID, Release Amount Release Reason Bill# Taxpayer Name RELEASE REASON: Address change 0000037779-2018-2018-0000-00-REG TGBG PROPERTIES LLC 0000037780-2018-2018-0000-00-REG TGBG PROPERTIES LLC 0000047322-2018-2018-0000-00-REG TGBG PROPERTIES LLC 0000047326-2018-2018-0000-00-REG TGBG PROPERTIES LLC 0000055741-2018-2018-0000-00-REG VAN VRANKIN, BLANCHE Subtotal RELEASE REASON: Adjustment 0000004212-2018-2018-0000-00-REG MASSEY, JERRY LAVORIS 0000011816-2018-2018-0000-00-REG COLLEY, REGINA LEIGH 0000016321-2014-2014-0000-00-REG EMMETT ROAD ASSOCIATES LLC 0000016321-2015-2015-0000-00-REG EMMETT ROAD ASSOCIATES LLC 0000016321-2016-2016-0000-00-REG EMMETI ROAD ASSOCIATES LLC 0000016321-2017-2017-0000-00-REG EMMETT ROAD ASSOCIATES LLC PAGE 1 of 10 Operator ID (Name) 8/11/2018 AMY BAIN 8/11/2018 AMY BAIN 8/11/2018 AMY BAIN 8/11/2018 AMY BAIN 8/11/2018 STEPHANIE WILSON 8/11/2018 MARGARET WRIGHT 8/11/2018 CRYSTAL THOMAS 8/9/2014 MARGARET WRIGHT 8/8/2015 MARGARET WRIGHT 8/6/2016 MARGARET WRIGHT 8/19/2017 MARGARET WRIGHT NCPTS V4 -9/26/2018 9/26/2018 9/26/2018 9/26/2018 9/13/2018 8/31/2018 9/11/2018 9/28/2018 9/28/2018 9/28/2018 9/28/2018 418.33 402.01 395.89 404.22 173.70 837.55 1,368.12 2,126.66 2,175.63 2,175.63 1,985.57 Agenda Item 4-C Release Amount($) 418.33 402.01 395.89 404.22 173.70 1,794.15 614.55 1,368.12 787.67 806.43 806.43 673.29 -. 0.00 0.00 0.00 0.00 0.00 223.00 0.00 1,338.99 1,369.20 1,369.20 1,312.28 101518a HCBOC Page 11
Bill# Taxpayer Name 0000016321-2018-2018-0000-00-REG PROREALESTATE LLC, 0000020373-2018-2018-0000-00-REG SANCHEZ, ALDEGUNDO MERINO 0000022613-2016-2016-0000-00-RE G HARPER, CONNIE RAY 0000022613-2017-2017-0000-00-REG HARPER, CONNIE RAY 0000022807-2018-2018-0000-00-REG AMERSON, QUINTON 0000027110-2018-2018-0000-00-REG VANSTONE, PHILLIP J 0000030095-2018-2018-0000-00-REG LANGDON, MARK E 0000034705-2018-2018-0000-00-REG MCDOUGALD, MALCOLM JR 0000036001-2018-2018-0000-00-REG MCLEAN, FREDERICK A 0000041790-2008-2008-0000-00-REG PAZ, CESAR AUGUSTO 0000041790-2009-2009-0000-00-REG DUNN CITY OF 0000041790-2010-2010-0000-00-REG DUNN CITY OF 0000041790-2011-2011-0000-00-REG DUNN CITY OF 0000041790-2012-2012-0000-00-REG DUNN CITY OF 0000041790-2013-2013-0000-00-REG DUNN CITY OF 0000041790-2014-2014-0000-00-RE G DUNN CITY OF 0000048027-2018-2018-0000-00-REG SHUE,FRANKJOSEPH 0000059328-2018-2018-0000-00-REG STONE, AARON LEWIS 0000060382-2018-2018-0000-00-REG PURCELL, NINA PAGE 2 of 10 Operator ID (Name) 8/11/2018 MARGARET WRIGHT 8/11/2018 MARGARET WRIGHT 8/6/2016 CRYSTAL THOMAS 8/19/2017 CRYSTAL THOMAS 8/11/2018 MARGARET WRIGHT 8/11/2018 MARGARET WRIGHT 8/11/2018 CRYSTAL THOMAS 8/11/2018 MARGARET WRIGHT 8/11/2018 MARGARET WRIGHT 8/3/2008 CRYSTAL THOMAS 8/27/2009 CRYSTAL THOMAS 7/9/2010 CRYSTAL THOMAS 8/5/2011 CRYSTAL THOMAS 7/26/2012 CRYSTAL THOMAS 8/7/2013 CRYSTAL THOMAS 8/9/2014 CRYSTAL THOMAS 8/11/2018 MARGARET WRIGHT 8/11/2018 MARGARET WRIGHT 8/11/2018 MARGARET WRIGHT 9/28/2018 9/6/2018 9/11/2018 9/11/2018 8/31/2018 9/26/2018 9/13/2018 8/31/2018 8/31/2018 9/25/2018 9/25/2018 9/25/2018 9/25/2018 9/25/2018 9/25/2018 9/25/2018 9/6/2018 9/25/2018 9/20/2018 -1,985.57 2,895.66 2,635.08 2,701.28 780.52 828.12 426.46 1,179.38 737.85 211.65 237.26 237.26 355.49 375.49 380.21 386.11 655.40 711.24 913.46 Release Amount($) 673.29 1,275.77 796.49 897.49 349.35 110.70 343.72 586.07 179.18 149.77 176.13 176.13 258.36 278.36 281.58 285.61 415.22 245.65 684.76 -. 1,312.28 1,619.89 1,838.59 1,803.79 431.17 717.42 82.74 593.31 558.67 61.88 61.13 61.13 97.13 97.13 98.63 100.50 240.18 465.59 228.70 101518a HCBOC Page 12
Bill# Taxpayer Name 0001306268-2018-2018-0000-00-REG SULLIVAN, HUBERT 0001306275-2018-2018-0000-00-REG PIEKULSKI, MAREK R 0001380577-2018-2018-0000-00-REG JONES, JASON 0001411712-2018-2018-0000-00-REG SOUTHERN LIVING INVESTMENT PROPERTI, ES LLC 0002076730-2018-2018-0000-00-REG VELEZ-ALLEN, MARIA ROSARIO 0002185317-2018-2018-0000-00-REG WILLIAMS, CHRISTINE G 0002254289-2018-2018-0000-00-REG AMERICAN HOMES 4 RENT L.P. 0002254290-2018-2018-0000-00-REG AMERICAN HOMES 4 RENT L.P. 0002254291-2018-2018-0000-00-REG AMERICAN HOMES 4 RENT L.P. 0002254294-2018-2018-0000-00-REG AMERICAN HOMES 4 RENT L.P. 0002254295-2018-2018-0000-00-REG AMERICAN HOMES 4 RENT L.P. 0002254296-2018-2018-0000-00-REG AMERICAN HOMES 4 RENT L.P. 0002254297-2018-2018-0000-00-REG AMERICAN HOMES 4 RENT L.P. 0002254298-2018-2018-0000-00-REG AMERICAN HOMES 4 RENT L.P. 0002254299-2018-2018-0000-00-REG AMERICAN HOMES 4 RENT L.P. 0002254301-2018-2018-0000-00-REG AMERICAN HOMES 4 RENT L.P. 0002254303-2018-2018-0000-00-REG AMERICAN HOMES 4 RENT L.P. 0002254304-2018-2018-0000-00-REG AMERICAN HOMES 4 RENT L.P. 0002254305-2018-2018-0000-00-REG AMERICAN HOMES 4 RENT L.P. 0002254307-2018-2018-0000-00-REG AMERICAN HOMES 4 RENT L.P. PAGE 3 of 10 Operator ID (Name) 8/11/2018 CRYSTAL THOMAS 8/11/2018 CRYSTAL THOMAS 8/11/2018 CRYSTAL THOMAS 8/11/2018 MARGARET WRIGHT 8/11/2018 APRIL DIAZ 8/11/2018 MARGARET WRIGHT 8/11/2018 KRISTY TAYLOR 8/1112018 KRISTY TAYLOR 8/11/2018 KRISTY TAYLOR 8/11/2018 KRISTY TAYLOR 8/11/2018 KRISTY TAYLOR 8/11/2018 KRISTY TAYLOR 8/11/2018 KRISTY TAYLOR 8/11/2018 KRISTY TAYLOR 8/11/2018 KRISTY TAYLOR 8/11/2018 KRISTY TAYLOR 8/11/2018 KRISTY TAYLOR 8/11/2018 KRISTY TAYLOR 8/11/2018 KRISTY TAYLOR 8/1112018 KRISTY TAYLOR 9/11/2018 9/11/2018 9/19/2018 8/31/2018 9/11/2018 8/31/2018 9/10/2018 9/10/2018 9/10/2018 9/10/2018 9/10/2018 9/10/2018 9/10/2018 9/10/2018 9/10/2018 9/10/2018 9/10/2018 9/10/2018 9/10/2018 9/10/2018 -4,030.59 2,713.97 71.46 1,612.11 46.36 2,119.86 11.30 11.30 11.30 11.30 11.30 11.30 11.30 11.30 11.30 11.30 11.30 11.30 11.30 11.30 Release Amount($) 772.14 574.86 71.46 1,603.35 46.36 1,101.60 11.30 11.30 11.30 11.30 11.30 11.30 11.30 11.30 11.30 11.30 11.30 11.30 11.30 11.30 -. 3,258.45 2,139.11 0.00 8.76 0.00 1,018.26 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 101518a HCBOC Page 13
Bill# Taxpayer Name 0002254308-2018-2018-0000-00-REG AMERICAN HOMES 4 RENT LP. 0002254309-2018-2018-0000-00-REG AMERICAN HOMES 4 RENT LP. 0002254311-2018-2018-0000-00-REG AMERICAN HOMES 4 RENT L.P. 0002254312-2018-2018-0000-00-REG AMERICAN HOMES 4 RENT L.P. 0002254313-2018-2018-0000-00-REG AMERICAN HOMES 4 RENT L.P. 0002254314-2018-2018-0000-00-REG AMERICAN HOMES 4 RENT L.P. 0002254315-2018-2018-0000-00-REG AMERICAN HOMES 4 RENT L.P. 0002254316-2018-2018-0000-00-REG AMERICAN HOMES 4 RENT LP. 0002254317-2018-2018-0000-00-REG AMERICAN HOMES 4 RENT LP. 0002259847-2018-2018-0000-00-REG SCHMIOT, KYLE DAVID Subtotal RELEASE REASON: Adjustment Release 0000030768-2018-2018-0000-01-PRV BLUEHER, JOHN J Subtotal RELEASE REASON: Assessed In Err 0002259765-2018-2018-0000-00-REG STRICKLAND, ROBERT DENNIS JR 0002260031-2018-2018-0000-00-REG KIMBLE, ALDEN WINFIELD 0002260563-2018-2018-0000-00-REG KRASZEWSKI, ROBERT STANLEY Subtotal RELEASE REASON: Duplication 0001403128-2018-2018-0000-00-REG BROCK, ANTHONY WAYNE 0001985208-2018-2018-0000-00-REG BLUE TRACK HOLDINGS LLC PAGE 4 of 10 Operator ID (Name) 8/11/2018 KRISTY TAYLOR 8/11/2018 KRISTY TAYLOR 8/11/2018 KRISTY TAYLOR 8/11/2018 KRISTY TAYLOR 8/11/2018 KRISTY TAYLOR 8/11/2018 KRISTY TAYLOR 8/11/2018 KRISTY TAYLOR 8/11/2018 KRISTY TAYLOR 8/11/2018 KRISTY TAYLOR 8/21/2018 APRIL DIAZ 1/22/2018 AMY BAIN 8/21/2018 CRYSTAL THOMAS 8/21/2018 APRIL DIAZ 8/21/2018 DINA BAREFOOT 8/11/2018 CRYSTAL THOMAS 8/11/2018 SHERRY LOCKAMY 9/10/2018 9/10/2018 9/10/2018 9/10/2018 9/10/2018 9/10/2018 9/10/2018 9/10/2018 9/10/2018 9/12/2018 9/28/2018 9/5/2018 9/6/2018 9/5/2018 9/25/2018 9/24/2018 -11.30 11.30 11.30 11.30 11.30 11.30 11.30 11.30 11.30 10.31 799.11 222.86 143.69 277.43 40.25 491.28 Release Amount($) 11.30 11.30 11.30 11.30 11.30 11.30 11.30 11.30 11.30 5.15 17,654.94 799.11 799.11 222.86 143.69 277.43 643.98 30.10 324.09 -0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 5.16 0.00 0.00 0.00 0.00 10.15 167.19 101518a HCBOC Page 14
Bill# Taxpayer Name 0002259022-2018-2018-0000-00-REG STAVLEY, WILLIAMS RONALD Subtotal RELEASE REASON: Elderly Exclusion 0000007071-2018-2018-0000-00-REG TYNDALL, JAMES EVANDER 0000013367-2018-2018-0000-00-REG HARRIS, GARNER TED 0000014475-2018-2018-0000-00-REG DENNING, JAMES S 0000050115-2018-2018-0000-00-REG WELLS, BONNIE LOUISE 0000052905-2018-2018-0000-00-REG TART, SAMMY OLIN 0000058722-2018-2018-0000-00-REG SUNDERMAN. LINDA M 0002258338-2018-2018-0000-00-REG WILLIS, CAROLE ELAINE Subtotal RELEASE REASON: Exempt Property 0000009345-2018-2018-0000-00-REG CAMPBELL UNIVERSITY INC 0002248030-2018-2018-0000-00-REG CAPTAINS LANDING PROPERTY OWNERS ASSOC INC Subtotal RELEASE REASON: Full rebate 0002177129-2017-2017-0000-00-REG WEBER, JODY L 0002177129-2018-2018-0000-00-REG WEBER, JODY L 0002255896-2018-2018-0000-00-REG BAGWELL, LILLIE MAE PAGE 5 of 10 Operator ID (Name) 8/11/2018 CRYSTAL THOMAS 8/11/2018 CRYSTAL THOMAS 8/11/2018 CRYSTAL THOMAS 8/11/2018 CRYSTAL THOMAS 8/11/2018 CRYSTAL THOMAS 8/11/2018 CRYSTAL THOMAS 8/11/2018 CRYSTAL THOMAS 8/11/2018 CRYSTAL THOMAS 8/11/2018 CRYSTAL THOMAS 8/11/2018 KIMBERLY BAKER 8/19/2017 MARGARET WRIGHT 8/11/2018 MARGARET WRIGHT 8/11/2018 MARGARET WRIGHT 9/4/2018 9/25/2018 9/25/2018 9/26/2018 9/25/2018 9/25/2018 9/25/2018 9/25/2018 9/6/2018 9/24/2018 9/20/2018 9/20/2018 9/25/2018 -. 277.20 853.60 1,151.25 1,863.51 583.00 1,727.57 277.98 60.61 1,044.61 166.00 295.24 295.24 21.50 Release Amount($) 277.20 631.39 853.60 1,151.25 1,863.51 583.00 1,727.57 207.98 60.61 6,447.52 974.61 166.00 1,140.61 295.24 295.24 21.50 -. 0.00 0.00 0.00 0.00 0.00 0.00 70.00 0.00 70.00 0.00 0.00 0.00 0.00 101518a HCBOC Page 15
Bill# Taxpayer Name 0002259007-2018-2018-0000-00-REG WILSON. WALTER RICHARD Subtotal RELEASE REASON: Landfill error 0000036595-2013-2013-0000-00-REG MCNEILL, JAMES ODELL 0000036595-2014-2014-0000-00-REG MCNEILL, WILLIAM JOSEPH 0000036595-2015-2015-0000-00-REG MCNEILL, WILLIAM JOSEPH 0000036595-2016-2016-0000-00-REG MCNEILL, WILL 1AM JOSE PH 0000036595-2017-2017-0000-00-REG MCNEILL, WILLIAM JOSEPH 0000036595-2018-2018-0000-00-REG MCNEILL, WILLIAM JOSEPH 0001713467-2018-2018-0000-00-REG COLLEY, REGINA LEIGH Subtotal RELEASE REASON: Listed In Error 0002178178-2018-2018-0000-00-REG RYDER TRUCK RENTAL INC Subtotal RELEASE REASON: Military 0001976168-2018-2018-0000-00-REG CHRISTMAN, VERNON ANTHONY 0002258371-2018-2018-0000-00-REG SPEIGHT. RITA E 0002258372-2018-2018-0000-00-REG SPEIGHT, RITA E 0002258774-2018-2018-0000-00-REG GANTT, FREDERICK LEE 0002259069-2018-2018-0000-00-REG VOLLMER, DAM IAN M 0002259226-2018-2018-0000-00-REG CLERMONT, MATTHEW AARON 0002259302-2018-2018-0000-00-REG COFFEY, SHERRY MARIE PAGE 6 of 10 Operator ID (Name) 8/11/2018 MARGARET WRIGHT 8/7/2013 CRYSTAL THOMAS 8/9/2014 CRYSTAL THOMAS 8/8/2015 CRYSTAL THOMAS 8/6/2016 CRYSTAL THOMAS 8/19/2017 CRYSTAL THOMAS 8/11/2018 CRYSTAL THOMAS 8/11/2018 CRYSTAL THOMAS 8/11/2018 SHERRY LOCKAMY 8/11/2018 APRIL DIAZ 8/11/2018 APRIL DIAZ 8/11/2018 APRIL DIAZ 8/11/2018 APRIL DIAZ 8/11/2018 APRIL DIAZ 8/21/2018 APRIL DIAZ 8/21/2018 SHANNON AUTRY -. 9/7/2018 12.25 9/11/2018 572.08 9/11/2018 582.80 9/11/2018 582.80 9/11/2018 582.80 9/11/2018 503.11 9/11/2018 503.11 9/11/2018 688.68 9/5/2018 2,911.04 9/13/2018 7.69 9/4/2018 528.36 9/4/2018 46.84 9/27/2018 20.69 9/7/2018 149.21 9/19/2018 7.92 9/5/2018 86.36 Release Amount($) 12.25 624.23 140.00 140.00 140.00 140.00 140.00 140.00 70.00 910.00 2,494.25 2,494.25 7.69 528.36 46.84 20.69 149.21 7.92 86.36 -0.00 432.08 442.80 442.80 442.80 363.11 363.11 618.68 416.79 0.00 0.00 0.00 0.00 0.00 0.00 0.00 101518a HCBOC Page 16
Bill# Taxpayer Name 0002259648-2018-2018-0000-00-REG MCCARROL, SYBIL ANNE 0002260400-2018-2018-0000-00-REG DENKER, CRAIG ALLEN 0002260521-2018-2018-0000-00-REG HORTA, MIGUEL COMAS 0002260744-2018-2018-0000-00-REG MINSHEW, EVAN FRIPP 0002260772-2018-2018-0000-00-REG KIBITLEWSKI, BRIAN B 0002260832-2018-2018-0000-00-REG WEEKS, LUCAS JAMES Subtotal RELEASE REASON: Not in County 0002255728-2018-2018-0000-00-REG DORMAN, JOEY ALEX Subtotal RELEASE REASON: Over Assessment 0002259244-2018-2018-0000-00-REG CARLSON, CONRAD KEITH 0002260570-2018-2018-0000-00-REG HEATH, TODD JAMES Subtotal RELEASE REASON: Over Listed 0001279732-2018-2018-0000-00-REG MULCAHY, RICHARD C Subtotal RELEASE REASON: Ownership change 0000007209-2018-2018-0000-00-REG LIANG, TONG 0000019563-2018-2018-0000-00-REG GILES, SHERRILL W 0000020564-2018-2018-0000-00-REG GRAY, KELLY M 0000030768-2018-2018-0000-00-PRV SEABURG, BRENDAL 0000030768-2018-2018-0000-00-REG SEABURG, BRENDAL 0002256741-2018-2018-0000-00-REG IVEY, BETTY S Subtotal PAGE 7 of 10 Operator ID (Name) 8/21/2018 APRIL DIAZ 8/21/2018 STEPHANIE WILSON 8/21/2018 APRIL DIAZ 8/21/2018 APRIL DIAZ 8/21/2018 DINA BAREFOOT 8/21/2018 APRIL DIAZ 8/11/2018 CRYSTAL THOMAS 8/21/2018 APRIL DIAZ 8/21/2018 APRIL DIAZ 8/11/2018 APRIL DIAZ 8/11/2018 AMY BAIN 8/11/2018 AMY BAIN 8/11/2018 AMY BAIN 1/22/2018 AMY BAIN 8/11/2018 AMY BAIN 8/11/2018 MARGARET WRIGHT 9/28/2018 9/5/2018 9/10/2018 9/27/2018 9/4/2018 9/12/2018 9/6/2018 9/4/2018 9/5/2018 9/4/2018 9/20/2018 9/4/2018 9/21/2018 9/28/2018 9/28/2018 9/6/2018 -361.20 282.42 431.73 165.67 287.89 248.65 619.85 37.35 110.40 39.93 1,718.46 25.29 1,407.48 0.00 799.11 6.14 Release Amount($) 361.20 282.42 431.73 165.67 287.89 248.65 2,624.63 619.85 619.85 33.36 100.60 133.96 29.99 29.99 1,718.46 25.29 1,407.48 799.11 799.11 6.14 4,755.59 -. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 3.99 9.80 9.94 0.00 0.00 0.00 -799.11 0.00 0.00 101518a HCBOC Page 17
Bill# Taxpayer Name RELEASE REASON: Removal of SW Fee 0000030598-2018-2018-0000-00-REG LAYTON CHAPEL BAPTIST CHURCH 0000030611-2018-2018-0000-00-REG LAYTON CHAPEL BAPTIST CHURCH INC, 0000038940-2013-2013-0000-00-REG MURPHY, DAYNA BAYLES 0000038940-2014-2014-0000-00-REG MURPHY, DAYNA BAYLES 0000038940-2015-2015-0000-00-R E G MURPHY, DAYNA BAYLES 0000038940-2016-2016-0000-00-REG MURPHY, DAYNA BAYLES 0000038940-2017-2017-0000-00-REG MURPHY, DAYNA BAYLES 0000038940-2018-2018-0000-00-REG MURPHY, DAYNA BAYLES 0000042702-2018-2018-0000-00-REG PITTMAN, MARILYN 0000055094-2014-2014-0000-00-REG TURLINGTON, FRED 0000055094-2015-2015-0000-00-REG TURLINGTON, FRED 0000055094-2016-2016-0000-00-REG TURLINGTON, FRED 0000055094-2017-2017-0000-00-REG TURLINGTON, FRED 0000055094-2018-2018-0000-00-REG TURLINGTON, FRED 000171017 4-2018-2018-0000-00-REG BAGWELL, LILLIE MAE 0002257560-2018-2018-0000-00-REG WILSON, BERNICE L Subtotal RELEASE REASON: Situs error 0002260156-2018-2018-0000-00-REG SHAW, JOSEPH PAGE 8 of 10 Operator ID (Name) 8/11/2018 MARGARET WRIGHT 8/11/2018 MARGARET WRIGHT 8/7/2013 MARGARET WRIGHT 8/9/2014 MARGARET WRIGHT 8/8/2015 MARGARET WRIGHT 8/6/2016 MARGARET WRIGHT 8/19/2017 MARGARET WRIGHT 8/11/2018 MARGARET WRIGHT 8/11/2018 MARGARET WRIGHT 8/9/2014 MARGARET WRIGHT 8/8/2015 MARGARET WRIGHT 8/6/2016 MARGARET WRIGHT 8/19/2017 MARGARET WRIGHT 8/11/2018 MARGARET WRIGHT 8/11/2018 MARGARET WRIGHT 8/11/2018 MARGARET WRIGHT 8/21/2018 CRYSTAL THOMAS -. 9/6/2018 210.00 9/6/2018 210.00 8/31/2018 963.66 8/31/2018 987.36 8/31/2018 987.36 8/31/2018 996.84 8/31/2018 1,106.21 8/31/2018 1,106.21 8/31/2018 87.00 9/25/2018 684.08 9/25/2018 225.12 9/25/2018 226.15 9/25/2018 236.36 9/25/2018 236.36 9/25/2018 199.00 8/31/2018 220.30 9/7/2018 16.04 Release Amount($) 210.00 70.00 140.00 140.00 140.00 140.00 140.00 140.00 70.00 140.00 140.00 140.00 140.00 140.00 70.00 70.00 2,030.00 16.04 -. 0.00 140.00 823.66 847.36 847.36 856.84 966.21 966.21 17.00 544.08 85.12 86.15 96.36 96.36 129.00 150.30 0.00 101518a HCBOC Page 18
Bill# Taxpayer Name 0002260621-2018-2018-0000-00-REG CLARNO, ROBERT EDWARD Subtotal RELEASE REASON: SMALL UNDERPAYMENT 0000007360-2018-2018-0000-00-REG PRIDGEN, JOY B 0000018518-2018-2018-0000-00-REG FREEMAN PEARLINE AND OTHERS 0000025855-2017-2017-0000-00-REG HUTCHINS, RANDY 0000032640-2017-2017-0000-00-REG MANESS, JOHNNY W JR 0000038598-2018-2018-0000-00-REG WEST, TRACY A 0000041937-2018-2018-0000-00-REG PELHAM, SHIRLEAN 0000048077-2017-2017-0000-00-REG SIGNAL, ANNA 0000049099-2018-2015-0070-00-REG UPCHURCH, JAMES M OOOOOS 1636-2018-2018-0000-00-RE G STRICKLAND, SAMUEL 0000055410-2018-2018-0000-00-REG TYNDALL, JAMES ROBERT 0000059845-2017-2017-0000-00-REG CAMP, JENNIFER MCDONALD 0000059995-2018-2018-0000-00-REG WILLIFORD, PATSY A 0000061187-2018-2018-0000-00-REG LIDDLE, BRENDA 0001570871-2018-2016-0000-00-REG PORTER, ANNIE MAE 0001672695-2009-2009-0000-00-REG HARDIN, VICTORIA ALMA 0002076860-2018-2018-0000-00-REG HAIR, LADEAN MCLAMB 0002092190-2013-2013-0000-00-REG GARCIA, LAURA SUSANA 0002095398-2018-2018-0000-00-REG J & R SALVAGE INC 0002177536-2018-2018-0000-00-REG CHAMPOU, JOYCE ANN PAGE 9 of 10 Operator ID (Name) 8/21/2018 SHANNON AUTRY 8/11/2018 JANNA HIGDON 8/11/2018 KARA DANIELS 8/19/2017 YVONNE MCARTHUR 8/19/2017 KIM BERL Y BAKER 8/11/2018 LOCKBOX DPC 8/11/2018 JANNA HIGDON 8/19/2017 KIMBERLY BAKER 9/20/2018 JANNA HIGDON 8/11/2018 KARA DANIELS 8/11/2018 KARA DANIELS 8/19/2017 KIMBERLY BAKER 8/11/2018 KARA DANIELS 8/11/2018 JANNA HIGDON 4/18/2018 YVONNE MCARTHUR 8/2/2009 AMY BAIN 8/11/2018 KARA DANIELS 7/1/2013 KARA DANIELS 8/11/2018 AMY BAIN 8/11/2018 KIMBERLY BAKER 9/5/2018 9/11/2018 9/10/2018 9/6/2018 9/7/2018 9/24/2018 9/7/2018 9/5/2018 9/21/2018 9/20/2018 9/7/2018 9/28/2018 9/5/2018 9/4/2018 9/20/2018 9/13/2018 9/21/2018 9/5/2018 9/7/2018 9/6/2018 -. 104.70 983.75 44.63 239.74 256.01 917.54 37.91 696.55 54.54 245.95 527.09 1,007.73 75.26 366.10 43.56 5.67 126.21 34.21 4.10 12.32 Release Amount($) 104.70 120.74 0.51 0.10 0.60 0.72 0.20 0.28 0.11 0.01 0.95 0.43 0.19 0.26 0.10 0.37 0.05 0.10 0.22 0.10 0.20 -. 0.00 983.24 44.53 239.14 255.29 917.34 37.63 696.44 54.53 245.00 526.66 1,007.54 75.00 366.00 43.19 5.62 126.11 33.99 4.00 12.12 101518a HCBOC Page 19
Bill# Taxpayer Name 0002251546-2018-2018-0000-00-REG JOHNSON, STEVEN PAUL Subtotal RELEASE REASON: Value Increase 0001709714-2018-2018-0000-00-REG DORMAN, CHARLES MICHAEL Subtotal Total PAGE 10 of 10 Operator ID (Name) 8/11/2018 JANNA HIGDON 8/11/2018 MARGARET WRIGHT -. 9/27/2018 3.33 9/20/2018 293.60 Release Amount($) 0.33 5.83 293.60 293.60 43,754.37 -. 3.00 0.00 101518a HCBOC Page 20
Agenda Item __ 4;..-__ Dc----
PROCLAMATION RECOGNIZING DAN HONEYCUTT FOR HIS
DEDICATED SERVICE TO HARNETT COUNTY AND ITS CITIZENS
WHEREAS, Dan Curtis Honeycutt Sr. was born on October 19, 1949, the son of Rupert
N . and Geraldine S. Honeycutt, and passed away on May 15, 2018 at age 68; and
WHEREAS, Dan grew up in Coats and graduated from Coats Union School in 1968
before earning degrees from North Carolina State University in 1972 and Campbell University in
1986;and
WHEREAS, in 1972, Dan unexpectedly embarked on a 37-year career in education
when he began teaching agriculture at Coats Union School after being recruited by his former
principal, J.C. Hawley; and ·
WHEREAS, during his time at Coats, Dan also served as transportation director and
FF A leader, and became the winningest high school softball coach in the State of North Carolina;
and
'· WHEREAS, Dan taught at Coats until 1985, when he became assistant principal at the
newly constructed Triton High School, which brought together studems from Coats, Erwin and
Dunn;and
WHEREAS, Dan spent two years as principal at Erwin Middle School before returning
to Triton in 1992 as principal, and then going to the central office where he became assistant
superintendent of Harnett County Schools in 2001, and superintendent in 2005 ; and
WHEREAS, Dan retired in 2009, having received numerous awards during his career
including the Wachovia Principal of the Year Ward, the Milken Educator Award and the Order
of the Longleaf Pine; and
WHEREAS, even after retiring from public education, Dan continued to serve his
community as a member of the Good Hope Hospital Board and the Central Carolina Community
College Board of Trustees, where he worked to help implement the first early college in Hamett
County; and
WHEREAS, even though he never envisioned a career in education, Dan's proudest
accomplishment was his work educating Harnett County's students and encouraging them to do
their best and contribute to their communities; and
WHEREAS, Dan's greatest strength was being able to see the potential in students and
encourage them to reach their potential; and
WHEREAS, generations of Harnett County students and citizens are indebted to Dan
Honeycutt for his many years of public service -not only for his work as an educator, coach,
administrator and leader, but for the example he set as a role model for others to emulate.
101518a HCBOC Page 21
NOW, THEREFORE, BE IT REOLVED that the Harnett County Board of
Commissioners expresses their deepest gratitude to Dan Honeycutt for his life and legacy of
service to Harnett County and its citizens, and extends condolences to Dan's wife, Teresa Neal
Honeycutt, to his sons, Dan Curtis "Curt" Honeycutt Jr. and Lance Neal Honeycutt, and to his
mother for their untimely loss .
ADOPTED this 15th day of October 2018.
HARNETT COUNTY BOARD OF COMMISSIONERS
C. Gordon Springle, Chairman
Howard Penny, Vice Chairman Abe Elmore
Barbara McKoy Joe Miller
101518a HCBOC Page 22
Agenda Item 4-E --------
PROCLAMATION CELEBRATING HARNETT COUNTY RESIDENT
HUBERT EDWARDS ON THE OCCASION OF HIS 100th BIRTHDAY
WHEREAS, Harnett County resident Hubert Garland Edwards will celebrate his I 001h
birthday on October 27, 2018 ; and
WHEREAS, Mr. Edwards was born October 27, 1918, on a 300-acre tobacco farm in
Beaufort County, N.C., one of 11 brothers and sisters ; and
WHEREAS, Mr. Edwards enlisted in the United States Army on September 28, 1939,
and was assigne d to the 17th Field Artillery Battalion; and
WHEREAS, Mr. Edwards was married in 1941 before going to England to train for the
invasion of North Africa; and
WHEREAS, Mr. Edwards served 37 months overseas on the front lines of the European
theatre during World War II, and participated in seven invasions in seven countries including
campaigns in Tunisia, North Africa, Sicily, Naples-Foggia, Rome-Amo, Southern France, the
Rhineland and Central Europe; and
WHEREAS, Mr. Edwards was discharged from the Army on July 20, 1945 at the rank of
sergeant, earning a Silver Star medal and two Bronze Star medals, along with Army
Marksmanship Qualification Badges for pistol and rifle; and
WHEREAS, following his military service, Mr. Edwards worked for Hamilton Beach as
a production manager, and in 1968 was selected as the Beaufort County campaign manager for
U.S. Sen. Robert Morgan of Lillington during his campaign for North Carolina Attorney
General; and
WHEREAS, in recent years, Mr. Edwards has received numerous honors related to his
military service including serving as the grand marshal of the Hamett County Veterans Parade in
2013 , and being a guest of honor when his beloved Atlanta Braves played the Florida Marlins at
Fort Bragg in 2016; and
WHEREAS, Mr. Edwards is a member of the Sanford Senior Dran1a Club in which he
has performed in two dinner theaters, and was made a lifetime member of the Western Hamett
Lion's Club in 2018; and
WHEREAS, Mr. Edwards presently resides in Carolina Lakes where he is a member of
First Baptist Church in Sanford, and enjoys cooking ( especially baking), traveling and dancing,
as well as speaking and sharing his experiences in front of civic clubs, churches and various
other organizations; and
WHEREAS, Mr. Edwards has been married to Lynda Edwards for 11 years, and has a
daughter, Gail Surles, who also lives in Carolina Lakes with her husband, Jim.
101518a HCBOC Page 23
NOW, THEREFORE, BE IT RESOLVED that the Harnett County Board of
Commissioners does hereby recognize and congratulate Mr. Edwards upon the celebration of his
100th birthday and extends its best wishes to him, wishing him continued health and happiness.
ADOPTED this 15th day of October, 2018.
HARNETT COUNTY BOARD OF COMMISSIONERS
C. Gordon Springle, Chairman
Howard Penny, Vice Chairman Abe Elmore
Barbara McKoy Joe Miller
101518a HCBOC Page 24
Board Meeting
Agenda Item
Agenda Item 4-F ---------
MEETING DATE: October 15, 2018
TO: HARNETT COUNTY BOARD OF COMMISSIONERS
SUBJECT: North Carolina Department of Transportation/Public Transportation
Division (NCDOT/PTD) "Public Transportation Grant Agreement" 5311 FY2019
REQUESTED BY: Barry A. Blevins
REQUEST:
General Services Director, Hamett Area Rural Transit System (HARTS) requests the Hamett
County Board of Commissioners consider and approve the North Carolina Department of
Transportation (NCDOT) FYI 9 5311 grant agreement in the amount of $488,449; total
county match is $62,768. The grant provides funding for both capital and administrative
expenses associated with providing public transportation for the citizens of Harnett County.
Aproved Fiscal Year 2019 budget contains county match.
FINANCE OFFICER'S RECOMMENDATION:
COUNTY MANAGER'S RECOMMENDATION:
\\hcfilea\GSUsers\apeele\M y Documents\TRANSPORTATION\FYI 819\18 .09.20-agenda request 18.10.15 NCDOT 5311
Grant.docx Page I of 2 101518a HCBOC Page 25
NORTH CAROLINA DEPARTMENT OF TRANSPORTATION
and
COUNTY OF HARNETT
PUBLIC TRANSPORTATION GRANT AGREEMENT FOR
COMMUNITY TRANSPORTATION RURAL FORMULA GRANT
PROGRAM
Federal Award Identification
Agreement Number:
NCDOT Project Number: 19-CT -040
Approved Indirect Cost Rate : 12.25%
FAIN Number(s): NC-2017-052-01
CFDA Number: 20.509
DUNS Number: 091565986
Total Amount of Award : $488,449
•••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••••
Federal Funded Programs:
D 5303 Metropolitan Planning Grant
D 5307 Urbanized Area Formula Grant
D 5310 Elderly and Disabled Formula Grant
~ 5311 Community Transportation Rural Formula Grant
D 5311 Appalachian Development Transit Assistance Program Grant
D 5311f Intercity Bus Grant
D 5316 Job Access Reverse Commute Grant
D 5317 New Freedom Grant
D 5339 Bus and Bus Facility Grant
NCDOT PTD Federal Agreement
Revised 6/28/2018
Page 1 of 24
101518a HCBOC Page 26
THIS AGREEMENT made this the day of , 20 ,
(hereinafter referred to as AGREEMENT) by and between the NORTH CAROLINA
DEPARTMENT OF TRANSPORTATION (hereinc?u ... ~ ~-.. -
agency of the State of North Carolina) and COUNT~ y/ea_5e._ do
as the grant recipient hereinafter referred to as 1 -··
Department as "Parties"). do.....te.,.,:
1. Purpose of Agreement
rnent", an
()D+-s capacity
ither with
The purpose of this Agreement is to provide fort ized and
small urban public transportation services as dt __ .. _..,.., 111 u 1t! proJect application
(hereinafter referred to as "Project") and to state the terms and conditions as to the
manner in which the Project will be undertaken and completed. This Agreement contains
the entire agreement between the parties and there are no understandings or
agreements, verbal or otherwise, regarding this Agreement except as expressly set forth
herein. This Agreement is solely for the benefit of the identified parties to the Agreement
and is not intended to give any rights, claims, or benefits to third parties or to the public
at large.
2. Availability of Funds
All terms and conditions of this Agreement are dependent upon, and, subject to the
allocation of funds for the purpose set forth in the Agreement and the Agreement shall
automatically terminate if funds cease to be available.
3. Period of Performance
This Agreement shall commence upon the date of execution with a period of
performance for all expenditures that extends from July 1, 2018 to June 30, 2019. Any
requests to change the Period of Performance must be made in accordance with the
policies and procedures established by the Department or FT A The Subrecipient shall
commence, carry on, and complete the approved Project in a sound, economical, and
efficient manner.
4. Project Implementation
a. Scope of Project. County of Harnett will use funds to support the
operation of the transit office. The funding will cover 100% of the salary
and benefits of the transit director, asst. transit director and 2 other
administrative positions. Funds will also be used to cover expenses for
travel, training, office and computer supplies, electricity, water, sewer,
phones marketing and promotional material and a portion of the vehicle
insurance, and vehicle radio airtime. Harnett County will purchase (3)
Raised Roof Vans, side entry, no lift, 12-13 passengers; (1)
Minivan/Crossover (Replacement) and building and security
surveillance equipment.
NCDOT PTO Federal Agreement
Revised 6/28/2018
Page 2 of 24
101518a HCBOC Page 27
b. The Subrecipient shall undertake and complete the project in accordance with
the procedures, terms, and conditions herein and as included in the related
grant application for financial assistance, the terms of which are incorporated
by reference.
c. Amendment. Any amendment to this Agreement shall be done in writing and
in accordance with established policies and procedures and only by mutual
consent of the Parties.
5. Cost of Project/Project Budget
The total cost of the Project approved by the Department is FOUR HUNDRED
EIGHTY EIGHT THOUSAND FOUR HUNDRED FORTY NINE DOLLARS ($488,449) as
set forth in the Project Description and Budget, incorporated into this Agreement as
Attachment A. The Department shall provide, from Federal and State funds, the
percentages of the actual net cost of the Project as indicated below, not in excess of the
identified amounts for eligible Administrative, Operating, and Capital expenses. The
Subrecipient hereby agrees that it will provide the percentages of the actual net cost of
the Project, as indicated below, and any amounts in excess of the Department's maximum
(Federal plus State shares) contribution. The net cost is the price paid minus any refunds,
rebates, or other items of value received by the Subrecipient which have the effect of
reducing the actual cost.
Administration Administration Administration Administration
WBS Total Federal (80%) State (5%)
36233.50.21.1 $278,449 $222,759 $13,922
Aareement #
Capital I Capital I Capital I Capital I
WBS Total Federal (80%) State (10%}
36233.50.21.3 $192,000 $153,600 $19,200
AQreement #
Capital II Capital II Capital II Capital II
WBS Total Federal (80%) State (10%}
36233.50.21.4 $18,000 $14,400 $1,800
Agreement#
Project Project Project Project
Total Total Total Federal Total State
$488,449 $390,759 $34,922
6. Project Expenditures, Payments, and Reimbursement
NCDOT PTO Federal Agreement
Revised 6/28/2018
Administration
Local (15%)
$41,768
Capital I
Local (10%}
$19,200
Capital II
Local {10%)
$1,800
Project
Total Local
$62,768
Page 3 of 24
101518a HCBOC Page 28
a. General. The Department, utilizing available state and federal funds, shall
reimburse the Subrecipient for allowable costs for work performed under the
terms of this Agreement.
b. Reimbursement Procedures. The Subrecipient shall submit for reimbursement
all eligible costs incurred within the agreement Period of Performance.
i. Claims for reimbursement shall be made no more than monthly or less
than quarterly, using the State's grant system, Enterprise Business
Services (EBS) Partner Application .
ii. All requests for reimbursement must be submitted within (30) days
following the end of the project's reporting period. Any Subrecipient that
fails to submit a request for reimbursement for the first two quarters of
agreement fiscal year by January 31 or the last two quarters by July 31
will forfeit its ability to receive reimbursement for those periods .
iii. All payments issued by the Department will be on a reimbursable basis
unless the Subrecipient requests and the Department approves an
advance payment.
iv. Supporting documentation for proof of payment may be requested.
c . Subrecipient Funds. Prior to reimbursement, the Subrecipient shall provide the
Department with proof that the Sub recipient has met its proportionate share of
project costs from sources other than FTA or the Department. Any costs for
work not eligible for Federal and State participation shall be financed one
hundred percent (100%) by the Subrecipient.
d. Operating Expenditures. In order to assist in financing the operating costs of
the project, the Department shall reimburse the Subrecipient for the lesser of
the following when providing operating assistance:
i. The balance of unrecovered operating expenditures after deducting all
farebox revenue , or
ii. The percentage specified in the Approved Project Budget of the
allowable total operating expenditures which shall be determined by
available funding.
e. Travel Expenditures. The Subrecipient shall limit reimbursement for meals,
lodging and travel to rates established by the State of North Carolina Travel
Policy . Costs incurred by the Subrecipient in excess of these rates shall be
borne by the Subrecipient.
NCDOT PTO Federal Agreement
Revised 6/28/2018
Page4of24
101518a HCBOC Page 29
f. Allowable Costs. Expenditures made by the Subrecipient shall be reimbursed
as allowable costs to the extent they meet all of the requirements set forth
below. They must be:
i. Consistent with the Project Description, plans, specifications, and
Project Budget and all other provisions of this Agreement
ii. Necessary in order to accomplish the Project
iii. Reasonable in amount for the goods or services purchased
iv . Actual net costs to the Subrecipient, i.e., the price paid minus any
refunds (eg, refundable sales and use taxes pursuant to NCGS 105-
164.14), rebates, or other items of value received by the Subrecipient
that have the effect of reducing the cost actually incurred
v. Incurred (and be for work performed) within the period of performance
and period covered of this Agreement unless specific authorization
from the Department to the contrary is received
vi. Satisfactorily documented
vii. Treated uniformly and consistently under accounting principles and
procedures approved or prescribed by the Department
g. Excluded Costs. The Subrecipient understands and agrees that, except to the
extent the Department determines otherwise in writing, the Department will
exclude:
i. Any Project cost incurred by the Subrecipient before the period of
periormance of the agreement,
ii. Any cost that is not included in the latest Approved Project Budget,
iii. Any cost for Project property or services received in connection with a
third-party contract, sub-agreement, lease, or other arrangement that is
required to be, but has not been, concurred in or approved in writing by
the Department, and
iv. Any cost ineligible for FTA participation as provided by applicable
Federal or State laws, regulations, or directives.
h. Final Allowability Determination. The subrecipient understands and agrees that
payment to the subrecipient on any Project cost does not constitute the Federal
or State Government's final decision about whether that cost is allowable and
eligible for payment and does not constitute a waiver of any violation by the
NCDOT PTD Federal Agreement
Revised 6/28/2018
Page 5 of 24
101518a HCBOC Page 30
subrecipient of the terms of this Agreement. The subrecipient acknowledges
that the Federal or State Government will not make a final determination about
the aflowability and eligibility of any cost until an audit of the Project has been
completed. If the Federal or State Government determines that the subrecipient
is not entitled to receive any portion of the Federal or State assistance the
subrecipient has requested or provided, the Department will notify the
Subrecipient in writing, stating its reasons. The Subrecipient agrees that Project
closeout will not alter the Subrecipient's responsibility to return any funds due
the Federal or State Government as a result of later refunds, corrections, or
other transactions; nor will Project closeout alter the Federal or State
Government's right to disallow costs and recover funds on the basis of a later
audit or other review. Unless prohibited by Federal or State law or regulation,
the Federal or State Government may recover any Federal or State assistance
funds made available for the Project as necessary to satisfy any outstanding
monetary claims that the Federal or State Government may have against the
Subrecipient.
i. Federal or State Claims, Excess Payments, Disallowed Costs, Including
Interest.
i. Subrecipient's Responsibility to Pay . Upon notification to the
Subrecipient that specific amounts are owed to the Federal or State
Government, whether for excess payments of Federal or State
assistance, disallowed costs, or funds recovered from third parties or
elsewhere , the Subrecipient agrees to remit to the Department promptly
the amounts owed, including applicable interest and any penalties and
administrative charges within 60 days of notification .
ii. Interest Paid to the Department. The Subrecipient agrees to remit to the
Department interest owed as determined i n accordance with NCGS §
147-86.23 .
iii. Interest and Fees Paid on Federal Funds. For amounts owed by the
Subrecipient to the Federal Government, whether for excess payments
of Federal assistance , disallowed costs, or funds recovered from third
parties or elsewhere, the Subrecipient agrees to remit to the Federal
Government promptly the amounts owed, including applicable interest,
penalties and administrative charges as established by the Federal
Transit Authority Master Agreement with NCDOT .
j. De-obligation of Funds. The Subrecipient agrees that the Department may de-
obligate unexpended Federal and State funds for grants that are inactive for six
months or more.
k. Project Closeout. Project closeout occurs when the Department issues the final
project payment or acknowledges that the Subrecipient has remitted the proper
NCDOT PTO Federal Agreement
Revised 6/28/2018
Page 6 of 24
101518a HCBOC Page 31
refund. The Subrecipient agrees that Project closeout by the Department does
not invalidate any continuing requirements imposed by this Agreement.
7. Accounting Records
a. Establishment and Maintenance of Accounting Records. The Subrecipient shall
establish and maintain separate accounts for the public transportation program ,
either independently or within the existing accounting system. All costs charged
to the program shall be in accordance with most current approved Project
Budget and shall be reported to the Department in accordance with NCDOT
Uniform Public Transportation Accounting System (UPTAS) guide.
b. Documentation of Project Costs. All costs charged to the Project, including any
approved services performed by the Subrecipient or others, shall be supported
by properly executed payrolls, time records, invoices, contracts, or vouchers
evidencing in detail the nature and propriety of the charges.
8. Reporting, Record Retention, and Access
a. Progress Reports. The Subrecipient shall advise the Department, through EBS,
regarding the progress of the Project at a minimum quarterly, and at such time
and in such a manner as the Department may require . Such reporting and
documentation may include, but not be limited to: operating statistics,
equipment usage, meetings , progress reports, and monthly performance
reports. The Subrecipient shall collect and submit to the Department such
financial statements, data, records, contracts , and other documents related to
the Project as may be deemed necessary by the Department. Reports shall
include narrative and financial statements of sufficient substance to be in
conformance with the reporting requirements of the Department. Progress
reports throughout the useful life of the project equipment shall be used , in part,
to document utilization of the project equipment. Failure to fully utilize the
project equipment in the manner directed by the Department shall constitute a
breach of contract, and after written notification by the Department, may result
in termination of the Agreement or any such remedy as the Department deems
appropriate.
b. Failure to comply with grant reporting and compliance guidelines set forth in
the NCDOT PTO State Management Plan could result in financial penalties up
to and including loss of current and future grant funding .
c. Record Retention. The Subrecipient and its third party subrecipients shall retain
all records pertaining to this Project for a period of five (5) years from the date
of final payment to the Subrecipient, or until all audit exceptions have been
resolved, whichever is longer.
d. Project Closeout. The Subrecipient agrees that Project closeout does not alter
the reporting and record retention requirements of this Agreement.
NCOOT PTO Federal Agreement
Revised 6/28/2018
Page 7 of 24
101518a HCBOC Page 32
e. State Auditor Oversight. The Subrecipient agrees to audit oversight by the
Office of the State Auditor, to provide the Office of the State Auditor with access
to accounting records, and to make available any audit work papers in the
possession of any auditor of the Subrecipient.
f. Financial Reporting and Audit Requirements . In accordance with 09 NCAC
03M.0205, all reports shall be filed with the Department in the format and
method specified by the agency no later than three (3) months after the end of
the recipient's fiscal year, unless the same information is already required
through more frequent reporting . Audit Reports must be provided to the funding
agency no later than nine (9) months after the end of the recipient's fiscal year.
g. Parts Inventory. Financial audits must address parts inventory management.
h. Third Party Loans . Within 30 days of receipt, the Subrecipient shall disclose to
the Department any loans received from a local government entity or other
entity not party to this agreement.
i. Audit Costs. Unless prohibited by law, the costs of audits made in accordance
with Title 2 CFR 200, Subpart F "Audit Requirements" are allowable charges to
State and Federal awards. The charges may be considered a direct cost or an
allocated indirect cost, as determined in accordance with cost principles
outlined in Title 2 CFR 200, Subpart E ''Cost Principles." The cost of any audit
not conducted in accordance with Title 2 CFR 200 and NCGS§ 159-34 is
unallowable and shall not be charged to State or Federal grants.
9. Compliance with Laws and Regulations
a. No terms herein shall be construed in a manner that conflicts with the rules and
regulations of the Department or with state or federal law.
b. The Subrecipient agrees to comply with all applicable state and federal laws
and regulations, including titles 09 NCAC 3M and 19A NCAC SB, as amended.
10. Conflicts of Interest Policy
The subrecipient agrees to file with the Department a copy of the subrecipient's policy
addressing conflicts of interest that may arise involving the subrecipient's management
employees and the members of its board of directors or other governing body. The
sub recipient's policy shall address situations in which any of these individuals may directly
or indirectly benefit, except as the subrecipient's employees or members of its board or
other governing body, from the subrecipient's disbursing of State funds, and shall include
actions to be taken by the subrecipient or the individual, or both, to avoid conflicts of
interest and the appearance of impropriety . The conflicts of interest policy shall be filed
with the Department prior to the Department disbursing funds to the subrecipient.
NCDOT PTO Federal Agreement
Revised 6/28/2018
Page 8 of 24
101518a HCBOC Page 33
Prohibition on Bonus or Commission Payments
The Subrecipient affirms that it has not paid and will not pay any bonus or commission
to any party to obtain approval of its Federal or State assistance application for the
Project.
11. Tax Compliance Certification
The Subrecipient shall complete and submit to the Department a sworn written
statement pursuant to NCGS 143C-6-23(c), stating that the Subrecipient does not have
any overdue tax debts, as defined by GS 105-243.1, at the Federal, State, or local level.
The Subrecipient acknowledges that the written statement must be submitted to the
Department prior to execution of this Agreement and disbursement of funds. The
certification will be incorporated into this Agreement as Attachment B.
12. Assignment
a. Unless otherwise authorized in writing by the Department, the Subrecipient
shall not assign any portion of the work to be performed under this Agreement,
or execute any contract, amendment, or change order thereto, or obligate itself
in any manner with any third party with respect to its rights and responsibilities
under this Agreement without the prior written concurrence of the Department.
b. The Subrecipient agrees to incorporate the terms of this agreement and any
applicable State or Federal requirements into written third-party contracts, sub-
agreements, and leases, and to take the appropriate measures necessary to
ensure that all Project participants comply with applicable Federal and State
laws, regulations, and directives affecting their performance, except to the
extent the Department determines otherwise in writing.
13. Hold Harmless.
Except as prohibited or otherwise limited by law, the Subrecipient agrees to indemnify,
save, and hold harmless the Department, the State of North Carolina and the United
States of America and its officers, agents, and employees acting within the scope of their
official duties against any liability, including costs and expenses, resulting from any willful
or intentional violation by the Subrecipient of proprietary rights, copyrights, or right of
privacy, arising out of the publication, translation, reproduction, delivery, use, or
disposition of any data furnished under the Project.
14. Real Property, Equipment, and Supplies.
Federal or State Interest. The Subrecipient understands and agrees that the Federal
or State Government retains an interest in any real property, equipment, and supplies
financed with Federal or State assistance (Project property) until, and to the extent, that
the Federal or State Government relinquishes its Federal or State interest in that Project
NCDOT PTO Federal Agreement
Revised 6/28/2018
Page 9 of24
101518a HCBOC Page 34
property . With respect to any Project property financed with Federal or State assistance
under this Agreement, the Subrecipient agrees to comply with the following provisions,
except to the extent FTA or the Department determines otherwise in writing :
a . Use of Project Property . The Subrecipient agrees to maintain continuing control of
the use of Project property. The Subrecipient agrees to use Project property for
appropriate Project purposes (which may include joint development purposes that
generate program income, both during and after the award period and used to
support public transportation activities) for the duration of the useful life of that
property, as required by FTA or the Department. Should the Subrecipient
unreasonably delay or fail to use Project property during the useful life of that
property , the Subrecipient agrees that it may be required to return the entire
amount of the Federal and State assistance expended on that property. The
Subrecipient further agrees to notify the Department immediately when any Project
property is withdrawn from Project use or when any Project property is used in a
manner substantially different from the representations the Sub recipient has made
in its Application or in the Project Description for this Agreement for the Project. In
turn, the Department shall be responsible for notifying FT A.
b . Maintenance and Inspection of Vehicles. The Sub recipient shall maintain vehicles
at a high level of cleanliness, safety, and mechanical soundness in accordance
with the minimum maintenance requirements recommended by the manufacturer
and comply with the Department's State Management Plan ("SMP"). The
Subrecipient shall register all vehicle maintenance activities into the Department's
Asset Management System (AssetWorks) or an electronic version of same. The
Department shall conduct frequent inspections to confirm proper maintenance
pursuant to this subsection and the SMP. The Subrecipient shall collect and submit
to the Department at such time and in such manner as it may require information
for the purpose of the Department's Asset Management System (AssetWorks) and
the Transit Asset Maintenance ("TAM") Plan .
c . Maintenance and Inspection of Facilities and Equipment. The Subrecipient shall
maintain any Project facility , including any and all equipment installed into or added
on to the facility as part of the Project, in good operating order and at a high level
of cleanliness, safety and mechanical soundness in accordance with good facility
maintenance and upkeep practices and in accordance with the minimum
maintenance requirements recommended by the manufacturer for all equipment
installed in or added to the facility as part of the Project. Such maintenance shall
be in compliance with applicable Federal and state regulations or directives that
may be issued, except to the extent that the Department determines otherwise in
writing . The Subrecipient shall document its maintenance program in a written
plan. The Department shall conduct inspections as it deems necessary to confirm
proper maintenance on the part of the Subrecipient pursuant to this subsection
and SMP. Such inspections may or may not be scheduled ahead of time but will
be conducted such that they shall not significantly interfere with the ongoing and
necessary functions for which the Project was designed . The Subrecipient shall
NC DOT PTD Federal Agreement
Revised 6/28/2018
Page 10 of 24
101518a HCBOC Page 35
make every effort to accommodate such inspections by the Department in
accordance with the Department's desired schedule for such inspections .
d. The Subrecipient shall collect and submit to the Department at such time and in
such manner as the Department may require information for the purpose of
updating the TAM Plan Inventory and any and all other reports the Department
deems necessary. The Subrecipient shall also maintain and make available to the
Department upon its demand all documents, policies, procedures, purchase
orders, bills of sale, internal work orders and similar items that demonstrate the
Subrecipient's maintenance of the facility in good operating order and at a high
level of cleanliness, safety and mechanical soundness.
e. Incidental Use. The Subrecipient agrees that any incidental use of Project property
will not exceed that permitted under applicable laws, regulations, and directives.
f. Title to Vehicles. The Certificate of Title to all vehicles purchased under the
Approved Budget for this Project shall be in the name of the Subrecipient. The
Department's Public Transportation Division shall be recorded on the Certificate of
Title as first lien-holder. In the event of project termination or breach of contract
provisions, the Subrecipient shall, upon written notification by the Department,
surrender Project equipment and/or transfer the Certificate(s) of Title for Project
equipment to the Department or the Department's designee within 30 days of
request.
g. Encumbrance of Project Property. The Subrecipient agrees to maintain
satisfactory continuing control of Project property as follows:
( 1) Written Transactions. The Subrecipient agrees that it will not execute any
transfer of title, lease, lien, pledge, mortgage, encumbrance, third party
contract, subagreement, grant anticipation note, alienation, innovative
finance arrangement (such as a cross border lease, leveraged lease, or
otherwise), or any other obligation pertaining to Project property, that in any
way would affect the continuing Federal and State interest in that Project
property.
(2) Oral Transactions . The Subrecipient agrees that it will not obligate itself in
any manner to any third party with respect to Project property.
(3) Other Actions. The Subrecipient agrees that it will not take any action
adversely affecting the Federal and State interest in or impair the
Subrecipient's continuing control of the use of Project property.
h. Alternative Use, Transfer, and Disposition of Project Property. The Subrecipient
understands and agrees any alternative uses, transfers, or disposition of project
property must be approved by the Department and done in accordance with
Departmental procedures.
NCDOT PTD Federal Agreement
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101518a HCBOC Page 36
i. Insurance Proceeds. If the Subrecipient receives insurance proceeds as a result
of damage or destruction to the Project property, the Subrecipient agrees to:
(1) Apply those insurance proceeds to the cost of replacing the damaged or
destroyed Project property taken out of service, or
(2) Return to the Department an amount equal to the remaining Federal and
State interest in the damaged or destroyed Project property.
j. Misused or Damaged Project Property. If any damage to Project property results
from abuse or misuse occurring with the Subrecipient 's knowledge and consent,
the Subrecipient agrees to restore the Project property to its original condition or
refund the value of the Federal and State interest in that property, as the
Department may require.
k. Responsibilities after Project Closeout. The Subrecipient agrees that Project
closeout by the Department will not change the Subrecipient's Project property
management responsibilities, and as may be set forth in subsequent Federal and
State laws, regulations, and directives, except to the extent the Department
determines otherwise in writing.
15. Insurance
The Subrecipient shall be responsible for protecting the state and/or federal financial
interest in the facility construction/renovation and equipment purchased under this
Agreement throughout the useful life. The Subrecipient shall provide, as frequently and
in such manner as the Department may require, written documentation that the facility
and equipment are insured against loss in an amount equal to or greater than the state
and/or federal share of the real value of the facility or equipment. Failure of the
Subrecipient to provide adequate insurance shall be considered a breach of contract and,
after notification may result in termination of this Agreement. In addition, other insurance
requirements may apply. The Subrecipient agrees to comply with the insurance
requirements normally imposed by North Carolina State and local laws, regulations, and
ordinances, except to the extent that the Department determines otherwise in writing.
16. Termination
a. Either party may terminate the Agreement by providing 60 days written notice
to the other party, or as otherwise permitted by law.
b. Should the Subrecipient terminate the Agreement without the concurrence of
the Department, the Subrecipient shall reimburse the Department one hundred
percent (100%) of all costs expended by the Department and associated with
the work.
17. Additional Repayment Requirements and Remedies
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a. The repayment requirements and remedies addressed in this Paragraph are in
addition to those repayment requirements and other remedies set forth
elsewhere in this Agreement, including the requirements to repay unspent
funds . No remedy conferred or reserved by or to the Department is intended
to be exclusive of any other available remedy or remedies, but each and every
such remedy shall be cumulative and shall be in addition to every other remedy
provided for in this Agreement, or now or hereinafter existing at law, in equity,
or by statute, and any such right or power may be exercised from time to time
and as often as may be deemed expedient.
b. If there is a breach of any of the requirements, covenants or agreements in this
Agreement (including , without limitation, any reporting requirements), or ifthere
are any representations or warranties which are untrue as to a material fact in
this Agreement or in relation to the Project (including the performance thereof),
the Subrecipient agrees that the Department may require repayment from the
Subrecipient of an amount of funds to be determined in the Department's sole
discretion but not to exceed the amount of funds the Subrecipient has already
received under this Agreement.
18. Civil Rights and Equal Opportunity
Under this Agreement, the Subrecipient shall at all times comply with the
requirements included as part of this agreement in the Federal Terms and
Conditions.
19. Choice of Law and Venue
This agreement is to be interpreted according to the laws of the State of North
Carolina . The Parties hereby agree that the proper venue for any claims filed as a result
of this Agreement shall be the Superior Court of Wake County, North Carolina.
20 . Severability
If any provision of the FTA Master Agreement or this Agreement for the Project is
determined invalid, the remainder of that Agreement shall not be affected if that remainder
would continue to conform to the · requirements of applicable Federal or State laws or
regulations .
21. Incorporated Terms and Conditions
In addition to the Terms and Conditions contained in this agreement and the terms
and conditions included in the grant application, which are hereby incorporated by
reference, additional terms and conditions incorporated by reference into this
agreement are checked below.
~ Federal Terms and Conditions, Attached
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NCDOT PTO Federal Agreement
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22. Federal Terms and Conditions
State Management Plan . The State Management Plan for Federal and State
Transportation Programs and any subsequent amendments or revisions thereto, are
herewith incorporated by reference, and are on file with and approved by the
Department. Nothing shall be construed under the terms of this Agreement by the
Department or the Subrecipient that shall cause any conflict with Department , State, or
Federal statutes, rules, or regulations .
Allowable Costs. Eligible costs are those costs attributable to and allowed under the
FTA program and the provisions of 2 CFR Parts 200 and 1201, "Uniform Administrative
Requirements, Cost Principles, and Audit Requirements for Federal Awards."
No Federal Government Obligations to Third Parties . The Subrecipient acknowledges
and agrees that, notwithstanding any concurrence by the Federal Government in or
approval of the solicitation or award of the underlying Agreement, absent the express
written consent by the Federal Government, the Federal Government is not a party to this
Agreement and shall not be subject to any obligations or liabilities to the Subrecipient or
any other party (whether or not a party to that contract) pertaining to any matter resulting
from the underlying Agreement.
The Subrecipient agrees to include the above clause in each contract financed in whole
or in part with Federal assistance provided by the FTA. It is further agreed that the clause
shall not be modified, except to identify the subcontractor who will be subject to its
provisions .
Program Fraud and False or Fraudulent Statements or Related Acts . The Subrecipient
acknowledges that the provisions of the Program Fraud Civil Remedies Act of 1986, as
amended , 31 USC§ 3801 et seq. and U.S . DOT regulations , "Program Fraud Civil
Remedies," 49 CFR part 31, apply to its actions pertaining to this project. Upon
execution of the underlying Agreement, the Subrecipient certifies or affirms the
truthfulness and accuracy of any statement it has made, it makes , it may make , or
causes to be made, pertaining to the underlying Agreement or the FTA assisted project
for which this Agreement work is being performed. In addition to other penalties that
may be applicable, the Subrecipient further acknowledges that if it makes, or causes to
be made, a false, fictitious, or fraudulent claim, statement, submission, or certification ,
the Federal Government reserves the right to impose the penalties of the Program
Fraud Civil Remedies Act of 1986 on the Subrecipient to the extent the Federal
Government deems appropriate.
The Subrecipient also acknowledges that if it makes, or causes to be made, a false,
fictitious, or fraudulent claim, statement, submission, or certification to the Federal
Government under a contract connected with a project that is financed in whole or in
part with Federal assistance originally awarded by FTA under the authority of 49 USC
chapter 53, the Government reserves the right to impose the penalties of 18 USC §
1001 and 49 USC § 5323(1) on the Subrecipient, to the extent the Federal Government
deems appropriate.
NCDOT PTD Federa l Agreement
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101518a HCBOC Page 40
The Subrecipient agrees to include the above two clauses in each subcontract financed
in whole or in part with Federal assistance provided by FTA. It is further agreed that the
clauses shall not be modified, except to identify the subcontractor who will be subject to
the provisions .
Access to Records and Reports.
a. Record Retention . The Subrecipient will retain, and will require its subcontractors of all
tiers to retain, complete and readily accessible records related in whole or in part to the
Agreement, including, but not limited to, data, documents, reports, statistics, sub-
agreements, leases, subcontracts, arrangements, other third-party agreements of any
type, and supporting materials related to those records.
c. Access to Records. The Subrecipient agrees to provide sufficient access to FT A and
its contractors to inspect and audit records and information related to performance of this
Agreement as reasonably may be required.
d. Access to the Sites of Performance. The Subrecipient agrees to permit FT A and its
contractors access to the sites of performance under this Agreement as reasonably may
be required.
Federal Changes. The Subrecipient agrees to comply with all applicable federal
requirements and federal guidance. All the standards or limits included in this agreement
are minimum requirements. The federal requirements and guidance that applied at the
time of the award this Agreement may be modified from time to time, and the modifications
will apply to the Subrecipient.
Civil Rights and Equal Opportunity . Under this Agreement, the Subrecipient shall at all
times comply with the following requirements and shall include these requirements in
each subcontract entered into as part thereof.
1. Nondiscrimination. In accordance with Federal transit law at 49 USC § 5332, the
Subrecipient agrees that it will not discriminate against any employee or applicant for
employment because of race, color, religion, national origin, sex, disability, or age. In
addition, the Subrecipient agrees to comply with applicable Federal implementing
regulations and other implementing requirements FT A may issue.
2. Race, Color. Religion, National Origin, Sex. In accordance with Title VII of the Civil
Rights Act, as amended, 42 USC§ 2000e et seq., and Federal transit laws at 49 USC§
5332, the Subrecipient agrees to comply with all applicable equal employment opportunity
requirements of U.S . Department of Labor (U.S . DOL) regulations, "Office of Federal
Contract Compliance Programs, Equal Employment Opportunity, Department of Labor,"
41 CFR chapter 60, and Executive Order No. 11246, "Equal Employment Opportunity in
Federal Employment," September 24, 1965, 42 USC§ 2000e note, as amended by any
later Executive Order that amends or supersedes it, referenced in 42 USC§ 2000e note.
The Subrecipient agrees to take affirmative action to ensure that applicants are employed,
and that employees are treated during employment, without regard to their race, color,
religion, national origin, or sex (including sexual orientation and gender identity). Such
NCDOT PTO Federal Agreement
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action shall include , but not be limited to , the following: employment, promotion, demotion
or transfer, recruitment or recruitment advertising, layoff or termination ; rates of pay or
other forms of compensation; and selection for training, including apprenticeship. In
addition, the Subrecipient agrees to comply with any implementing requirements FTA
may issue .
3. Age . In accordance with the Age Discrimination in Employment Act , 29 USC §§
621634, U.S. Equal Employment Opportunity Commission (U .S. EEOC) regulations, "Age
Discrimination in Employment Act," 29 CFR part 1625, the Age Discrimination Act of
1975, as amended, 42 USC§ 6101 et seq ., U.S . Health and Human Services regulations,
"Nondiscrimination on the Basis of Age in Programs or Activities Receiving Federal
Financial Assistance," 45 CFR part 90, and Federal transit law at 49 USC § 5332, the
Subrecipient agrees to refrain from discrimination against present and prospective
employees for reason of age . In addition , the Subrecipient agrees to comply with any
implementing requirements FTA may issue.
4. Disabilities. In accordance with section 504 of the Rehabilitation Act of 1973, as
amended, 29 USC§ 794, the Americans with Disabilities Act of 1990, as amended, 42
USC§ 12101 et seq ., the Architectural Barriers Act of 1968, as amended , 42 USC§ 4151
et seq ., and Federal transit law at 49 USC§ 5332 , the Subrecipient agrees that it will not
discriminate against individuals on the basis of disability. In addition , the Subrecipient
agrees to comply with any implementing requirements FT A may issue .
Disadvantaged Business Enterprises. It is the policy of the North Carolina Department of
Transportation that Disadvantaged Business Enterprises (DBEs) as defined in 49 CFR
Part 26 shall have the equal opportunity to compete fairly for and to participate in the
performance of contracts financed in whole or in part by Federal Funds . The Subrecipient
is also encouraged to give every opportunity to allow DBE participation in Supplemental
Agreements . The Subrecipient, subconsultant , and subcontractor shall not discriminate
on the basis of race, religion, color, national origin, age, disability or sex in the
performance of this contract. The Subrecipient shall comply with applicable requirements
of 49 CFR Part 26 in the award and administration of federally assisted contracts. Failure
by the Subrecipient to comply with these requirements is a material breach of this
contract , which will result in the termination of this contract or such other remedy, as the
Department deems necessary .
When payments are made to Disadvantaged Business Enterprise (DBE) Subrecipients,
including material suppliers, Subrecipients at all levels (Subrecipient , Subconsultant or
Subrecipient) shall provide the Contract Administrator with an accounting of said
payments. The accounting shall be listed on the Department's Subrecipient Payment
Information Form (Form DBE-IS). In the event the Subrecipient has no DBE participation,
the Subrecipient shall indicate this on the Form DBE-IS by entering the word 'None' or
the number 'zero' and the form shall be signed. Form DBE-IS may be accessed on the
website at: https:/ /apps. dot.state. nc. us/guickfind/forms/Defau It. aspx .
A responsible fiscal officer of the payee Subrecipient, subconsultant or Subrecipient who
can attest to the date and amounts of the payments shall certify that the accounting is
NCDOT PTD Federal Agreement
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101518a HCBOC Page 42
correct. A copy of an acceptable report may be obtained from the Department of
Transportation. This information shall be submitted as part of the requests for payments
made to the Department.
Prompt payment provisions. When a subcontractor has performed in accordance with
the provisions of his contract, the contractor shall pay to his subcontractor and each
subcontractor shall pay to his subcontractor, within seven days of receipt by the
contractor or subcontractor of each periodic or final payment, the full amount received
for such subcontractor's work and materials based on work completed or service
provided under the subcontract NCGS §22C-1.
Incorporation of FTA Terms. Provisions of this Agreement include, in part, certain
standard terms and conditions required by the U .S. DOT. All contractual provisions
required by the U.S. DOT, as set forth in FTA Circular 4220.1, as amended, are
incorporated by reference. Anything to the contrary herein notwithstanding, all FTA-
mandated terms shall be deemed to control in the event of a conflict with other provisions
contained in this Agreement. The Subrecipient shall not perform any act, fail to perform
any act, or refuse to comply with ·any Department request, which would cause the
Department to be in violation of FT A terms and conditions, as referenced in the current
FTA Master Agreement shall prevail and be the instrument governing the receipt of
Federal assistance from the Federal Transit Administration.
Energy Conservation. The Subrecipient agrees to comply with mandatory standards and
policies relating to energy efficiency, which are contained in the state energy conservation
plan issued in compliance with the Energy Policy and Conservation Act.
Debarment. Suspension, Ineligibility and Voluntary Exclusion . The Subrecipient shall
comply and facilitate compliance with U.S. DOT regulations, "Non-procurement
Suspension and Debarment," 2 CFR part 1200, which adopts and supplements the U.S.
Office of Management and Budget (U.S. 0MB) "Guidelines to Agencies on Government-
wide Debarment and Suspension (Non-procurement)," 2 CFR part 180 . As such, the
Subrecipient shall verify that its principals, affiliates, and subcontractors are eligible to
participate in this federally funded Agreement and are not presently declared by any
Federal department or agency to be:
a) Debarred from participation in any federally assisted Award;
b) Suspended from participation in any federally assisted Award;
c) Proposed for debarment from participation in any federally assisted Award;
d) Declared ineligible to participate in any federally assisted Award;
e) Voluntarily excluded from participation in any federally assisted Award; or
f) Disqualified from participation in ay federally assisted Award.
By signing and submitting this Agreement, Subrecipient certifies as follows :
NCOOT PTO Federal Agreement
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101518a HCBOC Page 43
The certification in this clause is a material representation of fact relied upon by the
Department. If it is later determined by the Department that the Subrecipient knowingly
rendered an erroneous certification, in addition to remedies available to the Department,
the Federal Government may pursue available remedies, including but not limited to
suspension and/or debarment. The Subrecipient agrees to comply with the requirements
of 2 CFR part 180, subpart C, as supplemented by 2 CFR part 1200, throughout the
period of this Agreement. The Subrecipient further agrees to include a provision requiring
such compliance in its lower tier covered transactions. These provisions apply to each
contract at any tier of $25,000 or more, and to each contract at any tier for a federally
required audit (irrespective of the contract amount), and to each contract at any tier that
must be approved by an FTA official irrespective of the contract amount.
Lobbying Restrictions. The Subrecipient agrees that neither it nor any third-party
participant will use federal assistance to influence any officer or employee of a federal
agency, member of Congress or an employee of a member of Congress, or officer or
employee of Congress on matters that involve this agreement, including any extension or
modification, according to the following:
(1) Laws, Regulations, Requirements, and Guidance. This includes:
(a) The Byrd Anti-Lobbying Amendment, 31 USC§ 1352, as amended,
(b) U.S. DOT regulations, "New Restrictions on Lobbying," 49 CFR part 20, to the extent
consistent with 31 USC § 1352, as amended, and
(c) Other applicable federal laws, regulations, requirements, and guidance prohibiting the
use of federal assistance for any activity concerning legislation or appropriations designed
to influence the U.S. Congress or a state legislature, and
(2) Exception. If permitted by applicable federal law, regulations, requirements, or
guidance, such lobbying activities described above may be undertaken through the
subrecipient's proper official channels.
The Subrecipient agrees to submit a signed and dated Certification on Lobbying that
appears in the attachment.
Clean Air Act and Federal Water Pollution Control Act. The Subrecipient agrees:
1) It will not use any violating facilities;
2) It will report the use of facilities placed on or likely to be placed on the U .S. EPA "List
of Violating Facilities;"
3) It will report violations of use of prohibited facilities to FT A; and
4) It will comply with the inspection and other requirements of the Clean Air Act, as
amended, (42 USC §§ 7401 -7671 q); and the Federal Water Pollution Control Act as
amended, (33 USC§§ 1251-1387).
NCDOT PTD Federal Agreement
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101518a HCBOC Page 44
Public Transportation Employee Protective Arrangements. The Subrecipient agrees to
comply with the following employee protective arrangements of 49 USC§ 5333(b):
1. Sections 5307 and 5339. Under this Agreement or any Amendments thereto that
involve public transportation operations that are supported with 49 USC § 5307 or 49
USC § 5339 federal assistance, a certification issued by U.S. DOL is a condition of the
Contract.
2. Section 5311 . When the Agreement involves public transportation operations and is
supported with federal assistance appropriated or made available for 49 USC § 5311,
U.S . DOL will provide a Special Warranty for its Award. The U.S. DOL Special Warranty
is a condition of the Agreement.
3. Section 5310. The conditions of 49 USC § 5333(b) do not apply to Subrecipients
providing public transportation operations pursuant to 49 USC§ 5310. FTA reserves the
right to make case-by-case determinations of the applicability of 49 USC § 5333(b) for all
transfers of funding authorized under title 23, United States Code (flex funds), and make
other exceptions as it deems appropriate, and, in those instances, any special
arrangements required by FTA will be incorporated herein as required.
Charter Service . The Subrecipient agrees to comply with 49 USC 5323(d), 5323(r), and
49 CFR part 604, which provides that recipients and subrecipients of FT A assistance are
prohibited from providing charter service using federally funded equipment or facilities if
there is at least one private charter operator willing and able to provide the service, except
as permitted under:
1. Federal transit laws, specifically 49 USC § 5323(d);
2. FTA regulations, "Charter Service ," 49 CFR part 604;
3. Any other federal Charter Service regulations; or
4 . Federal guidance, except as FTA determines otherwise in writing.
The Subrecipient agrees that if it engages in a pattern of violations of FT A's Charter
Service regulations, FT A may require corrective measures or impose remedies on it.
These corrective measures and remedies may include:
1. Barring it or any subcontractor operating public transportation under its Award that has
provided prohibited charter service from receiving federal assistance from FT A;
2. Withholding an amount of federal assistance as provided by Appendix D to part 604 of
FTA's Charter Service regulations; or
3 . Any other appropriate remedy that may apply. The Subrecipient should also include
the substance of this clause in each subcontract that may involve operating public transit
services .
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101518a HCBOC Page 45
School Bus Operations. The Subrecipient agrees to comply with 49 USC 5323{f), and 49
CFR part 605, and not engage in school bus operations using federally funded equipment
or facilities in competition with private operators of school buses, except as permitted
under:
1. Federal transit laws, specifically 49 USC§ 5323(f);
2 . FTA regulations, "School Bus Operations," 49 CFR part 605;
3. Any other Federal School Bus regulations; or
4 . Federal guidance, except as FTA determines otherwise in writing.
If Subrecipient violates this School Bus Agreement, FT A may:
1. Bar the Subrecipient from receiving Federal assistance for public transportation; or
2. Require the Subrecipient to take such remedial measures as FTA considers
appropriate.
When operating exclusive school bus service under an allowable exemption, the
contractor may not use federally funded equipment, vehicles, or facilities.
The Subrecipient shall include the substance of this clause in each subcontract or
purchase under this contract that may operate public transportation services.
Substance Abuse Requirements (Recipients of Sections 5307, 5311, and 5339 funds
QI!M. The Subrecipient agrees to establish and implement a drug and alcohol testing
program that complies with 49 CFR parts 40 and 655, produce any documentation
necessary to establish its compliance with part 655, and permit any authorized
representative of the United States Department of Transportation or its operating
administrations or the Department to inspect the facilities and records associated with the
implementation of the drug and alcohol testing program as required under 49 CFR part
655 and review the testing process. The Subrecipient agrees further to submit the Drug
and Alcohol Management Information System (DAMIS) reports before February 15 to
NCDOT Public Transportation Compliance Office or its designee.
23. Contract Administrators.
All notices permitted or required to be given by one Party to the other and all questions
about this Agreement from one Party to the other shall be addressed and delivered to the
other Party's Contract Administrator. The name, postal address, street address,
telephone number, fax number, and email address of the Parties' respective initial
Contract Administrators are set out below . Either Party may change the name, postal
address, street address, telephone number, fax number, or email address of its Contract
Administrator by giving timely written notice to the other Party.
NCDOT PTD Federal Agreement
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101518a HCBOC Page 46
For the Department
Name:
Title:
Agency:
Email:
MSC:
Myra Freeman
Financial Manager
NCDOT/PTD
Msfreeman 1@ncdot.gov
1550 Mail Service Center -Raleigh, NC 27699-1550
Physical
Address: 1 S. Wilmington St, Rm 542, Transportation Building, Raleigh, NC 27601
Phone: 919-707-4672 Fax: 919-733-2304
For the Subrecipient:
Name:
Title:
Agency :
Email :
+kr0e:tl :nreCL RurWl :J?aosi± sysr--c~
bb kv ·tns ~bQrn_-etT.or-g
Phone :
NCDOT PTD Federal Agreement
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101518a HCBOC Page 47
IN WITNESS WHEREOF, this Agreement has been executed by the Department, an
agency of the State of North Carolina, and the Subrecipient by and through a duly
authorized representative and is effective the date and year first above written.
SUBRECIPIENT'S FEDERAL TAX ID
NUMBER:
SUBRECIPIENT'S FISCAL YEAR END:
ATTEST:
TITLE:
ATTEST:
TITLE:
NCDOT PTD Federal Agreement
Revised 6/28/2018
BY:
TITLE:
BY:
TITLE:
COUNTY OF HARNETT
5Lp-lo OD03Cio
JUNE 30, 2019
CHAIRPERSON
.... . . . .
DEPARTMENT OF: : : : : : : ·: ·: · '. ·
TRANSPORTATION
DEPUTY SECRETARY FOR
MULTI-MODAL TRANSPORTATION
Page 23 of24
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101518a HCBOC Page 48
Attachment
Certification Regarding Lobbying
The Subrecipient certifies, to the best of his or her knowledge and belief, that:
(1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the
undersigned, to any person for influencing or attempting to influence an officer or
employee of an agency, a Member of Congress, an officer or employee of Congress, or
an employee of a Member of Congress in connection with the awarding of any Federal
contract, the making of any Federal grant, the making of any Federal loan, the entering
into of any cooperative agreement, and the extension , continuation, renewal,
amendment, or modification of any Federal contract, grant, loan, or cooperative
agreement.
(2) If any funds other than Federal appropriated funds have been paid or will be paid to any
person for influencing or attempting to influence an officer or employee of any agency, a
Member of Congress, an officer or employee of Congress, or an employee of a Member
of Congress in connection with this Federal contract, grant, loan, or cooperative
agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure
Form to Report Lobbying," in accordance with its instructions.
(3) The Subrecipient shall require that the language of this certification be included in the
award documents for all subawards at all tiers (including subcontracts, subgrants, and
contracts under grants, loans. and cooperative agreements) and that all subrecipients
shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this
transaction was made or entered into . Submission of this certification is a prerequisite for
making or entering into this transaction imposed by section 1352, title 31, U.S . Cod~ .. ~.n.y . . . .
person who fails to file the required certification shall be subject to a civil penalty of.ryof l~ · "ttiao ·
$10,000 and not more than $100,000 for each such failure.
Subrecipient's Authorized Representative :
Title : Chc{tr ®o of ~ &::osr\ o-6 C.Offi('(\l S'S\crers
Date:
NCDOT PTD Federal Agreement
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Page 24 of24
101518a HCBOC Page 49
PUBLIC TRANSPORTATION PROGRAM RESOLUTION
FY 2019 RESOLUTION
Section 5311 (including AOTAP), 5310, 5339, 5307 and applicable State funding, or combination thereof.
Applicant seeking pennission to apply for Public Transportation Program funding, enter into agreement with the North
Carolina Department of Transportation, provide the necessary assurances and the required local match.
AmotionwasmadebyCa¥..,~SS1 9 fH;J:: Abe. ~(vv;o»-e... andsecondedbyVi,e Cka:.,..m~I\
for the adoption of the folfowing resolution. and upon being put to a vote was duly adopted.
WHEREAS, Article 28 of Chapter 136 of the North Carolina General StatLftes and the Governor of North Carolina
have designated the North Carolina Department of Transportation (NCDOT) as the agency responsible tor
admtnistering federal and state public transportation funds; and
WHEREAS, the North Carolina Department of Transportation will apply for a grant from the US Departn,ent of
Transportation, Federal Transit Administration and receives funds from the North Carolina General Assembly to
provide assistance for rural public transportation projects; and
WHEREAS, the purpose of these transportation funds is to provide grant monies to local agencies for the
provision of rural, small urban. and urban public transportation services consistent with the policy requirements of
each fonding source for planning, community and agency involvement, service design, service alternatives,
training and conference participation, reporting and other requirements {drug and alcohol testing policy and
program. disadvantaged business enterprise program, and fully allocated costs analysis); and
WHEREAS, the funds applied for may be Administrative . Operating, Planning , or Capital funds and will have
different percentages of federal, state, and local funds .
WHEREAS, non-Community Transportation applicants may apply for funding for ··purchase-of-service" projects
under the Section 5310 program .
WHEREAS. Countv of Hamett hereby assures and certifies that it will provide the required local matching funds:
that its staff has the technical capacity to implement and manage the project(s), prepare required reports, obtain
required tr~ining, attend meetings and conferences; and agrees to comply with the federal and state statutes,
regulations. executive orders. Section 5333 (b) Warranty, and all administrative requirements related to the
applications made to and grants received from the Federal Transit Administration, as well as the provisions of
Section 1001 ofTitle 18, V. S. C
WHEREAS , the applicant has or wiU provide all annual certifications and assurances to the
State of North Carolina required for the project;
Revised 07-27-2017
101518a HCBOC Page 50
NOW. THEREFORE, be it resolved that the Chairman of Hamett County Board of Commissioners rs hereby
authorized to submit grant application (s) for federal and state funding in response to NCDOT's calls for projects,
make the necessary assurances and certifications and be empowered to enter into an agreement with the NCDOT to
provide rural, small urban, and urban public transportation services.
I Margaret Regina Wheeler. Clerk to the Board of Commissioners do hereby certify that the above is a true and
correct copy of an excerpt from the minutes of a meeting of the Harnett County Board of Commissioners duly held
on the __ll, i4'i day of Oc.:bzbe c . 2017.
;./J \J .r-1 • 1! 1 J • _ i),, A Yll~~~ ~ ~-~__k_ -------signatufl, of Certif;ing ~=
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•l'Jofe ~at the authorized official, certifying official, and notQTY public should be three separate individuals.
Seal Subsclibed and swam to me (date} ~Jnlxc_/Jq__,__P.:Qi r1 Affix Notnry Seal Here
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My commission expires (cfete) lili: [J)Q.Q__ __ _
2 Revised 07-27-2017
101518a HCBOC Page 51
PROGRAM SUMMARY SHEET REQUIREMENTS
5311 Rural Form ula
FEDERAL
Adm inistration, Operating, Capital , Planning
•· ...... --i:--..
This guidance for all subrecipients receiving capital, administration , and operating
PRINCIPLE assistance to support public transportation in rural areas (areas with populations of Jess
than 50,000).
To be eligible , transit providers must have a signed resolution from the County
Commissioners of each county served, designating them as the 5311 recipient in thei r
jurisdiction in order to be eligible to apply for funds. Starting in FY 2018, these resolutions
ELIGIBLE are updated on a 5-year basis . The resolution is part of the grant application process .
SUBRECIPIENTS North Carolina's coordinated approach to service delivery allows a single applicant w ithin
each designated service area.
General public transportation activities in rural North Carolina (areas outside urbanized area
boundaries) are the focus of this funding . The goal of Section 5311 program is to enhance
the overall mobility of people living in rural areas , therefore, projects may include
transportation to or from rural areas. Service must be open and promoted to the general
ELIGIBLE SERVICE
public, however, a rural transit provider may design its Section 5311 funded services to
maximize use by members of the general public who are transportation-disadvantaged.
and SERVICE AREA Transportation disadvantaged people include seniors , people with disabilities, and low-
income individuals. Providers receiving both 5311 and 5307 funds must have a method of
allocating costs between the two programs .
PTD suggests Subrecipients have sufficient funds to operate and maintain the NC DOT
FINANCIAL funded program for at least three months without incoming revenue from grants.
CAPACITY Subrecipients must have fiscal control and accounting procedures sufficient to permit the
and MANAGEMENT tracking and reporting of grant funds. Any funds borrowed from a parent organization or
governmental organization must be reported to NCDOT within 15 days.
Subrecipients that expend more than $500,000 in federal funds from all sources (including
AUDIT REPORTS federal funds provided through NCDOT) in a year must subm it the annual single audit
and FINANCIAL required by 09 NCAC 03M and evidence of resolution of findings related to the transit
STATEMENTS program to NCDOT. The value of a bus or van purchased must be considered when
determining whether a Subrecipient meets the threshold for a single audit.
Subrecipients will title the equipment and NCDOT Public Transportation D ivision be named
VEHICLE TITLES
first lien holder. When the project equipment has been replaced , NCDOT will release the
lien. Useful life standards are maintained in NCDOT's Transit Asset Management (TAM)
Tier II Sponsored Plan . This inventory is updated on an annual basis.
INSURANCE Subrecipients will maintain insurance as defined in the procedures.
Subrec ipients will maintain project equipment at a high level of cleanliness, safety, and
MAINTENANCE mechanical soundness. An 80 percent on-time performance standard for eouipment and
1
101518a HCBOC Page 52
PROGRAM SUMMARY SHEET REQUIREMENTS
wheelchair lifts has been set. All maintenance activities are entered into Trapeze EAM
and performance is monitored . FTA and state funded facilities require a written
maintenance plan and annual submission of the maintenance performed .
PTD discourages incidental uses of real property unless it can generate additional
revenues for the transit system or, at a reasonable cost. enhances system ridership . Prior
INCIDENTAL USE written approval is required for incidental uses of real property which must be compatible
with the original purposes of the contract. Incidental uses, such as meal delivery, are
allowed if they do not interfere with the public transit service and cover the costs of the
uses. Nutrition programs must cover the ooeratina costs attributable to meal delivery.
NCDOT Public Transportation Division requires quarterly and year end reports. Program
PROGRAM status reports are also required with each claim submitted . Failure to submit reports on
REPORTING AND time will result in a reduction in the Rural 011erating Assistagce Program (ROAP).
NCDOT Public Transportation Division maintains all procedures required for oversight.
These expectations, the State Management Plan, funding applications and Certifications
OVERSIGHT
and Assurances must be followed to maintain good standing for future funding. Failure to
submit reQorts on time will result in a reduction in the Rural Oeerating Assistance
Program f ROAP}.
Section 5311 Circular -C 9040 .1G:
Award Management Requirements 5010.1 E:
09 NCAC03M
Third Party Contracting Guidance 4220.1 F
NCDOT's Business Guide
REFERENCES Federal Transit Administration
Annual Certifications and Assurances and Agreements
Additional Terms & Conditions in the agreement
State Management Plan
PTO 5311 application overview and program material
UPDATES/REVISIONS Original Date : 4/9/2018
Last Amended Date:
2
101518a HCBOC Page 53
PROGRAM SUMMARY SHEET REQUIREMENTS
3
101518a HCBOC Page 54
APPENDIX A
NORTH CAROLINA DEPARTMENT OF TRANSPORTATION
PUBLIC TRANSPORTATION DIVISION
PROJECT NUMBER: 19-CT-040
APPROVED BUDGET SUMMARY
EFFECTIVE DATE 7/1/2018
PROJECT SPONSOR: COUNTY OF HARNETI
PROJECT DESCRIPTION FY2019 COMMUNITY TRANSPORTATION PROGRAM
I. TOTAL PROJECT EXPENDITURES
DEPARTMENT -4521 ADMINISTRATION -
PERIOD OF PERFORMANCE JULY 01, 2018 · JUNE 30, 2019
DEPARTMENT· 4523 CAPITAL I -ROLLING STOCK
PERIOD OF PERFORMANCE JULY 01 , 2018 -JUNE 30, 2019
DEPARTMENT· 4523 CAPITAL 11 • SUPPORT EQUIP AND FACILITIES
PERIOD OF PERFORMANCE JULY 01, 2018 -JUNE 30 , 2019
II . TOTAL PROJECT FUNDING
ADMINISTRATION -36233 .50.21.1
AGREEMENT#
CAPITAL I -ROLLING STOCK 36233 .50.21.3
AGREEMENT#
CAPITAL II -SUPPORT EQUIP & FACILI 36233 .50.21.4
AGREEMENT#
TOTAL
36233 .50.21 .1
36233.50.21 .3
36233.50.21.4
TOTAL FEDERAL
100% 80%
$278,449 $222 ,759
TOTAL FEDERAL
100% 80%
$192,000 $153 ,600
TOTAL FEDERAL
100% 80%
$18 ,000 $14,400
$488,449 $390 ,759
$278,449
$192,000
$18 ,000
STATE LOCAL
5% 15%
$13,922 $41,768
STATE LOCAL
10% 10%
$19 ,200 $19 ,200
STATE LOCAL
10% 10%
$1,800 $1,800
$34,922 $62,768
101518a HCBOC Page 55
NORTH CAROLINA DEPARTMENT OF TRANSPORTATION
PUBLIC TRANSPORTATION DIVISION
APPROVED PROJECT BUDGET
PROJECT : 19-CT-040
SPONSOR: COUNTY OF HARNETT
WBS: 36233.50.21.1
DEPARTMENT 4521 -ADMINISTRATION
TITLE -OBJECT
G121 SALARIES AND WAGES -FULL TIME
G127 SALARIES AND WAGES -LONGEVITY
G181 Social Sec. Contrib .
G183 Hosp. Ins. Contrib .
G185 Unemp. Comp. Contrib
G186 Workers Comp Cont.
G197 Drug & Alcohol Test
G212 Uniforms
G261 Office Sup & Mat.
G311 Travel
G312 Travel Subsis.
G321 Telephone Service
G325 Postage
G331 Electricity
G333 Natural Gas
G334 Water
G335 Sewer
G341 Printing & Reprod
G371 Mrktng .Paid Adv
G372 Promotional Items
G391 Legal Advertising
G395 Training-Employ Edu.
G431 Lease Reproduct Eq
G433 Lease Communicate Eq
G441 Maint Cont-Commun Eq
G452 Insurance-Vehicles
G481 Central Services
G491 Dues and Subscript
G 182 Retirement Contrib.
G291 Computer Supplies
TOTAL ADMINSTRATION
Approved Admin Budget
APPROVED
BUDGET
131,219
533
10,079
29,688
658
5,014
2,000
6,301
4,000
2,500
2,500
2,000
300
4,500
2,000
700
600
1,000
5,509
1,377
600
3,500
0
10,200
0
18,589
17,847
800
11,935
2,500
$278,449
Page 2 of 5
101518a HCBOC Page 56
NORTH CAROLINA DEPARTMENT OF TRANSPORTATION
PUBLIC TRANSPORTATION DIVISION
APPROVED PROJECT BUDGET
SALARY AND WAGE DETAIL
PROJECT: 19-CT-040
SPONSOR: COUNTY OF HARNEIT
SQNO
01
02
03
04
POSITION NO % -------------------H·--------or:r>r~ 4521 oeJECT eODE ur------·
TRANSIT SERV. MGR . 01 100%
TRANSIT SERV. ASST. 01 100%
ADMIN SUPP. SPECIALIST 01 100%
DATNADMIN SUPP. SPEC. 01 100%
TOTAL -OBJECT CODE 121
DEPT. 4521 OBJECT CODE 125
TOTAL -OBJECT CODE 125
DEPT. 4521 OBJECT CODE 126
TOTAL -OBJECT CODE 126
TOTAL DEPT. 4521 SALARIES AND WAGES
Approved Salary and Wage Detail
FTE RATE ·----------------
$ 41,588
$ 26,823
$ 37,262
$ 25,546
$
BUDGET ·-·-----------------·
$ 41,588
$ 26,823
$ 37,262
$ 25,546
$ 131,219
$
$
$
$
$
$
$
$
$
$
$
$
$ 131,219
3 of 5
101518a HCBOC Page 57
PROJECT:
SPONSOR:
WBS :
NORTH CAROLINA DEPARTMENT OF TRANSPORTATION
PUBLIC TRANSPORTATION DIVISION
APPROVED PROJECT BUDGET
19-CT-040
COUNTY OF HARNETT
36233.50.21 .3
DEPARTMENT 4523-CAPITAL I ROLLING STOCK ----·------------p~----------------------------·~-------------------·----------------------------------------------------
OBJECT -TITLE
G545
G571
TOTAL CAPITAL I
High-top vehicle(R)
Mini-Van Repl.
DEPARTMENT 4523 -CAPITAL II SUPPORT EQUIP AND FACILITIES ---------------------------------------••••M••••••• WBS: 36233 .50.21.4
OBJECT -TITLE
G586
TOT AL CAPITAL II
Build Secur/Surv Eq
Approved Capital Budget
APPROVED
BUDGET
162,000
30,000
$192,000
APPROVED
BUDGET
18,000
$18,000
Page4 of 5
101518a HCBOC Page 58
Approved Capital Budget
Page 5 of 5
101518a HCBOC Page 59
Board Meeting
Agenda Item
Agenda Item __ 4 __ -_G ___ _
MEETING DATE: October 15, 2018
TO: HARNETT COUNTY BOARD OF COMMISSIONERS
SUBJECT: Harnett Regional Jetport (HRJ) Grant Agreement for Terminal Site
Improvements.
REQUESTED BY: Barry A. Blevins
REQUEST:
The Director of General Services/ Airport requests the Hamett County Board of
Commissioners consider and approve the North Carolina Department of
Transportation/Division of Aviation grant agreement to provide professional services for the
design/permitting of the terminal site improvements and related work to replace the existing
terminal at the Hamett Regional Jetport. The County of Hamett will receive 90% federally
funded grant under the State Block Grant Non-Primary Entitlement (NPE) Program. Hamett
County's local match is a 10% contribution which is funded by the current budget. The grant
agreement requires a resolution by the Hamett County Board of Commissioners to
appropriate 10% of the total estimated project cost. A project ordinance was approved on
March 20, 2017, by the Board of Commissioners. The total project cost is $134,759.
FINANCE OFFICER'S RECOMMENDATION:
COUNTY MANAGER'S RECOMMENDATION:
C: \U sers\gwhee ler\Ap pData \Local\Microsoft \ Windows\INetCache\C on te nt. Outlook\ TPTE Q CI, Y\ 18. 09 .25 -A g enda
Request T erminal S it e Improvements 101518.docx Pa ge I of 2
101518a HCBOC Page 60
BLOCK GRANT AGREEMENT
NON PRIMARY ENTITLEMENT FUNDING
ST ATE AID TO AIRPORTS BLOCK GRANT
BETWEEN
THEN. C. DEPARTMENT OF TRANSPORTATION,
AN AGENCY OF THE STATE OF NORTH CAROLINA
AND
COUNTY OF HARNETT
THIS AGREEMENT made and entered into this the
Do
AIRPORT: HARNETTREGIONAL
PROJECT NO: 36237.25.17.1
________ , 20 ___ , by and between
nc + ' • -
0 s "Department") and the the NORTH CAROLINA DEPARTMENT OF TRANSPO
COUNTY OF HARNETT, the owners of the BARNET, Dc~.:te_ fter referred to as "Sponsor").
WHEREAS , Chapter 63 of the North Carolina Gener: it to administer a program of State
Aid to Airports, subject to the limitations stated in that C11u.1---.
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 FAA Modernization and Reform Act of 2012; and
WHEREAS, the Department has approved a grant of funds to the Sponsor under the State Block Grant Program Non
Primary Entitlement funds .
NOW THEREFORE, the Department and the Sponsor do hereby mutually agree as follows :
1) That the approved scope of this project shall consist of:
TERMINAL SITE IMPROVEMENTS
2) That the Grant of funds shall include maximum funding obligations for federal funds which shall be:
State Block Grant NPE Program: $121,283 (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 JULY 1, 2019,
unless a written extension of time is granted by the Department.
DOA FORM (12/10)
101518a HCBOC Page 61
5) That all work performed on the Project shall conform 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) Debarment 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, "Debarment and
Suspension," 31 U.S.C. § 6101 note , and U.S. DOT regulations on Debarment 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 , unless the Department issues a written waiver to the contrary.
10) 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 14
101518a HCBOC Page 62
IN WITNESS WHEREOF, THE PARTIES HERETO EXECUTED THIS GRANT AGREEMENT THE DAY AND YEAR
FIRST WRITTEN ABOVE:
NORTH CAROLINA DEPARTMENT OF TRANSPORTATION:
NCDOTSEAL BY: -------------------
Deputy Secretary of Multi-Modal Transportation
ATTEST: --------~·-..-· _. ·,-·~·-· ,,_..· ·~·-· ·~·~·-
SIGNED : ---~:C.--'-r-:i ·~:>·--. >-::i-.. :
% tn m-,s C,
SPONSOR: mz
SPONSOR SEAL
TITLE: _{:_\\"---Cl=->'"'-----'l (___.M~CU1.c....,.__,___~~~-· ............. .
& • • • • I . . . . . . . .. . . .
ATTEST: -----------.. ....... .. . . . ' .
" o • l. • " I
• • • I I • •
t • I ~ o • f
STATE OF NORTH CAROLINA, COUNTY OF-----------------------
!,---------------' a Notary Public in and for the State aforesaid , do hereby certify that
---------------------personally came before me this day and acknowledged that he
is ______________ ofthe ________________________ _
(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 the
(Name and Title)
Seal of the Sponsor affixed hereto.
WITNESS my hand and Notarial Seal , this the ____ day of ____________ , 20 __ .
• • f ••••
• I \ \ • I . . -~·.·.··.·.·.
_________________ __...~ -·--.
Notary Public (Signature)
My Commission expires:------------SEAL
DOA FORM (12/10)
Page 3 of 14
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... . . . .. . .. . ' ~ . .. .. . . . . '
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101518a HCBOC Page 63
RESOLUTION
A motion was made by-----------------------------and seconded by
(Name and Title)
-------------------------for the adoption of the following resolution, and upon
(Name and Title)
being put to a vote was duly accepted :
WHEREAS, a Grant in the amount of$121.283 has been approved by the Department based on total estimated cost
of$134,759; and
WHEREAS, an amount equal to or greater than ten percent (10%) of the 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.
I,-------------------------------------' 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
DOA FORM (12/10)
Page 4 of 14
101518a HCBOC Page 64
SECTION A: SPONSOR'S ASSURANCES: GENERAL CONDITIONS
A-1 . 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 written 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
written approval of the Department.
Page 5 of 14
101518a HCBOC Page 65
SECTION B: SPONSOR'S ASSURANCES: PROJECT ADMINISTRATION
B-1 . The Airport shall comply with all requirements of the State Aid to Aitports Program Guidance Handbook.
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 requirement s 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 .1101 -.1112 ofNorth Carolina Administrative Code 09A NCAC 02D.l 101).
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 (AV-
CONCURJ A V-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 infonnation -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 infonnation -electronic copies: PDF fonnat and AutoCAD or MicroStation
format -Paper copy: bond-true half-size for plan sheets / sketches
Construction Projects
a. All reports , projections -PDF Format. Any element of the documents shall be delivered in its
original electronic fonnat (i .e. MS Word , Excel, AutoCAD ... ) ifrequested by the Department
b . Sketches and drawings -electronic copies: PDF format and AutoCAD or Micro Station fonnat -Paper
copy: bond -true half-size for plan sheets / sketches.
Page 6 of 14
101518a HCBOC Page 66
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 format and Paper copy : bond-true
half-size for plan sheets .
3. As-built / 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/ A V-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 of the Sponsor's Employment of specific contractors within ten ( I 0) days ofreceipt. 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 (AV-STATUS /AV-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 in spections involving the Sponsor , his
contractor(s), consultant(s), and/or federal funding agencies concerning Project.
B-9. The Sponsor shall notify the Department within thirty (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 14
101518a HCBOC Page 67
B-10. 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-11. 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.
B-12. The provisions of this section related to United States Department of Transportation (US DOT) Order 1050.2A, Title
49 Code of Federal Regulations (CFR) part 21, 23 United States Code (U .S.C.) 140 and 23 CFR part 200 (or 49 CFR 303, 49
U.S.C . 5332 or 49 U.S.C . 47123) are applicable to all North Carolina Department of Transportation (NCDOT) contracts and to
all related subcontracts, material supply, engineering, architectural and other service contracts, regardless of dollar amount. Any
Federal provision that is specifically required not specifically set forth is hereby incorporated by reference.
NCDOT Title VI Assurance (1050.2A. Appendices A & E)
i. During the performance of this contract, the contractor, for itself, its assignees, and successors in interest (hereinafter
referred to as the "contractor") agrees as follows:
(1) Compliance with Regulations: The contractor (hereinafter includes consultants) will comply with the Acts and
the Regulations relative to Nondiscrimination in Federally-assisted programs of the U.S. Department ofTransportation,
Federal Highway Administration (FHWA), as they may be amended from time to time, which are herein incorporated
by reference and made a part of this contract.
(2) Nondiscrimination: The contractor, with regard to the work performed by it during the contract, will not
discriminate on the grounds of race, color, or national origin in the selection and retention of subcontractors, including
procurements of materials and leases of equipment. The contractor will not participate directly or indirectly in the
discrimination prohibited by the Acts and the Regulations, including employment practices when the contract covers
any activity, project, or program set forth in Appendix B of 49 CFR Part 21.
(3) Solicitations for Subcontractors, Including Procurements of Materials and Equipment: In all solicitations,
either by competitive bidding, or negotiation made by the contractor for work to be performed under a subcontract,
including procurements of materials, or leases of equipment, each potential subcontractor or supplier will be notified
by the contractor of the contractor's obligations under this contract and the Acts and the Regulations relative to
Nondiscrimination on the grounds of race, color, or national origin.
(4) Information and Reports: The contractor will provide all information and reports required by the Acts, the
Regulations, and directives issued pursuant thereto and will permit access to its books, records, accounts, other sources
of information, and its facilities as may be determined by the Recipient or the FHW A to be pertinent to ascertain
compliance with such Acts, Regulations, and instructions. Where any information required of a contractor is in the
Page 8 of 14
101518a HCBOC Page 68
exclusive possession of another who fails or refuses to furnish the information, the contractor will so certify to the
Recipient or the FHW A , as appropriate, and will set forth what efforts it has made to obtain the information.
(5) Sanctions for Noncompliance: In the event of a contractor's noncompliance with the Non-discrimination
provisions of this contract , the Recipient will impose such contract sanctions as it or the FHW A may determine to be
appropriate, including, but not limited to :
(a) withholding payments to the contractor under the contract until the contractor complies; and/or
(b) cancelling, terminating, or suspending a contract, in whole or in part.
(6) Incorporation of Provisions: The contractor will include the provisions of paragraphs one through six in every
subcontract, including procurements of materials and leases of equipment, unless exempt by the Acts, the Regulations
and directives issued pursuant thereto. The contractor will take action with respect to any subcontract or procurement
as the Recipient or the FHW A may direct as a means of enforcing such provisions including sanctions for
noncompliance. Provided, that if the contractor becomes involved in, or is threatened with litigation by a subcontractor,
or supplier because of such direction, the contractor may request the Recipient to enter into any litigation to protect the
interests of the Recipient . In addition, the contractor may request the United States to enter into the litigation to protect
the interests of the United States.
11 . During the performance of this contract, the contractor, for itself, its assignees, and successors in interest (hereinafter
referred to as the "contractor"} agrees to comply with the following nondiscrimination statutes and authorities; including
but not limited to :
Pertinent Nondiscrimination Authorities
• Title VI of the Civil Rights Act of 1964 ( 42 U .S.C. § 2000d et seq ., 78 stat. 252), (prohibits discrimination on
the basis of race , color, national origin); and 49 CFR Part 21.
• The Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970, (42 U.S.C. § 4601),
(prohibits unfair treatment of persons displaced or whose property has been acquired because of Federal or
Federal-aid programs and projects);
• Federal-Aid Highway Act of 1973, (23 U .S .C. § 324 et seq .), (prohibits discrimination on the basis of sex);
• Section 504 of the Rehabilitation Act of 1973, (29 U.S.C. § 794 et seq.), as amended, (prohibits discrimination
on the basis of disability); and 49 CFR Part 27;
• The Age Discrimination Act of 1975 , as amended, (42 U .S .C. § 6101 et seq .), (prohibits discrimination on the
basis of age);
• Airport and Airway Improvement Act of 1982 , (49 USC § 471, Section 47123), as amended, (prohibits
discrimination based on race, creed, color, national origin, or sex);
• The Civil Rights Restoration Act of 1987, (PL 100-209), (Broadened the scope, coverage and applicability of
Title VI of the Civil Rights Act of 1964, The Age Discrimination Act of 1975 and Section 504 of the
Rehabilitation Act of 1973, by expanding the definition of the terms "programs or activities" to include all of
the programs or activities of the Federal-aid recipients, sub-recipients and contractors, whether such programs
or activities are Federally funded or not);
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• Titles II and III of the Americans with Disabilities Act , which prohibit discrimination on the basis of disability
in the operation of public entities , public and private transportation systems , places of public accommodation ,
and certain testing entities (42 U .S .C. §§ 12131-12189) as implemented by Department of Transportation
regulations at 49 C.F.R. parts 37 and 38 ;
• The Federal Aviation Administration's Nondiscrimination statute (49 U .S.C . ~ 47123) (prohibits
discrimination on the basis of race , color, national origin , and sex);
• Executive Order 12898 , Federal Actions to Address Environmental Justice in Minority Populations and Low-
Income Populations , which ensures Nondiscrimination against minority populations by discouraging
programs, policies, and activities with disproportionately high and adverse human health or environmental
effects on minority and low-income populations;
• Executive Order 13166, Improving Access to Services for Persons with Limited English Proficiency, and
resulting agency guidance, national origin discrimination includes discrimination because of Limited English
proficiency (LEP). To ensure compliance with Title VI, you must take reasonable steps to ensure that LEP
persons have meaningful access to your programs (70 Fed . Reg . at 74087 to 74100);
• Title IX of the Education Amendments of 1972, as amended , which prohibits you from discriminating because
of sex in education programs or activities (20 U.S .C . 1681 et seq).
NCDOT Title VI Nondiscrimination Program (23 CFR 200.5(v))
The North Carolina Department of Transportation (NCDOT) has assured the US DOT that, as a condition to receiving
federal financial assistance, NCDOT will comply with Title VI of the Civil Rights Act of 1964 and all requirements
imposed by Title 49 CFR part 21 and related nondiscrimination authorities to ensure that no person shall, on the ground
of race , color , national origin , limited English proficiency , income-level, sex, age , or disability, (or religion , where
applicable) be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any
programs , activities , or services conducted or funded by NCDOT. Contractors and other organizations under contract
or agreement with NCDOT must also comply with Title VI and related authorities, therefore:
1. During the performance of this contract or agreement, contractors (e.g., subcontractors, consultants, vendors ,
prime contractors) are responsible for complying with NCDOT's Title VI Program. Contractors are not
required to prepare or submit Title VI Programs . (USDOJ Title VI Legal Manual, VI(F))
ii . Subrecipients (e.g . cities , counties, LGAs , MPO/RPOs) may be required to prepare and submit a Title VI
Program to NCDOT , which may include Title VI Nondiscrimination Assurances and/or agreements .
Subrecipients must also ensure that their contractors and subrecipients comply with Title VI. (23 CFR
200.9(b)(7)) conntractors and subrecipients comply with Title VI. (23 CFR 200.9(b)(7))
iii. lf reviewed or investigated by NCDOT , the contractor or subrecipient agrees to take affirmative action to
correct any deficiencies found within a reasonable time period, not to exceed 90 calendar days, unless
additional time is granted by NCDOT . (23 CFR 200.9(b)(l 5))
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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 Aimorts 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 0MB 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 of the 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 The Compliance Supplement (Supplement) is based on the requirements of the 1996 Amendments
and 2 CFR part 200, Subpart F, which provide for the issuance of a compliance supplement to assist auditors in performing the
required audits, 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
C-4 . Payment of the funds obligated under this Grant Agreement shall be made in accordance with the following 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.:
(1) The Grant Agreement has been executed and a Project Concurrence (AV-CONCUR/AV-503) issued .
(2) The Project has received an appropriate environmental finding .
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(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 / or Vendor Cost , Schedule of Deliverables, Estimated Construction Cost, Plan Sheet
List
b) Actual Bidding Cost (once a project is bid)-Bid Tabulation / Bid Schedule, Recommendation for Award .
(4) Additional information shall be provided as requested.
(5) The Sponsor has submitted an executed Interim Payment Request (AV-PAY/AV-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 co s ts incurred.
At such point the Sponsor has requested payments equaling l 00% of the State Grant, it is expected that the approved Project
will be 100% complete .
D. Upon receipt of I 00% 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 of the Project by the Department, the final State share of approved eligible items is less than the
amount of State funds actually di sbursed 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.
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 ac cordance 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 of the
FAA Grant Agreement affecting the work elements in the approved Project.
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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.
D-7. No negotiation for property acquisition shall be commenced between the Sponsor and the property O\mer 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-10 . 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 of this Section shall apply .
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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:
( 1) 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 5/3/18
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FAA
il'M~?l'tt-* Airports
A. General.
ASSURANCES
Airport Sponsors
l. 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 (10) years from the date of acceptance of Federal aid
for the project.
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3. Airport Planning Undertaken by a Sponsor.
Unless otherwise specified in this grant agreement, only Assurances 1, 2, 3, 5, 6, 13,
18, 25, 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; there shall be no limit on the duration of the assurances
regarding Airport Revenue so long as the airport is used as an airport.
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 seq.1
c. Federal Fair Labor Standards Act -29 U.S.C. 201, et seq.
d. Hatch Act-5 U.S.C. 1501, et seq.2
e. Uniform Relocation Assistance and Real Property Acquisition Policies Act of
1970 Title 42 U.S.C. 4601, et seg.12
f National Historic Preservation Act of 1966-Section 106-16 U.S.C. 470(f).1
g. Archeological and Historic Preservation Act of 1974 -16 U.S.C. 469 through
469c.1
h. Native Americans Grave Repatriation Act -25 U.S.C. Section 3001, et seq.
1. Clean Air Act, P.L. 90-148, as amended.
J. Coastal Zone Management Act, P.L. 93-205, as amended.
k. Flood Disaster Protection Act of 1973 -Section 102(a) -42 U .S.C. 40 l 2a.1
l. Title 49, U.S.C., Section 303, (formerly known as Section 4(f))
m. Rehabilitation Act of 1973 -29 U.S.C. 794.
n. Title VI of the Civil Rights Act of 1964 (42 U.S.C. § 2000d et seq., 78 stat. 252)
(prohibits discrimination on the basis ofrace, color, national origin);
o. Americans with Disabilities Act of 1990, as amended, (42 U.S.C. § 12101 et
seq.), prohibits discrimination on the basis of disability).
p. Age Discrimination Act of 1975 -42 U.S.C. 6101, et seq.
q. American Indian Religious Freedom Act, P.L. 95-341, as amended.
r. Architectural Barriers Act of 1968 -42 U .S.C. 4151, et seq.1
s. Power plant and Industrial Fuel Use Act of 1978 -Section 403-2 U.S.C. 83 73 .1
t. Contract Work Hours and Safety Standards Act -40 U.S.C. 327, et seg.1
u. Copeland Anti-kickback Act -18 U.S.C. 874.1
v. National Environmental Policy Act of 1969 -42 U .S.C. 4321, et seg.1
w. Wild and Scenic Rivers Act, P .L. 90-542, as amended.
x. SingleAuditActofl984-31 U.S.C. 7501,etseq.2
y. Drug-Free Workplace Act of 1988 -41 U.S.C. 702 through 706.
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z. The Federal Funding Accountability and Transparency Act of 2006, as amended
(Pub . L. 109-282, as amended by section 6202 of Pub. L. 110-252).
Executive Orders
a. Executive Order 11246 -Equal Employment Opportunity 1
b. Executive Order 11990 -Protection of Wetlands
c. Executive Order 11998 -Flood Plain Management
d. Executive Order 12372 -Intergovernmental Review of Federal Programs
e. Executive Order 12699 -Seismic Safety of Federal and Federally Assisted New
Building Construction 1
f. Executive Order 12898 -Environmental Justice
Federal Regulations
a. 2 CFR Part 180 -0MB Guidelines to Agencies on Governmentwide Debarment
and Suspension (Nonprocurement).
b. 2 CFR Part 200, Uniform Administrative Requirements, Cost Principles, and
Audit Requirements for Federal Awards. [0MB Circular A-87 Cost Principles
Applicable to Grants and Contracts with State and Local Governments, and 0MB
Circular A-133 -Audits of States, Local Governments, and Non-Profit
Organizations]. 4' 5' 6
c. 2 CFR Part 1200-Nonprocurement Suspension and Debarment
d. 14 CFR Part 13 -Investigative and Enforcement Procedures14 CFR Part 16 -
Rules of Practice For Federally Assisted Airport Enforcement Proceedings.
e. 14 CFR Part 150 -Airport noise compatibility planning.
f. 28 CFR Part 35-Discrimination on the Basis of Disability in State and Local
Government Services.
g. 28 CFR § 50 .3 -U.S. Department of Justice Guidelines for Enforcement of Title
VI of the Civil Rights Act of 1964.
h. 29 CFR Part 1 -Procedures for predetermination of wage rates. 1
1. 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
J. 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
k . 41 CFR Part 60 -Office of Federal Contract Compliance Programs, Equal
Employment Opportunity, Department of Labor (Federal and federally assisted
contracting requirements).'
1. 49 CFR Part 18 -Uniform administrative requirements for grants and cooperative
agreements to state and local govemments.3
m. 49 CFR Part 20 -New restrictions on lobbying.
n. 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.
o. 49 CFR Part 23 -Participation by Disadvantage Business Enterprise in Airport
Concessions.
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p. 49 CFR Part 24 -Uniform Relocation Assistance and Real Property Acquisition
for Federal and Federally Assisted Programs. i 2
q. 49 CFR Part 26 -Participation by Disadvantaged Business Enterprises in
Department of Transportation Programs.
r. 49 CFR Part 27 -Nondiscrimination on the Basis of Handicap in Programs and
Activities Receiving or Benefiting from Federal Financial Assistance.1
s. 49 CFR Part 28 -Enforcement of Nondiscrimination on the Basis of Handicap in
Programs or Activities conducted by the Department of Transportation.
t. 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.
u. 49 CFR Part 32 -Governrnentwide Requirements for Drug-Free Workplace
(Financial Assistance)
v. 49 CFR Part 37 -Transportation Services for Individuals with Disabilities
(ADA).
w. 49 CFR Part 41 -Seismic safety of Federal and federally assisted or regulated
new building construction.
Specific Assurances
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.
Footnotes to Assurance C.1.
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 2 CFR Part 200 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.
4 On December 26, 2013 at 78 FR 78590, the Office of Management and Budget
(0MB) issued the Uniform Administrative Requirements, Cost Principles, and
Audit Requirements for Federal Awards in 2 CFR Part 200. 2 CFR Part 200
replaces and combines the former Uniform Administrative Requirements for
Grants (0MB Circular A-102 and Circular A-110 or2 CFR Part 215 or
Circular) as well as the Cost Principles (Circulars A-21 or 2 CFR part 220;
Circular A-87 or 2 CFR part 225; and A-122, 2 CFR part 230). Additionally it
replaces Circular A-133 guidance on the Single Annual Audit. In accordance
with 2 CFR section 200.110, the standards set forth in Part 200 which affect
administration of Federal awards issued by Federal agencies become effective
once implemented by Federal agencies or when any future amendment to this
Part becomes final. Federal agencies, including the Department of
Transportation, must implement the policies and procedures applicable to
Federal awards by promulgating a regulation to be effective by December 26,
2014 unless different provisions are required by statute or approved by 0MB.
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5 Cost principles established in 2 CFR part 200 subpart E must be used as
guidelines for determining the eligibility of specific types of expenses.
6 Audit requirements established in 2 CFR part 200 subpart F are the guidelines
for audits.
2. Responsibility and Authority of the Sponsor.
a. Public Agency Sponsor:
It has legal authority to apply for this grant, and to finance and carry out the proposed
project; that a resolution, motion or similar action has been duly adopted or passed as
an official act of the applicant's governing body authorizing the filing of the
application, including all understandings and assurances contained therein, and
directing and authorizing the person identified as the official representa6ve of the
applicant to act in connection with the application and to provide such additional
information as may be required.
b. Private Sponsor:
It has legal authority to apply for this grant and to finance and carry out the proposed
project and comply with all terms, conditions, and assurances of this grant agreement.
It shall designate an official representative and shall in writing direct and authorize
that person to file this application, including all understandings and assurances
contained therein; to act in connection with this application; and to provide such
additional information as may be required.
3. Sponsor Fund Availability.
It has sufficient funds available for that portion of the project costs which are not to
be paid by the United States. It has sufficient funds available to assure operation and
maintenance of items funded under this grant agreement which it will own or control.
4. Good Title.
a. It, a public agency or the Federal government, holds good title, satisfactory to the
Secretary, to the landing area of the airport or site thereof, or will give assurance
satisfactory to the Secretary that good title will be acquired.
b. For noise compatibility program projects to be carried out on the property of the
sponsor, it holds good title satisfactory to the Secretary to that portion of the
property upon which Federal funds will be expended or will give assurance to the
Secretary that good title will be obtained.
5. Preserving Rights and Powers.
a. It will not take or permit any action which would operate to deprive it of any of
the rights and powers necessary to perform any or all of the terms, conditions, and
assurances in this grant agreement without the written approval of the Secretary,
and will act promptly to acquire, extinguish or modify any outstanding rights or
claims of right of others which would interfere with such performance by the
sponsor. This shall be done in a manner acceptable to the Secretary.
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b . It will not sell, lease, encumber, or otherwise transfer or dispose of any part of its
title or other interests in the property shown on Exhibit A to this application or,
for a noise compatibility program project, that portion of the property upon which
Federal funds have been expended, for the duration of the terms, conditions, and
assurances in this grant agreement without approval by the Secretary. If the
transferee is found by the Secretary to be eligible under Title 49, United States
Code, to assume the obligations of this grant agreement and to have the power,
authority, and financial resources to carry out all such obligations, the sponsor
shall insert in the contract or document transferring or disposing of the sponsor's
interest, and make binding upon the transferee all of the terms, conditions, and
assurances contained in this grant agreement.
c. For all noise compatibility program projects which are to be carried out by
another unit of local government or are on property owned by a unit of local
government other than the sponsor, it will enter into an agreement with that
government. Except as otherwise specified by the Secretary, that agreement shall
obligate that government to the same terms, conditions, and assurances that would
be applicable to it if it applied directly to the FAA for a grant to undertake the
noise compatibility program project. That agreement and changes thereto must be
satisfactory to the Secretary. It will take steps to enforce this agreement 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. 13 6 of Public Law 112-95 and the sponsor assurances.
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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. Metropolitan Planning Organization.
In projects involving the location of an airport, an airport runway, or a major runway
extension at a medium or large hub airport, the sponsor has made available to and has
provided upon request to the metropolitan planning organization in the area in which
the airport is located, if any, a copy of the proposed amendment to the airport layout
plan to depict the project and a copy of any airport master plan in which the project is
described or depicted.
11. Pavement Preventive Maintenance.
With respect to a project approved after January 1, 1995, for the replacement or
reconstruction of pavement at the airport, it assures or certifies that it has
implemented an effective airport pavement maintenance-management program and it
assures that it will use such program for the useful life of any pavement constructed,
reconstructed or repaired with Federal financial assistance at the airport. It will
provide such reports on pavement condition and pavement management programs as
the Secretary determines may be useful.
12. Terminal Development Prerequisites.
For projects which include terminal development at a public use airport, as defined i,n
Title 49, it has, on the date of submittal of the project grant application, all the safety
equipment required for certification of such airport under section 44 706 of Title 49,
United States Code, and all the security equipment required by rule or regulation, and
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has provided for access to the passenger enplaning and deplaning area of such airport
to passengers enplaning and deplaning from aircraft other than air carrier aircraft.
13 . Accounting System, Audit, and Record Keeping Requirements.
a. It shall keep all project accounts and records which fully disclose the amount and
disposition by the recipient of the proceeds of this grant, the total cost of the
project in connection with which this grant is given or used, and the amount or
nature of that portion of the cost of the project supplied by other sources, and such
other financial records pertinent to the project. The accounts and records shall be
kept in accordance with an accounting system that will facilitate an effective audit
in accordance with the Single Audit Act of 1984.
b. It shall make available to the Secretary and the Comptroller General of the United
States, or any of their duly authorized representatives, for the purpose of audit and
examination, any books, documents, papers, and records of the recipient that are
pertinent to this grant. The Secretary may require that an appropriate audit be
conducted by a recipient. In any case in which an independent audit is made of the
accounts of a sponsor relating to the disposition of the proceeds of a grant or
relating to the project in connection with which this grant was given or used, it
shall file a certified copy of such audit with the Comptroller General of the United
States not later than six (6) months following the close of the fiscal year for which
the audit was made.
14. Minimum Wage Rates.
It shall include, in all contracts in excess of $2,000 for work on any projects funded
under this grant agreement which involve labor, provisions establishing minimum
rates of wages, to be predetermined by the Secretary of Labor, in accordance with the
Davis-Bacon Act, as amended ( 40 U.S.C. 276a-276a-5), which contractors shall pay
to skilled and unskilled labor, and such minimum rates shall be stated in the invitation
for bids and shall be included in proposals or bids for the work.
15. Veteran's Preference.
It shall include in all contracts for work on any project funded under this grant
agreement which involve labor, such provisions as are necessary to insure that, in the
employment oflabor (except in executive, administrative, and supervisory positions),
preference shall be given to Vietnam era veterans, Persian Gulf veterans,
Afghanistan-Iraq war veterans, disabled veterans, and small business concerns owned
and controlled by disabled veterans as defined in Section 47112 of Title 49, United
States Code. However, this preference shall apply only where the individuals are
available and qualified to perform the work to which the employment relates.
16. Conformity to Plans and Specifications.
It will execute the project subject to plans, specifications, and schedules approved by
the Secretary. Such plans, specifications, and schedules shall be submitted to the
Secretary prior to commencement of site preparation, construction, or other
performance under this grant agreement, and, upon approval of the Secretary, shall be
incorporated into this grant agreement. Any modification to the approved plans,
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specifications, and schedules shall also be subject to approval of the Secretary, and
incorporated into this grant agreement.
17. Construction Inspection and Approval.
1t 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 umestricted 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 ,
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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-
I) 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 which is
substantially damaged or destroyed due to an act of God or other condition or
circumstance beyond the control of the sponsor.
b. It will suitably operate and maintain noise compatibility program items that it
owns or controls upon which Federal funds have been expended .
20. Hazard Removal and Mitigation.
It will take appropriate action to assure that such terminal airspace as is required to
protect instrument and visual operations to the airport (including established
minimum flight altitudes) will be adequately cleared and protected by removing,
lowering, relocating, marking, or lighting or otherwise mitigating existing airport
hazards and by preventing the establislunent or creation of future airport hazards.
21. Compatible Land Use.
It will take appropriate action, to the extent reasonable, including the adoption of
zoning laws, to 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 takeoff of aircraft. In addition, if the project is for noise compatibility
program implementation, it will not cause or permit any change in land use, within its
jurisdiction, that will reduce its compatibility, with respect to the airport, of the noise
compatibility program measures upon which Federal funds have been expended.
22 . Economic Nondiscrimination.
a. It will make the airport available as an airport for public use on reasonable terms
and without unjust discrimination to all types, kinds and classes of aeronautical
activities, including commercial aeronautical activities offering services to the
public at the airport.
b . In any agreement, contract, lease, or other arrangement under which a right or
privilege at the airport is granted to any person, firm, or corporation to conduct or
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to engage in any aeronautical activity for furnishing services to the public at the
airport, the sponsor will insert and enforce provisions requiring the contractor to-
I) furnish said services on a reasonable, and not unjustly discriminatory, basis to
all users thereof, and
2) charge reasonable, and not unjustly discriminatory, prices for each unit or
service, provided that the contractor may be allowed to make reasonable and
nondiscriminatory discounts, rebates, or other similar types of price reductions
to volume purchasers.
c. Each fixed-based operator at the airport shall be subject to the same rates, fees,
rentals, and other charges as are uniformly applicable to all other fixed-based
operators making the same or similar uses of such airport and utilizing the same
or similar facilities.
d. Each air carrier using such airport shall have the right to service itself or to use
any fixed-based operator that is authorized or permitted by the airport to serve any
air carrier at such airport.
e. Each air carrier using such airport (whether as a tenant, non-tenant, or subtenant
of another air carrier tenant) shall be subject to such nondiscriminatory and
substantially comparable rules, regulations, conditions, rates, fees, rentals, and
other charges with respect to facilities directly and substantially related to
providing air transportation as are applicable to all such air carriers which make
similar use of such airport and utilize similar facilities, subject to reasonable
classifications such as tenants or non-tenants and signatory carriers and non-
signatory carriers. Classification or status as tenant or signatory shall not be
unreasonably withheld by any airport provided an air carrier assumes obligations
substantially similar to those already imposed on air carriers in such classification
or status.
f. It will not exercise or grant any right or privilege which operates to prevent any
person, firm, or corporation operating aircraft on the airport from performing any
services on its own aircraft with its own employees [including, but not limited to
maintenance, repair, and fueling] that it may choose to perform.
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.
1. 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.
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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
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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.
2) If the Secretary approves the sale of a privately owned airport to a public
sponsor and provides funding for any portion of the public sponsor's
acquisition of land, this limitation on the use of all revenues generated by the
sale shall not apply to certain proceeds from the sale. This is conditioned on
repayment to the Secretary by the private owner of an amount equal to the
remaining unamortized portion (amortized over a 20-year period) of any
airport improvement grant made to the private owner for any purpose other
than land acquisition on or after October l, 1996, plus an amount equal to the
federal share of the current fair market value of any land acquired with an
airport improvement grant made to that airport on or after October 1, 1996.
3) Certain revenue derived from or generated by mineral extraction, production,
lease, or other means at a general aviation airport (as defined at Section 47102
of title 49 United States Code), if the FAA determines the airport sponsor
meets the requirements set forth in Sec. 813 of Public Law 112-95.
b. As part of the annual audit required under the Single Audit Act of 1984, the
sponsor will direct that the audit will review, and the resulting audit report will
provide an opinion concerning, the use of airport revenue and taxes in paragraph
(a), and indicating whether funds paid or transferred to the owner or operator are
paid or transferred in a manner consistent with Title 49, United States Code and
any other applicable provision of law, including any regulation promulgated by
the Secretary or Administrator.
c. Any civil penalties or other sanctions will be imposed for violation of this
assurance in accordance with the provisions of Section 47107 of Title 49, United
States Code.
26. Reports and Inspections.
It will:
a. submit to the Secretary such annual or special financial and operations reports as
the Secretary may reasonably request and make such reports available to the
public; make available to the public at reasonable times and places a report of the
airport budget in a format prescribed by the Secretary;
b. for airport development projects, make the airport and all airport records and
documents affecting the airport, including deeds, leases, operation and use
agreements, regulations and other instruments, available for inspection by any
duly authorized agent of the Secretary upon reasonable request;
c. for noise compatibility program projects, make records and documents relating to
the project and continued compliance with the terms, conditions, and assurances
of this grant agreement including deeds, leases, agreements, regulations, and other
instruments, available for inspection by any duly authorized agent of the Secretary
upon reasonable request; and
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d. in a format and time prescribed by the Secretary, provide to the Secretary and
make available to the public following each of its fiscal years, an annual report
listing in detail:
1) all amounts paid by the airport to any other unit of govenunent and the
purposes for which each such payment was made; and
2) all services and property provided by the airport to other units of government
and the amount of compensation received for provision of each such service
and property.
27. Use by Government Aircraft.
It will make available all of the facilities of the airport developed with Federal
financial assistance and all those usable for landing and takeoff of aircraft to the
United States for use by Government aircraft in common with other aircraft at all
times without charge, except, if the use by Govenunent aircraft is substantial, charge
may be made for a reasonable share, proportional to such use, for the cost of
operating and maintaining the facilities used. Unless otherwise determined by the
Secretary, or otherwise agreed to by the sponsor and the using agency, substantial use
of an airport by Government aircraft will be considered to exist when operations of
such aircraft are in excess of those which, in the opinion of the Secretary, 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
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roads), including all proposed extensions and reductions of existing airport
facilities;
3) the location of all existing and proposed nonaviation 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
ofrestoring 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 promptly take any measures necessary to ensure that no person in the United
States shall, on the grounds of race, creed, color, national origin, sex, age, or
disability be excluded from participation in, be denied the benefits of, or be otherwise
subjected to discrimination in any activity conducted with, or benefiting from, funds
received from this grant.
a. Using the definitions of activity, facility and program as found and defined in§§
21.23 (b) and 21.23 ( e) of 49 CFR § 21, the sponsor will facilitate all programs,
operate all facilities, or conduct all programs in compliance with all non-
discrimination requirements imposed by, or pursuant to these assurances.
b. Applicability
l) Programs and Activities. If the sponsor has received a grant (or other federal
assistance) for any of the sponsor's program or activities, these requirements
extend to all of the sponsor's programs and activities.
2) Facilities. Where it receives a grant or other federal financial assistance to
construct, expand, renovate, remodel, alter or acquire a facility, or part of a
facility, the assurance extends to the entire facility and facilities operated in
connection therewith.
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3) Real Property. Where the sponsor receives a grant or other Federal financial
assistance in the form of, or for the acquisition of real property or an interest
in real property, the assurance will extend to rights to space on, over, or under
such property.
c. Duration.
The sponsor agrees that it is obligated to this assurance for the period during
which Federal financial assistance is extended to the program, except where the
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:
1) So long as the airport is used as an airport, or for another purpose involving
the provision of similar services or benefits; or
2) So long as the sponsor retains ownership or possession of the property.
d. Required Solicitation Language. It will include the following notification in all
solicitations for bids, Requests For Proposals for work, or material under this
grant agreement and in all proposals for agreements, including airport
concessions, regardless of funding source:
"The (Name of Sponsor), in accordance with the provisions of Title VI of the
Civil Rights Act of 1964 (78 Stat. 252, 42 U.S.C. §§ 2000d to 2000d-4) and the
Regulations, hereby notifies all bidders that it will affirmatively ensure that any
contract entered into pursuant to this advertisement, disadvantaged business
enterprises and airport concession disadvantaged business enterprises will be
afforded full and fair opportunity to submit bids in response to this invitation and
will not be discriminated against on the grounds of race, color, or national origin
in consideration for an award."
e. Required Contract Provisions.
1) It will insert the non-discrimination contract clauses requiring compliance
with the acts and regulations relative to non-discrimination in Federally-
assisted programs of the DOT, and incorporating the acts and regulations into
the contracts by reference in every contract or agreement subject to the non-
discrimination in Federally-assisted programs of the DOT acts and
regulations.
2) It will include a list of the pertinent non-discrimination authorities in every
contract that is subject to the non-discrimination acts and regulations.
3) It will insert non-discrimination contract clauses as a covenant running with
the land, in any deed from the United States effecting or recording a transfer
of real property, structures, use, or improvements thereon or interest therein to
a sponsor.
4) It will insert non-discrimination contract clauses prohibiting discrimination on
the basis of race, color, national origin, creed, sex, age, or handicap as a
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covenant running with the land, in any future deeds, leases, license, permits,
or similar instruments entered into by the sponsor with other parties:
a) For the subsequent transfer ofreal property acquired or improved under
the applicable activity, project, or program; and
b) For the construction or use of, or access to, space on, over, or under real
property acquired or improved under the applicable activity, project, or
program.
f. It will provide for such methods of administration for the program as are found by
the Secretary to give reasonable guarantee that it, other recipients, sub-recipients,
sub-grantees, contractors, subcontractors, consultants, transferees, successors in
interest, and other participants of Federal financial assistance under such program
will comply with ail requirements imposed or pursuant to the acts, the regulations,
and this assurance.
g. It agrees that the United States has a right to seek judicial enforcement with
regard to any matter arising under the acts, the regulations, and this assurance.
31. Disposal of Land.
a. For land purchased under a grant for airport noise compatibility purposes,
including land serving as a noise buffer, it will dispose of the land, when the land
is no longer needed for such purposes, at fair market value, at the earliest
practicable time. That portion of the proceeds of such disposition which is
proportionate to the United States' share of acquisition of such land will be, at the
discretion of the Secretary, (I) reinvested in another project at the airport, or (2)
transferred to another eligible airport as prescribed by the Secretary. The
Secretary shall give preference to the following, in descending order, ( 1)
reinvestment in an approved noise compatibility project, (2) reinvestment in an
approved project that is eligible for grant funding under Section 47117(e) of title
49 United States Code, (3) reinvestment in an approved airport development
project that is eligible for grant funding under Sections 47114, 47115, or 47117 of
title 49 United States Code, (4) transferred to an eligible sponsor of another public
airport to be reinvested in an approved noise compatibility project at that airport,
and (5) paid to the Secretary for deposit in the Airport and Airway Trust Fund. If
land acquired under a grant for noise compatibility purposes is leased at fair
market value and consistent with noise buffering purposes, the lease will not be
considered a disposal of the land. Revenues derived from such a lease may be
used for an approved airport development project that would otherwise be eligible
for grant funding or any permitted use of airport revenue.
b. For land purchased under a grant for airport development purposes ( other than
noise compatibility), it will, when the land is no longer needed for airport
purposes, dispose of such land at fair market value or make available to the
Secretary an amount equal to the United States' proportionate share of the fair
market value of the land. That portion of the proceeds of such disposition which
is proportionate to the United States' share of the cost of acquisition of such land
will, ( 1) upon application to the Secretary, be reinvested or transferred to another
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eligible airport as prescribed by the Secretary. The Secretary shall give
preference to the following, in descending order: (1) reinvestment in an approved
noise compatibility project, (2) reinvestment in an approved project that is eligible
for grant funding under Section 47117(e) of title 49 United States Code, (3)
reinvestment in an approved airport development project that is eligible for grant
funding under Sections 47114, 47115, or 47117 of title 49 United States Code, (4)
transferred to an eligible sponsor of another public airport to be reinvested in an
approved noise compatibility project at that airport, and (5) paid to the Secretary
for deposit in the Airport and Airway Trust Fund.
c. Land shall be considered to be needed for airport purposes under this assurance if
(1) it may be needed for aeronautical purposes (including runway protection
zones) or serve as noise buffer land, and (2) the revenue from interim uses of such
land contributes to the financial self-sufficiency of the airport. Further, land
purchased with a grant received by an airport operator or owner before December
31, 1987, will be considered to be needed for airport purposes if the Secretary or
Federal agency making such grant before December 31, 1987, was notified by the
operator or owner of the uses of such land, did not object to such use, and the land
continues to be used for that purpose, such use having commenced no later than
December 15, 1989.
d. Disposition of such land under (a) (b) or ( c) will be subject to the retention or
reservation of any interest or right therein necessary to ensure that such land will
only be used for purposes which are compatible with noise levels associated with
operation of the airport.
32. Engineering and Design Services.
It will award each contract, or sub-contract for program management, construction
management, planning studies, feasibility studies, architectural services, preliminary
engineering, design, engineering, surveying, mapping or related services with respect
to the project in the same manner as a contract for architectural and engineering
services is negotiated under Title IX of the Federal Property and Administrative
Services Act of 1949 or an equivalent qualifications-based requirement prescribed for
or by the sponsor of the airport.
33. Foreign Market Restrictions.
It will not allow funds · provided under this grant to be used to fund any project which
uses any product or service of a foreign country during the period in which such
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 for AIP projects, dated (the latest
approved version as of this grant offer) and included in this grant, and in accordance
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with applicable state policies, standards, and specifications approved by the
Secretary.
35. Relocation and Real Property Acquisition.
a. It will be guided in acquiring real property, to the greatest extent practicable under
State law, by the land acquisition policies in Subpart B of 49 CFR Part 24 and
will pay or reimburse property owners for necessary expenses as specified in
Subpart B.
b . 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.
c. 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 sponsor shall not discriminate on the basis ofrace, color, national origin or sex in
the award and performance of any DOT-assisted contract covered by 49 CFR Part 26,
or in the award and performance of any concession activity contract covered by 49
CFR Part 23 . In addition, the sponsor shall not discriminate on the basis of race,
color, national origin or sex in the administration of its DBE and ACDBE programs
or the requirements of 49 CFR Parts 23 and 26. The sponsor shall take all necessary
and reasonable steps under 49 CFR Parts 23 and 26 to ensure nondiscrimination in the
award and administration of DOT-assisted contracts, and/or concession
contracts . The sponsor's DBE and ACDBE programs, as required by 49 CFR Parts
26 and 23, and as approved by DOT, are incorporated by reference in this
agreement. Implementation of these programs is a legal obligation and failure to
carry out its terms shall be treated as a violation of this agreement. Upon notification
to the sponsor of its failure to carry out its approved program, the Department may
impose sanctions as provided for under Parts 26 and 23 and may, in appropriate cases,
refer the matter for enforcement under 18 U.S.C. l 001 and/or the Program Fraud
Civil Remedies Act of 1936 (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.
Airport Sponsor Assurnnces 3/2014 Page 19 of20
101518a HCBOC Page 93
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-
I) 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 I 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.
Airport Sponsor Assurances 3/2014 Page 20 of20
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Special Conditions
Sponsor Type of Project Special Conditions
Type 1
Airport Multi-year Grants/ MULTI-YEAR GRANTS-LETTER OF AGREEMENT: The maximum
Phased Projects obligation for the current fiscal year stated in Condition 1 of this grant
agreement may be increased by the additional amounts, if any, added by
the FAA letter to the Sponsor discussed in the subparagraph below, but
may not exceed the United States' share of the total estimated cost of
completion, except as provided in 49 USC§ 47108{b).
Under 49 USC§ 47108, as amended, and at the Sponsor's request, the
FAA commits the United States to obligate an additional amount to this
project for FY-[Enter Fiscal Year] pursuant to 49 USC§ 47114 and subject
to the restrictions on the use of such apportionments imposed on FAA by
current or future statute or regulation .
It is further understood by the Sponsor and the FAA that this
commitment does not in itself obligate, preclude, nor restrict the FAA in
the use of any funds made available for discretionary use to further aid
the Sponsor in meeting the cost of this project under the terms of this
grant agreement and limitations of the law.
The exact amount of this commitment will be established for each fiscal
year by the FAA in a letter to the Sponsor stating the current maximum
obligation for this project. This letter will be issued to the Sponsor by the
FAA when such computation and obligation can be made in FY [Enter
Fiscal Year} The Sponsor and the FAA agree that upon its issuance, this
letter will be considered incorporated by reference into this grant
agreement.
Airport ARFF and SRE : ARFF and SRE EQUIPMENT AND VEHICLES: The Sponsor agrees that it
Equipment will:
Acquisition 1) house and maintain the equipment in a state of operational
readiness on and for the airport;
2) provide the necessary staffing and training to maintain and operate
the vehicle and equipment;
3) restrict the vehicle to on-airport use only;
4) restrict the vehicle to the use for which it was intended; and
5) amend the Airport Emergency Plan and/or Snow and Ice Control Plan
to reflect the acquisition of the vehicle and equipment.
Airport Equipment [Choose the situation below that applies)
Replacement EQUIPMENT OR VEHICLE REPLACEMENT: The Sponsor agrees that it will
such as ARFF and SRE use the proceeds from the trade-in or sale of equipment being replaced
by this project to reduce the total project costs .
1 Sponsor types include Airport Sponsor (Public and Private), Airport Sponsor (Private Only), Noise, and State or
Local Government
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Special Conditions
Sponsor Type of Project Special Conditions
Type 1
EQUIPMENT OR VEHICLE REPLACEMENT: The Sponsor agrees that it will
use the Fair Market Value of equipment being replaced by this project to
reduce the total project costs.
EQUIPMENT OR VEHICLE REPLACEMENT: The Sponsor and the FAA agree
that the Fair Market Value of equipment being replaced by this project is
less than $5,000, and that reimbursement to the FAA for the value of the
replaced equipment to reduce the total project costs
Airport ARFF Equipment-Off-OFF-AIRPORT STORAGE OF ARFF VEHICLE : The Sponsor agrees that it
Airport Storage will :
1) house and maintain the vehicle in a state of operational readiness for
the airport;
2) provide the necessary staffing and training to maintain and operate
the vehicle;
3) restrict the vehicle to airport use only;
4) amend the Airport Emergency Plan to reflect the acquisition of the
vehicle;
5) within 60 days, execute an agreement with local government
including the above provisions and a provision that violation of
agreement could require repayment of grant funding; and
6) submit a copy of the executed agreement to the FAA .
Airport AWOS AUTOMATED WEATHER OBSERVING SYSTEMS (AWOS}: The Sponsor
agrees that it will :
1) within 60 calendar days of grant acceptance, establish a
Memorandum of Agreement (MOA) with the FAA;
2) develop an Operations Maintenance Manual to more specifically
describe the operational, maintenance, and documentation requirements
for the AWOS;
3) within 60 calendar days of installation, take the necessary actions to
initiate the AWOS commissioning by the FAA; and
4) provide for the installation, commissioning, continuous operation, and
maintenance of any Non-Federal AWOS funded under this grant for the
useful life of the equipment.
The Sponsor further understands that the FAA will not take over the
ownership, operation, or maintenance of any Sponsor-acquired
equipment.
Airport ALP & AIP Funded AIRPORT LAYOUT PLAN: The Sponsor understands and agrees to
Construction update the Airport layout Plan to reflect the construction to standards
satisfactory to the FAA and submit it in final form to the FAA . It is further
mutually agreed that the reasonable cost of developing said Airport
Layout Plan Map is an allowable cost within the scope of this project.
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Special Conditions
Sponsor Type of Project Special Conditions
Type 1
Airport Lighting -Operation LIGHTING: The Sponsor must operate and maintain the lighting system
and Maintenance during the useful life of the system in accordance with applicable FAA
standards .
Airport Temporary NAVAIDS TEMPORARY NAVAIDS: The Sponsor agrees that [Enter Type of
Equipment} equipment is being acquired for temporary use to minimize
disruptions to the airp<?rt during construction. The Sponsor further agrees
that upon construction completion of this project or at the point when
this equipment is no longer needed for its intended use (but no later than
the construction completion of the project), that the Sponsor will house
this equipment in an interior enclosure . The Sponsor further agrees to
make this equipment available, without cost, to be transferred to another
airport or as directed by the FAA .
Airport Construction on land NOTICE TO PROCEED -PROPERTY INTEREST AC!JUIRED: The Sponsor
not yet acquired/ understands and agrees that the FAA authorization for the Sponsor to
Good Title issue a notice to proceed with construction work will not be given until
the Sponsor has adequately certified that good title will be acquired on
the land on which construction is to be performed .
Airport Construction on land TITLE EVIDENCE: The Sponsor understands and agrees that the FAA will
not yet acquired/ not make nor be obligated to make any payments involving Parcel(s}
Good Title [Enter parcel number(s) and other land identifying information] until title
evidence has been submitted to, and found satisfactory by the FAA,
subject to no liens, encumbrances, reservations or exceptions which in
the opinion of the FAA might create an undue risk or interference with
the use and operation of the airport.
Airport DBE Plan DBE PLAN: The Sponsor understands and agrees that the FAA will not
make nor be obligated to make any payments on this grant until the
Sponsor has received approval of its DBE Plan from the FAA Office of Civil
Rights .
Airport Environmental ENVIRONMENTAL: The environmental approval for this project was
issued on [Enter Approval Date] This project includes the following
mitigation measures :
[Enter Mitigation Measures]
The Sponsor understands and agrees to complete the above-listed
mitigation measures to standards satisfactory to the FAA . It is further
mutually agreed that the reasonable cost of completing these mitigation
measures is an allowable cost within the scope of this project.
Airport EMAS EMAS BLOCK PRE-PURCHASE: The Sponsor understands that it may
request reimbursement for payment made by the Sponsor to the EMAS
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Special Conditions
Sponsor Type of Project Special Conditions
Type 1
manufacturer for up to 90% of the cost of EMAS block manufacturing
costs of EMAS blocks that rema i n in the manufacturer's care, custody and
control provided that the Sponsor has provided a certification to the FAA
as to quantity and condition of the EMAS blocks. The remaining payment
may be made after delivery to the Sponsor's location and acceptance by
the Sponsor.
Airport Equipment EQUIPMENT ACQUISITION: The Sponsor understands and agrees that
any equipment acquired through this grant is considered a facility as that
term is used in the Grant Assurances . Further, the equipment must be
only operated by the Sponsor. The Sponsor agrees that it will maintain
the equipment and use it exclusively at the airport for airport purposes.
Airport Equipment -Friction FRICTION MEASURING DEVICES: The Sponsor agrees that it will properly
Measuring Device calibrate, operate, and maintain the friction measuring equipment. The
friction measuring equipment and tow vehicle (if applicable) must not be
used for any other purpose other than for conducting friction measuring
tests on airport pavement surf aces and directly related activities .
Airport NAVAIDS-ILS INSTRUMENT LANDING SYSTEM AND ASSOCIATED EQUIPMENT IN
PROJECT : The Sponsor agrees that it will :
Note that in general, 1) Prior to commissioning, assure the equipment meets the FAA's
Category I ILS are no standards; and
longer being installed . 2) Remove, relocate, lower, mark, or light each obstruction to obtain a
Instead, RNAV clear approach as indicated in the 14 CFR part 77 aeronautical surveys .
approaches provide
equivalent approach
minima. Installation of
a new ILS must follow
the ILS policy and
must have APP-1
approval.
Airport Fence -Wildlife WILDLIFE FENCE: The Sponsor understands that the fence is being
installed to prevent wildlife from entering the airfield . The Sponsor
agrees that it will maintain the integrity of the fence for its useful life, but
no less than 20 years from the date of the grant was issued . The Sponsor
understands that maintenance of the fence includes repair of damage to
the fence or gates due to any purpose .
Airport Land -Revise Exhibit UPDATE APPROVED EXHIBIT "A" PROPERTY MAP FOR LAND IN PROJECT:
"A" Property Map The Sponsor understands and agrees to update the Exhibit
"A" Property Map to standards satisfactory to the FAA and submit it i n
final form to the FAA . It is further mutually agreed that the reasonable
cost of developing said Exhibit "A" Property Map is an allowable cost
within the scope of this project.
Airport Land acquisition -FUTURE DEVELOPMENT LAND: The Sponsor agrees to perform the
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Special Conditions
Sponsor Type of Project Special Conditions
Type 1
Future land airport development which requires this land acquisition within [Enter
Number of Years (20 or less)) years of this grant agreement, and further
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 [Enter
Number of 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.
Airport Master Plan -COORDINATION: The Sponsor agrees to coordinate this master planning
Coordination study with the metropolitan planning organizations, other local planning
agencies, and with the State Airport System Plan prepared by the State's
Department of Transportation and consider any pertinent information,
data, projections, and forecasts which are currently available or as will
become available. The Sponsor agrees to consider any State
Clearinghouse comments and to furn ish a copy of the final report to the
State's Department of Transportation.
Airport-New runway, new COORDINATION: The Sponsor has made available to (or will make
Medium or airport, or major available to) and has provided (or will provide) upon request to the
Large Hub extension -metropolitan planning organization, if any, in the area in which the
Only Coordination airport is located, a copy of the proposed airport layout plan or ALP
amendment to depict the project and a copy of any airport master plan in
which the project is described or dep icted .
Airport NAVAIDS-AIRPORT-OWNED VISUAL OR ELECTRONIC NAVIGATION AIDS IN
Operations and PROJECT: The Sponsor agrees that it will :
maintenance
1) Provide for the continuous operation and maintenance of any
navigational aid funded under this grant agreement during the useful life
of the equipment;
2) Prior to commissioning, assure the equipment meets the FAA's
standards; and
3) Remove, relocate, lower, mark, or light each obstruction to obtain a
clear approach as indicated in the 14 CFR part 77 aeronautical survey .
Airport New or Replacement SITE SELECTION: The Sponsor understands and agrees that the Project
Airport cannot proceed beyond the site selection study until the Sponsor has
received formal approval from the FAA to proceed .
Airport Non-AIP Utility UTILITIES PRORATION: For purposes of computing the United States'
Proration share of the allowable project costs, the allowable cost of the [Enter
Utility Name) included in the project must not exceed [Enter Percent
(Numerica I Value)] percent.
Airport Utility Relocation UTILITY RELOCATION IN PROJECT: The Sponsor understands and
agrees that:
1) the United States will not participate in the cost of any utility
relocation unless and until the Sponsor has submitted evidence
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Special Conditions
Sponsor Type of Project Special Conditions
Type 1
Airport
Airport
March 27, 2014
satisfactory to the FAA that the Sponsor is legally responsible for
payment of such costs;
2} FAA participation is limited to those utilities located on-airport or off-
airport only where the Sponsor has an easement for the utility; and
3) the utilities exclusively serve the Airport;
Obstruction Removal OBSTRUCTION REMOVAL: The Sponsor agrees to clear Parcel(s} [Enter
Parcel Numbers], as shown on Exhibit "A" Property Map, of the following
obstructions; [Enter All Obstructions] prior to final payment under the
project . The Sponsor also agrees that it will not erect, nor permit the
erection of any permanent structures or obstructions on the airport
except those required for aids to air navigation or those which have been
specifically approved by the FAA.
Pavement PAVEMENT MAINTENANCE MANAGEMENT PROGRAM: The Sponsor
agrees that it will implement an effective airport pavement maintenance
management program as required by Grant Assurance Pavement
Preventive Management. The Sponsor agrees that it will use the program
for the useful life of any pavement constructed, reconstructed, or
repaired with federal financial assistance at the airport. The Sponsor
further agrees that the program will
1 . follow FAA Advisory Circular 150/5380-6, "Guidelines and
Procedures for Maintenance of Airport Pavements," for specific
guidelines and procedures for maintaining airport pavements,
establishing an effective maintenance program, specific types of
distress and its probable cause, inspection guidelines, and
recommended methods of repair;
2. detail the procedures to be followed to assure that proper
pavement maintenance, both preventive and repair, is
performed;
3. include a Pavement Inventory, Inspection Schedule, Record
Keeping, Information Retrieval, and Reference, meeting the
following requirements:
a. Pavement Inventory. The following must be depicted in
an appropriate form and level of detail:
1) location of all runways, taxiways, and aprons;
2) dimensions;
3) type of pavement, and;
4) year of construction or most recent major
rehabilitation.
b. Inspection Schedule.
1) Detailed Inspection . A detailed inspection must be
performed at least once a year . If a history of recorded
pavement deterioration is available, i.e., Pavement
Condition Index (PCI) survey as set forth in the Advisory
Circular 150/5380-6, the frequency of inspections may be
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Special Conditions
Sponsor Type of Project Special Conditions
Type 1
extended to three years.
2} Drive-By Inspection. A drive-by inspection must be
performed a minimum of once per month to detect
unexpected changes in the pavement condition . For
drive-by inspections, the date of inspection and any
maintenance performed must be recorded.
4. Record Keeping. Complete information on the findings of all
detailed inspections and on the maintenance performed must be
recorded and kept on file for a minimum of five years. The type of
distress, location, and remedial action, scheduled or performed,
must be documented . The minimum information is:
a. inspection date;
b. location;
c. distress types; and
d. maintenance scheduled or performed .
5. Information Retrieval System . The Sponsor must be able to
retrieve the information and records produced by the pavement
survey to provide a report to the FAA as may be required .
Airport Pavement Exceeding PROJECTS WHICH CONTAIN PAVING WORK IN EXCESS OF S2501000:
$250,000 The Sponsor agrees to:
a) Furnish a construction management program to the FAA prior to
the start of construction which details the measures and
procedures to be used to comply with the quality control
provisions of the construction contract, including, but not limited
to, all quality control provisions and tests required by the Federal
specifications . The program must include as a minimum:
(1) 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.
(2) 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 .
(3} Procedures for determining that the testing laboratories
meet the requirements of the American Society of Testing
and Materials standards on laboratory evaluation referenced
in the contract specifications (D 3666, C 1077).
(4) Qualifications of engineering supervision and construction
inspection personnel.
(5) 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.
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Special Conditions
Sponsor Type of Project Special Conditions
Type 1
(6} Procedures for ensuring that the tests are taken in
accordance with the program, that they are documented
daily, and that the proper corrective actions, where
necessary, are undertaken.
b) 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 that did not meet the
applicable test standard. The report must include the pay
reductions applied and the reasons for accepting any out-of-
tolerance material. An interim test and quality control report
must be submitted, if requested by the FAA .
c} Failure to provide a complete report as described in paragraph b,
or failure to perform such tests, will, absent any compelling
justification; result in a reduction in Federal participation for
costs incurred in connection with construction of the applicable
pavement. Such reduction will 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 the grant agreement.
d} 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 test results are
inaccurate.
Airport-No State Highway STATE HIGHWAY SPECIFICATIONS: The Sponsor agrees that because
primary Specifications -State highway specifications will be used for airfield pavement
Pavement construction instead of FAA standard specifications, it will not seek AIP
grant funds for the rehabilitation or reconstruction of airfield pavement
included in this grant agreement for a period of 10 years after
construction is completed unless the FAA determines that the
rehabilitation or reconstruction is required for safety reasons, per 49
USC§ 47114(d) (S) {A).
Airport Pavement MAINTENANCE PROJECT LIFE: The Sponsor agrees that pavement
maintenance grant grant maintenance is limited to those aircraft pavements that are in
sufficiently sound condition that they do not warrant more extensive
work, such as reconstruction or overlays in the immediate or near future.
The Sponsor further agrees that AIP funding for the pavements
maintained under this project will not be requested for more substantial
type rehabilitation (more substantial than periodic maintenance) for a S-
year period following the completion of this project unless the FAA
determines that the rehabilitation or reconstruction is required for safety
reasons.
Airport RPZ Acquisition PROTECTION OF RUNWAY PROTECTION ZONE: The Sponsor agrees to
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Special Conditions
Sponsor Type of ProJect Special Conditions
Type 1
prevent the erection or creation of any structure, place of public
assembly, or other use in the runway protection zone, as depicted on the
Exhibit "A": Property Map, except for NAVAIDS that are fixed by their
functional purposes or any other structure permitted by the FAA.
The Sponsor further agrees that any existing structures or uses within the
Runway Protection Zone will be cleared or discontinued by the Sponsor
unless approved by the FAA.
Airport RPZ Acquisition PROTECTION OF 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 an airport hazard 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.
Airport RPZ Future ACQUISITION OF THE RUNWAY PROTECTION ZONE: Future Interest in
Acquisition the Runway Protection Zone: The Sponsor agrees that it will acquire
[Enter the Fee Title or Easement) in the Runway Protection Zones for
runways that presently are not under its control within [Enter Number of
Years] years of this Grant Agreement. The Sponsor further 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 . The Sponsor further agrees that any existing structures or uses
within the Runway Protection Zone will be cleared or discontinued by the
Sponsor unless approved by the FAA.
Airport -Not Discretionary Funds in SMALL AIRPORT FUND: The source of this grant may include funding a
a large or project large or project from the Small Airport Fund .
medium hub
Airport VALE equipment LOW EMISSION SYSTEMS: The Sponsor agrees that vehicles and
equipment included in this grant:
1) will be maintained and used at the airport for which they were
purchased;
2) will not be transferred, relocated, or used at another airport without
the advance consent of the FAA;
3) will be clearly labeled using the FAA-designed VALE program
emblem;
4} will be replaced, at the Sponsor's own cost, any disabled or seriously
damaged vehicle or equipment at any time during its useful life, with an
equivalent vehicle or unit that produces an equal or lower level of
emissions for the useful life of the vehicle or equipment, or life of Airport
Emission Reduction Credits, whichever is longer.
The Sponsor further agrees that it will maintain annual records on
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Special Conditions
Sponsor Type of Project Special Conditions
Type 1
individual vehicles and equipment, project expenditures, cost
effectiveness, and emission reductions.
Airport VALE Recharging RECHARGING SYSTEM VALE-USE AND OPERATION REQUIREMENTS:
System The Sponsor understands that it is obligated to earn emissions credits
from the state air quality agency on a yearly basis for the use of this
recharging system and the use of electric ground support equipment at
the airport. The Sponsor understands and agrees that the Sponsor may
be obligated to repay to the FAA some or all of the federal share of the
recharging project if Sponsor does not earn the emissions credits that the
Sponsor estimated in the project application.
Airport or Building Allowable BUILDING AIP PRORATION: For purposes of computing the United
Noise Costs {Prorate) States' share of the allowable project costs of the project, the allowable
cost of the [Enter Name of Work Item] included in the project must not
exceed (Enter Percent (Numerical Value) percent of the actual cost of the
entire building.
Airport or Noise land ACQUISITION OF NOISE LAND: The Sponsor agrees that as part of the
Noise land acquisition in this project, it will prepare or update a Noise Land
Inventory Map and Reuse Plan to standards satisfactory to the FAA and
submit said documentation in final form to the FAA. It is further mutually
agreed that the reasonable cost of developing or updating a Noise Land
Inventory Map and Disposal Plan is an allowable cost within the scope of
this project.
Airport or Noise -Annual ANNUAL NOISE REPORT: As a condition of this Airport Improvement
Noise Report Noise Program (AIP} grant, the Sponsor agrees to provide to the FAA, an
annual report of funds expended and actions associated with this grant
within 90 days following the end of each Federal fiscal year the grant
remains open. The report must provide the following information:
1) Total noise grant funds expended during the fiscal year.
2) Amount of funds expended by Program Element(s) as identified in the
Sponsor's Noise Compatibility Program (NCP).
3) Number of parcels mitigated by DNL contour and Program Element as
identified in the Sponsor's NCP.
4) Total number of people impacted by the Sponsor's NCP (by DNL
contour) and total number of people mitigated during the fiscal year by
DNL contour and Program Element as identified in the Sponsor's NCP.
5) A graphic (map) depicting DNL contours and the location of
mitigation action as defined by the Program Element(s} of the
Sponsor's NCP, including a list by address for mitigation actions shown on
the map.
6) A written plan outlining actions being planned for the next year
based on the Sponsor's priorities and the NCP.
7) Other information as required by the FAA.
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Special Conditions
Sponsor Type of ProJect Special Condrtrons
Type 1
All Sponsor Plans and PLANS AND SPECIFICATIONS PRIOR TO BIDDING: The Sponsor agrees
Types Specifications that it will submit plans and specifications for FAA review and approval
prior to advertising for bids.
All Sponsor Plans and PLANS & SPECIFICATIONS APPROVAL BASED UPON CERTIFICATION:
Types Specifications Types Certification The FAA and the Sponsor agree that the FAA approval
Certification of the Sponsor's Plans and Specification is based primarily upon the
Sponsor's certification to carry out the project in accordance with
policies, standards, and specifications approved by the FAA . The Sponsor
understands that:
l}The Sponsor's certification does not relieve the Sponsor of the
requirement to obtain prior FAA approval for modifications to any AIP
standards or to notify the FAA of any limitations to competition within
the project;
2)The FAA's acceptance of a Sponsor's certification does not limit the FAA
from reviewing appropriate project documentation for the purpose of
validating the certification statements;
3) if the FAA determines that the Sponsor has not complied with their
certification statements, the FAA will review the associated project costs
to determine whether such costs are allowable under AIP.
All Sponsor Grants Based on GRANTS ISSUED ON ESTIMATES: The Sponsor understands and agrees
Types Estimates that this Grant Offer is made and accepted based on estimates for [Enter
Project Name]; and the parties agree that within [Enter Number of Days]
days from the date of acceptance of this Grant Offer, the Sponsor will
receive bids for [Enter Project Being Bid] contained within the grant
description. If, after the Sponsor has received bids, the FAA determines
that the maximum grant obligation of the United States exceeds the
expected needs of the Sponsor by $25,000.00 or five percent (5%),
whichever is greater based on the actual bid prices received, the FAA can
issue a letter to the Sponsor unilaterally reducing the maximum
obligation. The Sponsor understands that amendment
calculations will then be limited by this reduced maximum obligation .
All Sponsor Consultant Contract CONSULTANT CONTRACT AND COST ANALYSIS: The Sponsor
Types Cost Analysis understands and agrees that no reimbursement will be made on the
consultant contract portion of this grant until the FAA has received the
consultant contract, the Sponsor's analysis of costs, and the independent
fee estimate .
All Sponsor Design-Only Grants DESIGN GRANT: This grant agreement is being issued in order to
Types complete the design of the project. The Sponsor understands and
agrees that within 2 years after the design is completed that the
Sponsor will accept, subject to the availability of the amount of federal
funding identified in the Airport Capital Improvement Plan (ACIP}, a grant
to complete the construction of the project in order to provide a useful
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Special Conditions
Sponsor Type of Project Special Conditions
Type 1
and useable unit of work. The Sponsor also understands that if the FAA
has provided federal funding to complete the design for the project, and
the Sponsor has not completed the design within four (4) years from the
execution of this grant agreement, the FAA may suspend or terminate
grants related to the design.
All Sponsor Force account FORCE ACCOUNT: The Sponsor agrees that proposals to accomplish
Types construction or engineering with the Sponsor's own personnel must
receive approval from the FAA prior to Sponsor incurring costs and that
no reimbursement payments will be made on that portion of this grant
until the Sponsor has received FAA approval for the force account
information.
All Sponsor Land Acquisition -PROGRAM INCOME AND REVENUE FROM REAL PROPERTY: The
Types Revenue and Program Sponsor understands that all program income produced from real
Income property purchased in part with Federal funds in this grant received while
the grant is open will be deducted from the total cost of that project for
determining the net costs on which the maximum United States'
obligation will be based . The Sponsor further agrees that once the grant
is closed, all net revenues produced from real property purchased in part
with Federal funds in this grant must be used on the airport for airport
planning, development, or operating expenses. This income may not be
used for the Sponsor's matching share of any grant. The Sponsor's fiscal
and accounting records must clearly identify actual sources and uses of
these funds .
All Sponsor Land acquisition -UNIFORM RELOCATION ACT: The Sponsor understands and agrees that
Types Relocation all acquisition of real property under this project will be in accordance
with the 49 Code of Federal Regulations Part 24, Uniform Relocation
Assistance And Real Property Acquisition For Federal And Federally
Assisted Programs .
All Sponsor Noise -mitigation INELIGIBILITY OF PREVIOUSLY INSULATED STRUCTURES: The Sponsor
Types understands and agrees that AIP funds may only be applied to noise
insulate structures under 14 Code of Federal Regulations Part 150 one
single time and that no structures in this grant have been previously
noise insulated using AIP funds.
All Sponsor Noise Mitigation -NOISE PROJECTS ON PRIVATELY OWNED PROPERTY: The Sponsor
Types Private Land understands and agrees that no payment will 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 the Grant Assurance Number 5: Preserving Rights and
Powers, and the FAA has determined that the agreement is satisfactory.
As a minimum, the agreement with the private owner must contain the
following provisions:
March 27, 2014 Page 12
101518a HCBOC Page 106
Special Conditions
Sponsor Type of Project Special Conditions
Type i
1) The property owner must inspect and approve or disapprove the work
on the project during and after completion of the measures as the FAA or
Sponsor reasonably requests.
2) The property owner is responsible for maintenance and operation of
the items installed, purchased , or. Neither the FAA nor the Sponsor bears
any responsibility for the maintenance, operation, or replacement of
these items.
3} If the Sponsor transfers Federal funds for the noise compatibility
measures to a private property owner or agent, the property owner must
agree to keep records and make those records available to the FAA and
the Sponsor about the amount of funds received and the disposition of
the funds.
4) The property owner's right to sue for adverse noise impacts will be
abrogated if the property owner deliberately or willfully reduces the
effectiveness of the noise compatibility measures during the useful life of
such measures. This obligation will remain in effect throughout the useful
life of the noise compatibility measures, but not to exceed 20 years from
the date of the Sponsor's acceptance of federal aid for the project.
All Sponsor Non AIP work in NON-AIP WORK IN APPLICATION: The Sponsor understands and agrees
Types project that:
1) the Project Application includes the planning and/or construction of
[Enter Non-Grant Work) that is not being funded with any Federal
funding in this project;
2) although the Sponsor has estimated a total project cost of $(Enter
Total Project Amount), the total allowable cost for purposes of
determining federal participation will not exceed $(Enter Maximum
Federal Amount};
3) it must maintain separate cost records for the AIP and non-AIP work;
4) all cost records must be made available for inspection and audit by the
FAA;
5) within [Enter Number of Days] days of accept_ance of this Offer, the
Sponsor will submit a revised Program Statement/cost estimate to the
FAA depicting the AIP and non-AIP costs and a revised cost estimate
depicting only AIP project costs;
6) the Sponsor understands that all non-AIP work is the sole
March 27, 2014 Page 13
101518a HCBOC Page 107
Special Conditions
Sponsor Type of Project Special Conditions
Type 1
responsibility of the Sponsor; and
7} the amount of allowable cost that will be used for purposes of
determining an increase in the maximum obligation of the United
States will not exceed $[Enter Maximum Federal Amount], which is the
total allowable cost for purposes of determining federal participation in
of this special condition .
All Sponsor Planning Scope of PRELIMINARY SCOPE OF WORK: This Grant is made and accepted
Types Work Types upon the basis of a preliminary scope of work. The parties agree
that within 30 days from the date of acceptance of this Grant Offer, the
Sponsor will furnish a final scope of work to the FAA and that no work will
commence, nor will there be any contract signed for accomplishment of
such work, until the final scope of work has been approved by the FAA .
The Sponsor and the FAA further agree that any refere nee to the scope of
work made in the Grant Offer or in the project application is i n respect to
the final scope of work.
Airport-Non-Fuel farms FUELING SYSTEM -USE AND OPERATION REQUIREMENTS: This project
primary includes the installation of a new aviation fuel system . All revenue
generated by this fueling system must be used for the operation and
maintenance of the Airport in accordance with the grant assurances . The
fueling system established under this grant, will be operated solely by the
Sponsor and/or the Sponsor's employees . The Sponsor is further
obligated to operate and maintain the fueling system for the 20-year
grant expected life, including meeting all local, state, and federal
regulations related to the fuel system.
Airport -Non-Revenue Producing REVENUE PRODUCING PROJECT: The Sponsor agrees and understands
primary Project that the Sponsor has certified to the FAA that it has made adequate
provisions for financing its airside needs. Further, the Sponsor agrees it
will not seek AIP discretionary grant funds for the airs i de needs of the
airport for the three fiscal years following the fiscal year in which this
grant is issued . All revenue generated by this project must be used for the
operation and maintenance of the Airport in accordance with the grant
assurances.
Airport-All Projects -PRIVATELY OWNED AIRPORTS: The Sponsor understands and agrees that
Privately-Obligated Land the portion of airport dedicated for airport use as shown on the approved
Owned Exhibit "A" Airport Property Map dated [Enter MM/DD/YYYY) of Exhibit
"A") must not be sold, exchanged, the title encumbered, or its use
changed to a non-airport use without the written consent of the FAA.
The Sponsor further understands and agrees that the portion of the
airport NOT dedicated to airport use, but financially contributing to the
overall viability of the airport (as shown on Exhibit "A" Airport Property
Map} must continue to support the operation of the airport for a period
March 27, 2014 Page 14
101518a HCBOC Page 108
Special Conditions
Sponsor Type of Project Specia I Condit ions
Type 1
of [Enter Number of Years (Minimum 10 Years)] years from the date of
this grant.
Airport Land Acquisition LAND ACQUISITION: The Sponsor agrees that no payments will be
made on the grant until the Sponsor has presented evidence to the FAA
that it has recorded the grant agreement, including the grant assurances
in the public land records of the county courthouse. The Sponsor
understands and agrees that recording the grant agreement legally
enforces these requirements, encumbrances and restrictions on the
obligated land.
March 27, 2014 Page 15
101518a HCBOC Page 109
Special Conditions
Sponsor Type of Project Special Conditions
Type 1
State and/or
local
government
March 27, 2014
Noise Mitigation -
Land use
Compatibility
COMPATIBLE LAND USE PLANNING AND PROJECTS: The Sponsor
agrees and understands that:
1) It will achieve, to the maximum extent possible, compatible land
uses consistent with Federal land use compatibility criteria in Title 14,
Code of Federal Regulations, Part 150, and those compatible land
uses will be maintained;
2) It will provide, in the case of a planning grant, a land use plan that -
(a) Is reasonably consistent with the goal of reducing existing
non-compatible land uses and preventing the introduction of
additional non-compatible land uses;
(b) Addresses ways to achieve and maintain compatible land
uses, including zoning, building codes, and any other land use
compatibility measures identified under Title 49, United
States Code§ 47504(a)(2), that are within the authority of the
Sponsor to implement;
(c) Uses noise contours provided by the airport operator that
are consistent with airport operation and planning, including
any noise abatement measures adopted by the airport
operator as a part of its own noise mitigation efforts;
(e) Does not duplicate, and is not inconsistent with, the
airport operator's noise compatibility measures for the same
area; and
(f) Has been approved jointly by the airport owner or
operator and the Sponsor.
3) It will make provision to implement, or has implemented, those
elements of the plan ineligible for Federal financial assistance.
Page 16
101518a HCBOC Page 110
FAA
Airports
Current FAA Advisory Circulars Required for Use in AIP
Funded and PFC Approved Projects
Updated: 12/31/2015
View the most current versions of these ACs and any associated changes at:
http ://www.faa .gov/airports/resources/advisory circulars
NUMBER TITLE
70/7460-1 L Obstruction Marking and Lighting
150/5020-1 Noise Control and Compatibility Planning for Airports
150/5070-6B Airport Master Plans
Changes 1 -2
150/5070-7 The Airport System Planning Process
Change 1
150/5100-13B Development of State Standards for Nonprimary Airports
150/5200-28E Notices to Airmen (NOT AMS) for Airport Operators
150/5200-30C Airport Winter Safety And Operations
Change 1
150/5200-31 C Airport Emergency Plan
Changes 1 -2
150/5210-5D Painting, Marking, and Lighting of Vehicles Used on an Airport
1 50/5210-7D Aircraft Rescue and Fire Fighting Communications
150/5210-13C Airport Water Rescue Plans and Equipment
150/5210-14B Aircraft Rescue Fire Fighting Equipment, Tools and Clothing
150/5210-15A Aircraft Rescue and Firefighting Station Building Design
150/5210-1 BA Systems for Interactive Training of Airport Personnel
FM Advisory Circulars Required for Use in
AIP Funded and PFC Approved Projects
Updated 12/31 /2015
ARP
Page 1 of 5
101518a HCBOC Page 111
NUMBER TITLE
150/5210-19A Driver's Enhanced Vision System (DEVS) Ground Vehicle Operations on
Airports
150/5220-10 E Guide Specification for Aircraft Rescue and Fire Fighting (ARFF) Vehicles
150/5220-160 Automated Weather Observing Systems (AWOS) for Non-Federal Applications
150/5220-1 ?B Aircraft Rescue and Fire Fighting (ARFF) Training Facilities
150/5220-1 BA Buildings for Storage and Maintenance of Airport Snow and Ice Control
Equipment and Materials
150/5220-20A Airport Snow and Ice Control Equipment
150/5220-21 C Aircraft Boarding Equipment
150/5220-22B Engineered Materials Arresting Systems (EMAS) for Aircraft Overruns
150/5220-23 Frangible Connections
150/5220-24 Foreign Object Debris Detection Equipment
150/5220-25 Airport Avian Radar Systems
150/5220-26, Airport Ground Vehicle Automatic Dependent Surveillance -Broadcast (ADS-B)
Change 1 Out Squitter Equipment
150/5300-?B FAA Policy on Facility Relocations Occasioned by Airport Improvements of
Changes
150/5300-13A, Airport Design
Change 1
150/5300-14C Design of Aircraft Deicing Facilities
150/5300-16A General Guidance and Specifications for Aeronautical Surveys: Establishment
of Geodetic Control and Submission to the National Geodetic Survey
150/5300-1 ?C Standards for Using Remote Sensing Technologies in Airport Surveys
150/5300-1 BC Survey and Data Standards for Submission of Aeronautical Data Using Airports
GIS
150/5320-5D Airport Drainage Design
150/5320-6E Airport Pavement Design and Evaluation
150/5320-12C, Measurement, Construction, and Maintenance of Skid Resistant Airport
Changes 1 -8 Pavement Surfaces
FAA Advisory Circulars Required for Use in
AIP Funded and PFC Approved Projects
Updated 12/31/2015
ARP
Page 2 of 5
101518a HCBOC Page 112
NUMBER TITLE
150/5320-15A Management of Airport Industrial Waste
150/5235-48 Runway Length Requirements for Airport Design
150/5335-5C Standardized Method of Reporting Airport Pavement Strength -PCN
150/5340-1 L Standards for Airport Markings
150/5340-5D Segmented Circle Airport Marker System
150/5340-1 SF Standards for Airport Sign Systems
150/5340-26C Maintenance of Airport Visual Aid Facilities
150/5340-30H Design and Installation Details for Airport Visual Aids
150/5345-3G Specification for L-821, Panels for the Control of Airport Lighting
150/5345-58 Circuit Selector Switch
150/5345-?F Specification for L-824 Underground Electrical Cable for Airport Lighting
Circuits
150/5345-10 H Specification for Constant Current Regulators and Regulator Monitors
150/5345-12 F Specification for Airport and Heliport Beacons
150/5345-138 Specification for L-841 Auxiliary Relay Cabinet Assembly for Pilot Control of
Airport Lighting Circuits
150/5345-26D FAA Specification For L-823 Plug and Receptacle, Cable Connectors
150/5345-27E Specification for Wind Cone Assemblies
150/5345-28G Precision Approach Path Indicator (PAPI) Systems
150/5345-39D Specification for L-853, Runway and Taxiway Retro reflective Markers
150/5345-42H Specification for Airport Light Bases, Transformer Housings, Junction Boxes,
and Accessories
150/5345-43G Specification for Obstruction Lighting Equipment
150/5345-44K Specification for Runway and Taxiway Signs
150/5345-45C Low-Impact Resistant (LIR) Structures
150/5345-46D Specification for Runway and Taxiway Light Fixtures
FAA Advisory Circulars Required for Use in
AIP Funded and PFC Approved Proje cts
Updated 12/31/2015
ARP
Page 3 of 5
101518a HCBOC Page 113
NUMBER TITLE
150/5345-47C Specification for Series to Series Isolation Transformers for Airport Lighting
Systems
150/5345-49C Specification L-854 , Radio Control Equipment
150/5345-508 Specification for Portable Runway and Taxiway Lights
150/5345-51 8 Specification for Discharge-Type Flashing Light Equipment
150/5345-52A Generic Visual Glideslope Indicators (GVGI)
150/5345-53D Airport Lighting Equipment Certification Program
150/5345-548 Specification for L-884, Power and Control Unit for Land and Hold Short
Lighting Systems
150/5345-55A Specification for L-893, Lighted Visual Aid to Indicate Temporary Runway
Closure
150/5345-568 Specification for L-890 Airport Lighting Control and Monitoring System
(ALCMS)
150/5360-12F Airport Signing and Graphics
150/5360-13 Planning and Design Guidelines for Airport Terminal Facilities
Change 1
150/5360-14 Access to Airports By Individuals With Disabilities
150/5370-2F Operational Safety on Airports During Construction
150/5370-1 OG Standards for Specifying Construction of Airports
150/5370-11 8 Use of Nondestructive Testing in the Evaluation of Airport Pavements
150/5370-13A Off-Peak Construction of Airport Pavements Using Hot-Mix Asphalt
150/5370-158 Airside Applications for Artificial Turf
150/5370-16 Rapid Construction of Rigid (Portland Cement Concrete) Airfield Pavements
150/5370-17 Airside Use of Heated Pavement Systems
150/5380-6C Guidelines and Procedures for Maintenance of Airport Pavements
150/5380-9 Guidelines and Procedures for Measuring Airfield Pavement Roughness
150/5390-2C Heliport Design
FAA Advisory Circulars Required for Use in
AIP Funded and PFC Approved Projects
Updated 12/31/2015
ARP
Page 4 of 5
101518a HCBOC Page 114
NUMBER TITLE
150/5395-1 A Seaplane Bases
THE FOLLOWING ADDITIONAL APPLY TO AIP PROJECTS ONLY
Updated : 12/31/2015
NUMBER TITLE
150/5100-14E, Architectural , Engineering, and Plann ing Consultant Services for Airport Grant
Change 1 Projects
150/5100-17, Land Acquisition and Relocation Assistance for Airport Improvement Program
Changes 1 -6 Assisted Projects
150/5300-15A Use of Value Engineering for Engineering Design of A irports Grant Projects
150/5320-1 7 A Airfield Pavement Surface Evaluation and Rating (PASER) Manuals
150/5370-128 Quality Control of Construction for Airport Grant Projects
150/5380-6C Guidelines and Procedures for Maintenance of Airport Pavements
150/5380-78 Airport Pavement Management Program
150/5380-9 Guidel ines and Procedures for Measuring Airfield Pavement Roughness
FAA Adv isory Circulars Required for Use in
AI P Funde d and PFC Approved P rojects
Updated 12/31/2015
ARP
Page 5 of 5
101518a HCBOC Page 115
0
U.S . Department
of Transportation
Federal Aviation
Administration
FAA Form 5100-129, Construction Project Final Acceptance -
Airport Improvement Program Sponsor Certification
Paperwork Reduction Act Burden Statement
A federal agency may not conduct or sponsor, and a person is not required to respond to , nor shall a
person be subject to a penalty for failure to comply with a collection of information subject to the
requirements of the Paperwork Reduction Act unless that collection of information displays a currently
valid 0MB Control Number. The 0MB Control Number for this information collection is 2120-0569. Public
reporting for this collection of information is estimated to be approximately 8 hours per response ,
including the time for reviewing instructions , searching existing data sources , gathering and maintaining
the data needed, complet i ng and reviewing the coltection of information . All responses to this collection of
information are required under 49 U.S.C. Section 47105 to retain a benefit and to meet the reporting
requirements of 2 CFR 200 . Send comments regarding this burden estimate or any other aspect of this
collection of information , including suggestions for reducing this burden to the Federal Aviation
Administration at: 800 Independence Ave. SW, Washington, DC 20591, Attn : Information Collection
Clearance Officer, ASP-110 .
FAA Form 5100-129
101518a HCBOC Page 116
_., U.S. Department of Transportation
t""~ Federal Aviation Administration
0MB CONTROL NUMBER: 2120-0569
EXPIRATION DATE : 8/31/2019
Construction Project Final Acceptance
Airport Improvement Program Sponsor Certification
Sponsor: Harne-t+ C..Ou.n-h-( ~oord o+ tc>('()rn·1ss'too-exs
Airport: r\o.rn-t:.-+-+ 1?e3,ono\ Je+-por+
ProjectNumber: 3Lca31. a15. 11. I
Description of Work: 1erM.-,V\et. \ S ·,te. :r:..rnp"<ouerv1.f•\.+
Application
49 USC § 47105(d}, authorizes the Secretary to require me certification from the sponsor that it will
comply with the statutory and administrative requirements in carrying out a project under the Airport
Improvement Program. General standards for final acceptance and close out of federally funded
construction projects are in 2 CFR § 200.343 -Closeout and supplemented by FAA Order 5100.38. The
sponsor must determine that project costs are accurate and proper in accordance with specific
requirements of the grant agreement and contract documents.
Certification Statements
Except for certification statements below marked not applicable (N/A), this list includes major
requirements of the construction project. Selecting "Yes " represents sponsor acknowledgment and
confirmation of the certification statement. The term "will" means Sponsor action taken at appropriate
time based on the certification statement focus area , but no later than the end of the project period of
performance . This list is not comprehensive and does not relieve the sponsor from fully complying with
all applicable statutory and administrative standards. The source of the requirement is referenced within
parenthesis .
1. The personnel engaged in project administration , engineering supervision , project inspection, and
acceptance testing were or will be determined to be qualified and competent to perform the work
(~Assurance).
lj2fves D No D NIA
2. Construction records , including daily logs , were or will be kept by the resident
engineer/construction inspector that fully document contractor's performance in complying with:
a. Technical standards (Advisory Circular (AC) 150/5370-12);
b. Contract requirements (2 CFR part 200 and FAA Order 5100 .38); and
c. Construction safety and phasing plan measures (AC 15015370-2).
~ 0No 0NtA
3. All acceptance tests specified in the project specifications were or will be performed and
documented. (AC 150/5370-12).
~ 0No 0NtA
FM Form 5100-129 (1/17) SUPERSEDES PREVIOUS EDITION page 1 of 3
101518a HCBOC Page 117
4. Sponsor has taken or will take appropriate corrective action for any test result outside of
alfow_;9le tolerances (AC 150/5370-12).
0'Yes D No ON/A
5 . Pay reduction factors required by the specifications were applied or will be applied in computing
final payments with a summary made available to the FAA (AC 150/5370-10).
~s 0No ON/A
6 . Sponsor has notified , or will promptly notify the Federal Aviation Administration (FAA) of the
following occurrences:
a. Violations of any federal requirements set forth or included by reference in the contract
documents (2 CFR part 200);
b. Disputes or complaints concerning federal labor standards (29 CFR part 5); and
c . Violations of or complaints addressing conformance w ith Equal Employment Opportunity or
Disadvantaged Business Enterprise requirements (41 CFR Chapter 60 and 49 CFR part 26).
~s 0No ON/A
7 . Weekly payroll records and statements of compliance were or will be submitted by the prime
contractor and reviewed by the sponsor for conformance with federal labor and civil rights
re~ir~ents as required by FAA and U.S. Department of Labor (29 CFR Part 5).
~es 0No ON/A
8 . Payments to the contractor were or will be made in conformance with federal requirements and
contract provisions using sponsor internal controls that include :
a. Retaining source documentation of payments and verifying contractor billing statements
against actual performance (2 CFR § 200 .302 and FAA Order 5100 .38);
b. Prompt payment of subcontractors for satisfactory performance of work (49 CFR § 26.29);
c. Release of applicable retainage upon satisfactory performance of work (49 CFR § 26.29);
and
d. Verification that payments to DBEs represent work the DBE performed by carrying out a
_c~ercially useful function (49 CFR §26.55).
Wes 0No O NIA
9 . A final project inspection was or will be conducted with representatives of the sponsor and the
contractor present that ensure:
a. Physical completion of project work in conformance with approved plans and specifications
(Order 5100.38);
b. Necessary actions to correct punch list items identified during final inspection are complete
(Order 5100.38); and
c. Preparation of a record of final inspection and distribution to parties to the contract
(g¢er 5100 .38);
~es O No ON/A
10. The project was or will be accomplished without material deviations, changes , or modifications
from apJ?roved plans and specifications, except as approved by the FAA (Order 5100 .38).
~ 0No ON/A
FAA Form 5100-129 (1/17) SUPERSEDES PREVIOUS EDITION page 2 of 3
101518a HCBOC Page 118
11 . The construction of all buildings have complied or will comply with the se ismic construction
requirements of 49 CFR § 41 .120 .
[Difu D No D N/A
12 . For development projects , sponsor has taken or will take the following close-out actions:
a. Submit to the FAA a final test and quality assurance report summarizing acceptance test
results, as applicable (Grant Condition);
b. Complete all environmental requirements as established within the project environmental
determination (Oder 5100 .38); and
c. Pr.Yre and retain as-built plans (Order 5100 .38).
~es D No ON/A
13. Sponsor has revised or will revise their airport layout plan (ALP) that reflects improvements made
and has submitted or will submit an updated ALP to the FAA no later than 90 days from the
period_7performance end date . (49 USC§ 47107 and Order 5100.38 ).
[g'Yes D No D N/A
Attach documentation clarifying any above item marked with "No" response.
Sponsor's Certification
I certify , for the project identified herein , responses to the forgoing items are accurate as marked and
additional documentation for any item marked "no " is correct and complete.
Executed on this day of
H C ·"'-L 12 oC\ d of C. o<YYY)·,ss, onesS Name of Sponsor: Qrne-t+ 0Ur ITv/ D r
Name of Sponsor's Authorized Official: GOfdZ>() S(Xiaje
Title of Sponsor's Authorized Official : C,.hD._\y-Mlt() ... .. . . . ...
Signature of Sponsor's Authorized Official : -------------------..:~-
I declare under penalty of perjury that the foregoing is true and correct. I understand that kn·o~/n~li,r~n~-.' .' .'
willfully providing false information to the federal government is a violation of 18 USC§ 1001 (False
Statements ) and could subject me to fines , imprisonment, or both.
FAA Form 5100-129 (1/17) SUPERSEDES PREVIOUS EDITION page 3 of 3
101518a HCBOC Page 119
0
U.S. Department
of Transportation
Federal Aviation
Administration
FAA Form 5100-130, Drug-Free Workplace -Airport Improvement
Program Sponsor Certification
Paperwork Reduction Act Burden Statement
A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a
person be subject to a penalty for failure to comply with a collection of information subject to the
requirements of the Paperwork Reduction Act unless that collection of information displays a currently
valid 0MB Control Number. The 0MB Control Number for this information collection is 2120-0569. Public
reporting for this collection of information is estimated to be approximately 8 hours per response,
including the time for reviewing instructions , searching existing data sources , gathering and maintaining
the data needed, completing and reviewing the collection of information. All responses to this collection of
information are required under 49 U.S.C. Section 47105 to retain a benefit and to meet the reporting
requirements of 2 CFR 200. Send comments regarding this burden estimate or any other aspect of this
collection of information , including suggestions for reducing this burden to the Federal Aviation
Administration at: 800 Independence Ave . SW, Washington, DC 20591 , Attn : Information Collection
Clearance Officer, ASP-110 .
FAA Form 5100-130
101518a HCBOC Page 120
., U .S. Department of Transportation
~e,' Federal Aviation Administration
0MB CONTROL NUMBER: 2120-0569
EXPIRATION DATE: 8/31/2019
Drug-Free Workplace
Airport Improvement Program Sponsor Certification
Sponsor:Harne++ Ccun-kJ 13oard of C.orn(Y')i .5'516¥1-ef.S
Airport: Hornet+ K-e_qlonD. \ J-€ + po.,.+
Project Number: 6 U> J "3 I. d S , 11, I
Description of Work : l-€..r ~\(\{l \ 5 ·, te.I. rv.. P'fO\J eVVl-Cl'\ -\-5
Application
49 USC§ 47105(d) authorizes the Secretary to require certification from the sponsor that it will comply
with the statutory and administrative requirements in carrying out a project under the Airport Improvement
Program (AIP). General requirements on the drug-free workplace within federal grant programs are
described in 2 CFR part 182 . Sponsors are required to certify they will be , or will continue to provide , a
drug-free workplace in accordance with the regulation . The AIP project grant agreement contains specific
assurances on the Drug-Free Workplace Act of 1988.
Certification Statements
Except for certification statements below marked as not applicable (NIA}, this list includes major
requirements of the construction project. Selecting "Yes " represents sponsor acknowledgement and
confirmation of the certification statement. The term "will " means Sponsor action taken at appropriate time
based on the certification statement focus area , but no later than the end of the project period of
performance. This list is not comprehensive and does not relieve the sponsor from fully complying with all
applicable statutory and administrative standards . The source of the requirement is referenced within
parenthesis.
1. A statement has been or will be published prior to commencement of project notifying employees
that the unlawful manufacture , distribution , dispensing, possession , or use of a controlled
substance is prohibited in the sponsor's workplace , and specifying the actions to be taken against
emp~es for violation of such prohibition (2 CFR § 182.205).
uY'es D No D NIA
2. An ongoing drug-free awareness program (2 CFR § 182.215) has been or will be established
prior to commencement of project to inform employees about:
a. The dangers of drug abuse in the workplace ;
b. The sponsor's policy of maintaining a drug-free workplace ;
c . Any available drug counseling, rehabilitation , and employee assistance programs ; and
d. The penalties that may be imposed upon employees for drug abuse violations occurring
/ in the workplace .
!2f Yes D No D NIA
FAA Form 5100-130 (1/17 ) SUPERSEDES PREVIOUS EDITION Page 1 of 3
101518a HCBOC Page 121
3. Each employee to be engaged in the performance of the work has been or will be given a copy of
the ~ement required within item 1 above prior to commencement of project (2 CFR § 182 .210).
~Yes O No O NIA
4 . Employees have been or will be notified in the statement required by item 1 above that , as a
condition employment under the grant (2 CFR § 182.205(c)), 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 .
ref Yes O No O NIA
5. The Federal Aviation Administration (FAA) will be notified in writing within 10 calendar days after
receiving notice under item 4b above from an employee or otherwise receiving actual notice of
such conviction (2 CFR § 182.225). Employers of convicted employees must provide notice ,
inclu_rg position title of the employee , to the FAA (2 CFR § 182 .300).
~es ONo ON/A
6 . One of the following actions (2 CFR § 182 .225(b)) will be taken within 30 calendar days of
receiving a notice under item 4b above w ith 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 requ irements of the Rehabilitation Act of 1973, as
amended ; and
b. Require such employee to part icipate satisfactorily in drug abuse assistance or
rehabilitation programs approved for such purposes by a federal , state , or local health ,
/ law enforcement, or other appropriate agency .
C!'Yes O No O NIA
7 . A good faith effort will be made , on a continuous basis , to maintain a drug-free workplace through
impl~ntation of items 1 through 6 above (2 CFR § 182.200).
[g'Yes O No O NIA
Site(s) of performance of work (2 CFR § 182.230):
Location 1
Name of Location : Hor-ne++t(e~c(\Df\Q.\ ~-e+-po,4-
Address : lo\':J f+tr por+~Ou(\. <c_ru.).l(\, l)C.., d~ 33'1
Location 2 (if applicable)
Name of Location :
Address :
Location 3 (if applicable)
Name of Location:
Address :
FAA Form 5100-130 (1/17) SUPERSEDES PREVIOUS EDITION Page 2 of 3
101518a HCBOC Page 122
Attach documentation clarifying any above item marked with a "No " response.
Sponsor's Certification
I certify, for the project identified herein , responses to the forgoing items are accurate as marked and
additional documentation for any item marked "no " is correct and complete.
Executed on this day of
NameofSponsor: Har0e.-t+ tounh(Toor-d o-P
Name of Sponsor's Authorized Official : t:l()('d()l')..5{)r:-1f'l~/e,
Title of Sponsor's Authorized Official : CJ'1£)1°\ r Ml.Xr\
Signature of Sponsor's Authorized Official : -----------------....,...L~
1 declare under penalty of perjury that the foregoing is true and correct. I understand that knowingty ~i,ti · · · ·
willfully providing false information to the federal government is a violation of 18 USC§ 1001 (False
Statements) and could subject me to fines , imprisonment, or both .
FAA Form 5100-130 (1/17) SUPERSEDES PREVIOUS EDITION Page 3 of 3
:r: en m-:a c:, mz
101518a HCBOC Page 123
U .S. Department
of Transportation
Federal Aviation
Administration
FAA Form 5100-131, Equipment and Construction Contracts -
Airport Improvement Sponsor Certification
Paperwork Reduction Act Burden Statement
A federal agency may not conduct or sponsor, and a person is not required to respond to , nor shall a
person be subject to a penalty for failure to comply with a collection of information subject to the
requirements of the Paperwork Reduction Act unless that collection of information displays a currently
valid 0MB Control Number. The 0MB Control Number for this information collect ion is 2120-0569. Public
reporting for this collection of information is estimated to be approximately 8 hours per response,
including the time for rev iewing instructions , searching existing data sources , gathering and maintaining
the data needed , completing and reviewing the collection of information. All responses to this collection of
information are required under 49 U.S.C. Section 4 7105 to retain a benefit and to meet the reporting
requirements of 2 CFR 200. Send comments regarding this burden estimate or any other aspect of this
collection of information , including suggestions for reducing this burden to the Federal Aviation
Administration at: 800 Independence Ave. SW, Washington , DC 20591 , Attn : Information Collection
Clearance Officer, ASP-110 .
FAA Form 5100-131
101518a HCBOC Page 124
·"' U.S. Department ofTransportation
~ Federal Aviation Administration
0MB CONTROL NUMBER: 2120-0569
EXPIRATION DATE: 8/31/2019
Equipment and Construction Contracts
Airport Improvement Sponsor Certification
Sponsor:Harf\e++ C.CX,h')tlt--eco-rd o+ C..or<Y'()iS~tcners
Airport: J-k)rne4-+ '12eq \ D l\a l Je+ por +
Project Number: '3l_p d\ ~#. ct:)1 \"1 , \
Description of Work: T~rrv(\ l"\C\ l -s ·, te.. Imo,ove..rvteJ\-t~
Application
49 USC § 47105(d) authorizes the Secretary to require certification from the sponsor that it will comply
with the statutory and administrative requirements in carrying out a project under the Airport Improvement
Program (AIP). General procurement standards for equipment and construction contracts within Federal
grant programs are described in 2 CFR §§ 200 .317-200.326. Labor and Civil Rights Standards
applicable to the AIP are established by the Department of Labor (www.dol.gov) AIP Grant Assurance
C.1-General Federal Requirements identifies all applicable Federal Laws , regulations, executive orders,
policies, guidelines and requirements for assistance under the AIP . Sponsors may use state and local
procedures provided the procurement conforms to these federal standards.
This certification applies to all equipment and construction projects. Equipment projects may or may not
employ laborers and mechanics that qualify the project as a "covered contract" under requirements
established by the Department of Labor requirements. Sponsor shall provide appropriate responses to
the certification statements that reflect the character of the project regardless of whether the contract is
for a construction project or an equipment project.
Certification Statements
Except for certification statements below marked as not applicable (NIA), this list includes major
requirements of the construction project. Selecting "Yes" represents sponsor acknowledgement and
confirmation of the certification statement. The term "will" means Sponsor action taken at appropriate
time based on the certification statement focus area , but no later than the end of the project period of
performance. This list is not comprehensive and does not relieve the sponsor from fully complying with all
applicable statutory and administrative standards. The source of the requirement is referenced within
parenthesis.
1. A written code or standard of conduct is or will be in effect prior to commencement of the project
that governs the performance of the sponsor's officers, employees, or agents in soliciting,
award~ and administering procurement contracts (2 CFR § 200.318).
~es DNo ON/A
FAA Form 5100-131 (1/17) SUPERSEDES PREVIOUS EDITION Page 1 of 4
101518a HCBOC Page 125
2. For all contracts, qualified and competent personnel are or will be engaged to perform contract
administration , engineering supervision , construction inspection, and testing
(Grant Assurance C .17).
~s O No ON/A
3. Sponsors that are required to have a Disadvantage Business Enterprise (DBE) program on file
with the FAA have included or will include clauses required by Title VI of the Civil Rights Act and
49 CFR Part 26 for Disadvantaged Business Enterprises in all contracts and subcontracts .
~es O No O NIA
4 . Sponsors required to have a DBE program on file with the FAA have implemented or will
implement monitoring and enforcement measures that:
a. Ensure work committed to Disadvantaged Business Enterprises at contract award is
actually performed by the named DBEs (49 CFR § 26.37(b));
b. Include written certification that the sponsor has reviewed contract records and has
monitored work sites for performance by DBE firms (49 CFR § 26.37(b)); and
c. Provides for a running tally of payments made to DBE firms and a means for comparing
./ actual attainments (i.e. payments) to original commitments (49 CFR § 26.37(c)).
0'Yes O No O NIA
5 . Sponsor procurement actions using the competitive sealed bid method (2 CFR § 200.320(c)). was
or will be:
a. Publicly advertised , allowing a sufficient response time to solicit an adequate number of
interested contractors or vendors ;
b. Prepared to include a complete , adequate and realistic specification that defines the
items or services in sufficient detail to allow prospective bidders to respond;
c. Publicly opened at a time and place prescribed in the invitation for bids; and
d. Prepared in a manner that result in a firm fixed price contract award to the lowest
responsive and responsible bidder.
~s ONo ON/A
6 . For projects the Sponsor proposes to use the competitive proposal procurement method (2 CFR §
200.320(d)), Sponsor has requested or will request FAA approval prior to proceeding with a
competitive proposal procurement by submitting to the FAA the following:
a . Written justification that supports use of competitive proposal method in lieu of the
preferred sealed bid procurement method;
b. Plan for publicizing and soliciting an adequate number of qualified sources; and
c/isting of evaluation factors along with relative importance of the factors.
~es O No O NIA
7 . For construction and equipment installation projects, the bid solicitation includes or will include the
current federal wage rate schedule(s) for the appropriate type of work classifications (2 CFR Part
200, 6Wendix II).
!ii(Yes O No O N/A
FAA Form 5100-131 (1/17) SUPERSEDES PREVIOUS EDITION Page 2 of 4
101518a HCBOC Page 126
8. Concurrence was or will be obtained from the Federal Aviation Administration (FAA) prior to
contract award under any of the following circumstances (Order 5100.38D):
a. Only one qualified person/firm submits a responsive bid;
b. Award is to be made to other than the lowest responsible bidder; and
/ Life cycle costing is a factor in selecting the lowest responsive bidder.
10"Yes O No O N/A
9. All construction and equipment installation contracts contain or will contain provisions for:
a. Access to Records(§ 200.336)
b. Buy American Preferences (Title 49 U.S .C. § 50101)
c . Civil Rights -General Provisions and Title VI Assurances( 41 CFR part 60)
d. Federal Fair Labor Standards (29 U.S.C. § 201, et seq)
e. Occupational Safety and Health Act requirements (20 CFR part 1920)
f. Seismic Safety -building construction (49 CFR part 41)
g. State Energy Conservation Requirements -as applicable(2 CFR part 200 , Appendix II}
h. U.S. Trade Restriction (49 CFR part 30)
i. Veterans Preference (49 USC§ 47112(c))
~s DNo ON/A
10. All construction and equipment installation contracts exceeding $2 ,000 contain or will contain the
provisions established by:
a. Davis-Bacon and Related Acts (29 CFR part 5)
b. Copeland "Anti-Kickback" Act (29 CFR parts 3 and 5)
~s DNo ON/A
11 . All construction and equipment installation contracts exceeding $3 ,000 contain or will contain a
contract provision that discourages distracted driving (E .O. 13513).
~s DNo ON/A
12. All contracts exceeding $10 ,000 contain or will contain the following provisions as applicable:
a. Construction and equipment installation projects -Applicable clauses from
41 CFR Part 60 for compliance with Executive Orders 11246 and 11375 on Equal
Employment Opportunity ;
b. Construction and equipment installation -Contract Clause prohibiting segregated facilities
in accordance with 41 CFR part 60-1 .8;
c. Requirement to maximize use of products containing recovered materials in accordance
with 2 CFR § 200 .322 and 40 CFR part 247; and
d. Provisions that address termination for cause and termination for convenience
(2 CFR Part 200, Appendix II).
~ ONo ON/A
FAA Form 5100-131 (1/17) SUPERSEDES PREVIOUS EDITION Page 3 of 4
101518a HCBOC Page 127
13. All contracts and subcontracts exceeding $25 ,000 : Measures are in place or will be in place (e .g .
checking the System for Award Management) that ensure contracts and subcontracts are not
awarded to individuals or firms suspended , debarred, or excluded from participating in federally
assis~ projects (2 CFR parts 180 and 1200).
efves O No O NIA
14. Contracts exceeding the simplified acquisition threshold (currently $150 ,000) include or will include
provisions, as applicable , that address the following :
a . Construction and equipment installation contracts -a bid guarantee of 5%, a performance
bond of 100%, and a payment bond of 100% (2 CFR § 200 .325);
b. Construction and equipment installation contracts -requirements of the Contract Work
Hours and Safety Standards Act (40 USC 3701-3708 , Sections 103 and 107);
c . Restrictions on Lobbying and Influencing (2 CFR part 200, Appendix II);
d. Conditions specifying administrative, contractual and legal remedies for instances where
contractor of vendor violate or breach the terms and conditions of the contract (2 CFR
§200, Appendix II); and
e. All Contracts -Applicable standards and requirements issued under Section 306 of the
Clean Air Act (42 USC 7401-7671q), Section 508 of the Clean Water Act (33 USC 1251-
1387. and Executive Order 11738.
¢e's O No D N/A
Attach documentation clarifying any above item marked with "No" response.
Sponsor's Certification
I certify , for the project identified herein , responses to the forgoing items are accurate as marked and
additional documentation for any item marked "no " is correct and complete .
Executed on this day of
H ,.. -· ~-A· c\ o+ Cof'<)rr\\ss·, ol\t.TS Name of Sponsor: ().r ne ++ \.J.,JV..n~ J,...Ll{.,,lf
Name of Sponsor's Authorized Official : bordO(') "::>(),.\'f°l~\-e
Title of Sponsor 's Authorized Official :thC.t \ r f'I\.£) f\
I declare under penalty of perjury that the foregoing is true and correct. I understand that knowingly and
willfully providing false information to the federal government is a violation of 18 USC § 1001 (False
Statements) and could subject me to fines, imprisonment, or both .
FAA Form 5100-131 (1/17) SUPERSEDES PREVIOUS EDITION Page4 of4
101518a HCBOC Page 128
U.S. Department
of Transportation
Federal Aviation
Administration
FAA Form 5100-132, Project Plans and Specifications -Airport
Improvement Program Sponsor Certification
Paperwork Reduction Act Statement
A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a
person be subject to a penalty for failure to comply with a collection of information subject to the
requirements of the Paperwork Reduction Act unless that collection of information displays a currently
valid 0MB Control Number. The 0MB Control Number for this information collection is 2120-0569. Public
reporting for this collection of information is estimated to be approximately 8 hours per response ,
including the time for reviewing instructions , searching existing data sources, gathering and maintaining
the data needed , completing and reviewing the collection of information. All responses to this collection of
information are required under 49 U.S.C. Section 47105 to retain a benefit and to meet the reporting
requirements of 2 CFR 200. Send comments regarding this burden estimate or any other aspect of this
collection of information , including suggestions for reducing this burden to the Federal Aviation
Administration at: 800 Independence Ave . SW, Washington , DC 20591 , Attn : Information Collection
Clearance Officer, ASP-110 .
FM Form 5100-132
101518a HCBOC Page 129
•"' U.S. Department of Transportation
'{"ei,, Federal Aviation Administration
0MB CONTROL NUMBER: 2120-0569
EXPIRATION DATE : 8/31/2019
Project Plans and Specifications
Airport Improvement Program Sponsor Certification
Sponsor:HorneH-C.OM-h.J ·~()Of'd o+ C.ornrni ss·1 OYle fS
Airport )-\-Dr t\-€ 4-t '1? e~ \OY)Cl \ j e-\-pD, t
Project Number: 3lod°31. a~,\ l, l
Description of Work:-re, {'(\\ M \ ~-, tL 1 M. pro\/ e Me..~,-s
Application
49 USC§ 47105(d) authorizes the Secretary to require certification from the sponsor that it will comply
with the statutory and administrative requirements in carrying out a project under the Airport Improvement
Program (AIP). Labor and civil rights standards applicable to AIP are established by the Department of
Labor (www.dol.gov/). AIP Grant Assurance C.1-General Federal Requirements identifies applicable
federal laws, regulations , executive orders , policies, guidelines and requirements for assistance under
AIP. A list of current advisory circulars with specific standards for procurement, design or construction of
airports, and installation of equipment and facilities is referenced in standard airport sponsor Grant
Assurance 34 contained in the grant agreement.
Certification Statements
Except for certification statements below marked as not applicable (NIA), this list includes major
requirements of the construction project. Selecting "Yes " represents sponsor acknowledgement and
confirmation of the certification statement. The term "will " means Sponsor action taken at appropriate
time based on the certification statement focus area, but no later than the end of the project period of
performance . This list is not comprehensive and does not relieve the sponsor from fully complying with all
applicable statutory and administrative standards . The source of the requirement is referenced within
pare nth es is.
1. The plans and specifications were or will be prepared in accordance with applicable federal
standards and requirements, so that no deviation or modification to standards set forth in the
advisory circulars, or FAA-accepted state standard, is necessary other than those explicitly
appr~ by the Federal Aviation Administration (FAA} (14 USC§ 47105).
!E'Yes O No O NIA
2. Specifications incorporate or will incorporate a clear and accurate description of the technical
requirement for the material or product that does not contain limiting or proprietary features that
unduly restrict competition (2 CFR §200.319).
~s O No ON/A
FAA Form 5100-132 (1/17) SUPERSEDES PREVIOUS EDITION Page 1 of 3
101518a HCBOC Page 130
3. The development that is included or will be included in the plans is depicted on the current airport
layout plan as approved by the FAA (14 USC§ 47107).
rn<es O No ON/A
4. Development and features that are ineligible or unallowable for AIP funding have been or will be
omitt~from the plans and specifications (FAA Order 5100.38 , par. 3-43).
~es O No ON/A
5. The specification does not use or will not use "brand name" or equal to convey requirements
unless sponsor requests and receives approval from the FAA to use brand name (FAA Order
5100 .38, Table U-5).
~s O No ON/A
6. The specification does not impose or will not impose geographical preference in their
procurement requirements (2 CFR §200 .319(b) and FAA Order 5100.38, Table U-5).
~ DNo ON/A
7. The use of prequalified lists of individuals, firms or products include or will include sufficient
qualified sources that ensure open and free competition and that does not preclude potential
entities rom qualifying during the solicitation period (2 CFR §319(d)).
8. Solicitations with bid alternates include or will include explicit information that establish a basis for
award of contract that is free of arbitrary decisions by the sponsor (2 CFR § 200.319(a)(7)).
0°"Yes O No O NIA
9 . Concurrence was or will be obtained from the FAA if Sponsor incorporates a value engineering
clause into the contract (FAA Order 5100.38 , par. 3-57).
10'1'es O No O NIA
10. The plans and specifications incorporate or will incorporate applicable requirements and
recommendations set forth in the federally approved environmental finding (49 USC §47106(c)).
~ ONo ON/A
11. The design of all buildings comply or will comply with the seismic design requirements of 49 CFR
§41 .120. (FAA0rder5100.38d , par. 3-92)
¢."s D No ON/A
12. The project specification include or will include process control and acceptance tests required for
the project by as per the applicable standard:
a. Construction and installation as contained in Advisory Circular (AC) 150/5370-10.
~ ONo ON/A
FM Form 5100-132 (1/17) SUPERSEDES PREVIOUS EDITION Page 2 of 3
101518a HCBOC Page 131
b. Snow Removal Equipment as contained in AC 150/5220-20.
~es D No D N/A
c . Airc7'ft Rescue and Fire Fighting (ARFF) vehicles as contained in AC 150/5220-10.
~Yes D No D N/A
13. For construction activ ities within or near aircraft operational areas(AOA):
a . The Sponsor has or will prepare a construction safety and phasing plan (CS PP) conforming
to Advisory Circular 150/5370-2.
b. Compliance with CSPP safety provisions has been or will be incorporated into the plans
and specifications as a contractor requirement.
c . Sponsor will not initiate work until receiving FAA's concurrence with the CSPP (FAA Order
/ 5100 .38 , Par. 5-29).
[}(Yes D No D N/A
14 . The project was or 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
(49 ~C §47110(b)(1) and FAA Order 5100.38d , par. 3-100).
MYes D No D N/A
Attach documentation clarifying any above item marked with "No " response .
Sponsor's Certification
I certify , for the project identified herein , responses to the forgoing items are accurate as marked and
additional documentation for any item marked "no " is correct and complete .
Executed on this day of
Name of sponsor: Hnr 0e H-Qour'l~ 13oa.f'c\ 0-t C..ON"Y,)\ ss °\ ooe. 10
Name of Sponsor's Authorized Official : Gar-dOf'\ 'S(),\(\(!}-e
Title of Sponsor 's Authorized Official : (j'\a_·\ r 1\/\Ct.V\
Signature of Sponsor's Authorized Official : --------------~·--:a· ~· . " . i i .... ~. m•
I declare under penalty of perjury that the foregoing is true and correct. I understand 1~i:lt }<~ • higl~ran c 1
willfully providing false information to the federal government is a violation of 18 USC§· 100, (Fal~e'
Statements) and could subject me to fines , imprisonment, or both.
FAA Form 5100-132 (1/17) SUPERSEDES PREVIOUS EDITION Page 3 of 3
101518a HCBOC Page 132
U.S . Department
of Transportation
Federal Aviation
Administration
FAA Form 5100-133, Real Property Acquisition -
Airport Improvement Program Sponsor Certification
Paperwork Reduction Act Burden Statement
A federal agency may not conduct or sponsor, arid a person is not required to respond to , nor shall a
person be subject to a penalty for failure to comply with a collection of information subject to the
requirements of the Papeiwork Reduction Act unless that collection of information displays a currently
valid OMS Control Number. The OMS Control Number for this information collection is 2120-0569. Public
reporting for this collection of information is estimated to be approximately 8 hours per response ,
including the time for reviewing instructions , searching existing data sources , gathering and maintaining
the data needed, completing and reviewing the collection of information. All responses to this collection of
information are required under 49 U.S.C . Section 47105 to retain a benefit and to meet the reporting
requirements of 2 CFR 200. Send comments regarding this burden estimate or any other aspect of this
collection of information , including suggestions for reducing this burden to the Federal Aviation
Administration at: 800 Independence Ave. SW, Washington , DC 20591 , Attn: Information Collection
Clearance Officer, ASP-110.
FAA Form 5100-133
101518a HCBOC Page 133
·~ U.S. Department of Transportation
~ Federal Aviation Administration
0MB CONTROL NUMBER: 2120-0569
EXPIRATION DATE: 8/31/2019
Real Property Acquisition
Airport Improvement Program Sponsor Certification
Sponsor: Ho.rn-et+ C..Ou.n+y 13oa~d c+ C-c('(")m\SS{ one v-S
Airport: rt()rrte-++ )<f0}0f)(l \ je+-por+
Project Number : 3 tp d ~I, d'S, rl' }
Description of Work: ---i:e_,M_.\'llct\ s·t+e :Lu._-pt OJ€ M-f i\.-t.:s
Application
49 USC § 47105(d) authorizes the Secretary to require certification from the sponsor that it will comply
with the statutory and administrative requirements in carrying out a project under the Airport Improvement
Program (AIP). General requirements on real property acquisition and relocation assistance are in
49 CFR Part 24 . The AIP project grant agreement contains specific requirements and assurances on the
Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 (Uniform Act), as
amended.
Certification Statements
Except for certification statements below marked not applicable (N/A), this list includes major
requirements of the real property acquisition project. Selecting "Yes " represents sponsor
acknowledgement and confirmation of the certification statement. The term "will" means Sponsor action
taken at appropriate time based on the certification statement focus area , but no later than the end of the
project period of performance. This list is not comprehensive and does not relieve the sponsor from fully
complying with all applicable statutory and administrative standards.
1. The sponsor's attorney or other official has or will have good and sufficient title as well as title
evidence on property in the project.
DYes ONo ~A
2 . If defects and/or encumbrances exist in the t itle that adversely impact the sponsor's intended use
of property in the project. they have been or will be extinguished , mod ified, or subordinated .
OYes ONo ~
3. If property for airport development is or will be leased , the following conditions have been met:
a . The term is for 20 years or the useful life of the project;
b. The lessor is a public agency ; and
c . The lease conJins no provisions that prevent full compliance with the grant agreement.
D Yes D No [!NIA
FAA Form 5100-133 (1/17) SUPERSEDES PREVIOUS EDITION Page 1 of 3
101518a HCBOC Page 134
4 . Property in the project is or will be in conformance with the current Exhibit A property map, which
is based on deeds , title opinions , land surveys , the approved airport layout plan, and project
documentation . /
DYes DNo ~/A
5. For any acquisition of property interest in noise sensitive approach zones and related areas ,
property interest was or will be obtained to ensure land ls used for purposes compatible with
noise levels associat1 with operation of the airport.
DYes DNo riNtA
6. For any acquisition of property interest in runway protection zones and areas related to
14 CFR 77 surfaces or to clear other airport surfaces , property interest was or will be obtained for
the following:
a . The right of flight ;
b. The right of ingress and egress to remove obstructions ; and
c. The right to rejt-ict the establishment of future obstructions .
DYes DNo csfNtA
7. Appraisals prepared by qualified real estate appraisers hired by the sponsor include or will
include the following :
a. Valuation data to estimate the current market value for the property interest acquired on
each parcel ; and
b. Verification that an opportunity has been provided to the property owner or representative
to accompany JPpraisers during inspections .
0Yes DNo ~/A
8. Each appraisal has been or will be reviewed by a qualified review appraiser to recommend an
amount for the offer of just compensation, and the written appraisals as well as review appraisal
are available to Feder~viation Administration (FAA) for review.
DYes DNo ~/A
9. A written offer to acquire each parcel was or will be presented to the property owner for not less
than the approved amrt of just compensation .
DYes DNo ~/A
10. Effort was or will be made to acquire each property through the following negotiation procedures :
a. No coercive action to induce agreement; and
b. Supporting dornents for settlements included in the project files .
DYes DNo CT°NIA
FAA Form 5100-133 (1/17) SUPERSEDES PREVIOUS EDITION Page 2 of3
101518a HCBOC Page 135
11 . If a negotiated settlement is not reached , the following procedures were or will be used:
a. Condemnation initiated and a court deposit not less than the just compensation made
prior to possession of the property ; and
b . Supporting documents for awards included in the project files .
0Yes 0No ~/A
12. If displacement of persons, businesses , farm operations, or non-profit organizations is involved, a
relocation assistance program was or will be established, with displaced parties receiving general
information on the program in writing , including relocation eligibility , and a 90-day notice to
vacate. /
OYes ONo lefNJA
13. Relocation assistance services , comparable replacement housing , and payment of necessary
relocation expenses were or will be provided within a reasonable time period for each displaced
occupant in accordan,-.with the Uniform Act.
0 Yes O No rg'N/A
Attach documentation clarifying any above item marked with "No" response .
Sponsor's Certification
I certify , for the project identified herein , responses to the forgoing items are accurate as marked and
additional documentation for any item marked "no" is correct and complete.
Executed on this day of
Name of Sponsor: )-\.Qrnett C.Wfli-'\} ·-eioo,d. o+ <20ff'<Y)i56i D{}-efS
Name of Sponsor's Authorized Official: Chorc\Q f> ~\v\.g le ..
Title of Sponsor's Authorized Official: C"-.ll.\'{ \\AC{'(\_
... ~ . . . . .
a I I 1 0 0 • ..............
• • I O f I
• • • • • f • r I ...
Signature of Sponsor's Designated Official Representative: ----------··---··-. .. . . ..
0 I • 0 0 I t
0 0 0 0 I I ........
I declare under penalty of perjury that the foregoing is true and correct. I understand that knowingly and
willfully providing false information to the federal government is a violation of 18 USC § 1001 (False
Statements) and could subject me to fines , imprisonment, or both .
FAA Form 5100 -133 (1/17) SUPERSEDES PREVIOUS EDITION Page 3 of 3
101518a HCBOC Page 136
U.S. Department
of Transportation
Federal Aviation
Administration
FAA Form 5100-134, Selection of Consultants -Airport
Improvement Program Sponsor Certification
Paperwork Reduction Act Statement
A federal agency may not conduct or sponsor , and a person is not required to respond to, nor shall a
person be subject to a penalty for failure to comply with a collection of information subject to the
requirements of the Paperwork Reduction Act unless that collection of information displays a currently
valid 0MB Control Number. The 0MB Control Number for this information collection is 2120-0569. Public
reporting for this collection of information is estimated to be approximately 8 hours per response ,
including the time for reviewing instructions , searching existing data sources , gathering and maintaining
the data needed, completing and reviewing the collection of information. All responses to this collection of
information are required under 49 U.S.C. Section 47105 to retain a benefit and to meet the reporting
requirements of 2 CFR 200 . Send comments regarding this burden estimate or any other aspect of this
collection of information, including suggestions for reducing this burden to the Federal Aviation
Administration at: 800 Independence Ave. SW, Washington , DC 20591, Attn: Information Collection
Clearance Officer, ASP-110 .
FAA Form 5100-134
101518a HCBOC Page 137
., U.S. Department of Transportation
~ Federal Aviation Administration
0MB CONTROL NUMBER 2120-0569
EXPIRATION DATE: 8/31/2019
Selection of Consultants
Airport Improvement Program Sponsor Certification
Sponsor: Har(\~++ C1,..,\f'rT\.\ t:;>00:rd ()~ QoM~S~\O){\e_rs
Airport: ~t n-e-+t --g-eq\OV\Q\ Je-+ pC)(-+
Project Number : '3LD-;}, 61' d. $ 1 Yl. )
Description of Work:\-€,M.\M )S.1-\-e .:UUfn.:)Je1\A.€ ~-ts-
Application
49 USC§ 47105(d) authorizes the Secretary to require certification from the sponsor that it will comply
with the statutory and administrative requirements in carrying out a project under the Airport Improvement
Program (AIP). General requirements for selection of consultant services within federal grant programs
are described in 2 CFR §§ 200 .317-200 .326. Sponsors may use other qualifications-based procedures
provided they are equivalent to standards of Title 40 chapter 11 and FM Advisory Circular 150/5100-14 ,
Architectural , Engineering, and Planning Consultant Services for Airport Grant Projects .
Certification Statements
Except for certification statements below marked as not applicable (N/A), this list includes major
requirements of the construction project. Selecting "Yes" represents sponsor acknowledgement and
confirmation of the certification statement. The term "will " means Sponsor action taken at appropriate time
based on the certification statement focus area , but no later than the end of the project period of
performance. This list is not comprehensive and does not relieve the sponsor from fully complying with all
applicable statutory and administrative standards . The source of the requirement is referenced within
parenthesis .
1. Sponsor acknowledges their responsibility for the settlement of all contractual and administrative
issueyrising out of their procurement actions (2 CFR § 200.318(k)).
rR'Yes D No D NIA
2. Sponsor procurement actions ensure or will ensure full and open competition that does not
undulvt.mit competition (2 CFR § 200 .319).
[D'Yes D No D NIA
3 . Sponsor has excluded or will exclude any entity that develops or drafts specifications,
requirements, or statements of work associated with the development of a request-for-
qua1ifications (RFQ) from competing for the advertised services (2 CFR § 200.319).
~ DNo ON/A
FAA Form 5100-134 (2/17) SUPERSEDES PREVIOUS EDITION Page 1 of 3
101518a HCBOC Page 138
4. The advertisement describes or will describe specific project statements-of-work that provide
cleaJ:,detail of required services without unduly restricting competition (2 CFR § 200.319).
f1Yes D No D N/A
5 . Sponsor has publicized or will publicize a RFQ that:
a . Solicits an adequate number of qualified sources (2 CFR § 200 .320(d)); and
y Identifies all evaluation criteria and relative importance (2 CFR § 200.320( d) ).
~es DNo ON/A
6 . Sponsor has based or will base selection on qualifications , experience , and disadvantaged
bus in~ enterprise participation with price not being a selection factor (2 CFR § 200.320(d)).
ID es D No D N/A
7. Sponsor has verified or will verify that agreements exceeding $25 ,000 are not awarded to
individuals or firms suspended , debarred or otherwise excluded from participating in federally
assis~ projects (2 CFR §180 .300).
Q'Yes D No O NIA
8 . A/E services covering multiple projects : Sponsor has agreed to or will agree to :
a . Refrain from initiating work covered by this procurement beyond five years from the date
of selection (AC 150/5100-14); and
b. Retain the right to conduct new procurement actions for projects identified or not
/identified in the RFQ (AC 150/5100-14).
efves O No O NIA
9. Sponsor has negotiated or will negotiate a fair and reasonable fee with the firm they select as
mos~alified for the services identified in the RFQ (2 CFR § 200 .323).
~es ONo ON/A
10. The Sponsor's contract identifies or will identify costs associated with ineligible work separately
from ¥s associated with elig ible work (2 CFR § 200.302).
si{es O No D NIA
11 . Sponsor as prepared or will prepare a record of negotiations detailing the history of the
ent action, rationale for contract type and basis for contract fees (2 CFR §200.31 B(i)).
ONo ON/A
12 . Sponsor as incorporated or will incorporate mandatory contact provisions in the consultant
contra for AIP-assisted work (49 U.S.C. Chapter 471 and 2 CFR part 200 Appendix II)
es 0No D NIA
FM Form 5100-134 (2/17) SUPERSEDES PREVIOUS EDITION Page 2 of 3
101518a HCBOC Page 139
13. For contracts that apply a time-and-material payment provision (also known as hourly rates,
specific rates of compensation, and labor rates), the Sponsor has established or will establish :
a. Justification that there is no other suitable contract method for the services (2 CFR
§200 .3180));
b. A ceiling price that the consultant exceeds at their risk (2 CFR §200. 3180)); and
c. A high degree of oversight that assures consultant is performing work in an efficient
/ manner with effective cost controls in place 2 CFR §200.3180)).
!i(Yes O No D NIA
14 . Sponsor is not using or will not use the prohibited cost-plus-percentage-of-cost (CPPC) contract
met~ (2 CFR § 200 .323(d)).
i0'Yes O No O NIA
Attach documentation clarifying any above item marked with "no" response .
Sponsor's Certification
I certify, for the project identified herein, responses to the forgoing items are accurate as marked and
additional documentation for any item marked "no" is correct and complete.
I declare under penalty of perjury that the foregoing is true and correct. I understand that knowingly and
willfully providing false information to the federal government is a violation of 18 USC§ 1001 (False
Statements) and could subject me to fines , imprisonment, or both .
Executed on this day of
Name of Sponsor: Hor-n-e# C.cLlffh.f1Sco,d o+ ecro<Y\°l'SS\ Od\€,S
Name of Sponsor's Authorized Official: b-to,d Of\ S9,, (\.Cj \-e_,
Title of Sponsor's Authorized Official: ~\ r N\Otn_
Signature of Sponsor's Authorized Official: ------------------'"""!Ii"'""'
I declare under penalty of perjury that the foregoing is true and correct. I understand that knov.1~~h1. ~ ·
willfully providing false information to the federal government is a violation of 18 USC § 1001 tFalse • ·
Statements) and could subject me to fines, imprisonment, or both.
FAA Form 5100-134 (2/17) SUPERSEDES PREVIOUS EDITION Page 3 of 3
101518a HCBOC Page 140
U.S . Department
of Transportation
Federal Aviation
Administration
FAA Form 5100-135, Certification and Disclosure Regarding
Potential Conflicts of Interest -Airport Improvement Program
Sponsor Certification
Paperwork Reduction Act Statement
A federal agency may not conduct or sponsor, and a person is not required to respond to , nor shall a
person be subject to a penalty for failure to comply with a collection of information subject to the
requirements of the Paperwork Reduction Act unless that collection of information displays a currently
valid 0MB Control Number. The 0MB Control Number for this information collection is 2120-0569. Public
reporting for this collection of information is estimated to be approximately 8 hours per response ,
including the time for reviewing instructions, searching existing data sources, gathering and maintaining
the data needed, completing and reviewing the collection of information. All responses to this collection of
information are required under 49 U.S.C. Section 47105 to retain a benefit and to meet the reporting
requirements of 2 CFR 200. Send comments regarding this burden estimate or any other aspect of this
collection of information , including suggestions for reducing this burden to the Federal Aviation
Administration at: 800 Independence Ave . SW, Washington , DC 20591 , Attn: Information Collection
Clearance Officer, ASP-110.
FAA Form 5100-135
101518a HCBOC Page 141
~" U .S . Department of Transportation
,..-_, Federal Aviation Administration
0MB CONTROL NUMBER: 2120-0569
EXPIRATION DATE : 8/31/2019
Certification and Disclosure Regarding Potential Conflicts of Interest
Airport Improvement Program Sponsor Certification
Sponsor: t-\ct,ne+-l-CouJ')tt/ '°BDDrd o.f Corn mi S45\ one.rs
Airport: ttDff\€44-K-f~~}CTY\0-.\ ~+
Project Number: QlQ d°'5t . ~I r1. \
Description of Work: °lerM\~"\(X..\ c:s·tte. ~pfOUQrfV\.--ev....ts
Application
Title 2 CFR § 200.112 and§ 1201 .112 address Federal Aviation Administration (FAA) requirements for
conflict of interest. As a condition of eligibility under the Airport Improvement Program (AIP), sponsors
must comply with FAA policy on conflict of interest. Such a conflict would arise when any of the following
have a financial or other interest in the firm selected for award :
a) The employee, officer or agent,
b) Any member of his immediate family,
c) His or her partner, or
d) An organization which employs , or is about to employ, any of the above .
Selecting "Yes " represents sponsor or sub-recipient acknowledgement and confirmation of the
certification statement. Selecting "No" represents sponsor or sub-recipient disclosure that it cannot fully
comply with the certification statement. If "No" is se lected , provide support information explain ing the
negative response as an attachment to this form. This includes whether the sponsor has established
standards for financial interest that are not substantial or unsolicited gifts are of nominal value (2 CFR §
200.318(c)). The term "will" means Sponsor action taken at appropriate time based on the certification
statement focus area , but no later than the end of the project period of performance.
Certification Statements
1. The sponsor or sub-rec ipient maintains a written standards of conduct governing conflict of
interest and the performance of their employees engaged in the award and administration of
contracts (2 CFR § 200.31 B(c)). To the extent permitted by state or local law or regulations , such
standards of conduct prov ide for penalties, sanctions , or other disciplinary actions for violations of
such standards by the sponsor's and sub-recipient's officers, employees, or agents , or by
cont~ors or their agents.
Mves D No
FAA Form 5 100-135 (2/17) SUPE RSEDES PREVI OUS ED IT ION Page 1 of 2
101518a HCBOC Page 142
2. The sponsor's or sub-recipient's officers, employees or agents have not and will not solicit or
accept gratuities , favors or anything of monetary value from contractors, potential contractors, or
parties to sub-agreements (2 CFR § 200.318(c)).
ct(es D No
3. The sponsor or sub-recipient certifies that is has disclosed and will disclose to the FAA any
known potential conflict of interest (2 CFR § 1200.112).
o<:s D No
Attach documentation clarifying any above item marked with "no" response .
Sponsor's Certification
I certify, for the project identified herein , responses to the forgoing items are accurate as marked and
have the explanation for any item marked "no" is correct and complete.
Executed on this day of
NameofSponsor:Ht\rne-\+ CQ\,lJ\~ 13ca.f'~ O+ wrn<Y)\88lner-..S
Name of Sponsor's Authorized Official: ~ C)(""c\ 0£'\ ~\ ""5 k
Title of Sponsor's Authorized Official : (:)\~\' MO. f\
....... ...... . . . . . . . .
... ---..
I declare under penalty of perjury that the foregoing is true and correct. I understand that knowingly and
willfully providing false information to the federal government is a violation of 18 USC § 1001 (False
Statements) and could subject me to fines , imprisonment, or both.
FAA Form 5100-135 (2/17) SUPERSEDES PREVI OUS ED ITION Page 2 of 2
z en m-
21 ,:, mz
101518a HCBOC Page 143
Board Meeting
Agenda Item
Agenda Item __ 4;;...-..;;H;;:;.__...,;
M EETING DATE : October 15, 2018
TO: HARNETT COUNTY BOARD OF COMMISSIONERS
SUBJECT: Wanda Carolyn Tart v. County of Harnett (Order Approving Compromise
Settlement Agreement)
REQUESTED BY: Monica Langdon Jackson, Senior County Staff Attorney
REQUEST:
Disclosure of Settlement A greement pur suant to Section 143-218 .11 (a)(3) of the North
C arolina General Statutes.
FINANCE OFFICER'S RECOMMENDATION:
COUNTY MANAGER'S RECOMMENDATION:
C :\Users\g wh ee le r\AppData\Local\M icroso ft\ W in dows\JN etCache\Content. Outlook\TPTEQC L V\ag en dafonn. W . Tart
Se ttl e men t Di sclos u re.do cx Page I of2
101518a HCBOC Page 144
NC Industrial Comm 9/25/2018 11:47:40 AM PAGE 2/002 Fax Server
NORTII CAROLINA INDUSTRIAL COMMISSION
I.C. NO. 1 7-791887 , WANDA C. TART, Employee, Plafnl1ff v. COUNTY OF HARNE1T, Self-
Insured Employer, Defendant. Admfnfstered by: York Rfsk Services.
ORDER APPROVING COMPROMISE SETnEMENT AGREEMENT
BY: ANTHONY L. LUCAS, Special Deputy Commissioner
FILED: 09/25/18
A duly executed oompromise settlement agreement was received in the office of the undersigned
for consideration on September 21, 2018 .
APPEARANCES
Plaint iff: Brent Adams & Associates , At torneys at Law
Dunn, NC; Sheila W. Chavis appearing
Facsimile: 910-892-0652
Defendants: Brewer Defense Group, Attorneys at Law
Raleigh, NC; Joy H. Brewer appearing
Facsimile: 919-926-116 l
Afler giving due consideration to all matters involved in this case in accordance with Chapter97 of
the North Carolina General Statutes and Commission Rules, and upon the parties' stated or implied
representaiion that an medical reports have been submitted with the agreement to the Commission as
required by Rule 11 NCAC 23A .0 502(bXl), the compromise settlement agreement is deemed bythe
Commission to be fair and just , and in the best interests of all parties . Furthermore, the interests of all
parties and of any person, including a health benefit plan, who paid medical expenses of the plaintiffhave
been set forth in the settlement agreement and have been considered . It further appears that the agreement
contains a finding that the positions of all parties to ibe agreement are .reasonable as to the payment of
medical expenses. The agreement is incolpOrated herein by reference and is approved in the amount of
SIS,000.00. Compliance with the terms of ibe agreement shall discharge defendants from further liability
under the Workers' Compensation Act by reason of the injury giving rise to this claim.
An attorney's fee of $3,750.00is approved for plaintiff's counsel to be dedu cted from theswn due
plaintiff and paid directly to the attorney.
Defendants shall pay the costs.
It is noted, however, that this Order does not purport to approve, resolve or addr~ any issue or
matter over which the Industrial Commission has no jurisdiction, whetheror not such issue or matte.r is
referred to in the compromise settlement agreemeni executed by the parties in this action.
$l1ati ~a~~ Fomr l&r: R~oort
v;>::in R1:>.:eipt of !~Js Or~er.
~!4--
<.:re :.:1a l I )~nrt~' ( \';•:m~is~~,'11t'1
101518a HCBOC Page 145
Board Meeting
Agenda Item
Agenda Item 4-1 --'--.;;....;--~;.:;
MEETING DATE: October 1, 2018
TO: HARNETT COUNTY BOARD OF COMMISSIONERS
SUBJECT: Purchase of Weapons
REQUESTED BY : Sheriff Coats
REQUEST:
The Harnett County Sheriffs Office request permission to purchase new 9MM weapons for
Deputies. The present w~ons(handguns)(40 Caliber and 9mm) have fired at least a
thousand rounds and some of the weapons have fired several thousand rounds during
training. We are standardizing our weapons to all 9mm.
We ask permission to trade in our present weapons to include handguns and other weapons to
offset the cost of the new weapons. After the trade in of weapons, the net cost of purchasing
the weapons will be approximately $ 36,951.00. The Sheriffs Office will use Asset
Fo~iture Funds to purchase the weapons.
The Sheriffs Office request permission to trade in our present 40 caliber ammunition for new
9 mm ammunition. The ammunition will be traded , dollar for dollar, at no additional cost.
Attached are informal bids that we requested on weapons that we request to be traded in for
new weapons. Attachment 1, 2 and 3 will be informal quotes received from three vendors.
We are requesting to Purchase the Glock weapons and traded in our old weapons from
Craig's Firearms Supply Inc ., they have the highest quote for the trade in weapons.
Sovereign Guns:
American Gun:
Craig's Firearm
$45,180.00
$11,117.00
$47,335.00
We request to purchase 25 Weapons from Lawmen's which are under NC State Contract.
See attachment 4.
C:\Users\gmcneill\Desktop\Weapon Purchase\W eapons Purchase agenda.docx
1 of2 Page
101518a HCBOC Page 146
0564-2018 , us am 1 ti{ a
,-Cr-.ug's Firearm Supply lne.
Poli<,e Di~--tributor
5620 Concord Pkwy S., Concord, NC 28027
Phone 980-258-0444/0445 -Fax 980-258-0453
8761 Chapman Highway, Knoxville, TN 37920
Phone 865-573-4567 -Fax 865-573-0820
tonyl@craigsfirearms.com
TO: LT JOSH CHRISTENSEN _ _;;;;_~..;;..;;:.;:.,;._;;;.:..;.;...;;;.;;;,~~;;;;;.;.;;-PHONE: 910-624-2332
AGENCY: HARNETT CO. S. 0. -----------EMAi L: jchristensen@harnett.org
DA TE: 08/29/18 ____ _;;..;;....;:..,:.;.._;_,;;. ___ _ Quote will be honored for __ 6""-'0'--_ days.
PA1750302AB
UPG2250702
UPN2250702
UPN22250702
UPG1750702
UPN17C50202
UWPP
USPGFDXD9
MINl-14S-B
RPC4-40
GLOCK GEN 5 G17, AMGLO BOLD NIGHT SIGHTS, 3
LE MAGAZINES, BACKSTRAP/BEAVERTAIL KIT, GUN $428.50
LOCK, BORE BRUSH/ROD, CASE
LESS TRADE OF THE FOLLOWING
USED GLOCK GEN 4 G22, GLOCK NIGHT SIGHTS , 3
MAGS
USED GLOCK GEN 3 G22, GLOCK NIGHT SIGHTS, 3
MAGS
USED GEN 2 GLOCK G22 , GNS, 3 MAGS EACH
USED GEN 4 G17 , GNS, 3 MAGS EACH
USED G17C , 3 MAGS EACH
USED WALTHER PPS M2, 9MM, 3 MAGS
USED SPRINGFIELD XD , 9MM, FULL-SIZE, NIGHT
SIGHTS 3 MAGS
USED RUGER MINl-14, .223 REM, BLUED,
SYNTHETIC
USED RUGER PC4 CARBINE, .40 S&W, PARKERIZED,
SYNTHETIC
-$260.00
-$260.00
-$260.00
-$270.00
-$280.00
-$230.00
-$275.00
-$185.00
-$225.00
170
60
88
2
1
15
1
1
6
10
$72,845.00
-$15,600.00
-$22 ,880.00
-$520.00
-$270.00
-$4,200.00
-$230.00
-$275.00
-$1,110.00
-$2,250.00
TOTAL $25,510.00
Please call with any questions about this quote.
Thank you, * Govt agency prices do not include sales tax or FETwhere applicable
* Prices are due and payable NET 30 days for each invoice
Tony Lardo
NC Law Enforcement Sales
CELL 865-388-6337
* Trade-In pistols must be in good, serviceable working order
• Deductions made if trade-ins are damagedor not as specified
• Trade-In or exchange pistols must be complete with 3 magazines, working sights,
in original box, unless otherwise noted.
• Trade-In or exchange pistols must be turned in within 30 days after receipt of new
Glock pistols, unless other arrangements have been made and approved
101518a HCBOC Page 147
James Lanier
From:
Sent:
To:
Subject:
Attachments:
Sovereign Guns <sovereignguns@gmail.com>
Saturday, September 01, 2018 11:20 AM
James Lanier
Re: Harnett County gun list
Harnettjpg
I
Thanks for the opportunity to bid on this lot. My total cash offer for the Hamett county gun list comes to
$45,180. I have attached my work sheet with the price per gun.
Thanks
Kiran
On Fri, Aug 31, 2018 at 11 :06 AM, James Lanier wrote:
I have attached a list of firearms that Hamett County Sheriff's Office is going to sell. If you are interested in
placing a bid, please respond with a price for each type of gun along with a total value that your store would
give for the entire lot of guns. Please call me if you have any questions about the firearms.
Lt. James Lanier
Crime Scene Investigation & Evidence Supervisor
Special Response Team
AR-15 Armorer I Certified Glock Armorer / Benelli Armorer
Hamett County Sheriff Office
175 Bain St. Lillington, NC 27546
1 101518a HCBOC Page 148
Harnett County Guns to be Sold
60 USED GLOCK GEN 4 G22, GLOCK NIGHT SIGHTS, 3 MAGS Z '1 D
88 USED GLOCK GEN 3 G22, GLOCK NIGHT SIGHTS, 3 MAGS 2.1, 0
2 USED GEN 2 GLOCK G22, GNS, 3 MAGS EACH Z q-D
1 USED GEN 4 G17, GNS, 3 MAGS EACH J l/-V
15 USED GEN 3 Gl 7C, 3 MAGS EACH > 4 0
1 USED WALTHER PPS M2, 9MM, 3 MAGS 200
1 USED SPRINGFIELD XO, 9MM, FULL-SIZE, NIGHT SIGHTS, 3 MAGS ·z O 0
6 USED RUGER MINl-14, .223 REM, BLUED, SYNTHETIC '.Jo 0
10 USED RUGER PC4 CARBINE, .40 S&W, PARKERIZED, SYNTHETIC '3 0 0
101518a HCBOC Page 149
James Lanier
From:
Sent:
To:
Subject:
Mrs Bashi rah < americangun@centurylink.net>
Tuesday, September 04, 2018 5 :18 PM
James Lanier
American Gun bid for HCSO Firearms
Hey, bud . I spoke to D.R. this afternoon. He didn't give me a breakdown of price per gun, but
authorized me to enter a cash bid on the lot in the amount of $11,117. I hope you can work with this
number. It's all I've got.
R. Nance
General Manager
American Gun & Pawn, LLC
(910) 814-3113
1 101518a HCBOC Page 150
SALES QUOTE
SQ-281356 I 6/14/2018
3319 Anvil Place
Raleigh , NC 27603
Ph : 919.779.6141
800 Clanton Road , Ste T
Charlotte, NC 28217
Ph: 704.494.7575
4961 Broad River Rd. Ste B
Columbia , SC 29212
Ph: 803.798 .2253 11111111111111111 IIIII IIIII IIIII IIII IIII
Customer I
HARNETT CO SHERIFF OFFICE
ATTN: ACCOUNTS PAYABLE
PO BOX 399
LILLINGTON NC 27546
Tel: ( 910) 893-0108
Fax: (910)893-6450
Account
HARNET
Quotation
SQ -281356
L Item / Model. / Brand
Description
Contact I
Terms
NET 15
PO #
1 S-Wl l810 / 0221 88872224 I S-W
M&P9 SHIELD M2.0, NTS , NS
2 BLA4 10563BKR / 648018219764 / BLA
SERPA CQC MATTE S&W M&P SHIELD RH
3 G-GB8213 / 768574109160 / G-G
MAG/CUFF CASE,PADDLE ,BLK LEATHER ,RH
4 DES01 4 PCX7ZO / 792695316305 / DES
DIE HARD ANKLE RIG M&P SHIELD 9/40 BK RH
5 SH
SH IPPING/HANDLING
**PLEASE VERIFY THAT THE PART NUMB ERS AND DESCRIPTIONS
ARE CORRECT BEFORE SUBMITTING YOUR ORDER.
**RESTOCKI NG FEES MAY APPLY TO RETURNED ITEMS.
**FREIGHT WILL BE ADDED TO ALL INVO I CES.
**PRICES QUOTED ARE BASED ON PAYMENT BY CHECK OR CASH.
**QUOTE IS GOOD FOR 30 DAYS.
Due Date
6/29/2018
Reference
JEFFERIES
Qt)/
25
25
25
3
l
Tax Detai1s
NCCTTY7.00 $800.899
Ship To I
HARNETT CO SHERIFF OFFICE
175 BAIN STREET
LILLINGTON NC 2754 6
Account Rep Schedul.e Date
VALENTINA SAWVEL 6/14/2018
Ship VIA Page Printed
Price
UM
$367 .00
EA
$38.99
EA
$37 .99
EA
$63 .99
EA
$149.95
EA
Taxabl.e
Total. Tax
Exempt
Total.
Bal.a nce
1
Discount
%
$0.00
$0 . 00
$0.00
$0.00
$0.00
8/2/2018
11: 19 : 49AM
Amount
$9,175.00
$974 .75
$949. 75
$1 91. 97
$149. 95
$11,441.42
$800.90
$0.00
$1 2 ,2 42.32
$12,242.32
101518a HCBOC Page 151
Board Meeting
Agenda Item
Agenda Item 4-J ------------
MEETING DATE : October 15, 2018
TO : HARN ETT COUNTY BOARD OF COMMISSIONERS
SUBJECT : Request Approval to accept $31,603.70 from Chatham Co. Partnership For
Children
REQUESTED BY: Bill Stone, Interim County Extension Director
REQUEST:
Harnett County Cooperative Extension request approval to accept $31 ,603.70 from Chatham
County Partnership for Children -LS 19-063 Child Care Resource -Core Services Program.
This Family Resource Program provides program administration and delivers services and
trainings to child care centers and child care homes .
··---------·---------...-... ~----.. ------.... ___ ,. ____ _
FINANCE OFFICER'S RECOMMENDATION:
COUNTY MANAGER'S RECOMMENDATION:
C:\Use rsl swi ll ia rn s1Des kto p\County fo rrn s\agendafo rrn2 0 I 8.docx
I of2
Pa ge
101518a HCBOC Page 152
Contract# 3289204013
CFDA # 93.575
Contract# 3289204013
COUNTY OF HARNETI
Core Services
This contract is hereby entered into by and between Chatham County Partnership for Children, hereinafter referred to as
(CCPC), and the County of Harnett (the "Contractor") (referred to collectively as the "Parties"}. The Contractor's federal tax
identification number is 56-6000306.
1. Contract Documents:
This contract consists of the following documents which are incorporated herein by reference:
( 1) This Contract Cover
(2) The General Terms and Conditions (Attachment A)
(3) Scope of Work (Attachment B)
(4) The Line Item Budget and The Line Item Budget Narrative (Attachment C}
(5) State Grant Certification -No Overdue Tax Debts (Attachment D)
(6) Federal Certifications (Attachment E)
(7) IRS Tax Exemption Verification Form (Annual) (Attachment F}
(8) Conflict of Interest Verification (Annual} (Attachment G}
(9) State Certification (Attachment H)
(10)Data Sharing Agreement (Attachment I}
Incorporated By Reference
The following documents are reference materials and are available by going to the following website , Open Window
http://dhhsopenwindow.nc.gov/index.aspx?pid=doc Refere nceDoc uments .
(1) Travel : Policies Governing Travel Related Expenses for Contractors
(2) Notice of Certain Reporting and Audit Requirements
(3) General Statutes G.S. 143C6 NonState Entities Receiving State Funds
(4) Subchapter 03M Uniform Administration of State Grants
In addition the manual is available from your Council Management Agency and provides fiscal reporting requirements .
(1) NC CCR&R Council Fiscal Policies and Procedures
These documents constitute the entire agreement between the Parties and supersede all prior oral or written
statements or agreements .
2. Precedence Among Contract Documents:
In the event of a conflict between or among the terms of the Contract Documents , the terms in the Contract Document
with the highest relative precedence shall prevail. The order of precedence shall be the order of documents as listed in
the contract document section (Paragraph 1, above), with the first-listed document having the highest precedence and
the last-listed document having the lowest precedence . If there are multiple Contract Amendments, the most recent
amendment shall have the highest precedence and the oldest amendment shall have the lowest precedence.
3. Effective Period:
This contract shall be effective on July 1, 2018 and shall terminate on June 30, 2019 for CORE Services, with the option
to extend, if mutually agreed upon, through a written amendment as provided for in the General Terms and Conditions
as described in Attachment A.
NCDHHS GCT1007 (Contract) (General) (Rev . 11.01.15) 101518a HCBOC Page 153
4. Contractor's Duties:
Contract# 3289204013
COUNTY OF HARNETI
Core Services
The Contractor shall provide the services as described in the Scope of Work in Attachment B and in accordance with
the approved budget in Attachment C. Key personnel in this contract are defined as the Contractor's CEO /Executive
Director, Chief Financial Officer, and CCR&R Director . CCPC will be notified in the event that there are any key
personnel changes.
5. Duties of Chatham County Partnership for Children:
CCPC shall pay the Contractor in the manner and in the amounts specified in the Contract Documents. The total
amount paid by CCPC to the Contractor under this contract shall not exceed $31,603.70. This amount consists of $0 in
State Funds , $0 in Local Funds, $0 in Other funds and $31,603.70 in Federal Funds.
The total contract amount is $31,603.70 .
6. Conflict of Interest Policy :
This is a financial assistance contract; therefore , the Contractor shall file with CCPC, a copy of the Contractor 's policy
addressing conflicts of interest that may arise involving the Contractor 's management of employees and the members of
its board of directors or other governing body. The policy shall address situations in which any of these individuals may
directly or indirectly benefit, except as the Contractor's employees or members of its board or other governing body,
from the Contractor's disbursing of CCPC funds and shall include actions to be taken by the Contractor or the individual,
or both to avoid conflicts of interest and the appearance of impropriety. The policy shall be filed before CCPC may
disburse the grant funds, as referenced in Attachment G. (N.C.G.S. 143C-6-23(b) (2007))
7. Statement of No Overdue Tax Debts:
Contractor's sworn written statement pursuant to N.C.G.S. 143C-6-23(c), stating that the Contractor does not have any
overdue tax debts, as defined by G.S. 105-243.1 , at the federal , state , or local level , is attached as Attachment D.
Contractor acknowledges that the written statement must be filed before CCPC may disburse the grant funds.
8. Reversion of Unexpended Funds:
Any unexpended grant funds shall revert to CCPC upon termination of this Contract.
9. Grants:
The Contractor has the responsibility to ensure that all sub-contractors, if any , provide all information necessary to
permit the Contractor to comply with the standards set forth in this contract.
10. Reporting Requirements:
CCPC has determined that this is a contract for financial assistance , and therefore is sub ject to the reporting
requirements of N.C . General Statute 143C-6.23. If a non-governmental grantee receives $500,000.00 in combined or
more funds from all state agencies, it must continue to submit a single or program-specific audit prepared and
completed in accordance with Generally Accepted Government Auditing Standards, also known as a Yellow Book audit ,
to RMAM at NCGrantsReporting@dhhs.nc.gov within 9 months of the grantee 's fiscal year end .
OCOEE encourages all of its non-governmental grantees that receive funds from other state agencies or DHHS
divisions to contact their assigned contract monitor(s) to determine if year-end reports must be submitted for those
particular grants/awards.
The Regional Lead Agencies and Local CCR&R agencies must submit their audit report within 9 months of
organization's year end to CCPC . Note : An A-133 audit may be substituted for the yellow book audit. Be sure to check
the State Auditor's website at www.ncaudi to r.net for updated information and forms .
NCDHHS GCT1007 (Contract) (Ge neral ) (Rev. 11 .01 .15)
101518a HCBOC Page 154
11. Payment Provisions:
Contract# 32 89204013
COUNTY OF HARNETT
Core Services
Upon execution of this contract , the Contractor may request and, upon approval by CCPC , receive an advance of no
more than one month 's operating expenses if approved by CCPC . The advance is limited to the amount to be
expended within the one-month period.
Monthly reimbursements shall be made based on actual expenditures made in accordance with the approved budget on
file with both parties and reported on the monthly financial status report (FSR) submitted by the Contractor. The original
FSR report shall be submitted to the Contract Administrator of CCPC . CCPC will analyze the cash needs of the
Contractor no less often than every three months. If CCPC determines that the advance exceeds the financial needs of
the Contractor based on actual monthly expenditures , the excess advance will be reduced from a subsequent month 's
expenditure reimbursement.
Any unexpended funds advanced to the Contractor must be returned or settled no later than the June FSR due date for
the year. If the expenditures reported on the June FSR are not sufficient to cover the advance , a check representing the
difference must be attached to the June FSR. CCPC must receive this report and check no later than with the July due
date for the June FSR.
The Contractor shall have up to 15 days for completion and submission of the final FSR report related to this contract
period. CCPC shall have no obligation for payments based on FSR reports submitted later than 30 days after
termination or expiration of the contract period. If this contract is terminated prior to the end of the contract period , the
Contractor is required to settle or return any funds advanced within 30 days of the termination date.
All payments are contingent upon fund availability.
Financial Status Reports are due the 10th calendar day of each month.
Payment shall be made in accordance with the Contra ct Documents as described in the Scope of Work ,
Attachment B.
12. Contract Administrators:
All notices permitted or required to be given by one Party to the other and all questions about the contract from one
Party to the other shall be addressed and delivered to the other Party 's Contract Administrator. The name , post office
address , street address , telephone number, fax number , and email address of the Parties' respective initial Contract
Administrators are set out below. Either Party may change the name , post office address, street address , telephone
number , fax number, or email address of its Contract Administrator by giving timely written notice to the other Party.
For CCPC :
IF DELIVERED BY US POSTAL SERVICE IF DELIVERED BY ANY OTHER MEANS
Ms. Genevieve Megginson , Executive Director Ms . Genevieve Megginson, Exec ut ive Director
Chatham County Partnership for Children Chatham County Partnership for Children
PO Box 637 220 Chatham Business Drive
Pittsboro , NC 27312 Pittsboro , NC 27312
Telephone: (919) 542-7449
Fax : (919) 542-0238
Email: genevieve@.chanthamkids .org
NCD HHS GCT1 007 (Contract) (Ge neral) (Rev. 11 .01 .15)
101518a HCBOC Page 155
For the Contractor :
IF DELIVERED BY US POSTAL SERVICE
Bill Stone, Interim Extension Director
County of Harnett
126 Alexander Dr ., Suite 300
Lillington , NC 27546
Telephone : 910-893-7530
Fax : 910-893-3195
13. Supplementation of Expenditure of Public Funds :
IF DELIVERED BY ANY OTHER MEANS
Bill Stone, Interim Extension Director
CO'JJmtw<nffttmatHt
1~~~efl>r.?$1.fit~OO
bin~Wh .~2~~~6
Telephone: 910-893-7530
Fax : 910-893-3195
Contract# 3289204013
COUNTY OF HARNED
Core Services
The Contractor assures that funds received pursuant to this contract shall be used only to supplement, not to supplant ,
the total amount of federal, state and local public funds that the Contractor otherwise expends for CORE Child Care
Resource and Referral services and related programs. Funds received under this contract shall be used to provide
additional public funding for such services ; the funds shall not be used to reduce the Contractor's total expenditure of
other public funds for such services.
14. Disbursements:
As a condition of this Contract, the Contractor acknowledges and agrees to make disbursements in accordance with the
following requirements :
a. Implement adequate intern al controls over disbursements ;
b. Pre-audit all vouchers presented for payment to determine :
• Validity and accuracy of payment
• Payment due date
• Adequacy of documentation supporting payment
• Legality of disbursement
c. Assure adequate control of signature stamps/plates;
d. Assure adequate control of negotiab le instruments ; and
e. Implement procedures to ensure that account balance is so lvent and reconcile the account monthly.
15. Outsourcing to Other Countries :
The Contractor certifies that it has identified to CCPC all jobs related to the Contract that have been outsourced to other
countries , if any. Contractor further agrees that it will not outsource any such jobs during the term of this Contract
without providing notice to and receiving prior written approval from CCPC.
16. CCPC Reports :
The Contractor shall submit to CCPC, reports that describe mid-year progress and a final report that details success
and /or failure to achieve outcomes as described in Attachment B, Scope of work. Mid-year reports are due to CCPC no
later than thirty (30) calendar days after contract mid-point. The Final Report is due no later than 30 calendar days
after the cont ract termination date.
17. Federal Certifications :
Individuals and Organizations receiving federal funds must ensure compliance with certain certifications required by
federal laws and regulations . The contractor is hereby complying with Certifications regarding Nondiscrimination , Drug-
Free Workplace Requirements , En vironmenta l Tobacco Smoke, Debarment, Suspension , Ineligibility and Voluntary
Exclusion Lower Tier Covered Transactions , and Lobbying. These assurances and certifications are accompanied by a
signature page and can be found in the Providers Managed Documents section of DHHS Open Window. The signature
page is to be signed by the contractor's authorized representative .
18. Performance Monitoring/Quality Assurance Plan
NC DHHS GCT1007 (Contract) (General) (Rev. 11 .0 1.15)
Bil ~
Ccu1
12D
Lill n
101518a HCBOC Page 156
CCPC Duties:
Contr act# 3289204 013
COU NTY OF HARNE TT
Core Servi ces
CCPC shall monitor, evaluate and provide guidance and direction to Subrecipient in the conduct of Approved Services
performed under this Agreement. CCPC has the responsibility to determine whether Subrecipient has spent funds in
accordance with applicable laws, regulations , including the federal audit requirements and agreements and shall
monitor the activities of Subrecipient to ensure that Subrecipient has met such requirements. CCPC may require
Subrecipient to take correction action if deficiencies are found .
Programmatic Reporting Requirements:
CCPC personnel will monitor contractors annually for compliance with programmatic and fiscal requirements through desk
audit reviews and/or site visits. If the Contractor is deemed out of compliance , technical assistance will be provided , which
may include completion of a corrective action plan . Failure to comply with programmatic and fiscal requirements may result in
termination of the contract.
CCPC personnel will also monitor contractors to ensure that the required reports and invoices/financial status reports (FSR)
are submitted accurately and timely. The Contract Administrator will review semi-annual and annual reports to monitor
program outputs, outcomes , and deliverables , in addition to conducting calls with Contractor on a quarterly basis, or as
needed.
19. Other Requirements:
Federal Funding Accountability and Transparency Act (FFATA)
As required by the Federal Funding Accountability and Transparency Act (FFATA), prime awardees of individual
Federal grants that are equal to or greater than $25,000 and awarded on or after October 1, 2010, are required to
report on data related to executive compensation and associated first-tier sub-grants of $25 ,000 or more .
Therefore , the contractor shall complete the enclosed form "Federal Fund ing Accountability and Transparency Act
(FFATA) Data Report ing Requirement "Subawardee Information" and return with the signed contract.
Contract Number: 3289204013
Contractor:
Federal Award Name:
COUNTY OF HARNETT
CCDF
State Fiscal Year: 2019
1. Sub-recipient name (which must
match registered name in DUNS) COU NTY OF HARNETT
1. Sub-recipients DUNS number 091565986
(see§ 200.32 Data Universal
Numbering System (DUNS)
number)
2. Federal Award Identification
Number (FAIN) G 1801 NC CCDF
3. Federal Award Date (see § 07/01 /2018
200.39 Federal award date)
NCDHHS GCT 1007 (Co nt ract) (G enera l) (Rev. 11.01 .15)
101518a HCBOC Page 157
4. Sub-award Period of
Performance Start and End Date
5. Amount of Federal Funds
Obligated by this action
6. Total Amount of Federal Funds
Obligated to the sub-recipient
7. Total Amount of the Federal
Award
8. Federal award project description ,
as required to be responsive to
the Federal Funding
Accountability and Transparency
Act (FFATA)
9. Name of Federal awarding
agency, pass-through entity, and
contact information for awarding
official
10 . CFDA Number and Name; the
pass-through entity must identify
the dollar amount made available
under each Federal award and
the CFDA number at the time of
disbursement
11 . Identification of whether the
award is R&D
12. Indirect cost rate for the Federal
award (including if the de minimis
rate is charqed)
July 1, 2018 -June 30, 2019
$31,603.70
$31,603.70
$214,461,452
Child Care Development Fund
Federal DHHS Office Administration for
Children and Families
NC DHHS /DCDEE
820 South Boylan Avenue
Raleigh , NC 27603
919-527-6500
CFDA# 93.575
Child Care Development Fund
No
10% De minim is
Contr act# 328920 4013
COUNTY OF HAR NETI
Core Services
This contract is in compliance with the Federal Office of Management and Budget (0MB) CFR Title 2 Part
200 . Follow the link below (or paste into your browser) for additional information:
http://www.ecfr.gov/cgi-bin/text-idx?tpl=/ecfrbrowse/Title02/2cfr200 main 02.tpl
Signatures follow on the next page
NC DHH S GC T1 007 (C ontract) (Genera l) (Rev. 11.01.15)
101518a HCBOC Page 158
20. Signature Warranty:
Contract# 3289204013
COUNTY OF HARNETT
Core Services
The undersigned represent and warrant that the y are authorized to bind their principals to the terms of this agreement.
In Witness Whereof, the Contractor and CCPC ha ve executed this contract in duplicate or iginals , with one original
being retained by each party .
County of Harnett
Signature
PG.u.Jc._ t. 6rt~l .,JGJ~
Pr in ted Name
TH~INST RUMENTHASBEEN
ltREAUDITED IN THE MANNER REQUIRED
BYTH LO CALGOVERNMENTBUDGE T
AN F SC C T OL ACT
Chatham County Partnership for Children
Signature
Printed Name
NCDHH S GCT1007 (Contract) (General) (Rev. 11 .01 .15)
Date
Jo-?--!(
Date
~Jeri( to ~e ~ vd
Title
Date
Ti tle
101518a HCBOC Page 159
Attachment A
Contract #3289204013
County of Harnett
GENERAL TERMS AND CONDITIONS
Relationships of the Parties
Independent Contractor: The Contractor is and shall
be deemed to be an independent contractor in the
performance of this contract and as such shall be wholly
responsible for the work to be performed and for the
supervision of its employees . The Contractor represents
that it has , or shall secure at its own expense , all
personnel required in performing the services under this
agreement. Such employees shall not be emp loyees of,
or have any individual contractual relationship with ,
Chatham County Partnership for Children .
Subcontracting : The Contractor shall not subcontract
any of the work contemplated under this contract without
prior written approval from Chatham County Partnership
for Children . Any approved subcontract shall be subject
to all conditions of this contract. Onl y the subcontractors
specified in the contract documents are to be considered
approved upon award of the contract. Chatham County
Partnership for Children shal l not be ob ligated to pay for
any work performed by an y unapproved subcontractor.
The Contractor shall be responsible for the performance
of all of its subcontractors .
Assignment: No assignment of the Contractor's
obligations or the Contractor's right to rece ive payment
hereunder shall be permitted. However, upon written
request approved by the issuing purchasing authority ,
the Chatham County Partnership for Children may: (a )
Forward the Contractor's payment check directly to any
person or entity designated by the Contractor , or (b )
Include any person or ent ity designated by Contractor as
a joint payee on the Contractor's payment check . In no
event shall such approval and action ob ligate Chatham
County Partnership for Children to anyone other than the
Contractor and the Contractor shall remain responsible
for fulfillment of all contract obligations .
Beneficiaries: Except as herein specifically provided
otherwise , this contract shall inure to the benefit of and
be binding upon the parties hereto and their respective
successors. It is expressly understood and agreed that
the enforcement of the terms and conditions of this
contract, and all rights of action relating to suc h
enforcement , shall be strictly reserved to Chatham
County Partnership for Children and the named
Contractor. Nothing contained in this document shall
give or allow any claim or right of action whatsoever by
any other third person . It is the express intention of
Chatham County Partnership for Children and
Contractor tha t any such person or entity , other than
Chatham Co unty Partnership for Children or the
Contractor , receiving services or benefits und er this
contract shall be deemed an incidental benefi ci ary only.
Indemnity and Insurance
Indemnification : The Contractor agrees to indemn ify
and hold harmless Chatham County Partnership for
Children , Child Care Resources Inc., the State of North
Carolina , and an y of their officers, agents and
employees , from any claims of third parties arising out of
any act or omission of the Contractor in connection with
the performance of this contract to the extent perm itted
by law.
Default and Termination
Termination Without Cause: Chatham County
Partnership for Children may terminate this contract
without cause by giving 30 days written notice to the
Contractor.
Termination for Cause: If, through any cause , the
Contractor shall fail to fulfill its obligations under this
contract in a timely and proper manner, Chatham County
Partnership for Children shall have the right to term inate
this contract by giv ing written notice to the Contractor
and specifying the effective date thereof. In that event ,
all finished or unfinished deliverable items prepared by
the Contractor under this contract shall , at the option of
Chatham County Partnership for Children, become its
property and the Contractor shall be ent itled to receive
just and equ itable compensation for any satisfactory
work completed on such materials, minus any payment
or compensat ion previously made . Notwithstanding the
foregoing provision , the Contractor shall not be relieved
of liability to Chatham County Partnership for Ch ildren
for damages sustained by Chatham County Partnership
for Children by virtue of the Contractor's breach of this
agreement, and Chatham County Partnership for
Children may withhold any payment due the Contractor
for the purpose of setoff until such tim e as the exact
amount of damages due Chatham County Partnership
for Children from such breach can be determined. In
case of default by the Contractor, without limiting any
other remedies for breach available to it , Chatham
County Partnership for Children may procure the
contract services from other sources and hold the
Contractor responsible for any excess cost occasioned
thereby . The filing of a petition for bankruptcy by the
Contractor shall be an act of default under this contract.
Waiver of Default: Waiver by Chatham County
Partnership for Children of any default or breach in
compliance with the terms of this contract by the
Contractor shall not be deemed a waiver of any
subsequent default or breach and shall not be construed
to be modifi cation of the terms of this contract unless
stated to be such in w riting , signed by an authorized
representative of Chatham County Partnership for
NCD H HS T C101 O (Gen eral Terms and Conditions) (Loca l Gove rnm ent) (Rev . 11 .01 .15) 101518a HCBOC Page 160
Children and the Contractor and attached to the
contract.
Availability of Funds: The parties to this contract agree
and understand that the payment of the sums specified
in this contract is dependent and contingent upon and
subject to the appropriation , allocation , and availability of
funds for this purpose to Chatham County Partnership
for Children .
Force Majeure: Neither party shall be deemed to be in
default of its obligations hereunder if and so long as it is
prevented from performing such obligations by any act of
war, hostile foreign action, nuclear explosion , riot ,
strikes , civil insurrection , earthquake, hurricane , tornado ,
or other catastrophic natural event or act of God .
Survival of Promises: All promises, requirements,
terms , conditions , provisions , representations ,
guarantees, and warranties contained herein shall
survive the contract expiration or termination date unless
specifically provided otherwise herein, or unless
superseded by applicable Federal or State statutes of
limitation.
Intellectual Property Rights
Copyrights and Ownership of Deliverables : All
deliverable items produced pursuant to this contract are
the exclusive property of OCOEE. The Contractor shall
not assert a claim of copyright or other property interest
in such deliverables.
Compliance with Applicable Laws
Compliance with Laws: The Contractor shall comply
with all laws , ordinances, codes , rules , regulations, and
licensing requirements that are applicable to the conduct
of its business , including those of federal , state , and
local agencies having jurisdiction and/or authority.
Equal Employment Opportunity: The Contractor shall
comply with all federal and State laws relating to equal
employment opportunity.
Health Insurance Portability and Accountability Act
(HIPAA): The Contractor agrees that, if Chatham County
Partnership for Children determines that some or all of
the activities w ithin the scope of this contract are subject
to the Health Insurance Portability and Accountability Act
of 1996, P.L. 104-91, as amended ("HIPAA"), or its
implementing regulations , it will comply with the HIPAA
requirements and will execute such agreements and
practices as Chatham County Partnership for Children
may require to ensure compliance.
Confidentiality
Attachment A
Contract #3289204013
County of Harnett
Confidentiality: Any information, data , instruments ,
documents, studies or reports given to or prepared or
assembled by the Contractor under this agreement shall
be kept as confidential and not divulged or made
available to any individual or organization without the
pr ior written approval of Chatham County Partnership for
Children . The Contractor acknowledges that in receiving ,
storing , processing or otherwise dealing with any
confidential information it will safeguard and not further
disclose the information except as otherwise provided in
this contract.
Data Security : The Contractor shall adopt and apply
data security standards and procedures that comply with
all app licable federal , state , and local laws , regulations ,
and rules.
Duty to Report: The Contractor shall report a suspected
or confirmed security breach to Chatham County
Partnersh ip for Children's Contract Administrator within
twenty-four (24) hours after the breach is first
discovered , provided that the Contractor shall report a
breach involving Social Security Administration data or
Internal Revenue Service data within one (1) hour after
the breach is first discovered . During the performance of
this contract, the contractor is to notify Chatham County
Partnership for Children contract administrator of any
contact by the federal Office for Civil Rights (OCR)
received by the contractor.
Cost Borne by Contractor: If any applicable federal,
state, or local law, regulation , or rule requires Chatham
County Partnership for Children or the Contractor to give
affected persons written notice of a security breach
arising out of the Contractor's performance under this
contract, the Contractor shall bear the cost of the notice .
Oversight
Access to Persons and Records: The State Auditor
shall have access to persons and records as a result of
all contracts or grants entered into by State agencies or
political subdivisions in accordance with General Statute
147-64.7. Additionally, as the State funding authority , the
Department of Health and Human Services shall have
access to persons and records as a result of all
contracts or grants entered into by State agencies or
political subdivisions .
Record Retention: Records shall not be destroyed ,
purged or disposed of without the express written
consent of Chatham County Partnership for Children .
State basic records retention policy requires all grant
records to be retained for a minimum of five years or
until all audit exceptions have been resolved , whichever
is longer. If the contract is subject to Federal policy and
regulations , record retention may be longer than five
years . Records must be retained for a period of three
NCDHHS TC1010 (General Term s and Conditions) (Loca l Governmen t) (Rev. 11 .01 .15) 101518a HCBOC Page 161
years following submission of the final Federal Financial
Status Report, if applicable, or three years following the
submission of a revised final Federal Financial Status
Report . Also , if any litigation, claim , negotiation, audit,
disallowance action , or other action involving this
Contract has been started before expiration of the five-
year retention period described above, the records must
be retained until completion of the action and resolution
of all issues which arise from it , or until the end of the
regular five-year period described above, whichever is
later. The record retention period for Temporary
Assistance for Needy Families (TANF) and MEDICAID
and Medical Assistance grants and programs must be
retained for a minimum of ten years.
Miscellaneous
Choice of Law: The validity of this contract and any of
its terms or provisions, as well as the rights and duties of
the parties to this contract, are governed by the laws of
North Carolina. The Contractor, by signing this contract,
agrees and submits, solely for matters concerning this
Contract, to the exclusive jurisdiction of the courts of
North Carolina and agrees, solely for such purpose, that
the exclusive venue for any legal proceedings shall be
Chatham County, North Carolina. The place of this
contract and all transactions and agreements relating to
it , and their situs and forum, shall be Chatham County ,
North Carolina , where all matters, whether sounding in
contract or tort , relating to the validity , construction ,
interpretation , and enforcement shall be determined .
Amendment: This contract may not be amended orally
or by performance. Any amendment must be made in
written form and executed by duly authorized
representatives of Chatham County Partnership for
Children and the Contractor. The Purchase and Contract
Divisions of the NC Department of Administration and
the NC Department of Health and Human Services shall
give prior approval to any amendment to a contract
awarded through Chatham County Partnership for
Children .
Severability: In the event that a court of competent
jurisdiction holds that a provision or requirement of this
contract violates any applicable law, each such provision
or requirement shall continue to be enforced to the
extent it is not in violation of law or is not otherwise
unenforceable and all other provisions and requirements
of this contract shall remain in full force and effect.
Attachment A
Contract #3289204013
County of Harnett
Headings: The Section and Paragraph headings in
these General Terms and Conditions are not material
parts of the agreement and should not be used to
construe the meaning thereof.
Gender and Number: Masculine pronouns shall be read
to include feminine pronouns and the singular of any
word or phrase shall be read to include the plural and
vice versa.
Time of the Essence: Time is of the essence in the
performance of this contract.
Key Personnel: The Contractor shall not replace any of
the key personnel assigned to the performance of this
contract without the prior written approval of Chatham
County Partnership for Children . The term "key
personnel" includes any and all persons identified as
such in the contract documents and any other persons
subsequently identified as key personnel by the written
agreement of the parties .
Care of Property: The Contractor agrees that it shall be
responsible for the proper custody and care of any
property furnished to it for use in connection with the
performance of this contract and will reimburse Chatham
County Partnership for Children for loss of, or damage
to , such property. At the termination of this contract, the
Contractor shall contact Chatham County Partnership for
Children for instructions as to the disposition of such
property and shall comply with these instructions .
Travel Expenses: Reimbursement to the Contractor for
travel mileage, meals , lodging and other travel expenses
incurred in the performance of this contra ct shall not
exceed the rates published in the applicable State rules
or approved local government travel policy. International
travel shall not be reimbursed under this contract.
Sales/Use Tax Refunds: If eligible, the Contractor and
all subcontractors shall: (a) ask the North Carolina
Department of Revenue for a refund of all sales and use
taxes paid by them in the performance of this contract ,
pursuant to G .S. 105-164.14 ; and (b) exclude all
refundable sales and use taxes from all reportable
expenditures before the expenses are entered in their
reimbursement reports.
Advertising : The Contractor shall not use the award of
this contract as a part of any news release or
commercial advertising .
NCDHH S T C101 O (G eneral T erms and Conditions) (Lo ca l Governm ent) (R ev . 11 .01 .15) 101518a HCBOC Page 162
Attachment B
Contract # 328920 40 13
Coun ty o f Hamett
Core Services
FY2019 Scope of Work
Core Services
Local CCR&R Agency Commitment
As the Local CCR&R Agency under contract to Chatham County Partnership for Children to
provide North Carolina Division of Child Development and Early Education (NCDCDEE) -funded
CCR&R Core Services in Region 13, the Contractor, County of Harnett, commits to ensuring the
successful delivery of these services and attainment of project goals, outcomes and outputs
within its local community and commits to work with other local CCR&R agencies across Region
13.
In addition, Contractor agrees to support the success of all additional NC OCOEE-funded CCR&R
services including, but not limited to, the Infant/Toddler Enhancement Project and the
Promoting Healthy Social Behaviors in Child Care Settings Project.
Contractor agrees to:
1. regularly attend semi-annual meetings convened by the Regional Lead CCR&R Agency and
leadership development/program area specific meetings as convened;
2. meet fill county specific goals as agreed upon and specified in the Regional Lead CCR&R
Agency's final R&R Council-approved contract for FY19 (regardless of the actual
Contractor's specified use of CCR&R Core Service funds as approved by the Regional Lead
CCR&R Agency);
3. provide information to the Regional Lead CCR&R Agency regarding the county's progress
toward goal attainment;
4. provide county data on service delivery to its Regional Lead CCR&R Agency on a timely
basis as required by the Regional Lead CCR&R Agency and the CCR&R Council;
5. submit Financial Status Report by the fifth (10th ) of the month, unless otherwise
requested by Chatham County Partnership for Children;
6. submit a line item budget and a plan for the distribution of resources within the
county(ies);
7. adhere to statewide core services and special initiatives delivery protocols and
expectations, as developed;
8. coordinate with other entities providing CCR&R, child and family services in region;
9. attend semi-annual meetings of local Smart Start Partnership Executive Directors and
Resource and Referral Executive Directors within its region;
10. supervise all Core Service staff as required to ensure successful program outputs and
outcomes; and
11. notify the Regional Lead CCR&R Agency within one week of a change in key CCR&R staff to
ensure continued communication between the local agency and the lead agency as well
as the NC CCR&R Council and DCDEE.
FY2019 Core Services Scope of Work Page 1
101518a HCBOC Page 163
Attachment B
Contract # 3289204013
County of Hamett
Core Services
Contractor also agrees to work cooperatively within their county and across the region to help
ensure successful statewide and regional outcomes and outputs with respect to the following
statewide goals:
1. Consumer education and referral and public awareness materials are available and
offered in the two most commonly used languages .*
2 . Consumer education counseling provided meets the NC CCR&R Consumer Education
standards.*
3. Professional development and technical assistance are provided in the two most
commonly used languages in each community.
4. Appropriate professional development for child care providers is available throughout
the counties served .
5 . Technical assistance is available throughout the counties served for all levels identified
in Core Services, including mandatory technical assistance .
6. Appropriate data is collected and quality assurance measures are in place .
7 . Customer satisfaction is regularly assessed and changes are made based on customer
assessment.
8. Information required by the Regional Lead CCR&R Agency pertaining to Core Services in
the Contractor's service delivery area is compiled and forwarded to the Regional Lead
CCR&R agency on a periodic basis as specified by the Regional Lead CCR&R Agency
and/or the CCR&R Council.
9 . Contractors participating in a Regional Consumer Education and Referral Hub for
Consumer Education and Referral services shall enter into a Memorandum of
Underst anding with the Regional Lead CCR&R Agency, outlining the responsibilities of
both the contractor and the Regional Lead .
10. Ensure that 50% of CCR&R staff providing professional development, coaching,
mentoring or technical assistance in Harnett County will be endorsed with e ither the
Professional Development and/or Technical Assistance Endorsement.
Contractor further agrees to meet expected Core Service performance requirements/
standards as well as outcomes and outputs for Professional Development and Technical
Assistance (the outcomes and outputs identified below are defined as minimum and are to be
met at the county level unless otherwise specified). If the Contractor is located in a CCR&R
Region that has transitioned to a Regional Consumer Education and Referral Hub, the
Contractor agrees to support the Lead Agency's efforts in meeting the Consumer Education &
Referral outputs and outcomes as indicated below.
Performance Requirements
1. Provide consumer education services to 190 unduplicated households*, including 160
unduplicated households with preschool children and 30 unduplicated households*
FY2019 Core Services Scope of Work Page 2
101518a HCBOC Page 164
Attachment B
Contract # 3289204013
Coun ty of Hamett
Core Services
with school-age children in Harnett County. *Households with all adults presently
working.
2. Provide on-site technical assistance services to 24 unduplicated preschool classrooms
and 5 unduplicated school-age classrooms for a total of 29 classrooms to increase the
quality of child care services and to support the professional development needs of child
care providers in Harnett County.
3. Provide professional development trainings including, but not limited to: Beyond Band-
Aids ; Ready, Set, Go; NC Foundations for Early Learning and Development;
Inclusion/Working with Children with Special Needs; Cultural Competence; Partnering
with Parents : Preventing Child Abuse and Neglect; and Emergency Preparedness; and
trainings on Child Care and Development Fund health and safety topics (i .e., Medication
administration; appropriate precautions in transporting children; building and physical
premises safety; handling and storage of hazardous materials and the appropriate
disposal of bio-contaminants; prevention and control of infectious diseases, including
immunizations; prevention of and response to emergencies due to food and allergic
reactions; prevention of shaken baby syndrome and abusive head trauma and child
maltreatment; and prevention of SIDS and use of safe sleeping practices} to at least 229
unduplicated child care providers in Harnett County.
4. Provide CEU trainings to 11 unduplicated child care providers in Harnett County.
5. Report the number of referral requests for children with special need s.*
6. Survey at least 20% of all customers (CER*, PD and TA} in each county served to
determine their satisfaction with services. Non-respondents will be replaced to ensure
that data represe nts 20% of customers served. For child care referral services, 20% is
non-inclusive of on-line referral s.
Core Service Outcomes
1. By June 30, 2019, at least 85% of households receiving child care referrals through
consumer education will demonstrate understanding th e importance of obtaining high
quality child care by enrolling their child(ren} in 3, 4 or 5 star rated licensed care.
2. By June 30, 2019, 80% of family child care homes who receive start-up technical
assistance and elect to become licensed will achieve 3-stars or higher within 9 month s
of receiving a temporary license .
3 . By June 30, 2019, 90% of child care centers who receive start-up technical assistance
and elect to become licen se d will achieve 3 -s tars or higher within 9 months of rece iving
a temporary license .
4. By June 30, 2019, 85% of training participants surveyed will report feeling confident in
their ability to apply the knowledge and skills gained through training. Data is analyzed
for participants endorsing a 4 or 5 on a Likert sca l e usi ng a 5 point Likert Scale.
FY2019 Core Se rvices Scope of Work Page 3
101518a HCBOC Page 165
Attac hm ent B
Contract # 3289204 013
C ounty of Harnett
Core Serv ices
5. By June 30, 2019, 85% of technical assistance recipients surveyed will report feeling
confident in their ability to apply the knowledge and skills gained through technical
assistance . Data is analyzed for participants endorsing a 4 or 5 on a Likert scale using a 5
point Likert Scale.
Performance Standards
The contractor shall:
1. Submit semi-annual and annual reports outlining progress on programmatic outputs
and outcomes, due 10/15/18, 12/15/18, 4/15/19 and 7 /15/19, respectively.
2. Ensure consistent and equitable delivery of all services in accordance with North
Carolina Child Care Resource & Referral Council best practices guidelines and policies.
3. Comply with state, federal, and Child Care and Development Fund regulations.
4. Provide Corrective Action Training and Technical Assistance as requested by the
Division.
5 . Enter all licensed child care programs into NACCRRAware. *
6. Ensure that all family consumer education staff are trained in the Division's course{s)
on serving and supporting families experiencing homelessness.*
7 . Upon request, share with the NC CCR&R Council/Division, and the public where
relevant, any data and/or analysis collected/conducted during the contract period that
pertains to child care supply/demand and/or emerging trends in early care and
education and school-age care.
8. Ensure professional development trainings include relevant, current, and research -
based information, including best practices in adult learning, and that CEU trainings
meet the International Association for Continuing Education and Training's {IACET)
standards or are issued by a Local Education Agency or an accredited institution of
higher education.
9. Utilize best practices and research -based information in the delivery of services.
10. Collaborate with local and statewide partners, including the Division, to meet the
needs of the child care workforce and to plan for the technical assistance and training
needs of providers .
11. Collect data on critical services/activities, including supply/demand for child care
services per Child Care Development Regulation, and report said data in annual report.
12. For all program activities, track and report the following data:
a. The age, gender, race/ethnicity of the participant as well as the county and Child
Care Resource and Referral Region in which they work.
b. The program setting wherein technical assistance was provided {Family Child Care
Home or Center-based), the number of unduplicated providers receiving technical
FY2019 Core Service s Scope of Work Page 4
101518a HCBOC Page 166
Attachment B
Co ntract # 32892040 13
Count y of Harnett
Core Serv ices
assistance within those settings, and the type of technical assistance provided (e.g .,
Health & Safety, Infant/toddler, etc.).
c. The number of unduplicated training participants by job title (e .g., Director, Lead
Teacher, Program Coordinator).
d . The number of children served by training participants working in direct service
programs by child age group (Birth-three, three-five, five and older).
e. The number of children referred through consumer education services. *
f. Other data as requested by the NC CCR&R Council/Division.
13. Ensure Child Care and Development Fund required consumer education materials are
available in each Child Care Resource & Referral region and all county Division of Social
Services offices, per North Carolina's statewide consumer education plan as specified
by the Division and the CCDF Coordinator. Contact should be made quarterly (via mail,
phone, email or in-person) with all DSS agencies in the region to ensure that sufficient
quantity is available.*
14. Provide additional support and resources to the child care workforce as needed and as
directed by the NC CCR&R Council/Division.
15. Collect and analyze data from learning event reviews to assess training needs, training
quality, and training effectiveness, including pre/post survey results .
16. Conduct periodic data analysis to identify supply and demand issues, examine service
comprehensiveness and examine service quality. NACCRRAware will be used to deliver
consumer education services.*
17 . Conduct public awareness in Harnett County around the supply and demand of child
care for children from birth to 12 years, the availability of services, and/or the impact
of child care on the community as a whole.
Reporting
On a quarterly basis (10/15/18, 12/15/18, 4/15/19 and 7/15/19) the contractor will submit to
its Regional Lead Agency the Process Measures Report and Outcome Measures Report on
Consumer Education*, Technical Assistance and Professional Development services indicating
the progress made in each county and across the region on the outputs/process measures and
overall goals.
If Contractor did not meet FY18 consumer education performance targets, Contractor will
submit first and third quarter reports (by October 31, 2018 and April 30, 2019) for consumer
education*. If Contractor failed to meet performance targets in FY18 for professional
development or technical assistance, Contractor will submit data reports on these service areas
after the first and third quarters as well. Additionally, Contractor will provide other data to
their Regional Lead Agency as requested for the counties served.
FY2019 Core Services Scope of Work Page 5
101518a HCBOC Page 167
Attachment B
Contrac t # 3289204013
County of Hamett
Core Services
Contractor agrees to: (1) verify that NACCRRAware is being used, and used correctly, to collect
and report consumer education output and outcomes data;* (2) verify that all other data is
being collected according to approved standards; (3) review the accuracy of data prior to
submitting it to their Lead Agency; (4) analyze data and use it to provide feedback within its
counties served and to monitor progress toward goals; (5) request and secure technical
assistance from its Regional Lead CCR&R Agency as needed and identified by Contractor's data
analysis of its progress toward contracted goal and outcomes.
*Only applies to Contractors who deliver Consumer Education services.
FY2019 Core Services Scope of Work Page 6
101518a HCBOC Page 168
Contractor Budget Worksheet. SFY 18-19
Column A
Category
Contract Number: 3289204013
Contractor: Harnett County
Pro ram Name : Core
Column B
Line Item
Staff
$
ColumnC
Amount
19,819.34
1,788.00
nmmm
erFTE sheet
er FTE sheet
Column D
Narrative
-·----------
2 . E ui ment
a. Communication
b . Office
c. IT
d . Assistive T echnoto
e. Other
3. Travel
a. Contractor Staff
b . Board Member E nse
4. Utilitie s
a. Gas/Electric/Water
b . Tele one
c.Other
5 . Re air and Maintenance
6. Staff Develo ment
7. Media/Communications
a . Advertisin
._ ___ _,b. Audiovisual
6. Rent
Presentations.Mu/timedia,etc.
c . Lo cs
d Promotional Items
e . Publications
f. Public Service Announcement and ·
Ads TV, Radio Presentations
. Re rints
i.'Websites and Web Materials
·. Other
a .Office S ace
b . E ui ent
c. Furniture
d . Vehicles
e .Other
9. Professional Services
a . Le al
b . IT
c. Accountin
d . Pa rot/
e. Securit
C1 . Contracts and Grants sub ect to Ovemead
C2. Contracts & Grants not &ub ect to o ve mead
D. Indirect Cost
E. Total Bud eted Ex end/lures
3,548.30
s 2,575.00
500.00
$ 500.00
7 123.30
$ 2 873.06
3 1,603.70
Page 1 of 2
101518a HCBOC Page 169
Contract FTE Worksheet Pro;ect Hie: CORE Aoencv Name: Hamett Ccuntv Proaosed Con1ract Period 7/1/2018-6130/2019 Percent of Annua1nmge llmo-Wor1u:d Worker's Unemploym Other Total Annual Annual Salary Ben<1fllsx % Total Salary Personnel Position (Title) and Employee Puc: .. ntofTI,.. Compensa ent H<!alth Fringe Fringe X % of Time of Time and fringe for TolAII Annual onlh1s Wotktdonlhi1 Name FTE (s) Salary$ Activity Ac:tlvil~ Retirement L~e FICA tion Oental Insurance Vision Insurance Benefits Benefrt.s Worked Worked FTE Proeram 5pec,a1,st !Vacant, Working 10.S Monltis, 20 Hours per week) 0.50 $16,017.34 100.00% $1,203.00 $236.00 S1,439.00 $16,017.34 $1,439.00 $17,456.34 Proeram SpecialiSI (Karrie McDonald, Working S Months. 10 Houn pet Wf':rk) 0.25 $3,802.00 100.00% S291.00 $58.00 S349.00 $3,802.00 $349.00 $4,151.00 0.00% $0.00 so.co S0.00 SO.CO 0.00% $0.00 $0.00 $0.00 $0.00 0.00% SO.OD $0.00 S0.00 SO.DO 0.00% SO.DO SO.DO SO.OD SO.DO 0.00% SO.DO $0.00 $0.00 $0.00 0.00% $0.00 $0.00 $0.00 $0.00 0.00% so.co $0.00 $0.00 $0.00 0.00% so.co so.co SO.OD $0.00 0.00% so.co SO.OD SO.OD $0.00 0.00% so.co $0.00 $0.00 SO.OD 0.00% $0.00 $0.00 $0.00 $0.00 0.00% $0.00 $0.00 $0.00 $0.00 0.00% $0.00 $0.00 so.co SO.OD 0.00% SO.DO $0.00 $0.00 SO.OD 0.00% $0.00 S0.00 $0.00 so.co 0.00% $0.00 SO.OD $0.00 SO.OD 0.00% $0.00 SO.OD so.co $0.00 0.00% SO.DO $0.00 so.co $0.00 0.00% SO.OD $0.00 so.co so.co 0.00% $0.00 $0.00 SO.DO $0.00 0.00% $0.00 $0,00 $0.00 SO.DO 0.00% $0.00 $0.00 SO.DO $0.00 0.00% $0.00 $0.00 SO.OD $0.00 0.00% $0.00 $0.00 $0.00 $0.00 0.00% $0.00 $0.00 SO.OD $0.00 0.00% $0.00 $0.00 $0.00 $0.00 0.00% SD.DO $0.00 $0.00 $0.00 0.00% $0.00 $0.00 SD.OD $0.00 TOTALS 0.75 19,819 $0,00 $0.00 $1,494.00 $294.00 SO.OD SD.OD $0.00 $0.00 $0.00 $1,788.00 $19,819.34 $1,788.00 $21,607.34 101518a HCBOC Page 170
September 5, 2018
To: State Agency Head and Chief Fiscal Officer
Certification:
Cooperative Extension
126 Alexander Drive , Suite 300
Lilling ton , NC 27546
Phone : 910-89 3-7 530
Fax : 9 10-893-7539
www.harnett .org
We certify that the County of Harnett does not have any overdue tax debts , as defined by N .C.G .S. I 05-243 .1, at the
federal , State, or local level. We further understand that any perso n who makes a false statement in violation of
N.C.G.S. I43C-6-23(c) is guilty of a criminal offense punishable as provided by N.C.G.S.) 143C-I 0-1 b.
Sworn Statement:
Gordon Springle, Board Chair and Paula Stewart, County Manager, being duly sworn, say that .;.,~a~;
Chair and County Manager, respectively, of County of Hamett of Lillington in the State ofNorth:Qac
the foregoing certification is true, accurate and complete to the best of our kno w led ge and was • ·
by us. We also acknowledge and understand that any mi suse of State fund s will be reported to th~ a
authorities for further action.
Board Chair
Q ... ..J.."' L9o tL ... r
County Manager 10 ... J ·-1&
Sworn to and subscribed before me on the day of the date of said certification.
(Notary Signature and Seal)
My Commission Expires: <cJo~Q If'~ ;.e
If there are any questions, please co nt act the state agency that provided yo ur grant. If needed, you may contact the North
Carolina Office of State Budget and Management:
NCGrants@osbm .nc.gov-(9 I 9)807-4 795
1 G .S. 105-243.1 defines : Overdue tax debt. -Any part of a tax debt that remains unpaid 90 days or more after the
notice of final assessment was mailed to the taxpayer. The term does not include a tax debt, however, if the taxpayer
entered into an installment agreement for the tax debt under G.S. 105-237 within 90 days after the notice of final
assessment was mailed and has not failed to make any payments due under the installment agreement."
Hamett County Government commit themselves to pos itive action to secure equal opportunity regardless of race, color, creed, national origin, rel igio n,
sex , age, or disability. In addition, the two Uni versities welcome all persons without reg ard to sexual orientation .
]
101518a HCBOC Page 171
FEDERAL CERTIFICATIONS
The undersigned states that:
1. He or she is the duly authorized representative of the Contractor named below ;
2. He or she is authorized to make , and does hereby make , the following certifications on behalf of the Contractor, as set
out herein :
a. The Certification Regarding Nondiscrimination;
b. The Certification Regarding Drug-Free Workplace Requirements ;
c. The Certification Regarding Environmental Tobacco Smoke ;
d. The Certification Regarding Debarment, Suspension , Inelig ibility and Voluntary Exclusion Lower Tier Co vered
Transactions ; and
e. The Certification Regarding Lobbying ;
3. He or she has completed the Certification Regarding Drug-Free Workplace Requirements by providing the addresses
at which the contract work will be performed;
4 . [Check the applicable statement]
[ ] He or she has completed the attached Disclosure Of Lobbying Activities because the Contractor has made,
or has an agreement to make , a payment to a lobbying entity for influencing or attempting to influence an officer
or employee of an agency , a Member of Congress, an officer or employee of Congress , or an employee of a
Member of Congress in connection with a covered Federal action;
OR
J He or she has not completed the attached Disclosure Of Lobbying Activities because the Contractor has not
made , and has no agreement to make , any payment to any lobbying entity for influencing or attempting to
influence any officer or employee of any agency, any Member of Congress , any officer or employee of Congress ,
or any employee of a Member of Congress in connect ion with a covered Federal action .
5. The Contractor shall requi re its subcontractors , if any, to make the same certifications and disclosure.
Date
[This Certification Must be Signed by the Same Individual Who Signed the Proposal Execution Page]
I. Certification Regarding Nondiscrimination
The Contractor certifies that it will comply with all Federal statutes relating to nondiscrimination . These include but are
not limited to: (a) Tit le VI of the Civil Rights Act of 1964 (P .L. 88-352) which prohibits discrimination on the basis of race ,
color or national origin ; (b) Title IX of the Education Amendments of 1972, as amended (20 U.S.C . §§1681 -1683, and
1685-1686), which prohibits discrimination on the basis of sex ; (c) Section 504 of the Rehabilitation Act of 1973, as
amended (29 U.S.C . §794), which prohibits discrimination on the basis of handicaps ; (d) the Age Discrimination Act of
1975 , as amended (42 U.S.C. §§6101 -6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office
and Treatment Act of 1972 (P .L. 92-255), as amended, re lating to nondiscrimination on the basis of drug abuse ; (f) the
Comprehensive Alcohol Abuse and Alcoholism Prevention , Treatment and Rehabilitation Act of 1970 (P.L. 91-616 ), as
amended , relating to nondiscrimination on the basis of alcohol abuse or alcoholism ; (g ) Title VIII of the Civil Rights Act of
1968 (42 U.S.C. §§3601 et seq .), as amended , relating to nondiscrim ination in the sale , rental or financing of housing ; (h)
the Food Stamp Act and USDA policy , which prohibit d isc rimination on the basis of religion and political beliefs ; and (i)
the requirements of any other nondiscrimination statutes which may apply to this Agreement.
101518a HCBOC Page 172
II. Certification Regarding Drug-Free Workplace Requirements
1. The Contractor certifies that it will provide a drug-free workplace by:
a. Publishing a statement notifying employees that the unlawful manufacture , distribution , dispensing, possession or
use of a controlled substance is prohibited in the Contractor's workplace and specifying the actions that w ill be
taken against employees for violation of such prohibition ;
b. Establishing a drug-free awareness program to inform employees about:
i. The dangers of drug abuse in the workplace ;
ii. The Contractor's policy of maintain ing a drug-free workplace;
iii. Any available drug counseling , rehabilitation, and employee assistance programs; and
iv . The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace ;
c . Making it a requirement that each employee be engaged in the performance of the agreement be given a copy of
the statement required by paragraph (a);
d. Notifying the employee in the statement required by paragraph (a) that , as a condition of employment under the
agreement, the employee will:
i. Abide by the terms of the statement; and
ii. Notify the employer of any criminal drug statute conviction for a violation occurring in the workplace no later
than five days after such conviction;
e. Notifying the Department within ten days after receiving notice under subparagraph (d)(ii) from an employee or
otherwise receiving actual notice of such convict ion;
f. Taking one of the following actions, within 30 days of receiving notice under subparagraph (d)(ii), with respect to
any employee who is so convicted:
i. Taking appropriate personnel action against such an employee, up to and including
termination; or
ii. Requiring 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 ; and
g. Making a good faith effort to continue to maintain a drug-free workplace through implementation of paragraphs
(a), (b), (c), (d), (e), and (f).
2 . The sites for the performance of work done in connection with the specific agreement are listed below (list all sites ;
add additional pages if necessary):
Address
City,State ,ZipCode l-dli'}8<ft>n) NC ot1'54--lp
Street
City, State , Zip Code
101518a HCBOC Page 173
3. Contractor will inform the Department of any additional sites for performance of work under this agreement.
4. False certification or violation of the certification may be grounds for suspension of payment, suspension or
termination of grants , or government-wide Federal suspension or debarment. 45 C .F .R. 82 .510 .
Ill. Certification Regarding Environmental Tobacco Smoke
Public Law 103-227, Part C-Environmental Tobacco Smoke, also known as the Pro-Chi ldren Act of 1994 (Act), requires
that smoking not be permitted in any portion of any indoor facility owned or leased or contracted for by an entity and used
routinely or regularly for the provision of health, day care, education, or library services to children under the age of 18 , if
the services are funded by Federal programs either directly or through State or local governments, by Federal grant,
contract, loan, or loan guarantee. The law does not apply to children's services provided in private residences, facilities
funded solely by Medicare or Medicaid funds, and portions of facilities used for inpatient drug or alcohol treatment. Failure
to comply with the provisions of the law may result in the imposition of a civil monetary penalty of up to $1 ,000.00 per day
and/or the imposition of an administrative compliance order on the responsible entity .
The Contractor certifies that it will comply with the requirements of the Act. The Contractor further agrees that it will
require the language of this certification be included in any subawards that contain provisions for children's services and
that all subgrantees shall certify accordingly.
IV. Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion Lower Tier
Covered Transactions
Instructions
[The phrase "prospective lower tier participant" means the Contractor.]
I . By signing and submitting this document, the prospective lower tier participant is providing the certificat ion set out
below.
2. The certification in this clause is a material representation of the fact upon which reliance was placed when this
transaction was entered into. If it is later determined that the prospective lower tier participant knowingly rendered an
erroneous certification , in addition to other remedies available to the Federal Government, the department or agency
with which this transaction originate may pursue availab le remedies, including suspension and/or debarment.
3. The prospective lower tier participant will provide immediate written notice to the person to whom this proposal is
submitted if at any time the prospective lower tier participant learns that its certification was erroneous when submitted
or has become erroneous by reason of changed circumstances .
4. The terms "covered transaction," "debarred ," "suspended," "ineligible," "lower tier cove red transaction ," "participant,"
"person ," "primary covered transaction ," "principal ," "proposa l," and "vol un tarily excluded ," as used in this clause , have
the meanings set out in the Definitions and Coverage sections of rules impl ementing Executive Order 12549, 45 CFR
Part 76. You may contact the person to whom this proposal is submitted for assistance in obtaining a copy of those
regulations.
5. The prospective lower tier participant agrees by submitting this proposal that, should the proposed covered
transaction be entered into, it shall not knowingly enter any lower tier covered transaction with a person who is
debarred , suspended, determined ineligible or voluntarily excluded from participation in this covered transaction
unless authorized by the department or agency with which this transaction originated.
6. The prospective lower tier participant further agrees by submitting this document that it will include the clause titled
"Certification Regarding Debarment, Suspension , Ineligibility and Voluntary Exclusion--Lower Tier Covered
Transaction ," without modification, in all lower tier covered transactions and in all solicitations for lower tier covered
transactions.
7. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered
transaction that it is not debarred, suspended, ineligible , or voluntarily excluded from covered transaction , unless it
knows that the certification is erroneous. A participant may decide the method and frequency by which it determines
the e ligib ility o f it s prin cipals . Each participant may, but is not required to , check th e Non procurement List.
101518a HCBOC Page 174
8. Nothing contained in the foregoing shall be construed to requ ire establishment of a system of records in order to
render in good faith the certification required by th is clause . The knowledge and information of a participant is not
required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings.
9. Except for transactions authorized in paragraph 5 of these instructions , if a participant in a covered transaction
knowingly enters into a lower tier covered transaction with a person who is suspended , debarred , ineligible, or
voluntarily excluded from participation in this transaction , in addition to other remedies available to the Federal
Government, the department or agency with which this transaction originated may pursue available remedies ,
including suspension, and/or debarment.
Certification
1. The prospective lower tier participant certifies, by submission of this document, that neither it nor its principals is
presently debarred, suspended , proposed for debarment, declared ineligible , or voluntarily excluded from participation
in this transaction by any Federal department or agency.
2. Where the prospective lower tier participant is unable to certify to any of the statements in this certification, such
prospective participant shall attach an explanation to this proposal.
V. Certification Regarding Lobbying
The Contractor certifies, to the best of his or her knowledge and belief, that:
I. No Federal appropriated funds have been paid or will be paid by or on behalf of the undersigned , to any person for
influencing or attempting to influence an officer or employee of any agency, a Member of Congress , an officer or
employee of Congress , or an employee of a Member of Congress in connection with the awarding of any Federal
contract, continuation, renewal , amendment, or modification of any Federal contract, grant, loan, or cooperative
agreement.
2. If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or
attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of
Congress , or an employee of a Member of Congress in connection with this Federally funded contract, grant, loan , or
cooperative agreement, the undersigned shall complete and submit Standard Form SF-LLL , "Disclosure of Lobbying
Activities ," in accordance with its instructions.
3. The undersigned shall require that the language of this certification be included in the award document for subawards
at all tiers (including subcontracts , subgrants, and contracts under grants , loans, and cooperative agreements) who
receive federal funds of $100 ,000.00 or more and that all subrecipients shall certify and disclose accordingly.
4. This certification is a material representation of fact upon which reliance was placed when this transaction was made
or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by
Section 1352, Title 31 , U .S . Code. Any person who fails to file the required certification shall be subject to a civil
penalty of not less than $10 ,000 .00 and not more than $100 ,000.00 for each such failure.
VI. Disclosure Of Lobbying Activities
Instructions
This disclosure form shall be completed by the reporting entity, whether subawardee or prime Federal recipient , at the
initiation or receipt of a covered Federal action , or a material change to a previous filing , pursuant to title 31 U.S .C. section
1352 . The filing of a form is required for each payment or agreement to make payment to any lobbying entity for
influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or
employee of Congress , or an employee of a Member of Congress in connection with a covered Federal action. Use the
SF-LLL-A Continuation Sheet for additional information if the space on the form is inadequate. Complete all items that
apply for both the initial filing and material change report. Refer to the implementing guidance published by the Office of
Management and Budget for additional information.
101518a HCBOC Page 175
I. Identify the type of covered Federal action for which lobbying activity is and/or has been secured to influence the
outcome of a covered Federal action .
2. Identify the status of the covered Federal action .
3. Identify the appropriate classification of this report. If th is is a follow-up report caused by a material change to the
information previously reported, enter the year and quarter in which the change occurred. Enter the date of the last
previously submitted report by this reporting entity for this covered Federal action.
4. Enter the full name, address, city , state and zip code of the reporting entity . Include Congressional District, if known .
Check the appropriate classification of the reporting entity that designates if it is, or expects to be, a prime or sub-
award recipient. Identify the tier of the subawardee, e .g., the first subawardee of the prime is the 1st tier . Subawards
include but are not limited to subcontracts, subgrants and contract awards under grants .
5. If the organization filing the report in Item 4 checks "Subawardee", then enter the full name , address , city , state and
zip code of the prime Federal recipient. Include Congressional District , if known .
6. Enter the name of the Federal agency making the award or loan commitment. Include at least one organizational
level below agency name , if known . For example, Department of Transportation, United States Coast Guard.
7. Enter the Federal program name or description for the covered Federal action (Item 1). If known, enter the full
Catalog of Federal Domestic Assistance (CFDA) number for grants, cooperative agreements, loans , and Joan
commitments.
8. Enter the most appropriate Federal Identifying number avai lable for the Federal action identified in Item 1 (e.g .,
Request for Proposal (RFP) number, Invitation for Bid (IFB) number, grant announcement number, the contract grant ,
or loan award number, the application/proposal control number assigned by the Federal agency). Include p refixes ,
e.g., "RFP-DE-90-001 ."
9. For a covered Federal action where there has been an award or loan commitment by the Federal agency, enter the
Federal amount of the award/loan commitment for the prime entity identified in Item 4 or 5.
l 0. (a) Enter the full name, address , city, state and zip code of the lobbying entity engaged by the reporting entity
identified in Item 4 to influence the covered Federal action.
(b) Enter the full names of the individual(s) performing services , and include full address if different from 1 O(a). Enter Last
Name, First Name and Middle Initial (Ml).
11. Enter the amount of compensation paid or reasonably expected to be paid by the reporting entity (Item 4) to the
lobbying entity (Item 10). Indicate whether the payment has been made (actual) or will be made (planned). Check all
boxes that apply . If this is a material change report , enter the cumulative amount of payment made or planned to be
made .
12. Check the appropriate boxes. Check all boxes that apply . If payment is made through an in-kind contribution, specify
the nature and value of the in -kind payment.
13 . Check the appropriate boxes. Check all boxes that apply. If other , specify nature.
14 . Provide a specific and detailed description of the services that the lobbyist has performed, or will be expected to
perform , and the date(s) of any services rendered . Include all preparatory and related activity, not just time spent in
actual contact with Federal officia ls. Identify the Federal official(s) or employee(s) contacted or the officer(s),
employee(s), or Member(s) of Congress that were contacted .
15 . Check whether or not a SF-LLL-A Continuation Sheet(s) is attached .
16. The certifying official shall sign and date the form, print his/her name, title, and telephone number.
101518a HCBOC Page 176
Public reporting burden for this collection of informatio n is estimated to average 30 minutes per response , including
time for reviewing instructions , searching existing data sources, gathering and maintaining the data needed , and
complet ing and revie wing the collection of information . Send comments regarding the burden estimate or any other
aspect of th is collection of information , including suggestions for reducing this burden , to the Office of Management and
Budqet, Paperwork Reduction Project (0348-0046), Washinqton , D. C. 20503
101518a HCBOC Page 177
1 .
D
D
D
D
D
D
4 .
D
D
Disclosure Of Lobbying Activities
(Approved by 0MB 0344-0046)
Complete this form to disclose lobbying activities pursuant to 31 U.S.C. 1352
Type of Federal Action: 2. Status of Federal Action: 3. Report Type:
a. contract D a. Bid/offer/application D a. initial filing
b. grant D b. Initial Award D b. material change
C. cooperat ive agreement D C . Post-Award
d . loan For Material Change Only:
e. loan guarantee
f . loan insurance Year Quarter
Date Of Last Report:
Name and Address of Reporting Entity: 5. If Reporting Entity in No. 4 is Subawardee, Enter Name
and Address of Prime:
Prime
Subawardee Tier (if known)
Congressional District (if known) Congressional District (if known)
6 . Federal DepartmenUAgency: 7. Federal Program Name/Description:
CFDA Number (if applicable)
8 . Federal Action Number (if known) 9 . Award Amount (if known) $
10 . a . Name and Address of lobbying Entity b. Individuals Performing Services (including address if
(if individual, last name, first name, Ml): different from No. 10a.) (last name, first name, Ml):
(attach Continuation Sheet(s) SF-LLL-A. if necessary) (attach Continuation Sheet(s) SF-LLL-A, if necessary)
11. Amount of Payment (check all that apply): 13. Type of Payment (check all that apply):
$ actual planned D a . retainer
D b. one-time fee
12. Form of Payment (check all that apply): D C. commission
D d . contingent fee
D a. cash D e . deferred
D b. In-kind; specify: Nature D f. other; specify :
Value
14. Brief Description of Services Performed or to be Performed and Date(s) of Services, including officer(s), employee(s), or
Member(s) contacted, for Payment Indicated in Item 11 (a ttach Continuation Sheet(s) SF-LLL -A. if necessary):
15. Conti nuation Sheet(s) SF-lll-A attached: D Yes D No
16. Information requested through this form is authorized by Signature:
title 31 U . S. C. section 1352 . This disclosure of lobbying
activities is a material representation of fact upon which Print Name :
reliance was placed by the tier above when this transacti on
was made or entered into. This disclosure is requ ired Title :
pursuant to 31 U. S. C. 1352. This information will be
reported to the Congress semi-annually and will be Telephone No: Date:
available for public inspection . Any person who fails to file
the required disclosure shall be subject to a civil penalty of
not less than $10 ,000 and not more than $100,000 for each
such failure.
Federal Use Only Authorized for local Reproduction
Standard Form -LLL
101518a HCBOC Page 178
IRS Tax Exemption Verification Form (Annual)
We, the undersigned entity, hereby testify that the 501 (c) (3) status is on file with the North
Carolina Department of Health and Human Services and is still in effect.
Name of Agency Ctuo:bf o+ ±fttvoe-44-
Chairman, Executive Director, or other Authorized Official
Sworn to and subscribed before me, this ___ day of _____ , __ .
Notary Public
My Commission expires : _______ _
NCDHHS NP1021 IR S Ve r ification (Rev. 4/11)
101518a HCBOC Page 179
Conflict of Interest Verification (Annual)
We, the undersigned entity, hereby testify that our Organization 's Conflict of Interest
Acknowledgement and Policy adopted by the Board of Directors/Trustees or other governing
body , is on file with the North Carol ina Department of Health and Human Services (DHHS ). If any
changes are made to the Conflict of Interest Policy, we will submit a new Conflict of Interest
Acknowledgment and Policy to the Department (DHHS ).
NCDHHS COIV101 5 Co nfl ict of Interest Ver ification (9 .19 .13 )
101518a HCBOC Page 180
State Certifications
Contractor Certifications Required by North Carolina Law
Instructions: The person who signs this document s hould read the text of the statutes and Executive Order listed below and consult
with counsel and other knowledgeable persons before signing. The text of each No11h Carolina General Statutes and of the Executive
Order can be found on line at:
• Article 2 of Chapter 64 : http ://www.ncga.state.nc.us/EnactcdLegislation/Statutes/PDf /BvA1ticlc/Chapter 64/Article 2.pdf
• G . S. 133-32: http://www.ncga.statc.nc.us/gascripts/statutcs/statutelookup.pl ?statute= 133 -32
• Executive Order No. 24 (Perdue, Gov., Oct. I , 2009): http://www.ethicscommission.nc.go v/library/pdfs/Laws/J-:024.pdf
• G .S . I 05-164.S(b ): http ://www.ncga.state.nc .u s/EnactedLegisla ti on /Statutes/PDF/BySection/Chaptcr I 05/GS I 05 -164.8.pdf
• G.S. 143-48.5: http ://www.ncga.state.nc.us/EnactedLegislation /Statutes/HTML/BySection/Chapter 14 3/GS 143-48.5.html
• G .S. 143-59.1: http ://www.ncga.state.nc.u s/EnactedLcgislati on /Statutes/PDF/BySection/Chaptcr 143 /GS 143-59. I .pdf
• G .S. 14 3 -59.2: http ://www.ncga.state.nc. us/EnactedLegi s lation /Statut es/l'DF/BySection/Chapter 14 3/GS 14 3-59.2.pdf
• G .S. 143-133 .3: http ://www.ncga.state.nc.us/Enacted Legi slation/Statutes/l lTML/BySection/C hapter 143/GS 143 -133 .3 .html
• G .S. 143B-l 39.6C: http://www.ncga.state.nc.us/E nacted Legislati on/Statutes/PDF/BySection/Chapter 14313/GS I 43B-I 39.6C.pdf
(I )
Certifications
Pursuant to G.S. 133-32 and Executive Order No. 24
(Perdue, Gov., Oct. 1, 2009), the undersigned hereby
certifies that the Contractor named below is in
comp liance with , and has not vio lated, the provisions of
country" as set forth in G.S. 143-59.l(c)(2)
after December 31, 2001 but the United States
is not the principal market for the public trading
of the stock of the corporation incorporated in
the tax haven country. either said statute or Executive Order.
(2) Pursuant to G.S. 143-48.5 and G.S. 143-133.3, the
undersigned hereby certifies that the Contractor named
below, and the Contractor's subcontractors, complies
with the requirements of Article 2 of Chapter 64 of the
NC General Statutes, including the requirement for
each employer with more than 25 employees in North
Carolina to verify the work authorization of its
employees through the federal £-Verify system." E-
Verify System Link: www.uscis.gov
(3) Pursuant to G.S. 143-59.l(b), the unders igned hereby
certifies that the Contractor named below is not an
"ineligible Contractor" as set forth in G.S. 143-59.1 (a)
because:
(a) Neither the Contractor nor any of its affiliates has
refused to co ll ect the use tax levied under Article 5
(4) Pursuant to G.S. 143-59.2(b), the undersigned hereby
certifies that none of the Contractor's officers,
directors, or owners (if the Contractor is an
unincorporated business entity) has been convicted of
any violation of Chapter 78A of the General Statutes or
the Securities Act of 1933 or the Securities Exchange
Act of 1934 within 10 years immediately prior to the
date of the bid so li citation.
(5) Pursuant to G.S. 143B-139.6C , the undersigned
hereby c e rtifies that the Contractor will not use a
former employee, as defined by G.S. l43B-
l39.6C(d)(2), of the North Carolina Department of
Health and Human Services in t h e administration of a
contract with the Department in violation of G .S.
l 43B-l 39.6C and that a violation of that statute shall
of Chapter I 05 of the General Statutes on its sales void the Agreement.
delivered to North Carolina when the sales met (6 ) The undersigned hereby certifies further that: one or more of the conditions of G.S. 105 -
164.S(b); and (a) He or s he is a dul y authorized representative of t he
(b) [check one of the fo ll owing boxes] Contractor named below;
(b) He or she is authorized to make, and does hereby
make, the foregoing certifications on behalf of the
Contractor; and
D Neither the Contractor nor any of its affiliates
has incorporated or reincorporated in a "tax
h aven country" as set forth in G .S. l 43-
59. l ( c)(2) after December 31, 2001 ; or
D The Contractor or one of its affiliates has
incorporated or reincorporated in a "tax haven
Contractor 's Name:
Contractor's
Authorized Agent: Signature PG, . J 0.-f:.He.. J G.Y
( c) He or she understands that any person who
knowingly submits a fa lse certification in response
to the requirements of G.S. 143-59. land -59.2
s hall be gui lty of a C lass I fe lony.
Date /Or 3 -t 8
__.._=-=-;"F-__.:_.c..:...1<-L-=>.~...,,._,.___-A-~-Title C..00,d:3 Mc. ,,.0.), r
Signature j....:4...D,~l..Wt.4+--l-'-~~""'---"'-V--P~"-=-4.£-----Date lO -~ .. J.S.
~~~'H-L-'-=---\A..<-1-1~-'--Title ~ I e~ k :he {A e Boa ;J
Witness:
nt signs this certification and should si gn and date thi s doc ument immediate ly th ereafter.
Co ntracto r Ce rtifi cati ons Requi red by North Ca rolina Law (Rev. 8/2 016) Page I of I
101518a HCBOC Page 181
Data Sharing Agreement
Attachment J -Data Sharing
Contract #3289204013
COUNTY OF HARNETI
This Agreement expresses the mutual intent of County of Harnett as the Local CCR&R Agency (hereinafter known as the
Con tractor) and Chatham County Partnership for Children to share data for all the counties in Region 13 upon request
according to the following terms and purposes.
Data Use and Restrictions
CCR&R data provided from the Contractor to Chatham County Partnership for Children will only be used for:
(1) providing monitoring for quality control of data ;
(2) reporting aggregated data regarding the status of child care supply, demand, gaps, needs and resources;
(3) reporting to the NC Division of Child Development on deliverables;
(4) assessing the effectiveness of the CCR&R delivery system;
(5) sharing with any CCR&R Council Management Agency to do any of the above things on a statewide level.
CCR&R data provided from the Contractor to Chatham County Partners hip for Children will NOT be used to:
( l) report individualized data about any person or organization receiving or providing services;
(2) solicit from or mail to any person or organization identified in the data;
(3) give away any information provided in the data for purposes other than those outlined above;
( 4) sell any information provided in the data; and
(5) populate a database for any commercial and/or income generating purpose and/or to be used to provide direct
services.
Confidentiality
All parties agree to comply strictly with any and all applicable laws and regulati ons concerning the confidentiality of
s hared data.
Ownership of the Data
Not w ith standing this Agreement, any and all data and intellectual prope1ty authored or invented by the Contractor or its
Employees s hall be owned by the Contractor. Any and all data and intellectual property authored and invented by an
R&R Subcontractor agency and shared with the Contractor shall be owned by the originating R&R s ubcontractor agency.
Security & Storage
Data will be delivered using a secure method. Any computer, file server, or other electronic processing devi se to which
the information is transferred must be phys ically secure from unauthorized usage and must be e lectronically secure from
unauthorized access or intrusion. Data will be stored in electronic form by Chatham County Partnership for Children in a
password-protected location . The files will be kept in a lo cation that is not available to the public or other professional s
outside of Chatham County Partners hip for Children.
fL.i~ I< Sl--c... )c.,K e Qy_.,j,\/ Ma. '1 '\)e o'l
Signature Title I
LGunb{ of t+@t:r~ /o-~-ti
Agency/Organization Date '
(Certification signature should be same as Contract signature.)
101518a HCBOC Page 182
~~:--, Harnett
COUNTY
Cooperative Extension
126 Alexander Drive. Suite 300
Lillington . NC 27546
Phone. 910-893-7530
Fax: 910-893-7 539
www.harnett.org
Letter from Board President/Chairperson Identifying
Individuals as Authorized to Sign Contracts
I, ~O I' j ~ J ~ hi , Board President/Chairperson of H"~~L+ to =:y = ~ J ~o WIIM ; SS ; 0 V} e i"( [Agon ,y/0,g'";,.,; •• ·, legal nam,J hereb y
identify the following indiv idual(s) who is (are) authorized to sign Contracts for the organization
named above:
Printed Name T itle
2. Bd ( sfvn~ :C"ni-etiM Cou~ Ex+.ensiOt\ D,Yed-cY-
Coury ti l'O.r{,t Qff; 'c e..-3 K , moo gj ttt! oey (l,v.,--tt-
4 . ---------------
Signature
* hidicate if y ou are th e Board President or Chairpers on
101518a HCBOC Page 183
Harnett
_.._._.,.....COUNTY
......_ __ i...,;;~ NORTH CAROLINA
Letter from Board President/Chairperson
Identifying Individuals as Authorized to Sign
Financial Status Reports
Cooperative Extension
126 Alexander Drive, Suite 300
Lillington, NC 27546
Phone: 910-893-7530
Fax: 910-893-7539
www.harnettorg
I, & or-J O '3 5 P" L ~ / e , Board President/Chairperson of
HH_,..a.lf-lA ............ e _.__'t........_'t____,,,C.....,.o'-"u.e>o<...:.....!V''i'--'-"'#-y---+-/J->-'(l....,.~~if'-'l,J~ol+-W:;---,C.,..,,.o ....... tt1~v1.1'1-f./-tos-sL..L..~ ~~ization, s legal name] here b y identify
the following individual(s) who is (are) authorized to sign Financial Status Reports for the
organization/agency named above:
Printed Name Title Signature
1. .Pa u.ltl slewa<-1-lfttrtl:'.) M.a.nOj ev R.......t.. ~~u-1-"
2. /Di. II &ne.. ~!il Co. !;'ft, J)11edw-~
1 J<imhcl ~ ~ c.uir Coun~ Fl 'rwxt offi'l_«__y~-=----=-""-=l-,-L----"-
4.
Signature * Title
101518a HCBOC Page 184
Agency Name:
Project Name:
Project Name:
Project Name:
FSR Electronic Submission Form
Ll>tAn{i of ftttmi{l--Coope< ~v~ f;~.en~icn
Chil~ (Afe ~.t,St)~ce_s, Ure Contract #: 32 <8920'-fOl.3
&n1fce.7
Contract #: -------
Contract #: -------
We, the undersigned, agree to the conditions stated below to be able to submit the
Financial Status Report (FSR) electronically.
1. This letter will be signed by the Contract Administrator, which states that the email
form of FSR submission is acceptable . The signature will be held on file.
2. The email will be sent from the Contract Administrator. This shows that the FSR has
been approved by the Contract Administrator and that the Grantee takes ownership of
the electronic FSR.
3. The Grantee agrees to accept responsibili ty to get the email to the Gran tor Agency by
the due date (the 101h of each month). If email is not working, then a signed hard
copy will need it to be delivered by the due date.
4. Any corrections to the FSR will need to be made by the Grantee and res ubmitted
using the same methodology.
If applicable:
I, the Contract Administrator, hereby grant 6 hdfD1\ {/l/) l(/ OJy\~
ftd.rn,ni s+m.:H Vf__ ft--s&f, permission to email the FSRs to the Grantor.
(T itl e)
Contract Admmistrator
101518a HCBOC Page 185
CERTIFICATION OF ELIGIBILITY
Under the Iran Divestment Act
Pursuant to G.S. 147-86.59, any person identified as engaging in investment activities in Iran,
determined by appearing on the Final Divestment List created by the State Treasurer pursuant
to G.S. 147-86.58, is ineligible to contract with the State of North Carolina or any political
subdivision of the State. The Iran Divestment Act of 2015, G.S . 147-86.55 et seq.* requires that
each vendor, prior to contracting with the State certify, and the undersigned on behalf of the
Vendor does hereby certify, to the following:
1. that the vendor is not identified on the Final Divestment List of entities that the State
Treasurer has determined engages in investment activities in Iran;
2 . that the vendor shall not utilize on any contract with the State agency any subcontractor
that is identified on the Final Divestment List; and
3 . that the undersigned is authorized by the Vendor to make th is Certification .
Vendor:
By: Plv..rlc.AL>iC<J a Y
Signature
/,o, }--1,I
Dat e
Printed
The State Tr eas u rer 's Fi n al Dives tm ent Li st can b e fo und o n the Sta t e Tr ea surer's we b site at the address:
b..\:!.Qs ://www.nctreasurer.c om/inside-t h e-department/OpenGovernment/Pages/l ran -Div estm ent-Act-Resources.aspx
and wi ll b e updated ever y 180 da ys. Fo r qu es tio ns abo ut the Depa r tm en t of State Tr easurer's Iran Divestm e nt
Pol icy, p lease contact M ery l Murtagh at M eryl.Mur t agh @nctreasure r .com o r (9 19) 8 14-385 2.
* Note: En acted by Se ssion Law 20 15-118 as G.S. 143(-55 et seq., but h as been ren u mbere d for codification at the
di rection of th e Revise r of Statutes.
101518a HCBOC Page 186
Federal Funding Accountability and Transparency Act (FFATA) Data Reporting Requirement
NC DHHS, Division of Child Development and Early Education Sub -awardee Information
A. Exemptions from Reporting
1. Entities are exempted from the entire FFATA reporting requirement if any of the following are true :
• The entity has a gross income, from all sources, of less than $300,000 in the previous tax year
• The entity is an individual
• If the required reporting would disclose classified information
2. Entities who are not exempted entirely from FFATA reporting may be exempted from the requirement
to provide executive compensation data. This executive compensation data is required ONLY if both
below are true:
• More than 80% of the entity's gross revenues are from the federal government and those
revenues are more than $25 million in the preceding fiscal year
• Compensation information is not already available through reporting to the U.S. Securities and
Exchange Commission
By signing below, I state that the entity listed below is exempt from:
The entire FFATA reporting requirement:
_ as the entity's gross income is less than $300,000 in the previous tax year.
_ as the entity is an individual.
_ as the reporting would disclose classified information.
ONLY the executive compen sa tion data reporting:
Vas at least one of the bulleted items in item number 2 above is not true .
Signature: ~t---LS-k'-' 'y. e-¥ Na me: ....:.~ ........... L;......,\ 6~l=l'-'-'.&~~\ ...... U:><=..+k----Title : W 4rc., rt:: C.o~"':\:)
Entity : --""'l9:!<......:W''-=---'-L~---=-+--__..o:f'-+-· -M~V .:........:..(\{;-=-*',..___ _______ _
jV\ "''' 'J-J
Date : /,0 ,3::;~
B. Reporting
1. FFATA Data required by all entities which receive federal funding {e xc ept those exempted above) per
the reporting requirements of the Federal Funding Accountability and Transparency Act {FFATA).
Entity's (; . ,) "'J"> J) Jfa-1.
Legal Name: c_;~y 01_ ({4/rf'lr
_ Active SAM reg is tration record i s attach ed t2j /f5£[; q <j /
An active registration with SAM i s required Entity's DUNS Number
(go to www.sam.gov for m ore info about SAM)
Page 1 of 2
Contract
Number 3)¥1 }()~0/3
Entity's Parent DUNS Nbr
(if applicable)
Feder al Fundi ng Accountability And Transpare ncy Act (FFATA)
Data Repo rting Requirements -Sub-awardee Information
101518a HCBOC Page 187
Entity's Location
Street address : f ;J-f /1h.ac4C ,(}.,. \w;f" ,02) Street address: ________ _
~~~~~~Zip +4 '-1~1f >,*'I/ ~~~~~~Zip+4
2. Executive Compensation Data for the entity's five most highly compensated officers (unless
exempted above):
Title Name Total Compensation
1 .
2.
3.
4.
5 .
C. Performance Location Under Award if different from entity's location identified in Item B above:
D.
Address: Address:
City /St/Zip: City/St/Zip:
Congressional Congressional
District/County: District/County:
Address: Address :
City /St/Zip : City/St/Zip :
Cong re ssiona l Congressional
District/County: Di strict/County:
Addre ss : Address:
City/St/Zip: City/St/Zip:
Congressional Congressional
District/County: District/County:
Certification:
Please provide the name and title of the appropriate individual who is authorized to attest to the accuracy
of the information provided above :
Print Name: __ 1?..L.......C..i-=---\ \'--->_io~M.....-=--------Title : I A-f.or't/Y\ C( 0
Signature: ~~ Date: Cf/ 'I//~ t ,
Question and Submission -Please Contact: Sonya V . Beatty
Page 2 of 2
NC DCDEE Budget Officer
820 S. Boylan, Raleigh, North Carolina 27603
eMail : sonya.beatty@dhhs.nc.gov
Fede ral Funding Accountability And T r anspa rency Act (FFATA)
Data Reporti ng Requirements -Sub-awardee Information
101518a HCBOC Page 188
DIVISION OF CHILD DEVELOPMENT AND EARLY EDUCATION
GENERAL CONTRACTOR'S UPDATE
CONTRACT PERIOD(S): JULY 1, 2018-JUNE 30, 2019
Please complete this form in its entirety so that contact information inc luded in your contract and payment addresses
are correct. All contracts are contingent upon the availability of funds .
1. Agency's Legal Name County of Harnett
2. Federal Tax ID Number 56-6000-306
3. DUNS Number 091565986
4. Agency Type X Public Private NIP Private F/P
5. What is your Agency's currently approved 10% --
indirect cost rate and when does it expire? Approved Rate (%) Expiration Date
6 . Agency Executive Director/President Bill Stone
7. Agency Board Chairperson Pauline Calloway
8. Address -Street 126 Alexander Drive, Suite 300
9. Address -Post Office Box
10. Address -Town, 9-digit Zip (must include 9 Lillington, NC 27546
digits)
11. Area Code and Phone Number 910-893-7530
12. Fax Number (include area code) 910-893-7 539
13. Person authorized to complete monthly Fiscal Bill Stone, bill stone@ncsu .edu .
Report Form (FSR). Must include the person's
telephone number and eMail address. 910-893-7530
14. Person Authorized to Bind Contract and Title Bill Stone , Interim County Extension Director
15. Name and working title of the person completing Bill Stone, bill stone@ncsu.edu
this form. Must include telephone number and
eMail address. 910-893-7530
I hereby certify that the information provided above is correct.
Agency EljjeP.{JJ-Title
OCOE E Updated January 2016 101518a HCBOC Page 189
Memorandum of Understanding (MOU)
By and between
C hatham Co unty Partnership for Children &
County of Hamett
The purpose of this Memorandum of Understanding is to define the responsibilities of each agency regarding
the delivery of Consumer Education and Referral Services in North Carolina Child Care Resource &
Referral Region 13 during FY2018-19.
I. The Lead CCR&R Agency (Chatham Co unty Partnership for Children) agrees to:
A. Provide Consumer Education and Referral (CER) services for clients in Region 13 , including chi ld care
referrals, consumer education, and printed educational materials.
B. Supervise and ensure the qua li ty of regional CER services.
C. Employ two part-time referral coordinators and provide back-up staff as needed to ensure callers are
served within one business day.
D. Provide CER clients with information on the local partner agencies in the client's county.
E. Complete c lient follow-up surveys as required by the NC CCR&R Council.
F. Maintain the NACCRRAware database, to include entering, updating, checking the accuracy of, and
deleting client, provider and community data .
G. Send client data and referral numbers to the local agency monthly, according to the Region 13
Consumer Education and Referral Policies.
H. Complete and submit CER reports to the NC CCR&R Counc il as requested.
I. Distribute Child Care Search marketing materials throughout the region to community agencies and
businesses.
VI. The Local CCR&R Agency (County of Harnett) agrees to:
A. Refrain from providing child care referral s or recommendations to families seeking child care options,
but instead refer them to Child Care Search;
B. Ensure that all agency staff are well-informed about Child Care Search services and h ow to refer
families seeking child care;
C. Report to CER staff any provider updates that the local agency is aware of, such as facility closure,
direc tor change, location change, etc.
D. Promote Child Care Search at community meetings and events
E. Notify CER staff about local events where they can participate in outreach to families;
F. Provide the Chi ld Care Search phone number and web link in a prominent place on the agency's
website;
G. Conduct public awareness activities about child care and analysis of child care supply and demand
issues in the local community.
Chatham County Partnership for Children
Genevieve Megginson
Executive Director
Date
County of Harnett
Name: Pc .... 1 c.. I<.... &vJU+-
Title: Cov. "'7-:> _h<.r, ~,u-
/ O ,. };yJ 3
Date
101518a HCBOC Page 190
501(C)(3) Status
Annual Verification
We, the undersigned entity, hereby testify that the undersigned entity's 501 (c)
status is on file with the North Carolina Department of Health and Human Services,
Division of Child Development is still in effect.
Name of Agency
Chairman, Executive Director, or other Authorized Official
DHHS (IRS Verification) Rev . 02/13 Page 1 of 1 DCD.0150
101518a HCBOC Page 191
Agenda Item 4-K --.;;....;;:.=...--.:
Board Meeting
Agenda Item
MEETING DA TE: October 15, 2018
TO: HARNETT COUNTY BOARD OF COMMISSIONERS
SUBJECT: (HHW) Anderson Creek Household Hazardous Waste Collection
REQUESTED BY: Amanda Bader, Director Engineering/Solid Waste
REQUEST:
Request the approval of the attached Household Hazardous Waste Collection (HHW)
contract for a grant of $46,129 from the State of North Carolina with a match of $14,720 for
establishing a permanent Household Hazard Waste Collection Site (HHW) at the Anderson
Creek Landfill. The grant proposal was approved at the July 1, 2018 meeting. This is the
associated contract.
FINANCE OFFICER'S RECOMMENDATION:
COUNTY MANAGER'S RECOMMENDATION:
U :\My Docum en ts\age ndaform201 8.docx Page I of I
101518a HCBOC Page 192
STATE OF NORTH CAROLINA
COUNTY OF WAKE
GRANT CONTRACT NO. 7562
GRANTEE'S FEDERAL
IDENTIFICATION
NUMBER : **·***0306
North Carolina Department of Environmental Quality
Financial Assistance Agreement
This financial assistance agreement is hereby made and entered into this 151 day of July, 2018 , by and between the
NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY (the "Department") and COUNTY OF HARNETT (the
"Grantee"1).
1. Audit and Other Reporting Requirements of the Local Government Commission. If subject to the audit and other
reporting requirements of the Local Government Commission pursuant to Article 3 of Chapter 159 of the North Carolina
General Statutes (Local Government Budget and Fiscal Control Act), the Grantee understands and agrees that the terms ,
conditions , restrictions and requirements hereinafter set forth shall only apply to the extent not inconsistent with , or
superseded by, the audit and other reporting requirements of the Local Government Commission .
2. Contract Documents. The agreement between the parties consists of this document (the "Contract Cover") and its
attachments, which are identified by name as follows :
a. State's General Terms and Conditions (Attachment A)
b. Department's Request for Proposals ("RFP ") (Attachment B)
c. Grantee's Response to RFP , including scope of work, line item budget , budget narrative and , if applicable , indirect
cost documentation (hereinafter referred to generally as the "Award Proposal") (Attachment C)
d. Notice of Certain Reporting and Audit Requirements (Attachment D)
Together, these documents (the "Contract Documents ") constitute the entire agreement between the parties (the
"Agreement "), superseding all prior oral or written statements or agreements . Modifications to this Contract Cover or to
any other Contract Document may only be made through written amendments processed by the Department's Financial
Services Div ision. Any such written amendment must be duly executed by an authorized rep resentative of each party .
3. Precedence Among Contract Documents . In the event of a conflict or inconsistency between or among the Contract
Documents , the document with the highest relative precedence shall prevail. This Contract Cover shall have the highest
precedence . The order of precedence thereafter shall be determined by the order of documents listed in § 1 above , with
the fi rst-listed document having the second-highest precedence and the last-listed document having the lowest
precedence . If there are multiple contract amendments , the most recent amendment has the highest precedence and the
oldest amendment has the lowest precedence.
4. Contract Period. This Agreement shall be effective from July 1, 2018 to June 30, 2019 , inclusive of those dates.
5. Grantee's Duties. As a condition of the grant award , the Grantee agrees to :
a. Undertake and deliver the grant award project , plan or services as described in the Award Proposal (Attachment C),
adhering to all budgetary provisions set out therein throughout the course of performance , as well as meeting the
Other General Terms and Conditions of the Department's RFP (Attachment B).
b. Ensure that all award funds are expended in a manner consistent with the purposes for which they were awarded, as
described more fully in the attached Cont ract Documents .
1 The contract documents attached hereto may at times use alternati ve terms to describe the Grantee. Such terms might include , but are not
necessarily limited to, the following (in comm on or proper form ): "recipient ," "applicant," or "participant."
Page 1 of 5
101518a HCBOC Page 193
GRANT CONTRACT NO. 7562
c. Comply with the requirements of 09 NCAC 03M .0101, et seq. (Uniform Administration of State Awards of Financial
Assistance), including , but not limited to , those provisions relating to audit oversight, access to records, and availability
of audit work papers in the possession of any auditor of any recipient of State funding.
d. Comply with the applicable provisions of Attachment D, Notice of Certain Reporting and Audit Requirements .
e. Maintain all records related to this Agreement (i) for a period of six (6) years following the date on which this Agreement
expires or terminates, or (ii) until all audit exceptions have been reso lved, whichever is longer.
f. Comply with all laws, ordinances, codes, rules, regulations , and licensing requirements applicable to its performance
hereunder and/or the conduct of its business generally, including those of Federal , State, and local agencies having
jurisdiction and/or authority .
g. Obtain written approval from the Department's Contract Administrator (see§ 13 below) prior to making any subaward
or subgrant not already described in the Award Proposal.
h. Ensure that the terms , conditions , restrict ions and requirements of this Contract Cover, including those incorporated
by reference to other Contract Documents and/or applicable law , are made applicable to , and binding upon, any
subgrantee who rece ives as a subaward or subgrant any port ion of the award funds made available to the Grantee
hereunder.
i. Take reasonable measures to ensure that any subgrantee (i) complies with the terms , con ditions, restrictions and
requirements set forth in this Contract Cover, including those incorporated by reference to other Contract Documents
and/or applicable law, and (ii) provides such information in its possession as may be necessary for the Grantee to
comply with such terms, conditions , restrictions and requirements .
6. Department's Duties. The Department shall pay the Grantee in the manner and amounts specified below and in
accordance with the approved budget set forth in the Award Proposal.
7. Total Award Amount. The total amount of award funds paid by the Department to the Grantee under this Agreement
shall not exceed FORTY-SIX THOUSAND ONE HUNDRED TWENTY-NINE DOLLARS ($46,129.00) (the "Total Award
Amount"). This amount consists of:
Fundin Source CFDA No.
North Carolina General Assembl N/A
Account Godin Information :
Dollars GL Company GL Account GL Center
$46,129 .00 1602 536961 6760
Grantee Matching Information :
] a. There are no matching requirements from the Grantee .
] b. There are no matching requirements from the Grantee ; however, the Grantee has committed the following match
to this project:
In -Kind $
Cash $
Cash and In-Kind $
Other / Specify : $
Page 2 of 5
101518a HCBOC Page 194
GRANT CONTRACT NO . 7562
[ X ] c. The Grantee 's matching requirement is $14,720.00 , which shal l cons ist of :
In-Kind $
X Cash $14 ,720 .00
Cash and In-Kind $
Other I Specify : $
[ J d. The Grantee is committing to an additional $0 to complete the project or services described in the Award Proposal.
Based on the figures above , the total contract amount is $60,849.00 .
8. Invoice and Payment. The award funds shall be disbursed to the Grantee in accordance with the following provisions :
a. The Grantee shall submit invoices to the Department 's Contract Administrator at least quarterly. The fina l invoice
must be received by the Department within forty-five (45) days following the date on which termination or expiration
of this Agreement becomes effective . Amended or corrected invoices must be received by the Department 's Financial
Services Division within six (6) months of such date . Any invoice received thereafter shall be returned without action.
b. The Department shall reimburse the Grantee for actual allowable expenditures, with the Department retaining a
minimum of ten percent (10%) of the Total Award Amount until all grant-related activities are completed and all
reports/deliverables are received and accepted by the Department. As used herein , "allowable expenditures " are
expenditures associated with work conducted to meet performance obligations under this Agreement, provided such
work is carried out in a manner consistent with the Award Proposal. The Department may withhold payment on
invoices when performance goals and expectations have not been met or when the manner of performance is
inconsistent with Attachment C.
9. Grantee's Fiscal Year. The Grantee represents that its fiscal year is from July 1 to June 30.
10. Availability of Funds. The Grantee understa nds and agrees that payment of the sums specified herein shall be subject
to , and contingent upon , the allocation and appropriation of funds to the Department for the purposes described in this
Agreement.
11. Reversion of Unexpended Funds. The Grantee understands and agrees that any unexpended grant funds shall revert
to the Department upon termination of this Agreement.
12. Supplantation of Expenditure of Public Funds. The Grantee understands and agrees that funds received pursuant to
this Agreement shall be used only to supplement , not to supplant , the total amount of Federal , State and local public
funding that the Grantee would otherwise expend to carry out the project or services described in the Award Proposal.
13. Contract Administrators. Each party shall submit notices , questions and correspondence related to this Agreement to
the other party's Contract Administrator. The contact information for each party 's Contract Administrator is set out below.
Either party may change its Contract Administrator and/or the associated contact information by giving timely written notice
to the other party .
Grantee Contract Administrator Deoartment's Contract Administrator
Amanda Bader, County Engineer Mike Greene
Harnett County Solid Waste North Carolina Department of Environmental Quality ,
Division of Environmental Assistance and Customer Service
Post Office Box 2773 1639 Mail Service Center
Lillington NC 27546 Raleigh NC 27699-1639
Telephone : (910) 814-6004 Telephone : (919) 707-8137
Fax: (910) 814-4041 Fax : (919) 707-8137
Email : abader(a)harnett .ora Email: mike .areenetmncde nr .aov
Page 3 of 5
101518a HCBOC Page 195
GRANT CONTRACT NO. 7562
14. Assignment. The Grantee may not assign its obligations or its rights to receive payment hereunder .
15. Procurement. The Grantee understands and agrees that all procurement activities undertaken in connection with
this Agreement shall be subject to the following provisions :
a. None of the work or services to be performed under this Agreement involving the specialized skill or expertise of the
Grantee shall be contracted without prior written approval from the Department.
b. In the event the Grantee or any subrecipient of the Grantee contracts for any of the work to be performed hereunder ,
the Grantee shall not be relieved of any duties or responsibilities herein set forth .
c. The Grantee shall not contract with any vendor who is restricted from contracting with the State of North Carolina
pursuant to N.C.G .S. §§ 143-133.3 , 143-59.1 , 143-59 .2 or 147 .86 .60.
16. Subawards. The Grantee understands and agrees that any subaward or subgrant of any portion of the financial assistance
provided hereunder shall not relieve the Grantee of any duties or responsibilities herein set forth .
17. Title VI and Other Nondiscrimination Requirements. Throughout the course of its performance hereunder, the Grantee
shall comply with all applicable State and Federal laws , regulations , executive orders and policies relating to
nondiscrimination , including, but not limited to :
Title VI of the Civil Rights Act of 1964, as amended;
Civil Rights Restoration Act of 1987, as amended;
Section 504 of the Rehabilitation Act of 1973, as amended ;
Age Discrimination Act of 1975, as amended ;
Titles II and Ill of the Americans with Disabilities Act of 1990, as amended ;
Title IX of the Education Amendments of 1972, as amended ;
Part Ill of Executive Order No . 11246 (September 24 , 1965), as amended ; and
Section 13 of the Federal Water Pollution Control Act Amendments of 1972 .
In accordance with the above laws and their implementing regulat ions, the Grantee agrees to ensure that no person in the
United States is , on the basis of race , color , national origin , sex, age or disability, excluded from participation in, denied
the benefits of, or subjected to discrim ination under any program or activity for which the Grantee recei ves Federal
assistance . For purposes of this provision , "program or activity " shall have the meaning ascribed to that term under Federal
law (see 42 U.S.C.S. § 2000d-4a).
The Grantee understands and acknowledges that , in addition to itself, any lower-tier recipient of the financial assistance
provided hereunder must also comply with the requirements of this section . Accordingly , the Grantee agrees to include a
similar provision in any financial assistance agreement made with any lower-tier recipient of such assistance .
18. E-Verify. To the extent applicable , the Grantee represents that it and each ·of its subgrantees , contractors and/or
subcontractors performing work pursuant to , or in association with , this Agreement are in compliance with Article 2 of
Chapter 64 of the North Carolina General Statutes, including, in particular, the requirement that certain employers verify
the work authorization of newly hired employees using the Fed eral E-Ver ify system.
Page 4 of 5
101518a HCBOC Page 196
GRANT CONTRACT NO. 7562
19. Termination by Mutual Consent. This Agreement may be term inated by mutual consent of the parties , provided the
consent is documented in writing and duly executed by an authorized representative of each party .
20. Survival. Any provision contained in this or any other Contract Document that contemplates performance or observance
subsequent to the termination or expiration of this Agreement shall survive the termination or exp iration hereof and continue
in full force and effect.
21. Signature Warranty. The undersigned represent and warrant that they are authorized to bind their principals to the terms
and conditions of this Contract Cover and the Agreement generally , including those incorporated by reference to applicable
law.
IN WITNESS WHEREOF , the Grantee and the Department execute this Agreement in two (2) originals , one (1) to
be retained by the Grantee and one ( 1) to be retained by the Department , the day and year first above written .
COUNTY OF HARNETT
By _____________ _
Grantee 's Signature
Printed Name and Title
Organization
NORTH CAROLINA DEPARTMENT 9Y iign ]
ENVIRONMENTAL QUALITY , ...... ___ ....:.;H..,;;e_r_e_,_
By ______________ _
Signature of Department Head or Authorized Agent
Tommy Kirby, Purchasing Director
Printed Name and Title
Financial Services Division, Purchasing and Contracts Section
Division/Section
ORIGINAL
Pag e 5 of 5
101518a HCBOC Page 197
GRANT CONTRACT NO. 7562
ATTACHMENT A
General Terms and Conditions
Governmental Entities
DEFINITIONS
Unless indicated otherwise from the context , the following terms
shall have the following meanings in this Contract. All definitions
are from 9 NCAC 3M.0102 unless otherwise noted. If the rule or
statute that is the source of the definition is changed by the
adopting authority , the change shall be incorporated herein.
(1) "Agency" (as used in the context of the definitions
below) means and includes every public office , public
officer or official (State or local , elected or appointed),
institution, board , commission, bureau , council ,
department, authority or other unit of government of the
State or of any county, unit, special district or other
political sub-agency of government. For other
purposes in this Contract , "Agency" means the entity
identified as one of the parties hereto.
(2) "Audit" means an examination of records or financial
accounts to verify their accuracy.
(3) "Certification of Compliance" means a report provided
by the Agency to the Office of the State Auditor that
states that the Grantee has met the reporting
requirements established by this Subchapter and
included a statement of certification by the Agency and
copies of the submitted grantee reporting package.
(4) "Compliance Supplement" refers to the North Carolina
State Compliance Supplement, maintained by the State
and Local Government Finance Agency within the
North Carolina Department of State Treasurer that has
been developed in cooperation with agencies to assist
the local auditor in identifying program compliance
requirements and audit procedures for testing those
requirements.
(5) "Contract" means a legal instrument that is used to
reflect a relationship between the agency, grantee , and
sub-grantee.
(6) "Fiscal Year" means the annual operating year of the
non-State entity.
(7 ) "Financial Assistance" means assistance that non-
State entities receive or administer in the form of
grants, loans , loan guarantees, property (including
donated surplus property), cooperative agreements ,
interest subsidies , insurance, food commodities , direct
appropriations , and other assistance. Financial
assistance does not include amounts received as
reimbursement for services rendered to individuals for
Medicare and Medicaid patient services.
(8) "Financial Statemen t" means a report providing
financial statistics relative to a given part of an
organization's operations or status.
(9) "Grant" means financial assistance provided by an
agency, grantee , or sub-grantee to carry out activities
whereby the grantor anticipates no programmatic
involvement with the grantee or sub-grantee during the
performance of the grant.
(10) "Grantee " has the meaning in G.S. 143C-6-23(a)(2): a
non-State entity that receives a grant of State funds
from a State agency , department , or institution but
does not include any non-State entity subject to the
audit and other reporting requirements of the Local
Government Commission. For other purposes in this
Contract, "Grantee" shall mean the entity identified as
one of the parties hereto. For purposes of this
contract , Grantee also includes other State agencies
such as universities.
(11) "Grantor'' means an entity that provides resources ,
generally financial , to another entity in order to achieve
a specified goal or objective.
(12) "Non-State Entity" has the meaning in N.C.G .S. 143C-
1-1 (d)(18): A firm , corporation, partnership, association ,
county , unit of local government, public authority , or
any other person , organization, group , or governmental
entity that is not a State agency, department, or
institution.
(13) "Public Authority" has the meaning in N.C.G.S. 159-
7(10): A municipal corporation that is not a unit of local
government or a local governmental authority, board,
commission, council, or agency that (i) is not a
municipal corporation , (ii) is not subject of the State
Budget Act , and (iii) operates on an area , regional, or
multiunit basis , and the budgeting and accounting
systems of which are not fully a part of the budgeting
and accounting systems of a unit of local government.
(14) "Single Audit" means an audit that includes an
examination of an organization's financial statements ,
internal controls , and compliance with the requirements
of Federal or State awards.
(15) "Special Appropriation" means a legislative act
authorizing the expenditure of a designated amount of
public funds for a specific purpose .
(16) "State Funds" means any funds appropriated by the
North Carolina General Assembly or collected by the
State of North Carolina . State funds include federal
financial assistance received by the State and
transferred or disbursed to non-State entities. Both
Federal and State funds maintain their identity as they
are sub-granted to other organizations. Pursuant to
N.C.G.S. 143C-6-23(a)(1), the terms "State grant
funds" and "State grants" do not include any payment
made by the Medicaid program, the Teachers' and
State Employees ' Comprehensive Major Medical Plan ,
or other similar medical programs .
(17) "Sub-grantee" has the meaning in G.S. 143C-6-
23(a)(4): a non -State entity that receives a grant of
State funds from a grantee or from another sub-grantee
but does not include any non-State entity subject to the
audit and other reporting requirements of the Local
Government Commission.
101518a HCBOC Page 198
(18) "Un it of Local Government has the meaning in G.S.
159-7(b)(15): A municipal corporation that has the
power to levy taxes , including a consolidated city-
county as defined by G.S. 160B-2(1), and all boards ,
agencies , commissions , authorities , and institutions
thereof that are not municipal corporations.
Relationships of the Parties
Independent Contractor: The Grantee is and shall be deemed
to be an independent contractor in the performance of this
Contract and as such sha ll be who ll y responsible for the work to
be performed and for the supervision of its employees. The
Grantee represents that it has , or shall secure at its own
expense, all personnel required in performing the services under
this agreement. Such employees shall not be employees of, or
have any individual contractual relationship with , the Agency.
Subcontracting: To subcontract work to be performed under
this contract which involves the specialized skill or expertise
of the Grantee or his employees , the Grantee first obtains
prior approval of the Agency Contract Administrator. In the
event the Grantee subcontracts for any or all of the services
or activities covered by this contract: (a) the Grantee is not
relieved of any of the duties and responsibilities provided in
this contract; (b) the subcontractor agrees to abide by the
standards contained herein or to provide such information as
to allow the Grantee to comply with these standards , and ; (c)
the subcontractor agrees to allow state and federa l au thori zed
representatives access to any records pertinent to its role as
a subcontractor.
Sub-g rantees : The Grantee has the re sponsibility to ensure that
all sub -grantees, if any, provide all information necessary to
permit the Grantee to comply with the standards set forth in this
Contract.
Assignment: The Grantee may not assign the Grantee's
obligations or the Grantee's right to receive payment hereunder.
However, upon Grantee 's written req uest approved by the
issuing purchasing authority, the Agency may:
(a) Forward the Grantee's payment check (s) directly to any
person or entity designated by the Grantee, or
(b) Include any person or entity designated by Grantee as
a joint payee on the Grantee's payment check(s).
Such approval and action does not obligate the State to anyone
other than the Grantee and the Grantee remains responsible for
fulfi llment of all contract ob ligations .
Beneficiaries: Except as herein specifically provided otherwise ,
this Contract inures to the benefit of and is binding upon the
parties hereto and thei r respective successors. It is expressly
understood and agreed that the enforcement of the terms and
conditions of this Contract , and all rights of action relating to such
enforcement , are strictly reserved to the Agency and the named
Grantee . Nothing contained in this document shall give or allow
any claim or right of action whatsoever by any other third person.
It is the express intention of the Agency and Grantee that any
GRANT CONTRACT NO. 7562
ATTACHMENT A
third person receiving services or benefits under this Contract is
an incidental beneficiary only.
Indemnity
Indemnification: In the event of a claim against either party by
a third party arising out of this contract, the party whose actions
gave rise to the claim is responsible for the defense of th e claim
and any re sulting liability , provided that a party may not waive the
other party's sovereign immunity or simi lar defen ses. The parties
agree to consult with each other over the appropriate handling of
a claim and , in the event they cannot agree, to consult with the
Office of the Attorney General.
Insurance: During the term of the contract, the Grantee at
its sole cost and expense provides commercial insurance
of such type and with such terms and limits as may be
reasonably associated with the contract. As a min imum
the Grantee provides and maintains the following coverag~
and limits:
(a) Worker's Compensation: The Grantee provides
and maintains Worker's Compensation
insurance as required by the laws of Nort h
Caro lina , as well as employer's liability coverage
with minimum limits of $500 ,000 .00 , coveri ng
all of Grantee's employees who are engaged in
any work under this contract. If any work is
sublet , the Grantee requires th e subgrantee to
provide the same coverage for any of his
employees engaged in any work under th is
contract.
(b) Commercia l Gene ral Liability: General Liability
Coverage on a Compre hens ive Broad Form on an
occurrence basis in the minimum
amount of $1 ,000,000 .00 Comb ined Sin gle Li mit.
(Defense cost shall be in excess of the li mit of
liabi lity.)
(c) Automobile: Automobi le Liability Insurance , to
include liability coverage , cover ing all owned ,
hired and non-owned vehicles used in
performance of the contract. The minimum
combined sing le limit is $500 ,000.00 bodily injury
and property damage ; $500 ,000.00
uninsured /under insured motorist; and $25,000.00
medical payment.
Providing and maintaining adequate insurance
coverage is a material obligation of the Grantee and is
of the essence of this contract. The Grantee may
meet its requirements of maintaining specified
coverage and limits by demonstrating to the Agency
that there is in force insurance with equivalent
coverage and limits that will offer at least the same
protection to the Agency . Grantee obtains insurance
that meets all laws of the State of North Carolina.
Grantee obtains coverage from companies that are
author ized to provide such coverage and that are
author iz ed by the Commissioner of Insurance to do
business in North Caro lina. The Grantee complies at
101518a HCBOC Page 199
all times with the terms of such insurance policies ,
and all requirements of the insurer under any such
insurance policies , except as they may conflict with
existing North Carolina laws or this contract. The
limits of coverage under each insurance policy
maintained by the Grantee do not limit the Grantee's
liability and obligations under the contract.
Default and Termination
Termination by Mutual Consent: Either party may terminate
this agreement upon sixty (60) days notice in writing from the
other party. In that event , all finished or unfinished
documents and other materials , at the option of the Agency ,
be submitted to the Agency. If the contract is terminated as
provided herein , the Grantee is paid in an amount which
bears the same ratio to the total compensation as the
services actually performed bear to the total services of the
Grantee covered by th is agreement; for costs of work
performed by subcontractors for the Grantee provided that
such subcontracts have been approved as provided herein; or
for each full day of services performed where compensation is
based on each full day of services performed , less payment of
compensation previously made. The Grantee repays to the
Agency any compensation the Grantee has received which is
in excess of the payment to which he is entitled herein.
Termination for Cause: If, through any cause , the Grantee
fails to fulfill in timely and proper manner the obligations
under this agreement , the Agency thereupon has the right to
terminate this contract by giving written notice to the Grantee
of such termination and specifying the reason thereof and the
effective date thereof. In that event, all finished or unfinished
documents , data, studies , surveys, drawings , maps, models ,
photographs , and reports prepared by the Grantee, at the
option of the Agency , be submitted to the Agency , and the
Grantee is entitled to receive just and equitable compensation
for any satisfactory work completed on such documents and
other materials . The Grantee is not relieved of liability to the
Agency for damages sustained by the Agency by virtue of any
breach of this agreement, and the Agency may withhold
payment to the Grantee for the purpose of set off until such
time as the exact amount of damages due the Agency from
such breach can be determined.
Waiver of Default: Waiver by the Agency of any default or
breach in compliance with the terms of this Contract by the
Grantee is not a waiver of any subsequent default or breach and
is not a modification of the terms of this Contract unless stated to
be such in writing , signed by an authorized representative of the
Agency and the Grantee and attached to the contract.
Availability of Funds: The parties to this Contract agree and
understand that the payment of the sums specified in th is
Contract is dependent and cont ingent upon and subject to the
appropriation , allocation , and availability of funds for this purpose
to the Agency.
GRANT CONTRACT NO. 7562
ATTACHMENT A
Force Majeure : Neither party is in default of its obligations
hereunder if it is prevented from performing such obligations by
any act of war , hostile foreign action, nuclear explosion, riot,
strikes , civil insurrection , earthquake , hurricane , tornado , or other
catastrophic natural event or act of God.
Survival of Promises : All promises , requirements, terms ,
conditions , provisions, representations, guarantees , and
warranties contained herein shall survive the contract expiration
or termination date unless specifically provided otherwise herein,
or unless superseded by applicable Federal or State statutes of
limitation.
Intellectual Property Rights
Copyrights and Ownership of Deliverables: Any and all
copyrights resulting from work under this agreement shall
belong to the Grantee. The Grantee hereby grants to the
North Carolina Department of Environmental Quality a
royalty-free, non-exclusive, paid-up license to use, publish
and distribute results of work under this agreement for North
Carolina State Government purposes only.
Compliance with Applicable Laws
Compliance with Laws: The Grantee understands and agrees
that it is subject to compliance with all laws , ordinances , codes ,
rules , regulations , and licensing requirement s that are applicable
to the conduct of its business , including those of federal , state ,
and local agencies having jurisdiction and /or authority.
Equal Employment Opportunity: The Grantee understands
and agrees that it is subject to compliance with all Federal and
State laws relating to equal employment opportunity.
Confidentiality
Confidentiality: As authorized by law, the Grantee keeps
confidential any information , data , instruments , documents ,
studies or reports given to or prepared or assembled by the
Grantee under this agreement and does not divulge or make
them available to any individual or organization without the prior
written approval of the Agency. The Grantee acknowledges that
in receiving , storing , processing or otherwise dealing with any
confidential information it will safeguard and not further disclose
the information except as otherwise provided in this Contract or
without the prior written approval of the Agency.
Oversight
Access to Persons and Records: The State Auditor and the
using agency 's internal auditors shall have access to persons
and records as a result of all contracts or grants entered into
by State agenc ies or political subdivisions in accordance with
General Statute 147-64.7 and Session law 2010-194 , Section
21 (i.e., the State Audito rs and internal auditors may audit the
records of the contractor during the term of the contract to
ver ify accounts and data affecting fees or performance). The
Contractor shall retain all re cords for a period of six (6) years
101518a HCBOC Page 200
following completion of the contract or until any audits begun
during this period are completed and findings resolved ,
whichever is later.
Record Retention : The Grantee may not destroy , purge or
dispose of records without the express written consent of the
Agency. State basic records retention policy requires all grant
records to be retained for a minimum of six (6) years or until all
audit exceptions have been resolved , whichever is longer . If the
contract is subject to Federal pol icy and regulations , record
retention may be longer than six (6) years since records must be
retained for a period of three years following submission of the
final Federal Financia l Status Report , if applicable , or three years
following the submission of a revised final Federal Financial
Status Report. Also , if any litigation , claim , negotiation , audit,
disallowance action , or other action involving this Contract has
started before expiration of the six (6) year retention period
described above, the records must be retained until completion of
the action and resolution of all issues which arise from it , or until
the end of the regular six (6) year period described above ,
whichever is later.
Time Records: The GRANTEE will maintain records of the time
and effort of each employee receiving compensation from this
contract , in accordance with the appropriate 0MB circular.
Miscellaneous
Choice of Law: The validity of thi s Contract and any of its terms
or provisions, as well as the rights and duties of the part ies to this
Contract, are governed by the laws of North Carolina. The
Grantee , by signing this Contract , agrees and submits , solely for
matters concerning th is Contract, to the exclusive ju risd iction of
the courts of North Carolina and agrees, solely for such purpose,
that the exclusive venue for any legal proceedings shall be Wake
County, North Carolina . The place of th is Contract and all
transactions and agreements relating to it , and their situs and
forum , shall be Wake County, North Carolina, where all matters,
whether sounding in contract or tort , relating to the va lidity,
construction, interpretation , and enforcement shall be
determined.
Amendment: This Contract may not be amended orally or by
performance. Any amendment mu st be made in written form and
executed by duly authorized representatives of the Agency and
the Grantee.
Severability: In the event that a court of competent jurisdiction
holds that a provision or requirement of this Contract violates any
applicable law, each such provision or requirement sha ll continue
to be enforced to the extent it is not in violation of law or is not
otherwise unenforceable and all other provisions and
requirements of this Contract shall remain in full fo rce and effect.
Headings: The Section and Paragraph headings in these
General Terms and Conditions are not material parts of the
agreement and should not be used to construe the meaning
thereof.
GRANT CONTRACT NO. 7562
ATIACHMENTA
Time of the Essence: Time is of the essence in the performance
of this Contract.
Care of Property: The Grantee agrees that it is responsible
for the proper custody and care of any State owned property
furnished him for use in connection with the performance of
his contract and will reimburse the State for its loss or
damage.
Ownership of equipment purchased under this contract rests
with the Agency. Upon approval of the Agency Contract
Administrator , such equipment may be retained by the
Grantee for the time the Grantee continues to provide
services begun under this contract.
Travel Expenses: All travel, lodging , and subsistence costs are
included in the contract total and no additional payments will be
made in excess of the contract amount indicated in above .
Contractor must adhere to the travel , lodging and subsistence
rates established in the Budget Manual for the State of North
Carolina.
Sales/Use Tax Refunds: If eligible , the Grantee and all sub-
grantees shall: (a) ask the North Carolina Department of
Revenue for a refund of all sales and use taxes paid by them in
the performa nce of this Contract, pursuant to G.S. 105-164.14 ;
and (b) exclude all refundable sales and use taxes from all
reportable expenditures before the expenses are entered in their
reimbursement reports.
Advertising: The Grantee may not use the award of this
Contract as a part of any news release or commercia l
advertising .
Recycled Paper: The Grantee ensures that all publications
produced as a result of this contract are printed double-sided on
recycled paper.
Sovereign Immunity: The Agency does not waive its sovereign
immunity by entering into this contract and fully retains all
immu nities and defenses provided by law with respect to any
action based on this contract.
Gratuities , Kickbacks or Contingency Fee(s): The parties
certify and warrant that no gratuities , kickbacks or contingency
fee(s) are paid in connection with this cont ra ct, nor are any fees ,
commissions, gifts or other conside rations made contingent upon
the award of this con tra ct.
Lobbying : The Grantee certifies that it (a) has neither used
nor will use any appropriated funds for payments to lobbyist ;
(b) will disclose the name, address , payment details, and
purpose of any agreement with lobby ists whom the Grantee
or its sub-tier contractor(s) or sub-grantee(s) will pay with
profits or non-appropriated funds on or after December 22 ,
1989 ; and (c) will file quarterly updates about the use of
lobb yists if material changes occur in their use.
101518a HCBOC Page 201
By Executive Order 24, issued by Governor Perdue, and N.C .
G.S.§ 133-32: 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 , Natural and Cultural Resources , Environmental Quality ,
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:
(1) 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 contrac tors are encouraged to review
Executive Order 24 and G.S . Sec. 133-32.
Executive Order 24 also encouraged and invited other State
Agencies to implement the requirements and prohibitions of the
Executive Order to their agencies. Vendors and contractors
should contact other State Agencies to determine if those
agencies have adopted Exe cutive Order 24 ."
GRANT CONTRACT NO. 7562
ATTA CHM ENT A
101518a HCBOC Page 202
GRANT CONTRACT NO. 7562
ATIACHMENTB
2018 Community Waste Reduction and Recycling Grant Program
REQUEST FOR PROPOSALS
N.C. Department of Environmental Quality
Division of Environmental Assistance and Customer Service
The purpose of this grant program is to assist local governments with the implementation, expansion, and
improvement of waste reduction and recycling programs in North Carolina. The Division of Environmental
Assistance and Customer Service (DEACS) administers the Community Waste Reduction and Recycling
Grant program through the Solid Waste Management Outreach Program.
With the release of this Request for Proposals (RFP), DEACS is seeking proposals that request grant funding
to help initiate or expand public waste reduction programs within the state. Applicants should carefully
read this entire RFP prior to submitting a proposal. Proposals must be received by DEACS by 5:00
p.m. on Friday, February 16, 2018. Please address any questions about this grant program to Joseph
Fitzpatrick at (919) 707-8121 , joseph .fitzpatrick@ ncdenr.gov .
Community Waste Reduction and Recycling Grant Program Parameters:
The 2018 Community Waste Reduction and Recycling (CWRAR) Grant Program seeks to fund projects that
help communities build lasting capacity to divert materials from the waste stream and / or that increase
public awareness of waste reduction and recycling. There are three categories of CWRAR Grants for 2018:
Standard Project Grants, Priority Project Grants, and Special Large Priority Project Grants . Different level s
of grant funding are available for each project category. See the Ava ilable Funding section of this document
for more information.
Standard Project Grants:
Standard Project Grants support a wide range of projects that increase and/ or enhance public waste
reduction and recycling. The following list provides examples of Standard Projects:
• Projects that demonstrate the potential to significantly increase a community 's overall divers ion of
material s from the solid waste stream ;
• Projects that improve recy cling program efficiency and / or cost effectiveness while s upporting
increase d waste reduction ;
• Projects that increase the divers ion of material s that are banned from di sposal in North Carolina;
• Projects that implement education and outreach efforts that will grow public awareness about waste
reduction and recy cling services and/ or that work to decrease contamination;
• Projects that implement new curbs ide recycling programs or that help transition an exis ting curbsi de
recycling program from collection usi ng bins or blue-bags to a cart-bas ed collection system ;
• Projects that implement or expand public school recycling programs. If seeking funding for public
school recyc ling, please see additional provisions for public s chool recycling projects in the Special
Requirements sec tion of this document;
• Projects that increase the efficiency or effectiveness of public electronics recycling programs . If
seeking funding for electronics recycling, please see additional provi sion s for electronics recycling
projects in the Special Requirem ents section of thi s document.
Priority Project Grants:
Priority Project Grants s upport investments in public recycling program areas that have been determined by
the state recyclin g prog ram to be of p articular importance to growing and expanding efficient and effective
waste reduction and recycling services throughout North Carolina.
-co ntinued o n n ext page -
101518a HCBOC Page 203
GRANT CONTRACT NO. 7562
ATTACHMENT B
Proposals that seek funding for the following Priority Projects are strongly encouraged:
• Projects that create or expand away-from-home recycling opportunities such as recycling
infrastructure for parks , sports fields , streetscape / pedestrian recycling, and/ or recycling at public
venues. If seeking funding for away-from-home recycling, please see additional provisions for
away-from-home recycling projects in the Special Requirements section of this document;
• Projects that implement or expand public curbside recycling service in unincorporated areas ;
• Projects that implement or support Hub and Spoke Recycling Systems that consolidate commingled
recyclable materials for bulk transfer to a Materials Recovery Facility (MRF);
• Projects that implement or expand recycling programs to collect and manage food waste from
residential or commercial sources.
Special Large Priority Project Grant for Household Hazardous Waste Programs:
With funding assistance from the Division of Waste Management Mercury Switch Program as provided by
NCGS l 30A-3 I0.54 and as amended by Session Law 2017-57, DEA CS is offering a limited number of
Special Large Priority Project Grants to support the implementation or expansion of permanent Household
Hazardous Waste (HHW) Collection Programs. The number of Special Large Priority Project Grants that are
funded will depend on the final availability of funds from the Mercury Switch Program and the number of
fundable applications received.
The goal of the Special Large Priority Project Grant is to increase citizen access to HHW services through
the implementation of new permanent HHW Programs or through the expansion of the operating hours of
existing permanent HHW Programs. To qualify for a Special Large Priority Project grant, a newly
established permanent HHW program must be open to collect HHW from the public at least four (4) separate
days during any given Fiscal Year. For communities operating an existing HHW program to qualify, the
HHW program must add a new location or it must significantly increase the number of days or hours of
operation at the existing facility.
Available Funding:
Grant Award Amounts:
• Standard Project: Applicants are eligible for a Standard Project grant award of up to $20,000.
• Priority Project: Applicants are eligible for a Priority Project grant award of up to $30,000.
• Special Large Priority Project: Applicants are eligible for a Special Large Priority Project grant
award of up to $70,000.
Communities preparing proposals for a 2018 CWRAR Grant are strongly encouraged to contact a DEA CS
Local Government Assistance Team staff member to discuss potential grant projects prior to submitting a
grant proposal. Local Government Team members are available to provide technical assistance and advice
on grant projects. A listing of team member contact information and areas of individual expertise is
available on this web site https://d e g.nc.gov /conservation/recycling/nc-recyc ling-contacts .
Please see the section of this document titled "Use of Grant Funds" for specific infonnation about allowable
uses of grant fund s.
Cash Match Requirement:
Required Cash Match: CWRAR grant winners must provide a cash match equal to or exceeding 20 percent
of the requested grant funding. For example, a grantee under thi s program requesting $20,000 in grant
funding from DEA CS must show a minimum expenditure of $4,000 of local funds on the project. To meet
the cash match requirement, a minimum of one ( 1) local dollar mus t be s pent for every five (5) dollars of
grant funding awarded.
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GRANT CONTRACT NO. 7562
ATTACHMENT B
Calculating Cash Match: To determine the necessary cash match for any grant project, first determine the
total budget associated with the project and then use the following equation: total project budget+ 6 =
required cash match. The difference between the total project budget and the required cash match equals the
maximum possible grant award.
Distributions from the $2 per ton Solid Waste Di sposal Tax may be used to cover cash match requirements.
In-kind contributions will not be accepted in lieu of cash match.
Grant Project Planning:
Available funding is limited and it is anticipated that the 2018 CWRAR Grant Round will be highly
competitive. For this reason, it is important that project seeking grant funding be well thought out and well
planned, and that applicants follow the instructions in this RFP when preparing proposals by providing all
information as outlined in the section addressing Required Proposal Fonnat. Proposa ls that seek grant funds
for the replacement of existing equipment will be scored substantially lower than projects that implement
new recycling services or projects that expand existing recycling services.
Use of Grant Funds:
Examples of approved uses of CWRAR Grant funds include site development costs, construction of
facilities to handle recyclable materials, equipment purchases, equipment installation costs, key recycling
program components, public awareness programs and material s that support public education such as signs
or brochures.
Examples of activities for which CWRAR Grant funds MAY NOT be used include employee salaries, land
acquisition costs, administrative expenses s uch as overhead , utility costs, studies or work performed by
consultants, contracted collection costs, and I or payment for other contracted recycling services such as
payment to a vendor for operating a household hazardous waste collection event.
If you have questions about eligible uses of grant funds , please contact Joseph Fitzpatrick at (919) 707-8 121
or joseph.fitz patrick@ ncdenr.gov for more information.
Eligible Entities:
• Counties, municipalities, councils of governments and solid waste authorities in North Carolina are
eligible to apply for funding from the CWRAR Grant Program.
• Applicants with an open CWRAR Grant contract from an earlier grant cycle mu st have invoiced
for 90% of eligible grant funds by the proposal due-date (February 16 , 2018) to be considered for
grant funding during thi s new grant cycle. Applicants that have completed and closed previous
CWRAR Grant projects may s ubmit another proposal under this grant round. Proposals will not be
accepted from applicants with an open CWRAR Grant from cycles prior to 2017 .
• Federal and state agencies are not eligible for funding through this grant program.
• Public universities, community colleges and private colleges and univers ities are not eligible for
funding through this grant program.
• Not-for-profit entities are not eligible for funding through this grant program; however, these
entities are eligible for funding through the Recycling Business Development Grant Round. For
more information about Recycling Business Development Grants, please contact Wendy Worley at
(919) 707-8136 or wendy.worley@ nc d enr.gov.
• Public school systems and individual public schools are not eligible to apply directly for funding
through this grant program. However, local governments (counties or municipalities) may ap ply for
funding to support public school recycling projects. If a county or municipality seeks funding for a
public school recycling project, the local government will be responsible for making purchases
associated with the grant project and will receive grant proceeds when seeking reimbursement.
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GRANT CONTRACT NO . 7562
ATTACHMENT B
Additional requirements a lso apply for projects seeking grant support for public school recycling
projects -see Special Requirements section below.
Conditions on Submittals:
• ONLY ONE PROPOSAL PER ELIGIBLE ENTITY WILL BE ACCEPTED . Grant proposals
may combine funding requests for multiple types of projects into one proposal. For example, a grant
proposal seeking funding for away-from-home recycling receptacles plus an investment in some
other public recycling program element unrelated to away-from-home recycling would be
considered. If combining different grant project elements into one proposal, the available funding
limits still apply and total request may not exceed the grant award amounts noted in the Available
Funding section of this document.
• Multi-party initiatives such as joint projects involving two or more local governments where each
local government contributes towards project funding are strongly encouraged. Any group
participating in a regional or multi-party project proposal may not submit additional proposals.
• All applicants selected for funding will undergo a compliance review to ensure that they do not have
an outstanding Notice of Violation (NOY) related to North Carolina solid waste statutes and rules .
Any outstanding NO Vs must be corrected to the satisfaction of the N.C. Divi s ion of Waste
Management (DWM) prior to any grant being awarded. Applicants with outstanding NO Vs are
responsible for providing DEA CS with information from DWM indicating that the community is in
compliance and that the NOVs have been corrected before a grant contract can be initiated.
• Applications will not be accepted from local governments that have not submitted the required Solid
Waste and Materials Management Annual Report for the most recent fiscal year.
• As a condition of grant award DEA CS may work with applicants to revise initially submitted
proposals before entering into a grant contract. Initial proposals must be received by the due date.
Changes to proposals may include adjustments to project scope, project budget, project timeline and
/ or other elements of the proposal. Any changes to initial proposals mu st be approved by DEA CS
and the applicant and the resu ltant Final CWRAR Proposal will become an attachment to the grant
contract.
• The annual CWRAR Grant cycle typically receives funding reque st s that exceed available funds.
However, it is a priority for DEACS to support as many qualifying projects as possible. After close
examination of funding requests and s ubject to agreement with the applicant, DEA CS may award
grant amounts lower than the original request. For any amount awarded, grantees must still provide
the required cash match as explained in the Cash Match Requirement section.
General Requirements:
General requirements for all appli cants:
• Usage ofN.C. Solid Waste Disposal Tax proceeds: Solid Waste Disposal Tax proceeds are
distributed to eligible local governments on a quarterly basis by the Department of Revenue.
According to § 105-187 .63, these fund s mus t be used by a city or county sole ly for solid waste
management programs and services. CWRAR Grant applicants must certify in writing that all
di s posal tax proceeds are used only for the purpose of providing solid waste and recycling services.
In addition to this written certification, applicants should describe how disposal tax funds are utilized
and whether proceeds will be used to s upply matching funds.
• Public Building Recycling Services: CWRAR Grants will not be awarded to applicants that do not
have recycling services for cans, bottles and paper available at their government buildings. As part
of the grant proposal, all applicants must indicate that employees in the key government buildings
operated by the applicant h ave reasonable access to recyclin g services and are able and encouraged
to recyc le materials generated in the course of government business. Please include a li st of the
materials collected for recycling at these facilities.
• Mercury Product Recycling: § l 30A-3 l 0.60 requires that any public agency using stat e funds for the
construction or operation or public buildings sh all establ ish a program for the collection and
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101518a HCBOC Page 206
GRANT CONTRACT NO. 7562
ATIACHMENTB
recycling of all spent fluorescent lights and thermostats that contain mercury generated in public
buildings. As part of the grant proposal , all applicants must indicate that they have a program in
place for the collection of fluorescent lights and mercury thermostats from their public buildings. If
the applicant does not have a program in place for the collection of these materials, then as a
precondition of any grant award the applicant must initiate such services. For more information
about these requirements and/ or for assistance implementing a mercury products recycling program
please contact Joseph Fitzpatrick at 919-707-8121, joseph.fitzpatrick@ncdenr.gov.
Special Requirements:
Applicants seeking funding for public school recycling, away-from-home recycling and/or electronics
recycling MUST address the following Special Requirement(s) in their submitted proposal.
• Special Requirements for Public School Recycling Projects : As stated in the section addressing
Eligible Entities, only counties, municipalities, councils of governments and solid waste authorities
in North Carolina are eligible to apply for CWRAR Grant funding. Proposals seeking funding for
public school recycling projects must come from one of these entities. Public school systems and or
individual schools may not apply directly for CWRAR Grant funding. Applicants seeking funding
for public school recycling projects must provide the supplemental information outlined below to
ensure that all necessary school recycling program elements are addressed and to help demonstrate
project planning. This is a competitive grant program and projects that institute or expand a system-
wide school recycling program will compete better than projects that only serve an individual school.
Eligible grant projects may seek funding for equipment (such as bins and roll carts) and/or education
materials. As with other CWRAR projects, administrative expenses, staff salaries and contract
collection costs are not eligible for grant funding nor can they be used as matching funds. If a public
school system will be contributing funds towards the implementation of a recycling grant project,
these funds shou ld be paid to the Eligible Entity that will be the state grantee in order to ensure that
the state grantee makes the purchases associated with the grant project. All purchases associated
with a grant project must be made by the grantee. Purchases made directl y by a public school system
shall not be eligible for reimbursement. Please contact Mindy Love at 919-707-8127,
mindy .lo ve@ncdenr.gov for information or assistance with public school re cycli ng projects.
School Recycling Supplemental Requirements :
o Describe the existing school recycling program (if any) that is available in the school system
associated with the grant project. The de sc ription should includ e the following items:
• Indicate whether recycling service is available to all schools within the district or
only to certain schools within the district.
• If recyclin g collection presently exists or if this project implements a new school
recycling service, then please indicate the recycl ing service provider (e.g. indicate
whether the collection of recyclables is provided by public school system
employees, by a spec ific local government, or through a contracted or third-party
service provider).
• Provide a list of the recyclable material s accepted by the program and indicate how
the material s are to be collected (single stream, dual stream, source separated).
• Indicate where the recyclables are going after they are collected (provide the name
of the materials proce ssor).
o Li st all of the public agencies and/or departments that collaborate to assist with or operate
the school recycling program and list the role of each entity. Examples could include the
local educational authority (school di strict), municipal and/or county solid waste
management departments. Ideall y, a holi stic sc hool system recycling program should include
cooperation between the community 's public recycling program and the public school
system.
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GRANT CONTRACT NO. 7562
ATTACHMENT B
o If a system-wide school recycling program is in place, explain if and how this grant will
expand recycling throughout the school system and note whether this grant project is part of
a phased plan .
o A designated recycling contact should be established for each school facility participating in
the recycling program. Examples of designated contacts might include school facility
manager, head custodian, the faculty coordinator or leader of a group or club, the principal ,
or school administrator. Please provide a list of schools to be served by this project and the
designated recycling contact for each school including the name and title of the designated
contact.
o Indicate the locations where recycling containers are or will be placed at the school facilities
(e.g. classrooms, cafeterias, hallways, athletic fields , administrative offices, library, copy
rooms, etc.).
o Indicate who will be responsible for emptying the recycling containers (e.g. custodian/
cleaning staff, teachers, students, student groups, etc.).
o Provide a plan for promoting recycling within the schools impacted by the grant project as
well as a plan for educating staff and students about the program.
• Electronics Recycling Projects: Any community seeking grant funds related to an electronics
recycling related project mus t indicate in their proposal whether the local government has ever
received funds distributed from the State's Electronics Management Program. For more information
on eligibility for Electronics Management Program Funds see this web s ite:
http://deq.nc.gov/about/divisions/waste-management/solid-waste-section/electronics-
management/nc-local-governments-info-page. If the local government has received Electronics
Management Fund distributions in the past, then the applicant must include information in its
proposal about how those funds have been used and about how the community intends to use the
funds that will be distributed in February 2018 and February 201 9.
Successful county applicants seeking grant funds to support an electronics recycling re lated project
that have not previously been eligible for distributions from the State 's Electronics Management
Program will be required to become eligible for Electronics Management Funds on or before
December 3 I, 2018 as a precondition of receipt of CWRAR Grant fund s .
Successful municipal applicants seeking grant funds to sup port an electronics recycling related
project that have not previously been eli g ible for di stributions from the State 's Electronics
Management Program must decide whether or not to make themselves eligible for Electronics
Management Funds prior to the December 31 , 2018 eligibility deadline. This deci sion should be
made in consultation with the county where the municipality is located and should be based on how
the distribution of funds can best serve the advancement of electronics recycling within the
community. If it is determined that the municipality should seek Electronics Management Funds, the
municipality should take action to become eligible for funds on or before December 31, 2018.
• Away-From-Home Recycling Projects: Grant funds for away-from-home Recycling projects can
only be use d for recycling related purchases and cannot be used to pay for the purchase of away-
from-home receptacles for the collection of waste (garbage). If a proposal includes the purchase of
away-from-home receptacles that collect BOTH waste and recyclable s, then the standard cash
matching fund requirement will be adjusted so that the applicant (grantee) covers the full cost of the
waste portion of the container with their matching funds. For example, if a community seeks to
purchase a combo waste/ recycling station that has one s lot for garbage and one for recyclables and
the receptacle costs $1 ,000 then the applicant will be expected to provide a cash match equal to one
half of the purchase price, or $500. If seeking funding for an away-from-home recycling project,
then please indicate in the Special Requirements section of the proposal whether any of the
6
101518a HCBOC Page 208
I
GRANT CONTRACT NO . 7562
ATIACHMENTB
equipment to be purchased will be used to collect waste materials that are intended to be disposed of
in a landfill.
In addition, applicants for away-from-home related grant projects are strongly encouraged to specify
which particular recycling receptacles are being considered for purchase as a part of their proposal.
For assistance with and guidance on the selection ofrecycling receptacles please contact Mindy
Love at 919-707-8127 or mindy.love@ncdenr.gov.
Grant Project Period/ Funding Period:
Successful grant applicants will be required to enter into a grant contract with the Department of
Environmental Quality. The resultant grant contract period is intended to align with the local government
fi s cal year, and will generally have a one (I) year contract long term. Grantees must expend funds within the
year-long contract period unless the grant contract end date is extended by written agreement between the
applicant and the N.C. Department of Environmental Quality (DEQ). Extensions are possible but not
guaranteed. It is anticipated that grant contracts resulting from this grant cycle will begin on July I, 2018
and end on June 30 , 2019. All purchases associated with grant funds must be made within the grant
contract period. Any purchased made prior to the start of the grant contract or after the end date of
the grant contract will not be eligible for reimbursement.
Proposal Due Date:
Proposals MUST be received by DEA CS by 5:00 p.m. on Friday, February 16, 2018. Any proposals
received after the deadline will not be considered . Local governments requiring board approval to apply for
grant funds should plan to procure that approval before the submittal deadline.
How to Submit Proposals:
One electronic copy of the proposal mu st be submitted by email to joseph.fitzpatri ck@ ncdenr.gov. Receipt
of all acceptable proposals will be acknowledged by e -mail. Please submit electronic versions of proposals
as Microsoft Word (preferred) or Adobe (PDF) files. If submittal of an electronic version of a grant proposal
presents a hards hip, please contact Joseph Fitzpatrick to discuss submittal options.
Proposals must be received by 5:00 p.m. on Friday, February 16, 2018. Proposals not received by 5:00
p.m. on Friday, February 16, 2018 will not be accepted.
Required Proposal Format:
The following outline indicates what applicants must include in their proposal for their application to be
considered complete. Proposals th at fail to provide all of the required information or that fail to follow
the following format may not compete well and may not be considered for funding.
• Project Title
• Applicant Contact Information: to include the followin g:
../ Name and title of main contact
../ Organization
../ Address
../ Phone number
../ Fax number
../ E-mail address
• Date of Proposal Submittal : thi s should be the dat e the proposal is submitted to D EA CS
• General Requirements: (see section on General Requirements for more information)
../ Written s tatement certifying that Solid Waste Di sposal Tax Procee ds are used only
for solid waste management purposes and a description of how proceeds are used .
../ Written statement indicating that the applicant has re cycling service s for cans, bottles and
paper ava ilable at the key government buildings and a li st of the materials collected .
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GRANT CONTRACT NO. 7562
ATTACHMENT B
./ Written statement indicating that the applicant has established a program for the collection
and recycling of fluorescent lights and mercury containing thermostats from pub I ic buildings
owned by the applicant.
• Project Description: Provide a description of the grant project and please include the following
information in the project description:
./ Description and quantities of items to be purchased with grant funds;
./ Description of the anticipated life of service for the items or materials to be purchased with
grant funds (estimate how lon g the project will continue to serve the community);
./ An estimate of the number of households or businesses that will be impacted by or have
access to the recycling services associated with the proposed project;
./ An estimate of the waste reduction impact of the proposed project ; and
./ A description of whether the grant project will create a new service, enhance or expand an
existing service, or support an existing recycling service without expanding that service.
• Special Requirements: Proposals for school recycling, e lectronics recycling or away-from-home
recycling must include additional information as stipulated in the Special Requirements section.
• Project Timeline: Bulleted li st showing project milestones and general implementation dates.
Timeline must begin on or after July 1, 2018 and project must be complete by June 30, 2019.
• Project Budget: to include the following:
./ Itemized list of intended expenditures and estimated costs;
./ Amount of funds requested from the state and amount of matching funds to be provided by
the applicant (see Cash Match Requirements);
./ If the grant project is not a Priority Project Grant, the state grant award cannot exceed
$20,000;
./ Please submit the Project Budget in a table following the example s hown below:
Sample Project Budget State Grant Award Applicant Cash Match Project Total
Re cycling Carts for Commercial Recycling
Program (100 carts@ $55 each) $4,583 $ 917 $5,500
Labels for Carts and Signs for Recycling Sites $ 343 $ 69 $ 412
Program Brochures (Design and Printing) $ 209 $41 $ 250
Total $5,135 $1,027 $6,162
* Note about Project Budgets: state and local sales taxes are not reimbursable expenditures and
s hould not be included as part of grant budgets.
Grant Selection Process:
Through a blind evaluation process, a selection committee w ill use the pre-established Award Criteria
identified below to rank proposals and make award decisions. The review process is expected to be
comp leted and preliminary award announcements should be made by April 20 18 .
Award Criteria:
Applicants are encouraged to consider the following Award Criteria as they develop their grant proposals. A
total of I 00 points is available.
I. Innovation / Creativity (0-5 points): Is the project innovative? Does the project address a new
waste stream or material, create a new recycling service, or take an approach not seen in North
Carolina? Does the project set a strong example for other communities to replicate?
2. Advancement of Public Recycling Service (0-10 points): Does the project implement a new
recycling service in the appli cant community? Does the project bring a new aspect of recycling to an
area or region of the state? Does the project implement a new program or service that is proven to be
effective in another community or region of the state?
8
101518a HCBOC Page 210
GRANT CONTRACT NO. 7562
ATTACHMENT B
3. Planning (0-20 points): Did the Project Description include all necessary elements as outlined in the
Required Proposal Format? Is the proposal well thought out, well researched and backed by valid
facts and assumptions?
4. Consistency with Best Management Practices (0-15 points): Is the project consistent with
recycling industry Best Management Practices (BMPs) and I or does the project involve the adoption
or expansion of an industry BMP? Recognized BMPs may include the collection of commingled
materials, collection using carts, the use of compacting equipment for collection vehicles, and / or
the use of equipment and / or practices proven to reduce contamination and maximize diversion in
other communities.
5 . Impact on the Waste Stream (0-15 points): Will the project contribute substantially toward
reduction of the local waste stream or will it substantially increase tonnage recovered through
recycling services?
6. Efficiency/ Cost-effectiveness (0-10 points): Will the project improve the efficiency or cost-
effectiveness of the local waste reduction program? Does the project increase the efficiency or
effectiveness of an existing recycling service? Does the project reduce the operating cost of a
current recycling service or does it adopt practices proven to be cost effective in other communities?
7. Sustainability/ Commitment (0-10 points): Will the project be ongoing and sustained in
subsequent annual budgets? Does the project have the support of the governing body? Does the
project make investments that will continue to serve the community for years to come?
8. Joint Effort (0 or 5 points): One party proposals will receive zero (0) points; multi-party proposals
(involving cash match from all participants) will receive five (5) points.
9. Priority Project * (0-10 points): Is the project seeking funding for a Priority Project Grant or a
Special Large Priority Project Grant, and to what extent does the project support investments
targeted in one of the Priority Project Grant categories?
If A Proposal is Selected for Fu nding:
DEACS anticipates that applicants selected to receive grant funding will be notified by the end of April
2018. DEACS will notify the applicant with a formal offer by e-mail. The applicant must accept or decline
the offer. The following will occur once the offer of grant funding is accepted :
• DEACS will conduct a compliance review with the Division of Waste Management (this may occur
before offer is accepted).
• When DEA CS requires revisions to the initially submitted proposal as a condition of grant award ,
DEACS and the applicant must both agree on the revisions to the proposal and the applica nt must
approve any changes and accept the offered grant in writing. The Final Proposal will become an
attachment to the grant contract. Applicants who fail meet this requirement will not be awarded
funding.
• Successful applicants will be required to register with the state 's e-procurement sys tem using the
same address provided in the applicant 's proposal. To register in the state's e-procurement sy stem
please visit the following link: http ://eprocurement.nc.go v/.
• DEA CS will submit a request through the DEQ contract processing system for a grant contract.
Grantee s must act to execute the resultant grant contract without excessive delay .
NOTE: Successful applicants that make purchases before a grant contract is signed by both DEQ and
the grant recipient will not be reimbursed.
Other General Terms and Conditions:
All grantees are s ubject to the following terms and conditions. Mo st of the se terms and conditions will be
outlined in the grant contract.
• Publications: all documents and publications ass ociated with a grant contract s hould be printed on
recycled paper containing at least 30 percent post-cons umer content.
9
101518a HCBOC Page 211
GRANT CONTRACT NO. 7562
ATTACHMENT B
• Final reports: a draft final report is required to be submitted to DEA CS at least 30 days prior to the
contract end date and a final report is required to be submitted by the contract end date. Final reports
and drafts should be submitted electronically. All applicants are strongly encouraged to visit the
following web site to review the final reporting format and guidelines:
https://deq.nc.gov/conservation/recycling/local-government-recycling-assistance/grant-programs .
Applicants and grantees without internet access should contact Joseph Fitzpatrick at (919) 707-812 I
to receive a copy of the Final Report Guidelines.
• Extensions/ Amendments: no-cost time extensions are possible but not guaranteed for grant
contracts. Grantees seeking no-cost time extensions should submit a request for a time extension at
least sixty (60) days prior to the contract end date. The request for extension must indicate how long
the grantee is seeking to extend the project and the reason that the extension is being requested (i.e.,
why the project cannot be completed on time). Any request for an extension must include a new
timeline wi th revised project milestones and should also include a revised project budget if budget
changes are also being requested. DEA CS reserves the right to decline any request for extension or
amendment that is not initiated at least sixty (60) days prior to the contract end date.
• Reimbursement: distribution ofDEACS grant funds is on a reimbursement basis. Requests for
reimbursement can only be made after the grantee has completed purchases associated with the grant
project. Reimbursement requests must be subm itted on letterhead , must include copies of invoices,
and must include proof that the grantee has made payment. Proof of payment may include copies of
canceled checks or other financial reports showing that funds were spent. State and local sales
taxes are not reimbursable, may not be counted towards expenditure requirements, and should
be excluded from reimbursement requests. The amount of actual grant payments may be prorated
for projects and I or project elements that come in under budget.
• Final 10 Percent of Funds: DEA CS will continue to reimburse grantees until 90 percent of the
grant award amount has been expended. The final IO percent of grant funds wi ll be held until an
acceptable final report has been received by DEACS. The final report must be received and
approved prior to the end date of the contract. All final requests for reimbursement must be received
within 45 days of the contract end-date or a ll remaining grant funds will be forfeited.
A Final Word on Grant Writing:
Proposals may receive low scores or even be rejected because appli cants fail to follow the instructions
outlined in this document. Applicants stand a better chance of success if they .in clude all of the required
components of a proposal and if they follow the Required Proposal Format. Project Descriptions should be
clear, concise, and should demonstrate thoughtful planning. Poorly prepared proposals create uncertainty
about the project goals and intended results . C lear details will provide grant proposal reviewers confidence
about the v iability and feasibility of a proposal. Applicants with questions are encouraged to contact DEA CS
for more information.
10
101518a HCBOC Page 212
, Harnett
COUNTY
NORlll CAROLINA
February 13, 2018
Mr. Joseph Fitzpatrick
Division of Environmental Assistance and Outreach
Engineering and Solid Waste
P.O. Box 2773
900 South 9th Street
Lillington, NC 27546
North Carolina Department of Environment and Natural Resources
1639 Mail Service Center, Raleigh, NC 27699-1639
RE : 2018 Community Waste Reduction and Recycling Grants
Household Hazardous Waste Collection at Anderson Creek Landfill
Dear Joseph and Selection Committee:
GRANT CONTRACT NO. 7562
ATTACHMENT C
910-814-6156
910-814-8263 fax
www .harnett.org
We are pleased to submit a proposal for the 2018 Community Waste Reduction and Recycling Grants.
Harnett County would like to establish a permanent Household Hazardous Recycling Collection Site at
the Anderson Creek Landfill.
Project Title: Anderson Creek Household Hazardous Waste Collection
Applicant Contact Information: Harnett County Solid Waste
Amanda Bader, PE, County Engineer
P.O. Box 2773
Lillington, NC 27546
Phone No. 910-814-6004
Fax No. 910-814-4041
Harnett County Tax ID: XXXXX0306
Date of Proposal Submittal: February 13, 2018
General Requirements: Attachments 1, 2 and 3 .
Written statement certifying that only NC Solid Waste Disposal Tax Proceeds are used only for solid
waste management purposes and a description of how proceeds are used (Attachment 1).
Written statement indicating that the applicant has recycling services available at the key government
buildings and a list of materials collected (Attachment 2).
Written statement indicating that the applicant has a recycling program for spent fluorescent bulbs and
thermostats containing mercury generated from public buildings (Attachment 3).
Project Description:
Harnett County is seeking a Special Large Priority Grant for our Household Hazardous Waste Program.
We held our first temporary HHW Event in 2012 . It started as an annual event in Lillington. We kept the
event In Lillington In 2013 and 2014 . We had two events at the Dunn Erwin Landfill, one in 2015 and
one in 2016. Two events were held at the Anderson Creek landfill in 2017. Our best participation by far
has been at Anderson Creek. NCDA partners with us at all of our events for pesticide disposal.
strong roots • new growth
101518a HCBOC Page 213
Mr. Fitzpatrick
Page 2
G RANT CONTRAC T NO. 7562
ATTAC HMENT C
The western portion of Harnett County is a rapidly growing community and has a strong military
presence. When these citizens are deployed or relocating, they want to know how to safely and
properly dispose of HHW . This is our most common citizen 's inquiry. We typically ask them to store
until our next event; donate finishes to Habitat for Humanity; or dispose of batteries and CFL's at Lowes .
By establlshing a permanent HHW collection Site, we can establish collection days on the first
Wednesday of the month and fill our container untll we have enough material to mobilize our HHW
vendor. Currently, with two events per year, we are incurring about $8,000 in mobilization costs plus
energy surcharge fees whether or not we fill the vendor's truck.
Since the addition of the convenience site at Ponderosa where cooking oil, motor oil, and anti-freeze are
collected, citizens are looking for more environmentally responsible ways to disposal of materials.
These special waste programs have been very successful. A 2015 Community Waste Reduction and
Recycling Grant funded the Ponderosa site.
We are requesting infrastructure to place a Chemical Storage Building at the convenience center at the
Anderson Creek landfill. A 20 ft x 40 ft carport will be used for collecting and sorting materials on the
days of the events. Storm drainage improvements are needed for spill containment. Drainage from the
proposed site flows to an open ended, rusted, metal pipe. We are requesting funds to replace the metal
pipe with an 18" HOPE box and grate. The grate will be placed on top of the upturned 18" pipe . An 18"
HOPE cap will be used to seal the grate and upturned pipe on the days of collection. We are requesting
funds for the electrical service to the building and signage .
Project Timeline: The following schedule assumes a start date of July 1, 2018.
• April 13-14, 2018 : Begin training of personnel for HHW collection .
• July l, 2018 : Submit permit for permanent HHW collection site.
• October 1, 2018 : Submit purchase order for HHW Building.
• November 1, 2018: Install storm drainage improvements .
• January l , 2019 : Install HHW building with electrical.
• April 1, 2019: Begin holding Household Hazardous Waste Events the first Wednesday of every
month.
• June 30, 2019: Submit Grant Final report to DEACS
Grant Tlmellne:
• April l , 2019: Begin holding Household Hazardous Waste Events the first Wednesday of every
month.
• June 30, 2019: Submit Grant Final report to DEACS
strong ro ots • new grow th
101518a HCBOC Page 214
Mr. Fitzpatrick
Page3
Project Budget:
Description
HHW Storage Building w/state
approval option.
1-20 ft. x 40 ft . canopy
Electrical for the panel in the
HHW building
Storm Drainage/Spill
Containment Improvements
Slgnage
Total
State Grant
Award
$30,144
$3,448
$2,700
$9,337
$500
$46,129
Applicant
cash Match
$6,028
$700
$500
$6,992
$500
$14,720
GRANT CONTRACT NO. 7562
ATTACHMENT C
Project Total
$36,172
$4,148
$3,200
$16,329
$1,000
$60,849
We appreciate your cons i deration and look forward to responding to any questions or comments you
may have.
Sincerely,
Amanda L. Bader, PE
County Engineer
Attachment 1: NC Solid Waste Disposal Tax Proceeds Certification
Attachment 2: Government Building Recycling Services Certification
Attachment 3: Government Buildings Fluorescent Bulb Certification
Attachment 4: Site Improvements Exhibit
Attachment 5: Cost Estimates for Materials and Work to be Performed
strong roots • new growth
101518a HCBOC Page 215
Harnett
'COUNTY
· H CAROLINA
February 15, 2018
Mr. Joseph Fitzpatrick
Attachmen t 1
Division of Environmental Assistance and Outreach
Engineering and Solid Waste
P.O. Box 2773
900 South 9 1h Street
Lillington, NC 27546
North Carol ina Department of Environment and Natural Resources
1639 Mail Service Center, Raleigh , NC 27699-1639
RE: 2018 Community Waste Reduction and Recycling Grants
NC Solid Waste Disposal Tax
Dear Joseph:
GRANT CO NTRACT NO . 7562
ATTACHMENT C
910-814-6156
www.harnett.org
This letter is to certify that NC Solid Waste Disposal Tax proceeds are used only for solid waste
management purposes. The funds are placed in our solid waste enterprise fund and are used to fund
leachate management, special waste and recycling programs and for operation costs for landfills and
convenience centers.
Sincerely,
Amanda L. Bader, PE
County Engineer
strong roots • new growth
101518a HCBOC Page 216
Harnett
COUNTY
NORTH CAROLI NA
February 15, 2018
Mr. Joseph Fitzpatrick
Attachment 2
Division of Environmental Assistance and Outreach
Engineering and Solid Waste
P.O. Box 2773
900 South 9th Street
Lillington, NC 27546
North Carolina Department of Environment and Natural Resources
1639 Mail Service Center, Raleigh, NC 27699-1639
RE: 2018 Community Waste Reduction and Recycl ing Grants
Government Building Recycling Certification
Dear Joseph :
G RANT CON TRACT NO . 75 62
ATTACHMENT C
910-814-6156
910-814-8263 fax
www.harnett.org
This letter is to certify that recycling services are at key governmental buildings. Employees are given
reasonable access to rec:ycling services and are able and encouraged to recycle materials generated in
the course of business . We contract with Waste Industries to provide this service.
In the past year, we have focused on the placement of twin bins in shared spaces such as lobbies and
conference rooms to increase recycling.
Sincerely,
Amanda L. Bader, PE
County E"ngineer
strong roots • new growth
101518a HCBOC Page 217
Harnett
COUNTY
NOR TH CAROLIN A
February 15, 2018
Mr. Joseph Fitzpatrick
Attachment 3
Division of Environmental Assistance and Outreach
Engineering and Solid Waste
P.O. Box 2773
900 South 9th Street
Lillington , NC 27546
North Carolina Department of Environment and Natural Resources
1639 Mail Service Center, Raleigh, NC 27699-1639
RE : 2015 Community Waste Reduction and Recycling Grants
Government Building Fluorescent Bulbs
Dear Joseph:
GRANT CON TRAC T N O. 756 2
ATTACH MENT C
910-814-6156
www.harnett.org
Spent fluorescent lights and thermostats that conta in mercury are stored at 200 McKinney Parkway,
Lillington, NC. They are collected for recycling at our annual Household Hazardous Waste Collection
day.
Sincerely,
Amanda L. Bader, PE
County Engineer
strong roots • new growth
101518a HCBOC Page 218
)(
j i'
i'
I RECYCLING· ~
X
b
~SD
GRANT CONTRACT NO. 7562
ATTACHMENT C
AND£RS0N CRfEK LANDFILL
CONVENIENCE CENTER
\_ NEW 18" HDPt,
.....
DONATION
BOX
---11---11~ I
HHW STORAGE
CONTAINER
""'-NEW 18" GRATE & FRAME
WITH 18" CAP FOR
COLLECTION DAYS
101518a HCBOC Page 219
~ U.S. CHEMICAL
~ 111ra1e ®
2/9/2018
Revised: 2/12/2018
Harnett County, NC
Ms . AMANDA BADER
PO B0X940
LILLINGTON, NC 27546
RE: uses Quote No . 0004628
Dear Ms. Bader:
Thank you for the opportunity to offer a proposal for your chemical storage needs .
GRANT CONTRACT NO. 7562
ATTACHMENT C
1806 River Street
WIikesboro, NC 28697
Phone: (800) 233 -1480
Phone:(336)990-0601
Fax: (336)-990-0076
Emal~ lnfo@luschemlcalstorage.com
www.uschemlcalstorage.com
US Chemical Storage has been manufacturing chemical storage structures in Wilkesboro, North Carolina for over 15
years . Our dedicated wor kforce and strict quality control combine to provide superb value t o our customers.
The following proposal is based upon your specifications and is conceived to provide an efficient solution to your
storage requ irements. After order placement we will provide you wit h an approval drawing for review detailing you r
project. Only after you review and sign the drawing wlll we begin fabrication of your equipme nt. Our customer service
team will guide you through the entire process and is always available to provide informatio n and assistance in working
with approval authorities.
We will contact you in a few days to review this proposal and answer any quest ions or concerns you m ay have. Pleas e
contact us in the meantime should you require any further information.
Thank you for the opportunity to work with you on this project .
Sincerely,
PATRICK HARRIS
Technical Sales Eng ineer
Direct: (336) 990-0668
pharris@uschemicalstorage.com
02/12/2018 US CS Quote:0004628 Page 1
101518a HCBOC Page 220
~ U.S. CHEMICAL
~ 111ra11 ®
QUOTE : 0004628
BUILDING QUOTATION PREPARED FOR:
Ms. AMANDA BADER
Harnett County, NC
PO B0X940
LILLINGTON, NC 27546
DL2408 NONFR 24X8X8 33DRUM FM
Full Storage:
Bldg Weight: 7,464 Lbs
Snow Load: 40 PSF
Sump Capacity: 683 Gallons
Wind Load: 90 MPH Exp. C
Floor Load: 500 PSF
Seismic: Category: C
Drum Capacity: 33
Standard Features
GRANT CONTRACT NO. 7562
ATTACHMENT C
1806 River Street
WIikesboro, NC 28697
Phone: (800) 233-1480
Phone: (336) 990-0601
Fax: (336)·990-0076
Emal~ info@uschemicalstorage.com
www.uschemicalstorage.com
Date: 2/9/2018
The steel used to fabricate the model quoted here is the highest grade American made steel and is free from
rough edges, kinks and sharp bends. Our manufacturing does not reduce the strength of the steel to a value
less than intended by the UL design . Our manufacturing is done precisely and in a neat fashion and all bends
are made by controlled means to ensure uniformity and strength . Our welding procedures are in accordance
with the American Welding Society and meet standards set forth by the ASTM, and all welds are sufficient In
size and shape to accommodate UL listed wall designs.
Actual Exterior: 24' x 8' x 8'4" Actual Interior: 23'3" x 7'3" x 7'2"
Locker Construction: Non-Combustible weatherproof construction with welded exterior 12-gauge steel panels
and 10-gauge sump for maximum durability and strength. Wall studs are 3-1/2" by 2" for superior strength,
manufactured from 12 gauge steel and producing a 3-1/2" wall cavity ready to accept standard insulation if
required. Continuously welded roof and sump sections provide added rigidity in transit and use.
02/12/2018 uses Quote: 0004628 Page2
101518a HCBOC Page 221
~U.S. CHEMICAL 111raae®
GRANT CONTRACT NO. 7562
ATTACHMENT C
1806 River Street
Wilkesboro, NC 28697
Phone: (800) 233-1480
Phone: (336) 990-0601
Fax: (336)·990-0076
Emalt lnfo@uschemlcalstorage.com
www.uschemicalstonage.com
Roof /Ceiling: Noncombustible weatherproof construction same as building walls. Continuously welded
12-gauge steel roof permanently attached to building. Equipped with rain shield over door.
Spill Containment Sump Construction: Built in 7" deep leak tight secondary containment sump surpasses FM
spill containment requirements. Heavy-duty construction utilizes 10-gauge steel for superior structural
support. Removable galvanized steel floor grating rated SOOpsf for heavy drum/pallet loads. Structural steel
floor supports are easily removed for clean up of spills within the sump.
Building Base: Open channel construction for under-sump inspection. Steel C-channels and hold down
brackets provided for ease of offloading and securing to site. Attains seismic and wind load anchoring.
Static Grounding System: Three (3) Interior grounding lugs, one (1) exterior static grounding connection and
one (1) galvanized steel grounding rod for prevention of explosive sparking hazards.
Ventilation: Gravity Air Flow Vents in both high and low positions, with weatherproof galvanized steel frame
and louvers to provide adequate air flow and natural draft. Interior screened openings prevent pest entry.
Signage: Permanent D.O.T . metal flip placard with rust proof aluminum holder and stainless steel clips. One
(1) pressure sensitive NFPA 704 Hazard Rating sign on door.
Certifications: Factory Mutual (FM) Approval label affixed.
Building Finish: After an extensive cleani ng process the interior and exterior surfaces are protected with a high
solids alkyd universal metal primer (primer) and a high solid acrylic alkyd enamel top coat providing proven
interior chemical resistance.
Accessories (may increase exterior dimensions)
Color Choices
BLEACHED BONE, WHITE, DOVE GRAY, BARBER GREEN, or AZTEC BROWN
Electrical Panel -Qty 1
UL LISTED, SINGLE PHASE, 3 WIRE, 120/240V 100 AMP 8 SPACE LOAD CENTER (NEMA 3R). RAINPROOF AND
SLEET-(ICE) RESISTANT-OUTDOOR ENCLOSURES ARE INTENDED FOR USE OUTDOORS TO PROTECT THE
ENCLOSED EQUIPMENT AGAINST RAIN AND MEET THE REQUIREMENTS OF UNDERWRITERS' LABORATORIES,
INC., PUBLICATION NO. UL 508, APPLYING TO "RAINPROOF ENCLOSURES." OTHER ELECTRICAL
CONFIGURATIONS AVAILABLE, ADDITIONAL COSTS MAY APPLY.
02/12/2018 uses Quote: 0004628 Page 3
101518a HCBOC Page 222
~ U.S. CHEMICAL
~ 111r111(it
Ory Chemical Fire Suppression -Qty 1
GRANT CON TRACT NO. 7562
ATTACHMENT C
1806 River Street
WIikesboro, NC 28697
Phone: (800) 233-1480
Phone: (336) 990-0601
Fa,c : (336)·990-0076
Emal~ info@uschemicalstorage.com
www.usd1emlcalstor1ge.com
UL, ULC LISTED AND FM APPROVED PRE-ENGINEERED DRY CHEMICAL FIRE SUPPRESSION SYSTEM FOR CLASS
A,B AND C FIRES. EQUIPPED WITH MEANS FOR REMOTE ANNUNCIATION. SYSTEM INCLUDES FUSIBLE LINK
DETECTION FOR AUTOMATIC ACTUATION , MANUAL PULL STATION, AND NOZZLE(S) FOR TOTAL FLOODING
APPLICATION . AGENT STORAGE LOCATED ON BUILDING EXTERIOR IN WEATHERPROOF ENCLOSURE.
AUDIBLE ALARM INCLUDED WITH SYSTEM . SYSTEM IS DELIVERED UNARMED AND MUST BE ARMED AND
CERTIFIED BY A LICENSED REP.
Air Inlet -Qty 3
AIR INLET VENT TO PROVIDE NATURAL VENTILATION . VENT IS EQUIPPED WITH AN EXTERIOR LOUVER AND
AN INTERIOR SCREEN TO PREVENT PEST ENTRY.
2 Ft. LED Strip Light -Qty 3
LED LOW PROFILE, CEILING OR WALL MOUNT, 2FT NOMINAL LENGTH STRIP LIGHT. UL 1598A, 844, 1598, &
8750; CUL LISTED. CLASS 1, DIV 2, GROUPS A, B, C, & D. CLASS 2, DIV 2, GROUPS F & G. NEMA 4X. DESIGNED
FOR USE IN HAZARDOUS LOCATIONS AND WHERE MOISTURE, DIRT, DUST, CORROSION AND VIBRATION MAY
BE PRESENT. ALUMINUM BODY W/ GRAY EPOXY FINISH ; T-ONE PIECE, NEOPRENE GASKET AND DIFFUSED
POLYCARBONATE LENS. 120-277/1, 50 OR 60HZ. 3737 LUMENS, 40 WATTS
XP Exhaust Fan -Qty 1
EXPLOSION PROOF EXHAUST FAN CONSISTING OF ONE (1) UL LISTED, CLASS I, DIVISION 1, GROUP C AND D
TOTALLY ENCLOSED MOTOR (llSVAC, 4.SA, 60HZ, 1-PHASE) WITH NON-STATIC TWELVE-INCH (12)
DIAMETER CAST ALUMINUM FAN BLADE. EXTERNAL HOUSING CONSTRUCTED OF 18 GA STEEL,
EPOXY-COATED OUTSIDE . EXHAUST INTAKE VENTS LOCATED WITHIN TWELVE INCHES (12) OF THE FLOOR.
ACTIVATED BY AN EXTERIOR UL LISTED FAN SWITCH . EXTERIOR EXHAUST FAN PORT OPENING EQUIPPED
WITH SHUTTER ASSEMBLY AND SCREEN . MECHANICAL VENT IS SIZED TO ALLOW FOR A MINIMUM OF 6 AIR
CHANGES PER HOUR.
Stainless Steel Shelving -Qty 36
STAINLESS STEEL SUMP SHELVING : ADJUSTABLE 16" LEAKPROOF STAINLESS STEEL SHELVING FORMED ANO
WELDED FROM HEAVY GAUGE STEEL WITH A 2" LIP AROUND THE ENTIRE SHELF. SHELVING LENGTHS ARE
APPROXIMATE AND MAY VARY DUE TO SPACE LIMITATIONS. PRICE IS PER LINEAR FOOT.
CL/DL PARTITION WALL 6'-8' -Qty 2
INTERIOR SEPERATION WALL FOR CL MODELS (6 1
-8' NOMINAL). NON-FIRERATED WALL CONSTRUCTION,
SEPERATION WALL EXTENDS FROM SUMP BASE TO CEILING .
Door· Qty 3
54"W X 8011 H 12 GAUGE STEEL DOOR. HEAVY-DUTY HARDWARE INCLUDES 3-POINT LOCKING SYSTEM WITH
KEYED MALLEABLE IRON DOOR HANDLE. INTERIOR SAFETY RELEASE LEVER. EXTERIOR DOOR HOLD OPEN.
02/12/2018 uses Quote: 0004628 Page4
101518a HCBOC Page 223
Qtv. of Units: 1
Subtotal: $36,172.00
Freight Estimate• FREIGHT NOT INCLUDED. ADDED TO INVOICE
Total Price: $36,172.00
All prices here in are quoted In US Dollars
Expiration: This Quotation Expires 30 DAYS from date of issue.
GRANT CONTRACT NO. 7562
ATTACHMENT C
1806 River Street
Wilkesboro, NC 28697
Phone: (800} 233·1480
Phone: (336) 990-0601
Fax: (336)-990--0076
Emal~ lnfo@u~hemlcalstorage.com
www.uschemlcalstor.age.com
Estimated Lead Time: 8-10 WEEKS
Actual Lead time may vary based
upon factory load at time of order.
Payment Terms: 50% Deposit Due at Order and Prior to Beginning of Lead Time, 50% Balance Due Net 30
From Date of Shipment. A 1% discount will be allowed for final payments received and
deposited within 15 days of shipment. A 1% penalty per month will be applied to balances
past 30 days.
Signature PO #
(Customer is responsible to check with appropriate agencies to determine ifony third party or local
approvals ore necessary. This order does not Include tax, offloading anchoring, arming .of dry chemical
fire suppress/an, electricol/w ater connections or permits. This order is subject to US Chem leaf Storage
LL C 's term s a n d ca n d itio n s w h le h a re lo ca t e d In ya u r b u i Id in g m an u a I w h ic h ca n b e do w n lo a de d fro m
.h.!!J1.://www.uschemicalstora 9 e .com /c om ~any1terms -and-cond itions .html. Projected lead time may vary and
w II/ be updated at time of order. Custom er is responsible for offloading and positioning of their building
on site .)
•freight is an estlm ate only, we w ii/attempt to honora freight quote but con not guarantee rates.
Ac curate freight prices will be a va ila b le pf/Or to a ctu a Id eliv e ry . At on y tim e customer m a y arrange for their own freight.
02/12/2018 uses Quote: 0004628 Pages
101518a HCBOC Page 224
~ U.8. CHEMICAL
~ 111r111G
GRANT CONTRACT NO. 7562
ATTACHMENT C
1806 River Street
Wll kesboro, NC 28697
Phone: (800) 233-1480
Phone: (336) 990-0601
Fax: (336)-990-0076
Em•lt info@uschemicalstorage.com
www.uschemlcabtorage.com
Optional Components (Additional to Subtotal and Total Price Listed Above)
State Approval-NC Qty 1 ........ 0ptlonal, please add $6,395.00 to total price
STATE APPROVAL-NORTH CAROLINA REVIEW, DESIGN AND/OR INSPECTION AS REQUIRED BY THE
STATE . THIS PROCESS WILL ADD SEVERAL WEEKS TO THE OVERALL CONSTRUCTION TIME DUE TO
REQUIRED REVIEW AND INSPECTIONS. US CHEMICAL STORAGE WILL PROVIDE AN UPDATED
OVERALL PROJECT LEAD-TIME CONSIDERING THIS APPROVAL AND CONSTRUCTION TIME AT THE
POINT OF ORDER .
lifting Lugs Qty 1 ........ 0ptlonal, please add $469.00 to total price
(4) 1" FLAT BAR X 4" WIDE HOT ROLLED STEEL WITH 11/4" HOLE FOR CHAIN.
Shrink Wrap Qty 1 ........ 0ptional, please add $2,298.00 to total price
7 MIL SHRINK WRAP APPLIED TO BUILDING PRIOR TO SHIPMENT TO PROECT FROM MINOR DIRT,
ROAD SALT AND OTHER ACCUMULATED RESIDUE THAT MAY BE ENCOUNTERED DURING SHIPMENT.
02/12/2018 uses Quote: 0004628 Page6
101518a HCBOC Page 225
Electrical Solutions Of NC INC .
902 Friendly Rd
Dunn, NC 28334
(910) 892-2452
electricalsolutionsnc@gmail.com
Name / Address
Anderson Creek Landfill
Description
Install a 100 amp service from scale house to new conex (UP TO
100')
Install Conduit underground to run circuit through
Install 100 amp fusible disconnect on outside of conex
Permit will need to be issued for doing worlc
Price for work stated above
GRANT CONTRACT NO. 7562
ATTACHMENT C
Estimate
Date Estimate#
2/15/2018 1599
Project
Qty Cost Total
3,200.00 3,200.00
Total $3,200.00
Customer Signature
101518a HCBOC Page 226
RL T & Associates, Inc.
111 Tasha Lane
Fuquay-Varina, NC 27526
Name/ Address
Hamett County Solid Waste
P0Box2773
Lillington, NC 27526
'
Description
Location: Anderson Creek Landfill
Saw cut asphalt Install 200 If of 18" double wall plastic pipe with a
l B" grate and frame. Pour a 4'x4 ' concrete slab around the grate and
frame. Install a metal cap over frame and grate that is moveable .
Patch asphalt
Mobilization
Saw cut asphalt
Provide and fastall 200 If of l B" DWPP
Basin grate and frame
Backfill and grade to drain to basin
4'x4 ' concrete slab
Cap old existing pipe
Asphalt patch
Phone# Fax#
919-552-4489 919-552-9600
Qty
Page 1
GRANT CONTRACT NO. 7562
ATTAC HMENT C
Proposal
Date Proposal #
2/13/2018 1198
P.O. No . Terms
Cost Total
500.00 SOO.OOT
77S.OO 775.00T
7,250.00 7,2SO.OOT
1,675.00 1,675.00T
650 .00 650.00T
600.00 600.00T
400.00 400.00T
3,420.00 3,420.00T
Total
101518a HCBOC Page 227
RL T & Associates, Inc.
111 Tasha Lane
Fuquay-Varina. NC 27526
Name I Addreaa
Hamett County Solid Waste
P0Box2773
Lillington, NC 27S26
Description
All material is guaranteed to be as specified and the above work to
be perfonned in accordance with the drawings and specifications
submitted for above work and completed in a substantial
workmanlike manner. With the payments to be made as follows :
Due within l S Days of Receipt of Invoice. ..Exclusions: Testing.
Unsu itable Soil/Rock/Materials & Permits unless specifically noted
in above description. Note: This Proposal may be withdrawn by
us if not accepted within 15 Days. Any Alteration or deviation from
above specifications Involving elttJ'II cost, will be executed only
upon written orders and will become an extra charge over and above
the estimated. Womnen's Compensation and Public Liability
Insurance on above work to be taken out by: RL T Construction
and/or RI.. T and Associates.
Acceptance of Proposal: The above prices, specifications and
conditions are satisfactory and are hereby accepted. You arc
authori?.ed to do woit as specified. Payment will be made as
outlined above. Accounts over 1 S days will incur a monthly service
charge of
1.S%
••••••••••0 ••1bis proposal is valid for J 5 days.
Hamett Co 7.0%
Phone# Fax#
919-SS2-4489 919-SS2·9600
Qty
Page2
GRANT CONTRACT NO. 7562
ATTACHMENT C
Proposal
Date Propoaal#
2/13/2018 1198
P.O.No. Terms
Co.t Total
7.00o..4 1,068.90
Total $16,338.90
101518a HCBOC Page 228
GRANT CONTRACT NO. 7562
ATTACHMENT D
Notice of Certain Reporting and ~udit Requirements
A recipient or subrecipient shall comply with the all rules and reporting requirements established by
statute or administrative rules found in 09 NCAC Subchapter 3M. For convenience , the requirements of
09 NCAC Subchapter 3M .0205 are set forth in this Attachment.
Reporting Thresholds.
There are three reporting thresholds established for recipients and subrecipients receiving State awards
of financial assistance. The reporting thresholds are :
(1) Less than $25 ,000 - A recipient or subrecipient that receives , hold , uses , or expends
State financial assistance in an amount less than twenty-five thousand dollars ($25,000)
within its fiscal year must comply with the reporting requirements established by this
Subchapter including:
(A) A certification that State financial assistance received or held was used for the
purposes for which it was awarded ; and
(8) An accounting of all State financial assistance received , held , used , or expended.
(2) $25,000 up to $500,000 -A recipient or subrecipient that receives, holds uses , or expends
State financial assistance in an amount of at least twenty-five thousand ($25,000) but
less than five hundred thousand dollars ($500 ,000) within its fiscal year must comply with
the reporting requirements established by this Subchapter including:
(A) A certification that State financial assistance received or held was used for the
purposes for which it was awarded ; and
(8) An accounting of all State financial assistance received , held , used , or expended.
(C) A description of activities and accomplishments undertaken by the recipient ,
including reporting on any performance measures established in the contract.
(3) Greater than $500 ,000 - A recipient or subrecipient that receives, holds , uses , or
expends State financial assistance in the amount equal to or greater than five hundred
thousand dollars ($500,000) within its fiscal year must comply with the reporting
requirements established by this Subchapter including :
(A) A certification that State financial assistance received or held was used for the
purposes for which it was awarded; and
(8) An accounting of all State financial assistance received , held , used, or expended.
(C) A description of activities and accomplishments undertaken by the recipient ,
including reporting on any performance measures established in the contract.
(D) A single or program-specific audit prepared and completed in accordance with
Generally Accepted Government Auditing Standards , also known as the Yellow
Book.
Other Provisions:
1. All reports shall be filed with the disbursing agency in the format and method specified by the agency
no later than three (3) months after the end of the recipient's fiscal year , unless the same information is
already required through more frequent reporting. Audits must be provided to the funding agency no
later than nine (9) months after the end of the recipient's fiscal year.
2. Unless prohibited by law, the costs of audits made in accordance with the provisions of 09 NCAC 03M
.0205 shall be allowable charges to State and Federal awards. The charges may be considered a
direct cost or an allocated indirect cost, as determined in accordance with cost principles outlined in
the Code of Federal Regulations , 2CFR Part 200. The cost of any audit not conducted in accordance
with this Subchapter shall not be charged to State awards.
3. Notwithstanding the provisions of 09 NCAC 03M .0205 , a recipient may satisfy the reporting
requirements of Part (3)(0) of this Rule by submitting a copy of the report required under the federal
law with respect to the same funds .
4. Agency-established reporting requirements to meet the standards set forth in this Subchapter shall be
specified in each recipient's contract.
101518a HCBOC Page 229
Agenda Item -~4--L=----
Board Meeting
Agenda Item
MEETING DATE: October 15, 2018
TO: HARNETT COUNTY BOARD OF COMMISSIONERS
REQUESTED BY: Jol
REQUEST:
At the October 2, 2018 meeting, the Board of Health approved to increase the following
fees:
CPTCODE
90621
90662
90670
90674
90681
90698
90710
90732
DESCRIPTION
Trumenba
Fluzone High Dose
Prevnar 13
Flucelvax Quad
Rotarix
Pentacel
Proquad
Pneumovax 23
RECOMMENDED PRICE
$180
$78
$210
$49
$116
$88
$225
$105
They also approved a new vaccine to be offered at the Health Department.
90750 Shingrix $182
Your approval of this request is appreciated.
FINANCE OFFICER'S RECOMMENDATION:
COUNTY MANAGER'S RECOMMENDATION:
\\hcfileb\ht hshare\admin\Fileshare\1-Excel\BOH PAT FEE INC-NEW FEES-BOC Requests\BOH 100218\BOC Age nda
Form Vacc in es 0920 18 10011 8 .docx Page I of I 101518a HCBOC Page 230
Agenda Item _ ___...;4:....-~M-=----
Board Meeting
Agenda Item
MEETING DA TE: October 15, 2018
TO: HARNETT COUNTY BOARD OF COMMISSIONERS
SUBJECT: Benhaven Emergency Services request permission to purchase a
compressor.
REQUESTED BY: Jimmy Riddle, Emergency Services Director
REQUEST:
Benhaven Emergency Services is requesting permission to purchase a compressor to replace
their 2006 compressor that is no longer operational which is used to fill their cascade system
at the station, on the rescue truck and the scba bottles.
They will replace it with a Legacy 13 Vertecon 13CFM 6KPSI 1 OHP from Safe Air Systems
in the amount of $21,387.13 ($19,999.10 + $1,388 .03 sales tax). It will have a five year
compressor block warranty and a 2 year warranty on the rest of the system.
The Benhaven Emergency Services Board of Directors approved this purchase on October 1,
2018.
The funds will be taken from their Capital Outlay Reserve Fund.
See attached request letter and quote from Benhaven Emergency Services.
FINANCE OFFICER'S RECOMMENDATION:
COUNTY MANAGER'S RECOMMENDATION:
C:\User s\bstancil\Desktop\agendaform2018.docx Page I of I
101518a HCBOC Page 231
..... EIE I IE
October 2, 2018
Mr. Jimmy Riddle
Emergency Services Director
Harnett County
1005 Edwards Brother Drive
Lillington, NC 27546
Dear Mr. Jimmy Riddle:
During the last 90 days we have experienced issues with our compressor that fills our cascade system at the
station, on the rescue truck and the scba bottles. We have contacted our Bauer service center who came out
and evaluated our system . The results were that the system was put on line on January 16, 2006 and the
system was timing out and overheating due to normal wear and tear due to the age of the system. It was also
due to the system being a 5 CFM system which is typical suited for a dive shop operation. The option for our
system is to do what they call a top end rebuilt to the compressor. The cost of the rebuilt was $4,169.12 with
a 90 workmanship warranty.
The situation was discussed with the board equipment committee and then with the full board on October 1,
2018. The board discussed the age of the system, cost of repair, warranty and chances of failure of the repair
and other components not replaced during the repair. The board reached the conclusion that it was not
economically feasible to repair an almost 13 year old system with little warranty and no guaranty on how
long it would last. They also considered the fact that the system was undersized for our use and we would go
from a 5 CFM system to a 13 CFM system. Based on the above information we are requesting to spend
$19,999.10 of funds not in our current budget to replace our compressor. It will have a five year compressor
block warranty and a 2 year warranty on the rest of the system. We will be able to make the purchase out of
our Capital Outlay Reserve fund . Thank you for your consideration on this matter.
Sincerely,
<@,4~
RA (Andy) Thomas, Chief
P. 0. Box 301 • Olivia, NC 28368
4023 NC HWY. 87 N. • Sanford, NC 27332 • Phone : 919-499-9511 • Fax : 919-498-0188 101518a HCBOC Page 232
210 Labrador Drive
Randleman, NC 27317
www.safeairsystems.com
toll free 800.424.8633
BILL TO:
Quote
SHIP TO:
info@safeairsystems.com
phone 336.674.0749
fax 336.674.3688
QUOTE# 0166156
Date: 7/24/2018
Customer Number: 0000084
BENHAVEN EMERGENCY SERVICES
PO BOX 301
BENHAVEN EMERGENCY SERVICES
4023 HWY 87 NORTH
OLIVIA, NC 28368 SANFORD, NC 27332
Confirm To: ANDY THOMAS, CHIEF PO#:
Qtv. Item
.. 5 YEAR BAUER COMPRESSOR BLOCK WARRANTY AND 2 YEAR WARRANTY ON REST OF
SYSTEM ..
1.00 LEGACY 13 VERTECON 13CFM6KPSI 10HP
VERTECON 13CFM 6KPSI 10HP
Bauer Open Vertical Compressor/Purifier configured for 13.0 scfm, 6000 psig, 4-stage
compressor, 10 hp, phase motor and 67,000 scf capacity purifier, integrated
purification system that meets NFPA 1989 requirements for firefighting and CGA Grade E
air for SCUBA, purifier indudes steel mechanical separator chamber, as well as purifier
safety vent port to prevent operating system w/o cartridge. Standard with Bauer long-life,
well-cooled, oil-pressure lubricated compressor block with stainless steel intercoolers,
high-temperature & low oil pressure shutdowns. Mounted pressure gauges for oil, final
stage and purifier. Includes PLC with touch pad controller with full color display, lighted
on/off switch, hour meter, emergency stop button, safety over-time timer, motor
controls/protection and UL-rated electrics.
AUTO CONDENSATE DRAIN SYSTEM
-Timed automatic drain, includes silencer and collection reservoir and user display
indicator if "full".
MTD INTERSTAGE PRESSURE GAUGES
SECURUS PURIFIER MONITOR SYSTEM
-Built-in, continuous monitor for purification cartridges.
-Includes user display indicators for "safe", "high moisture", "cartridges expired" and
"contact fault".
-Automatic system shutdown for faults; fail-safe (can not be over-ridden); no warm up
required.
-Can extend the purifier cartridge's useable life.
1.00 26-SASC0-24V PNL MOUNTED CO MONITOR 24 V
1.00 OUTV-KIT/ VERT COMP OUTLET VLV KIT
1.00 /AIRTEST-N11989-NC AIRTEST SINGLE GRADE 1989 (08)
1.00 /FREIGHT ES-FREIGHT
2.00 /SHOP LABOR-NC
7.00 /FIELD LABOR-NC
ES-SHOP LABOR
FIELD LABOR-NC
Salesperson:
HOUS Amount
Continued
101518a HCBOC Page 233
QUOTE# 0166156
126.00 /MILEAGE ES-MILEAGE
0 5 YEAR BAUER COMPRESSOR BLOCK WARRANTY AND 2 YEAR ON REST OF SYSTEM**
THIS QUOTE IS FOR A BAUER OPEN LEGACY 13 WITH THE FOLLOWING FEATURES: 13 CFM, 6000 PSI, 10 HP, SINGLE
PHASE MOTOR, AUTO CONSENDATE DRAIN, INTERSTATE GAUGES, ELECTRIC MOISTURE MONITOR AND CO MONITOR.
INSTALLATION WILL INCLUDE THE USE OF THE CUSTOMERS EXISTING (4) 6000 PSI DOT CYLINDERS AND EAGLE FILL
STATION. NOTE: HOSES AND FITIINGS WILL BE INSPECTED AT TIME OF INSTALLATION AND ANY IN NEED OF
REPLACEMENT WILL BE BROUGHT TO THE ATIENTION OF THE CUSTOMER AND THE COST, PLUS TAX, WILL BE ADDED
TO FINAL INVOICE.
ONE TIME AIR TEST WILL BE PULLED AT TIME OF START UP.
****FREIGHT IS ESTIMATED.
****PRICE INCLUDES DELIVERY AND INSTALLATION OF EQUIPMENT TO CUSTOMERS LOCATION. USER TRAINING WILL
BE CONDUCTED AT TIME OF INSTALLATION.
****CUSTOMER TO SUPPLY SUITABLE ELECTRICAL CONNECTION FOR THIS UNIT TO INCLUDE WALL MOUNT
DISCONNECT AND PIG TAIL (PIG TAIL CONSISTS OF 10 FT OF FLEX CONDUIT WITH 90 DEGREE ELBOW AND 12 FT OF
WIRE). SAFE AIR SYSTEM WILL MAKE FINAL CONNECTION.
Includes: • Estimated Freight • * Delivery * * Setup, installation and piping * * Startup and System Verification * •
Comprehensive User Training *
Terms: NET 30 DAYS
FOB: Randleman, NC
Quote is mlid for 30 days, unless othenrise stated.
Deliverv: 30 -60 days after receipt of order
Shio Via: BESTWAY
Final billinfl mai• include sales tax if applicable.
1.5% Monthly Finance Charge will apply to any unpaid balance after payment due date.
Safe Air Systems is a Master Distributor for
Net Order:
Sales Tax:
Order Total:
2
$19,999.10
$1,388.03
$21,387 .13
www.safeairsystems.com
210 Labrador Drive
Randleman, NC 27317
i=f21i1§j~
COMPRESSORS
Oflice(336)674-0749
Fax (336) 674-3688
101518a HCBOC Page 234
QUOTE# 0166156
OPTIONAL EQUIPMENT AND/OR SERVICES:
5 YEAR COMPRESSOR PREVENTIVE MAINTENANCE & AIR TESTING PROGRAM.
THE COMPRESSOR MAINTENANCE AND AIR TESTING PROGRAM WILL BE IN EFFECT FOR YOUR FIRST FIVE YEARS
OF OWNERSHIP. THE PROGRAM INCLUDES AN ANNUAL SITE VISIT DURING WHICH YOUR EQUIPMENT Will BE
SERVICED ACCORDING TO THE MANUFACTURERS' REQUIREMENTS. THE PROGRAM ALSO INCLUDES BEFORE ANO
AFTER AIR TESTING AND QUARTERLY AIR TESTING AS REQUIRED BY THE NFPA.
WITH THE AIR TESTING PROGRAM YOU Will RECEIVE A DETAILED REPORT WITH EACH SAMPLE TAKEN
ADVISING THE
QUALITY OF AIR THAT YOUR EQUIPMENT IS PRODUCING.
ADVANTAGES OF THIS PROGRAM ARE:
*IDENTIFIES OUT OF POCKET EXPENSES FOR YOUR COMPRESSOR DURING YOUR FIRST 5 YEARS OF SYSTEM
OWNERSHIP, ASSUMING NO MALICIOUS ACTS OR ACTS OF GOD.
*MEETS BAUER'S REQUIREMENTS TO KEEP THE WARRANTY IN EFFECT.
*MEET'S NFPA 1989, 2013 EDITION REQUIREMENTS FOR SERVICING & AIR TESTING.
COST FOR THIS PROGRAM IS $6,443.00
Sales Department
Order Acceptance
Any changes made after signed acceptance of quote and customer requirement sheet will result in a change order fee.
Sign: Title:
Date: PO#
Safe Air Systems is a Master Distributor for
3
\Y\Vw.safeairsystems.com
210 Labrador Drive
Randleman, NC 27317
[ !Z'(i)3;~
COMPRESSORS
Office (336) 674-0749
Fax (336) 674-3688
101518a HCBOC Page 235
Agenda Item _ __::.4-:-N~--'
Board Meeting
Agenda Item
MEETING DATE: October 15, 2018
TO: HARNETT COUNTY BOARD OF COMMISSIONERS
SUBJECT: Joint Resolution Adopting North Carolina Geodetic Survey's Resurvey of
the Common Boundary Between Harnett County and Wake County
REQUESTED BY: Clint Williams, GIS/E-911 Operations Administrator
REQUEST:
Harnett County GIS/E-911 requests that the Board of Commissioners:
1. Adopts the location of the boundary line between Hamett County and Wake County in
accordance with the attached plat prepared by North Carolina Geodetic Survey, and
adopts the attached joint resolution.
2. Directs the Hamett County Tax Administrator to assess parcels, or portions thereof, that
have previously been assessed in Wake County but will now be in Hamett County, in
accordance with the attached plat prepared by North Carolina Geodetic Survey and
mutually agreed to by this Board and th e Wake County Board of Commissioners.
FINANCE OFFICER'S RECOMMENDATION:
COUNTY MANAGER'S RECOMMENDATION:
S :\Agenc ics\Board of Commissioncrs\Agcndas\a gendafonn2018-1015-Hamctt-Wakc-County-Line.docx
I of2
Page
101518a HCBOC Page 236
Agenda Item Additional Information
Item Title : Joint Resolution Adopting North Carolina Geodetic Survey's ResuNey of the
Common Boundary between Harnett County and Wake County
Specific Action Requested:
That the Board of Commissioners:
1. Adopts the location of the boundary line between Harnett County and Wake
County in accordance with the plat prepared by North Carolina Geodetic
Survey, and adopts the joint resolution.
2. Directs the Harnett County Tax Administrator to assess parcels, or portions
thereof, that have previously been assessed in Wake County but will now be
in Harnett County, in accordance with the plat prepared by North Carolina
Geodetic Survey and mutually agreed to by this Board and the Wake County
Board of Commissioners.
Item Summary:
Purpose:
Background :
North Carolina General Statute 153A-18 gives Counties the autho rity
to mutually establish county boundary lines that are uncertain
through ratification of a survey prepared by North Carolina Geodetic
Survey .
On April 16 , 2018 , the Board of Commissioners jointly agreed with
the Wake County and Chatham County Board of Commissioners to
resolve issues with the boundary line by first authorizing legislation
to establish the correct common corner shared by all three counties .
On June 25, 2018, the North Carolina General Assembly ratified
legislation, Session Law 2018-62, that corrects the common corner
for Wa ke , Harnett, and Chatham Counties .
The next step is to resolve uncertainties in the shared boundary line
between Wake County and Harnett County. This can be
accomplished by mutua l agreement (Joint Resolution) of the plat
prepared by North Carolina Geodetic Survey that depicts the newly
established boundary line (attached ).
If adopted , the Resolution will also direct the Harnett County Tax
Administrator to assess parcels, or portions thereof, that have
previously been assessed in Wake Co unty but will now be in Harnett
County.
101518a HCBOC Page 237
All changes to the County line described herein become effective on
January 1, 2019. Staff has been in contact with all impacted property
owners and has notified them of today's meeting .
Additional Information:
Uncertainty with the location of county boundary lines is not uncommon in North Carolina.
Today's technology can locate boundary lines much more precisely and uncover
discrepancies in those boundaries. These discrepancies can create issues when it comes
to tax assessment, property value , deed recordation, zoning, building permitting , public
safety, board of elections , and the school system.
The current issue has been prompted by differences between the boundary line that
Harnett County uses versus the one that Wake County uses . In some instances, the
boundary line used between the two counties varies as much as several hundred feet.
This has resulted in confusion over the delivery of services and tax assessment to the
properties along the boundary line.
Given the uncertainties, Harnett and Wake County staff requested North Carolina
Geodetic Survey to conduct historical research and field work to determine the accurate
location of the shared boundary line. During their work they discovered errors in the 1961
Wake County and Chatham County survey whereby the Wake/Chatham/Harnett corner
was incorrectly located. This error was corrected in the recent Session Law 2018-62 and
was supported by all three counties. With this correction, Harnett County and Wake
County can now proceed with resolving the uncertainty in their shared boundary line.
North Carolina Geodetic Survey has completed the field work and prepared a plat
showing where the Harnett and Wake County boundary line should be (attached). In
accordance with North Carolina General Statute 153A-18, both Harnett County and Wake
County can mutually agree to establish this as the county boundary line .
Since last year, staff from each county have been working collaboratively on identifying
all the parcels impacted by the boundary line issue. Staff conducted two community
meetings (December 5, 2017 and March 27 , 2018) where property owners were able
learn more about the issue. Property owners were also sent letters detailing the impact
on their property. For example, where the boundary line splits a parcel , the property will
now become split assessed between the two counties. This is in accordance with state
law. In other cases , the property will move entirely from one county to the other. Two of
the more common concerns from property owners are : 1) will future development be
restricted in some way on a parcel that is split between the two counties? and 2) will a
split parcel affect the current agricultural tax deferment (which allows property owners
who are farming their land to have a reduced tax value until the property transitions to a
non-agricultural use)? The answer to both questions is no impact at all.
101518a HCBOC Page 238
The following summarizes the property impacts along the Harnett/Wake County boundary
line:
Harnett I Wake County Boundary -PRELIMINARY EST/MA TES
Properties Affected Count Estimated
Value
Homes moving from Wake to Harnett (Gain) 10 $1,266 ,193
Homes moving from Hamett to Wake (Loss) 5 $ 588 ,260
Homes split between Harnett and Wake (Gain) 8 $ 198,955
Parcels split between Harnett and Wake with a (Gain) 51 $ 389,930
Parcels split between Harnett and Wake with a (Loss) 34 $ 382 ,880
Total Preliminary Estimated Tax Value for Harnett (Gain) $ 883,938
Total Preliminary Estimated Tax Revenue for Harnett (Gain) $ 6,630
The attached resolution is also being considered by the Wake County Board of
Commissioners at their meeting on October 15, 2018. Should both boards adopt it, the
newly established line will become effective on January 1, 2019. Several months prior to
the effective date , each County will apply zoning to the properties, or portions thereof,
that are being transferred into the county . Property owners will be notified during this
process. Additionally, each County will record with their Register of Deeds a document
that identifies all impacted parcels resulting from this corrective action of the county
boundary line .
101518a HCBOC Page 239
JOINT RESOLUTION ADOPTIONG AND ESTABLISHING THE COMMON
BOUNDARY LINE BETWEEN WAKE COUNTY AND HARNETT COUNTY
WHEREAS, N.C.G.S. § 153A-18 provides that if two or more counties are uncertain as
to the exact boundary between them, they may cause the boundary to be surveyed, marked and
mapped; and
WHEREAS, pursuant to a Joint Resolution with Wake County, Harnett County and Chatham
County approved by the Harnett County Board of Commissioners and Wake County Board of
Commissioners on or about April 16, 2018, North Carolina Geodetic Survey was authorized to
locate and survey the boundary line between Wake County and Hamett County; and
WHEREAS, as part of the preliminary survey work completed by North CaroJina
Geodetic Survey, it was determined that Wake County and Chatham County had been using a
boundary comer established by survey in 1961 that differed from the actual location of the
Wake/Chatham/Harnett tri-county boundary comer; and
WHEREAS, pursuant to SL2018-62 ratified by the North Carolina General Assembly on
or about June 25, 2018, the tri-county comer boundary between Wake, Chatham and Harnett
County was established in accordance with N.C.G.S. § 153A-17; and
WHEREAS , now that the tri-county comer has been established, Wake County and
Harnett County mutually desire to finalize the location of the common boundary shared between
them; and
WHEREAS, North Carolina Geodetic Survey has prepared an official survey of the
Wake County and Harnett County common boundary for adoption and ratification by the Wake
County and Hamett County Boards of Commissioners.
NOW THEREFORE, BE IT RESOLVED BY THE WAKE COUNTY BOARD OF
COMMISSIONERS AND THE HARNETT COUNTY BOARD OF COMMISSIONERS
that the survey completed by the North Carolina Geodetic Survey attached hereto as Exhibit A is
hereby adopted for the purpose of locating the common boundary between Wake County and
Harnett County.
BE IT FURTHER RESOLVED that upon adoption of this Joint Resolution, Wake
County and Harnett County will work together to reconcile county services to affected properties
such as board of elections, zoning, building permitting, emergency response, and tax assessments.
1
101518a HCBOC Page 240
BE IT FURTHER RESOLVED that upon adoption of this Joint Resolution, staff is
directed to register a copy of the same with the Register of Deeds in Wake County and Hamett
County as well as the North Carolina Secretary of State's Office.
That this JOINT RESOLUTION shall become effective on January 1, 2019.
WAKE COUNTY
Adopted this 15th day of October, 2018.
ATIEST: ----------Denise Hogan
Clerk to the Board
Jessica N. Holmes, Chair
Board of Commissioners
2
101518a HCBOC Page 241
HARNETT COUNTY
Adopted this 15th day of October 2018.
AITEST: ----------
Margaret Regina Wheeler
Clerk to the Board
Gordon Springle, Chair
Board of Commissioners
3
101518a HCBOC Page 242
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101518a HCBOC Page 243
HARNETT-WAKE
COUNTY BOUNDARY LINE
SUMMARY OF RESEARCH FINDINGS
September 14 , 2018
NORTH CAROLINA GEODETIC SURVEY
Prepared By :
Ronald R .Harding, PLS
NC Geodetic Survey/RM/EM
NC Department of Public Safety
Claude D. Bowers Building
4105 Reedy Creek Road
Raleigh, NC 27604
(mail : 4298 Mail Service Center, Raleigh, NC 27699-4298)
ron . hardi ng@ncdps.go v
101518a HCBOC Page 244
HARNETT-WAKE COUNTY BOUNDARY LINE
SUMMARY OF RESEARCH FINDINGS) September 2018
HISTORY
Hamett County was fonned in 1855 from Cumberland County
Hamett County were fonned from Cumberland County in 1855. From page 116 of David Leroy Corbitt 's
book "The Formation of the North Carolina Counties 1663 -1943 " reads .... ,Beginning at the intersection
o(lines ofJohnston and Sampson counties, 011 Black Mingo ; thence a direct line to the mouth of Lower
little river; thence up said river to the bridge at Elliot ·s mills; thence a straight li11e to the place on the
Murchison road where Hector's creek cross es; thence with said line to road lo the Moore county line;
rhence with said line to the Chatham county line; then ce with that to the Wake county line; thence with
that to the Johnston county line; thence with that to the beginning. (Public Laws, 1854-55, Ch. 8)
Wake County was formed in 1770 from Johnston County
Wake County were fom1ed from Johnston County in 1770. From page 212 of David Leroy Corbitt's book
"The Formation of the North Carolina Counr ies /663-1943 " reads .... ,the said Counties ofJohnston,
Cumberland, and Orange, be divided by the following lines; that is lo say; Beginning at Edgecomb Line
on Mocossin Swamp, a Mile above James lea's Plantation, running a direct Line to the Neuse River, at
th e upper End of.John Beddingfield ·s Plantation: then to David Mimm 's Mill Creek. between Mimm ·s
Mill and Tanner ·sold Mill; then the same course continued to th e Ridge which divides Cumberland and
Johnston Counties; then a straight Line 10 Orange Line, at the lower End of Richard Hi!l 's Plantation , on
Buckhorn; then the same Course continued Five Miles; th en to the Corner of Johnston County on
Granville line; then with the same Line and Bute line to Edgecomb line; and along Edgecomb line to
the Beginning; he thenceforth erected into a Distinct County and Parish by the name of Wake County.
and St. Margaret's Parish. (S. R., XXJII, 819)
CONCLUSION
The earliest record of a survey of the Harnet1-Wake County boundary line is that of the 1855 creation of
Hamett County is most probable th e first survey. Although adoption and ratification records of this survey
aren't available, witness of it having been conducted is presented in the description of the Land Grant
#266 recorded in Chatham County Register of Deeds Office in 1780 as well as the Harnett County
Register of Deeds Office recordation of a deed in 1923; the North Carolina General Assembly Session
2017-2018 House Bill I 082 adopting the EIP in rock pile as the Chatham, Harnett, Wake County comer;
the existing truck ax le per Plat Book 1987 ; Page 788 and Plat Book 1941; Page 35 in Wake County
Register of Deeds Office; wi th Land Grant #776 Cumberland County states to James Liphott I 790 calls
for a pine at the truck axle location; the existing NCGS monument disk stamped" Wake Johnston Hamett
dated 2005. In conclusion , research of th e original county line descriptions, historic maps , land grant
descriptions, property deed descriptions, and property survey plats illustrate the best wi tness to the
position of the county boundary line is at the EIP in rock pile in a southeasterly direction to the truck axle;
then in southeasterl y direction to the NCGS monument to be the red line drawn on preliminary map titled
Hamett County and Wake County Boundary Line as attached.
101518a HCBOC Page 245
EIP IN ROCK
TRI COUNTY CORNER
PER HOUSE BILL 1082
101518a HCBOC Page 246
EXISTING
TRUCK AXLE
101518a HCBOC Page 247
EXISTING MONUMENT
AT THE HARNETI, JOHNSTON, WAKE COUNTY CORNER
101518a HCBOC Page 248
Board Meeting
Agenda Item
Agenda Item 4-0 --~::;._ __
MEETING DA TE: October 15, 2018
TO: HARNETT COUNTY BOARD OF COMMISSIONERS
SUBJECT: Amendment to Contract with YMCA of the Sandhills
REQUESTED BY: Carl Davis, Harnett County Parks and Recreation Director
REQUEST:
Hamett County Parks and Recreation requests consideration of an amendment to the contract
between the County of Harnett and the YMCA of the Sandhills to open a YMCA facility in
Hamett County. The amendment includes a five month extension of the 50 percent
completion date from April 30, 2019 to September 30, 2019 as requested.
FINANCE OFFICER'S RECOMMENDATION:
COUNTY MANAGER'S RECOMMENDATION:
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contract agendafonn2018.docx Pagel of l
101518a HCBOC Page 249
FIRST AMENDMENT TO FUNDING AGREEMENT BETWEEN
YOUNG MEN'S CHRISTIAN ASSOCIATION OF THE SANDHILLS AND
COUNTY OF HARNETT
THIS FIRST AMENDMENT TO FUNDING AGREEMENT is made and entered
into as of the _ day of October 2018 (hereinafter referred to as the "Effective Date"), by and
between Young Men 's Christian Association of the Sandhills (hereinafter referred to as the
"YMCA") and County of Harnett (hereinafter referred to as "County").
WITNESSETH :·
WHEREAS, the YMCA and County entered into a Funding Agreement (hereinafter
referred to as the "Agreement") dated February 5, 2018 for County's commitment to provide
financial support for the operation of YMCA's new recreational facility; and
WHEREAS, according to Section 2.2 entitled "Funding," a failure to complete at least
50 percent of the renovations by April 30, 2019 shall be cause for termination unless an
extension is mutually agreed upon in writing by both parties; and
WHEREAS, according to Section 6.1 entitled "Entire Agreement," the Agreement may
only be amended in writing and signed by duly authorized officers of County and the YMCA;
and
WHE REAS , the YMCA and County mutually desire to amend the Agreement to extend
the 50 percent completion date of the renovations.
NOW THEREFORE, in consideration of the mutual promises and consideration herein
contained, the parties hereby agree as follows:
1. Section 2 .2 entitled "Funding" of the Agreement is hereby amended as follows:
By striking the language contained in the third sentence of Section 2.2 stating "A
failure to complete at least 50 percent of the renovations by April 30, 2019 shall be
cause for termination unless an extension is mutually agreed upon in writing by both
parties" and replacing said language with "A failure to complete at least 50 percent of
the renovations by September 30, 2019 shall be cause for termination unless an
extension is mutually agreed upon in writing by both parties."
2 . All other term s of the February 5, 2018 Agreement will remain unchanged.
[THE REMAINDER OF THIS PAGE IS INTENTIONALL Y LEFT BLANK.]
1
101518a HCBOC Page 250
IN WITNESS WHEREOF , the parties hereto, through their duly authorized representatives
or officers, have executed this First Amendment to Funding Agreement as of the Effective Date:
ATTEST:
Gina Wheeler, Clerk
ATTEST:
[Name & Title]
COUNTY OF HARNETT
By: _________ _
Gordon Springle, Chairman
Board of Commissioners
YOUNG MEN'S CHRISTIAN
ASSOCIATION OF THE SANDHILLS
By: ___________ _
Rick Houp, CEO
Young Men's Christi an
Association of the Sandhills
2
101518a HCBOC Page 251
This instrument has been pre-audited in the
manner required by the Local Government
Budget and Fiscal Control Act.
KIMBERLY HONEYCUTT
Hamett County Finance Officer
3
101518a HCBOC Page 252
Agenda Item 7
October 15, 2018 APPOINTMENTS NEEDED
ADULT CARE HOME COMMUNITY ADVISORY COMMITTEE
There are five (7) vacancies on this committee.
BOARD OF HEALTH
There is a vacancy on this board for an engineer position.
HARNETT COUNTY AIRPORT COMMITTEE
There will be one vacancy for District 5 on this committee in December 2018.
HARNETT COUNTY BOARD OF ADJUSTMENT
There are two (2) vacancies for alternate members representing District 3 & 5.
HARNETT COUNTY COUNCIL FOR WOMEN
There are three (3) vacancies on this council.
HARNETT COUNTY DISTRICT H TOURISM AUTHORITY
Ricky Ray would like to serve on this Board . Application attached.
There are two (2) Business/Tourism vacancies on this board.
HARNETT COUNTY PUBLIC LIBRARY BOARD
There is one (1) vacancy on this board.
HOME AND COMMUNITY CARE BLOCK GRANT COMMITTEE
There are three (3) vacancies on this committee.
MID-CAROLINA AGING ADVISORY COMMITTEE
There is one (1) vacancies on this committee.
NONPROFIT FUNDING COMMITTEE
There is one vacancy for District 4.
NURSING HOME COMMUNITY ADVISORY COMMITTEE
There is one (1) vacancy on this board.
Page 1 -Appointments
101518a HCBOC Page 253
APPLICATION TO SERVE ON A BOARD APPOINTED BY THE
HARNETT COUNTY BOARD OF COMMISSIONERS
/j
BOARD: 7.<:7v,11s...,... _ _,_;..;:..::;_::___:_,L....a:...:.....!..__;.__;_-+---------------------
N AME: f2,c£ -----f-..!....:_-1------------------------
A DD RESS: _P_<D~f3:::..=..:Y(....:._. _/_o../...., ___..!.8;::__;_; ... \.:...:e{__:(,:..:.l'--=:.:',a::..:.k__.:M~__.!:i::....!1...::!....s~oh~------
VOTTNG DISTRICT: (Please check district number in which you live):
0 District l, Commissioner McKoy's O District 4, Commissioner Springle's
D District 2, Commissioner Elmore's D District 5, Commissioner Miller's
D District 3, Commissioner Penny's
TELEPHONE: (HOME) ? I~-3 2 o-S11~ 3 (WORK) q;o, f{';t/-f./J~L
PRESENToccuPATION: ..()s:m:.;/e A .D /&lr.1,,,/ ;af({.>s
YEARS OF FORMAL EDUCATION: __ (, __________________ _
CIVIC AND FRATERNAL ORGANIZATIONS TN WHICH YOU HA VE PARTICIPATED:
DATE: --J--7.J-b;;_.J:--__.1 f!'--t_f __ SIGNATURE: 44;
••••••••••••••••••••••••••••••••••••••••
FOR OFFICE USE ONLY:
DATE RECEIVED: -------------------------
DATE FORWARDED TO COUNTY COMMISSIONERS: --------------
101518a HCBOC Page 254
Board Meeting
Agenda Item
Agenda Item ____ 8 __
MEETING DA TE: October 15, 2018
TO: HARNETT COUNTY BOARD OF COMMISSIONERS
SUBJECT: Proposed Zoning Change: Case# PLAN1808-0001
REQUESTED BY: Development Services/ Mark Locklear
REQUEST:
Landowner/Applicant: Moses & Melanie Farmer I Par 5 Development Group, LLC; 2.5 +/-
acres; Pin #0518-91-0268.000; From RA-30 to Commercial Zoning District; Intersection of
NC Hwy 27 West & SR# 1238 (Springhill Church Road); Upper Little River Township.
Development Services staff reccomends APPROVAL for the requested rezoning to
Commercial. This request is compatible with the Harnett County Land Use Plan and would
have an unreasonable impact on the surrounding community because of the existing non
residential uses within the area.
Additional Information:
On September 4th , the Hamett County Planning Board voted unanimously (5-0) to
recommend approval based on compliance with the County's Land Use plan as well as the
existing nonresidential uses.
No one attended the meeting in opposition.
FINANCE OFFICER'S RECOMMENDATION:
COUNTY MANAGER'S RECOMMENDATION:
C :\Users\gwheeler\AppData\Local\Microsoft\ Windows\lNetCache\Content.Outlook\TPTEQC L V\Par5 _ CC ag e nd a
form.docx Pag e I of I
101518a HCBOC Page 255
Harnett
COUNTY
NOR fH CAROLINA
REZONING STAFF REPORT
Case: PLAN 1808-001
Jay Sikes, Mgr. of Planning Services
jsikes@harnett.org
Phone: (910) 893-7525 Fax : (910) 814-8278
Planning Board: September 4, 2018 County Commissioners:
Dc.foher /.5
September 17, 2018
Requesting a Rezoning from RA-30 to Commercial
Applicant Information
Owner of Record:
Name: Moses & Melanie Farmer
Address: 576 Earnest Brown Rd
City/State/Zip: Lillington, NC 27546
Property Description
PIN(s): 0518-91-0268
Address/SR No .: 8044 NC 27
Applicant:
Name: Par 5 Development Group, LLC
Address: 507 Juniper Lake Rd
City/State/Zip: West End, NC 27376
Acreage: 2.s ------
-------------------------------
Township:
D (01) Anderson Creek
D (02) Averasboro
D (03) Barbecue
D (04) Black River
Vicini
Page 1 of 7
D (05) Buckhorn
D (06) Duke
D (07) Grove
D (08) Hectors Creek
D (09) Johnsonville
D (10) Lillington
D (11) Neill's Creek
D (12) Stewart's Creek
[2J (13) Upper Little River
STAFF REPORT
101518a HCBOC Page 256
Site Description: Site is currently vacant.
Surrounding Land Uses: Area land uses consist of individual single-family residences and several
nonresidential uses .
Services Available
Water:
1:8:!Public (Harnett County)
0Private (Well)
D Other : Unverified
Page 2 of 7
Sewer:
D Public (Harnett County)
l:8J Private (Septic Tank)
D Other: unverified
Transportation:
Annual Daily Traffic Count:
approx. 6,000 on NC 27
Site Distances: good
STAFF REPORT
101518a HCBOC Page 257
Zonin District Com atibilit
Land Use Classification Com
Page 3 of 7
Parks & Rec
Natural Preserves
Bona Fide Farms
Sin le Famil
Manufactured Homes,
Design Regulated
Manufactured Homes
Multi-Fa mil
Institutional
Commercial Services
Retail
Wholesale
Industrial
Manufacturing
Parks & Rec
Natural Preserves
Bona Fide Farms
Sinale Familv
Manufactured Homes,
Desian Reaulated
Manufactured Homes
Multi-Familv
Institutional
Commercial Service
Retail
Wholesale
Industrial
Manufacturina
CURRENT
RA-30
X
X
X
X
X
REQUESTED
Commercial
X
X
X
X
ZONING LAND USE
Commercial Rural Center
X
X
X
X
X
X
X X
X X
X X
STAFF REPORT
101518a HCBOC Page 258
Site
Hwy 27 and Spring Hill Church & Clark Rd
intersections
Pag e 4 of 7
Site & adjacent property on Spring Hill Church Rd
Store@ intersection
STAFF REPORT
101518a HCBOC Page 259
Evaluation
r8J Yes D No The IMPACT to the adjacent property owners and the surrounding community is
reasonable, and the benefits of the rezoning outweigh any potential inconvenience or
harm to the community.
REASONING: The requested zoning change to Commercial will not have a negative
impact on the community as it is similar in nature to existing uses within this area,
specifically around this intersection.
r8J Yes D No The requested zoning district is COMPATIBLE with the existing Land Use Classification.
REASONING: The requested zoning district is compatible with this area's land use
classification of a Rural Center development node . Small scale commercial centers are
typical for these development nodes with non-residential areas usually less than 50,000
square feet in total.
r8J Yes D No The proposal does ENHANCE or mainta in the public health, safety and general welfare .
REASONING: The requested rezoning to Commercial would maintain or enhance the
public health, safety, and general welfare due to area's existing commercial uses as
well as the potential site improvements that would be required.
~ Yes D No The request is for a SMALL SCALE REZONING and should be evaluated for
reasonableness.
REASONING: Due to the size of the tract and that the proposed zoning district is not
immediately adjacent the application should be evaluated for Small Scale Rezoning .
Suggested Statement-of-Consistency (Staff concludes that...)
As stated in the evaluation, the requested rezoning to Commercial is compatible with Harnett County
regulatory documents and would not have an unreasonable impact on the surrounding community based
on the uses in this area as well as the County's Land Use Plan designation for this area. Therefore it is
recommended that this rezoning request be APPROVED .
Additional Information
On September 4th, the Harnett County Planning Board voted unanimously (5-0) to recommend approval of
the application based on compatibility to the Land Use Plan.
: Small Scale Zoning was considered and all four facts were approved as well.
: No one spoke in opposition.
Review Worksheets
SMALL SCALE REZONING EVALUATION
Small scale zoning is permissible in North Carolina if it is reasonable. The courts have set out the following
four factors to be used in a case -by-case analysis to determine if a particular zoning is reasonable.
RESONABLENESS FINDINGS OF FACT
D Yes D No A. SIZE OF THE TRACT
The overall size of the tract of land proposed for rezoning is reasonable when compared
to the size of the zoning district in which the subject property is located.
0 Yes O No B. COMPATIBILITY WITH A COMPREHENSIVE PLAN
The proposed rezoning is consistent with any comprehensive plan, plan or elements
thereof.
D Yes D No C. IMPACT
Page 5 of 7
The impact to the adjacent property owners and the surrounding community is
reasonable, and the benefits of the rezoning outweigh any potential inconvenience or
harm to the community.
STAFF REPORT
101518a HCBOC Page 260
0 Yes O No D . COMPARISON OF USES
The allowed uses within the proposed zoning district are similar or comparable to uses
permitted as currently zoned .
It is at the discretion of the Board to carefully analyze the above criteria to determine if the proposed
zoning change would be considered reasonable.
0 GRANTING A SMALL SCALE REZONING
Motion to grant the small scale rezon i ng upon finding that the request is reasonable considering one or
more of the above findings of fact A-D being found in the affirmative
0 DENYING A SMALL SCALE REZONING
Motion to deny the rezoning upon finding that the proposed rezoning does not advance the public interest
and is unreasonable due to the following:
D The size of the tract
D Incompatibility with the comprehensive plan
D Impact to surrounding community and immediate neighbors
D Proposes uses are extremely dissimilar to those currently permitte
TRADITIONAL STANDARDS OF REVIEW
The Planning Board shall consider and make recommendations to the County Board of Commissioners
concerning each proposed zoning district. The following policy guidelines shall be followed by the Planning
Board concerning zoning districts and no proposed zoning district will receive favorable recommendation
unless:
0Yes
0Yes
0Yes
0Yes
0No
D No
0No
0No
A. The proposal will place all property similarly situated in the area in the same
category, or in appropriate complementary categories.
B. There is convincing demonstration that all uses permitted under the proposed district
classification would be in the general public interest and not merely in the interest of the
individual or small group.
C. There is convincing demonstration that all uses permitted under the proposed district
classification would be appropriate in the area included in the proposed change. (When
a new district designation is assigned, any use permitted in the district is allowable, so
long as it meets district requirements, and not merely uses which applicants state they
intend to make of the property involved.)
D. There is convincing demonstration that the character of the neighborhood will not be
materially and adversely affected by any use permitted in the proposed change.
D Yes D No E. The proposed change is in accordance with the comprehensive plan and sound
planning practices.
0 GRANTING THE REZONING REQUEST
Motion to grant the rezoning upon finding that the rezoning is reasonable based on All of the above
findings of fact A-E being found in the affirmative and that the rezoning advances the public interest.
0 DENYING THE REZONING REQUEST
Motion to deny the rezoning upon finding that the proposed rezoning does not advance the public interest
and is unreasonable due to the following:
D The proposal will not place all property similarly situated in the area in the same category, or in
appropriate complementary categories.
D There is not convincing demonstration that all uses permitted under the proposed district
classification would be in the general public interest and not merely in the interest of the
individual or small group.
D There is not convincing demonstration that all uses permitted under the proposed district
classification would be appropriate in the area included in the proposed change . (When a new
district designation is assigned, any use permitted in the district is allowable, so long as it
Pa ge 6 of 7 STAFF REPORT
101518a HCBOC Page 261
meets district requirements, and not merely uses which applicants state they intend to make of
the property involved .)
D There is not convincing demonstration that the character of the neighborhood will not be
materially and adversely affected by any use permitted in the proposed change .
D The proposed change is not in accordance with the comprehensive plan and sound planning
practices.
D The proposed change was not found to be reasonable for a small scale rezoning
Page 7 of 7 STAFF REPORT
101518a HCBOC Page 262
~~ APPLICATION FOR ZONING CHANGE
Harnett Planning Department
108 E. Front Street
COUNTY P.O. Box 65, Lillington, NC 2754 6
Phone: (910) 893-7525 Fax : (910) 893-2793
Total Fee:
Receipt: ---
Permit: ?L4tv /6:!)%-~o.J/
Hearing Date: -~ -~ 1J 7
Applicant Information
Owner of Recor d:
Name: Mose, & Melanie hmnc1
Address: 576 !:.rnest Rro 1\n RoacJ
City/State/Zip: Lillinoton. NC 275..J6
E-mail: MoscsTFa rm cr@gmai l.com
Phone: 910 -890 -2300
Fax:
Property Description
Appficant :
Name: Par 5 De, clopmc111 t;roup , LI .C
Address: 2075 Juniper L1kc RoacJ
Ci t y/State/Zip: We st EmL NC 27J76
E-mail : 1ohn@par5dc1·clopmcn1.rn111
Phone: 910 -9.:W -0881
Fax: 910-94-1-0882
PI N(s): O:illl -91-0268.000 Acreage: 2.5 Acres
Address/SR No.: 80+t NC H\11 27/SR 1238
Directions from Lillington: Take N C H", 27. W oi11 s,f LillJ.!!E10111 01 hc i111crscction 015pri ng
llill C'hu rch Road (-8 mile~). l'rojccl will bc ~m ri!!ht side of strccl
Deed Book : 358..J
Plat Book:
Ex i sting Zoning:
D Conservation
0 RA -2 0M
0 RA-20R
~ RA-30
0 RA-40
D Commercial
0 Light Industrial
D I ndustrial
0 Office & I nst'I
A ttachment s
Page : 170
Page:
Requested Zoning :
D Conservation
0 RA -20M
0 RA -20R
0 RA -30
0 RA-40
!xi Commercial
0 Light Industrial
D Industrial
D Office & Inst'!
Township:
0 (01) Anderson Creek
D (02) Averasboro
0 (03) Barbecue
D (04) Black River
0 (05) Buckhorn
D (06) Duke
0 (07) Grove
0 (08) Hectors Creek
D (09) Johnsonvil le
0 (10) Ltlltngton
D (1 1) Neill's Creek
D ( 1 2) Stewart's Creek
[x] ( 13) Upper Little River
• Written description of p roperty from recorded deed
• Recorded map of property at scale of not less than one ( 1) inch = 200 feet
• Explanation of why the zoning change is requested, addressing applicable portions of Article XIV of
the Zoning Ordinance
Signatures
The undersigned applicant hereby certifies thal , to lhe hest of his or her knowledge and belief, all
information supplied with is appli ca tion is true and accurate:
~-~' Property i ture Authorized Agent Sig na ture Date
Page 1 of 2 APPLICATION FOR ZONING CHANGE
101518a HCBOC Page 263
Requiremen ts for Consideration
The Planning Board shall consider and make recommendations to the County Board of Commissioners
concerning each proposed zoning district. The following policy guidelines shall be followed by the Planning
Board concerning zoning districts and no proposed zoning district will receive favorable recommendation
unless:
2.1 The proposal will place all property similarly situated in the area in the same category, or 1n
appropriate complementary categories.
2.2 There 1s convincing demonstration that all uses permitted under the proposed district classification
would be in the general public interest and not merely in the interest of the i ndividual or small
group.
2.3 There is convincing demonstration that all uses permitted under the proposed district classification
would be appropriate in the area included In the proposed change. (When a new district
designation 1s assigned, any use permitted 1n the district is allowable, so long as it meets district
requirements, and not merely uses which applicants state they intend to make of the property
involved.)
2.4 There is convincing demonstration that the character of the neighborhood will not be materially and
adversely affected by any use permitted in the proposed change.
2. 5 The proposed change is in accordance with the comprehensive plan and sound planning practices.
Page 2 ol 2 APPLICATION FOR ZONING CHANGE
101518a HCBOC Page 264
(' l ), t ' ., ! I ,, ' r • H
l'Xf>l.,\N1\TION JOH ZO!\ l:d, RUJI IF~T
This property is currently zoned residential. The owner would like to allow for a retail store and
the associated improvements to be constructed on this property. The store planned will be a
si ngle story 10,000sqft building with parking, dumpster pad and loading area .
•
910 426 -6777 910-426-5777
On t,,ne e;erv time 4Ds 1tesolut1ons
101518a HCBOC Page 265
; ! I j I ! i I I j ....... -I VICINITY MAP NOTTO SCALE .:,1~;:.~-. .... "'4. .. l-0$-··.,. .,. _(11, ...... •I'-_,,,,_. 9( ........ _,.f~otlll-----·••li*a __ _....,.._ ... ,_ -----·I'll·-· --·••-o .... -·-·-.. -·""'--·--••1,• -·· --.. ""'"' -----•>4o.il;WII•' -'-""°l .. ,. -'°'"-_,... __ c.c,,._ ·-·-"'""'-~:.---·-<n"(lr,t ·--m••t""Ool .. ,o, ... !:::.o::.. .... , ... . ,.. ............. _.. =-· q. •t.-t11c-,-.r ·---110"1.1"'" fl01'J .. c ...... u .t~·.:. l'I: I I I I I I I I I I I I .... ~ ·-i~~{t-' ·--~ !.:'f~a: ~ i ' • '· \ ~::s~~-, \ \ u,;..;.---_.... ... ,. 0 ~•1•• •''""'"''"o(' ,,,,,.1t~oe.·•-•re __ .. if»&tll9l .. \ \ \, \ \ \ \ \ \ \ ~ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \. \ \ \ \ \ \ \ l, '. \\ \ ., .,.,.,_ .... ... ·-·-· .-.o,c;, .. \ \ \ ~ ,.,, \ \ \ \ '. \ \ \ \ \ \ _) \ \ \ \ \ \ \ .. -....... •, .... ,, \/'-/ ---==--· .. =~ .... ,,...-. -......_, ••vr,;:~) ----. ·--~---··-··-"····-··-··--·-:i .. ,. -··-····· t ·-···· -l··-··-··-··---. .. , L---=~= ~~=:~i: ___ --------·=='~=--------·; '\'\ ... .w.,._~... --·-----------··----------_ __/ \ \ ' ' \ I .. -·-~·-, .._,n·--........... · .. ~-· ., -·-o(,,·-· ...~ .. -· .. .. 11• """ \ CRAPIUC SCAIF ~ '~~' ... r·· / <' \ \. \ !---------------------------------------------------' •4Dsite ~.~~ -----=--~-;,: i::t 0 ~t W• er ~ 0. -...co-xxxxxxx SITE PLAN '""" PARS DEVELOPMENT GROUP,LLC Jl!"\,),ewl.-. ... .... f. .. No1'(.-.!'")-.; ,...... r;:\IHOII' ~CT~l'IOII ~~" l "' 1 _.. .. . ··fl~... ... -"":''·~· -~ --ICMf "(R'IQll,11,t r.u· Ot.f(fltU.AMO rrmo• ;101• C-2.0 101518a HCBOC Page 266
AFFP
SENTER'S MEMORY CARE 10/15/18
Affidavit of Publication
STATE OF NC}
COUNTY OF HARNETT}
ss
The Undersigned, being duly sworn, says:
That she is Representative of the The Daily Record, a
weekly newspaper of general circulation, printed and
published in Dunn, Hamett County, NC; that the
publication, a copy of which is attached hereto, was
published in the said newspaper on the following dates:
September 26, 2018
That said newspaper was regularly issued and circulated
on those dates.
Y7!,~ 4/J-~
SIGNED : i
Represe~.
Subscribed to and sworn to me this 26th day of
September 2018. \\1 1 I It t t t f I I,,
,,,' F>,.RY p ',,,
Agenda Item ----'9 ____ _
NOTICE OF A PUBLIC HEARING
REGARDING
NOT TO EXCEED $8,500 ,000
PUBLIC FINANCE AUTHORITY
ASSISTED LIVING REVENUE BONDS
(SENTER'$ MEMORY CARE)
NOTICE IS HEREBY GIVEN that, as required by Section 147(f) of the
lntemal Revenue Code of 1986, as amended (the "Code"), the Board of
Commissioners of Hamett County, North Carolina (the ·county"), will hold a public
hearing at its regularly scheduled meeting on October 15, 2018, at 7 PM in the
Board of Commissioners' Meeting Room located at 420 McKinney Parkway,
Lillington, North Carolina 27546, or as soon as
practicable thereafter, concerning the proposed issuance by the Public
Finance Authority (the "Authority"), a commission organized under and
pursuant to the provisions of Sections 66.0301, 66.0303 and 66.0304 of the
Wisconsin Statutes, of its Assisted Living Revenue Bonds, in one or more series or
issues (the "Bonds").
The Bonds are expected to be issued by the Authority in a maximum
principal amount not to exceed of $8,500,000. The proceeds from the sale of the
Bonds will be loaned to Fuquay-Varina Health Holdings, LLC and HP6 Fuquay-
Varina Health Investors, LLC, each a North Carolina limited liability company, of
which Regional Housing & Community Services Corporation, a California public-
service corporation and an organization described in Section 501 (c)(3) of the Code,
is the sole member (collectively, the "Borrower"), and used to finance or refinance (i)
the acquisition and capital improvements to an assisted living facility to an
approximately 26.773 square foot, 50 unit (50 beds) facility to be located at 40 Rawls
Club Road, Fuquay-Varina, North Carolina 27526, including the acquisition of land,
certificates of need, licenses and certain predevelopment expenses associated with
the facility (collectively, the "Projecr), and (ii) certain fees and costs associated with
the issuance of the Bonds.
,' «.,~ , ........ & '4 ~ .. 00 .. ~:;.,l""'· ,'. ·.:.;/115' \ The Project will initially be owned and operated by the Borrower.
: ,.... :;$' ' 'f.·,', ui ~ ~ I'.:"\& ...... ::, ~OT ARY '.,.• •
0 IYY)Q.J).(~VY, 4 -oJ : 8 t ' :. ': 3'he Bonds will be special limited obligations of the Authority payable solely from the
• ; ,-;,, • lOan repayments to be made by the Borrower to the Authority, and certain funds and
~ , ~ j:. • •• ~,:,, PUBLIC_,/.: u · .;iccounts established by the trust indenture for the Bonds . .. , ~ ·.:1.t~..... , .. ~"';.~-:.·.: ~-: ., .. ?. . ~,)'()\ t '{,-\•"--" •• "' ... My commission expires : July 23 2022',, ;,i.;·-.:.-..... ~-1. · ,,' At the time and place fixed for the public hearing, all persons who appear will be ' ',,, rr co\.\~ ,,,' given a reasonable opportunity to express their views, both orally and in writing , for
00012821 00036356
''',, , , , , , , , ''' or against the proposed issuance of the Bonds, the location and nature of the
Project and other related matters. The Board also intends at the October 15, 2018 ,
meeting to consider and take action on a resolution
regarding the issuance of the Bonds by the Authority .
PARKER POE ADAMS & BERNSTEIN , LLP
PO BOX389
The resolution will explicitly provide that: The County has no responsibility for the
payment of the principal of or interest on the Bonds or for any costs incurred by the
Borrower with respect to the Bonds or the Project. The County pledges neither its
taxing power nor revenues for the Bonds. The County has no responsibility for the
Borrower, the Project or for the success of the Project. 301 FAYETTEVILLE ST.
RALEIGH, NC 27601 Any person wishing to submit written comments regarding the proposed
issuance of the Bonds, the location and nature of the Project and other
related matters should do so by submitting comments to the Clerk to the Board no
later than 5:00 PM on October 15, 2018, at 420 McKinney
Parkway. Lillington, North Carolina 27546.
101518a HCBOC Page 267
At~NANDO ~ MEDIA COMPANY
consult. strategize . de l iver.
Powered by McClatchy
The News & Observer
421 Fayetteville Street. Suite 104
Raleigh. NC 27601
AFFIDAVIT OF PUBLICATION
Account# Ad Number Identification
109113 0003864 226 Revenue Bonds (Senters Memory Care)
Attention:
PARKER POE ADAMS & BERNSTEI
301 FAYETTEVILLE ST, SUITE 1400
RALEIGH, NC 27601
NOTICE OF A PUBLIC HEARING
REGARDING
NOT TO EXCEED Sll.500,000
PUBLIC FINANCE AUTHORITY
ASSISTED LIVING REVENUE BONDS
(SENT ER'S MENl:JRY CARE)
NOTICE IS HEREBY GIVEN thol, OS required bv Section 147(f) of the tntemol
Revenue Code ot 1986, as amended (the J. the Boord of Commissioners of
Harnett County, North Carolina (the "C ). will hold a public hearing at ils
regularlv scheduled meeting on October ot 7 PM In the Board of Commis-
sioners' Meellnu Room localed al~ McKl iiwov, Lllllns,ton, Nortt, Coi'o-
11_!10 27546, or Os soo-n OSPraCtlCobie thereiifler , cOnCernJl1g lhe proP<>se<fiSsuonCe
by the Public Finance Authorit y (the "Authority"), a commission orgonited un·
der and purwant to the provisions of Secfions 66.0JOl, 66.0303 and 66.0304 of the
Wisconsin Statutes. of its Assisted living Revenue Bonds, in one or more series
or iswes Clhe" Bonds").
The Bonds ore expected to be issued by the Authority in a maximum principal
amount no, to exceed of S8,SQO,OOO. The proceeds from the sole of the Bonds will
be loaned to Fuquov-Vorina Health Holdings, LLC and HP6 Fuquov-Vorino
Health Investors. LLC. each a North Carolina limited liability company. ot which
Ri:gionol Housing &. Community Services Corporation. o California public-service
torPOrotion ond an organization described in Section S01(c)(3) ot lhe Code, is the
sole member (colleclively. lhe "Bo~wer"), and used to finance or refinance (i)
the acquisition and capital improvements to an assisted living facility to an OP·
proximately 26.nJ square foot, SO unit (SO beds) facility to be located al AO Rawls
Club Rood, Fuquay-Varina , North Carolina 27526. including the acquisition of
~~n!ir:~~~~':i!:ifit~1 (~!1?e~~~;;,;.~s 1i~d .. crr~~Yl:1cf.-'1~!~11flr~~trt!i~re!;s a0:JDf~~:~
associated with the issuance of the Bonds .
The Proiecl will initially be owned and operated by the Borrower.
The Bonds will be specio1 limited obligations of the Authority payable solely
from the loan repayments to be mode bY the Borrower to lhe Au lhorily, and cer-
tain tunds and accounts establisheo by the trust indenlure for lhe 8oncts.
A l the rime and place fixed for the PtJblic h eori11g, all persons who appear will
be given a reosonable OPPDrlunity to express their views, both orally and in writ-
ing. tor or against the propased issuance of the Bonds, the location and nature of
the Pr oiect encl other related matters. The Board a lso intends at lhe October I S,
2018. meeting lo consider and toke action on a resolution regarding the issuance
of the Bonds by the Aulhoritv.
The resolution will expficilly provide that : The County hos no ress:,onsfbJllty for
the l>OVmeffl of the principal of or Interest on the Bonds or tor onv costs Incurred
by tho Borrower wllh respect to the Bonds or the Proiect. Th<: O>untv pledges nei-
ther Ifs loxing pa,,,,r nor .......,..ues for the Borm. The County has no resPGnslblll-
ty for the Borrower, the Praled or for the success of the Prolect.
Any person wishing to submit writlen comments regarding the prOPosed issu-
ance of the Bonds, the location and nature at 1he Proiect and other reloled mat·
lers should do so bv submiUing comments to the Clerk to the Soard no later than
5:00 PM on October 15, 1018, at 420 McKinney Parkway, Lillington.. North Caroli-
no 275'6.
Additional informalion concerning the Prolecr may be obtoinea from Jelf Poley,
!=sq., 301 Favelleville St reet, Suite 1400, Raleigh, NC 21601; Email Address:
1ef fP0 ley@.lporkerproe.com .
N&O: September 26, 2018
PO Cols Lines
2 60
STATE OF NORTH CAROLINA
COUNTY OF WAKE
Before the undersigned, a Notary Public of
Johnston County, North Carolina, duly
commissioned and authorized l o administer
oaths, affirmations, etc .. personally appeared
PAM OLENICZAK. who being duly sworn or
affirmed, according to law, doth depose and
say that he or she is Accounts Rece ivabl e
Specialist of the News & Observer Publishing
Company. a corporation organized and doing
bus iness under the Laws of the State of
North Carolina, and publishing a newspaper
known as The News & Observer, VVake
County and State aforesaid, the said
newspaper in which such notice, paper,
document. or legal advertisement was
published wa s, at the time of each and every
such publ ication, a newspaper meeting all of
the requirements and qualifications of Section
1-597 of the General Statutes of North
Carolina and was a qualified newspaper
within the meaning of Section 1-597 of the
General Statutes of North Carolina, and that
as such he or she makes this affidavit ; and is
familiar with the books. files and business of
said corporation and by reference to the files
of said publication the attached advertisement
----lnsertion(s)
Published On:
September 26 , 2016
PAM OLENI CZAK. Accounts Recei-rable
Specialist
Sworn to and sub~bed before me this
27th day of September, 2016
My Commission Expires: 7/10/2023
WENDY DAWSON
Notary Public
North Carolina
John st on Co unty
101518a HCBOC Page 268
PROCEEDINGS OF THE BOARD OF COMMISSIONERS OF THE COUNTY OF HARNETT,
NORTH CAROLINA AT ITS REGULAR MEETING HELD ON OCTOBER 15, 2018
At approximately 7:00 p.m., the Chair of the Board of Commissioners of the County of
Harnett, North Carolina ("Board") opened the public hearing relating to the Project and Bonds as
set forth in the public hearing notice published on September 26, 2018 and attached as Exhibit A.
A compilation of the comments received is set forth in Exhibit B.
Thereupon, the Chair closed the public hearing and the Board adopted the following
resolution:
A RESOLUTION
REGARDING THE ISSUANCE BY THE PUBLIC FINANCE AUTHORITY OF
ITS ASSISTED LIVING REVENUE BONDS, IN ONE OR MORE SERIES, IN
THE PRINCIPAL AMOUNT NOT TO EXCEED $8,500,000.00, FOR THE
PURPOSE OF FINANCING OR REFINANCING THE ACQUISITION AND
CONSTRUCTION OF CERTAIN ASSISTED LIVING FACILITIES LOCATED
IN THE COUNTY; AND OTHER RELATED MATTERS.
WHEREAS, the Board is advised that the Public Finance Authority ("Authority"), a State
of Wisconsin commission, acting by and through its Board of Directors, is authorized and
empowered under and pursuant to the provisions of Sections 66.0301 , 66.0303, and 66.0304 of the
Wisconsin Statutes, as amended ("Act"), to issue bonds and enter into agreements with public or
private entities for the purpose of financing capital improvements located within or without the
State of Wisconsin and owned, sponsored, or controlled by a participant, as defined in the Act;
WHEREAS, the Board is advised that HP6 FUQUAY-VARINA HEALTH INVESTORS, LLC
and FUQUAY-VARINA HEALTH HOLDINGS, LLC , each a North Carolina limited liability company,
the sole member of each is Regional Housing & Community Services Corporation, a California
nonprofit corporation and an organjzation described in Section 501(c)(3) of the Internal Revenue
Code of 1986, as amended ("Code") (collectively, "Borrower") applied to the Authority to issue
its Assisted Living Revenue Bonds ("Bonds") in one or more series in an aggregate principal
amount of $8,500,000.00, which will be loaned to the Borrower to finance or refinance: (a) the
acquisition of land, certificates of need, and licenses; (b) certain predevelopment expenses; and ( c)
expansion and improvements to an assisted living facility to an approximately 26,773 square foot,
50 urut (50 beds) at 40 Rawls Club Road, Fuquay-Varina, North Carolina 27526 (collectively, the
"Project"); and ( d) pay certain fees and costs associated with the issuance of the Bonds;
WHEREAS, the Board is advised that the Project will be initially owned and operated by
the Borrower;
WHEREAS, the Borrower believes that the Project will benefit the County of Harnett, North
Carolina ("County"), generally and, in particular, by providing affordable, decent, safe, and
sarutary housing and assisted living facilities for people from the County and surrounding areas;
WHEREAS, the Board is advised that pursuant to Section 66.0304(1 l)(a) of the Wisconsin
Statutes and Section 4 of the Amended and Restated Joint Exercise Power Agreement Relating to
the Public Finance Authority dated as of September 28 , 2010 (collectively, "Authority
Requirements") and Section 147(f) of the Code and Treasury Regulations Section 5f.103-2(f), as
101518a HCBOC Page 269
amended ( collectively, "Federal Tax Requirements"), prior to the issuance of the Bonds by the
Authority, and after a public hearing held following reasonable public notice, the Borrower is
requesting the Board as the highest elected representatives of the County and the governmental
unit having jurisdiction over the area in which the Project is located, to approve the Authority's
issuance of the Bonds and the financing the Project in the County;
WHEREAS, on this date, prior to any deliberations regarding this Resolution, the County
held a public hearing at which all interested persons had a reasonable opportunity to express their
views on the location of the Project, the issuance of the Bonds, and other related matters. The
public hearing was duly noticed by publication, attached as Exhibit A , in a newspaper having
general circulation in the County, not less than 14 days prior to the date thereof; and
WHEREAS, neither the Board nor the staff of County independently confirmed or verified
the information provided to the Board by the Borrower or its representatives recited above; and
WHEREAS, at the Borrower's request, the Board now desires to approve the Authority's
issuance of the Bonds and the financing of the Project in order to satisfy the Authority
Requirements and the Federal Tax Requirements.
NOW, THEREFORE, BE IT RESOLVED by the Board as follows:
Section 1. It is hereby found , determined, and declared that the Project and the Bonds
will give rise to no pecuniary liability of the County, or a charge against its general credit or taxing
power.
Section 2. As required by and in accordance with the Authority Requirements and the
Federal Tax Requirements, the Board, as the applicable elected repre sentatives of the
governmental unit having jurisdiction over the area in which the Project is located, approves the
Authority's issuance of the Bonds and the financing of the costs of the Project in the County solely
for the Authority Requirements and the Federal Tax Requirements.
Section 3. The County shall have no responsibility for the payment of the principal of
or interest on the Bonds or for any costs incurred by the Borrower with respect to the Bonds or the
Project. The County pledges neither its taxing power nor revenues for the Bonds. The County has
no responsibility for the Borrower, the Project or for the success of the Project.
Section 4. The Board makes no finding regarding whether the Project will benefit the
general public welfare of Harnett County or whether the Project constitutes a "public purpose"
under the applicable provisions of the North Carolina Constitution and the case law interpreting
those provisions.
Section 5. All orders and resolutions and parts thereof in conflict herewith are to the
extent of such conflict hereby repealed, and this Resolution shall take effect and be in full force
and effect from and after its adoption.
[Signature Page Follows]
2
101518a HCBOC Page 270
Adopted this 15th day of October 2018.
COUNTY OF HARNETT, NORTH CAROLINA
By: -----------------
Gordon Springle
Chairman of the Board of Commissioners
Attest:
Margaret Regina Wheeler, Clerk
3
101518a HCBOC Page 271
AFFP
SENTER'S MEMORY CARE 10/15/18
Affidavit of Publication
STATE OF NC}
COUNTY OF HARNETT}
ss
The Undersigned, being duly sworn, says:
That she is Representative of the The Daily Record, a
weekly newspaper of general circulation, printed and
published in Dunn, Hamett County, NC; that the
publication, a copy of which is attached hereto, was
published in the said newspaper on the following dates:
September 26, 2018
That said newspaper was regularly issued and circu lated
on those dates. ·
SIGNED: i ~ 4£)-&,±,
Subscribed to and sworn to me this 26th day of
September 2018. ,~,,· ..... ,, ,,,
NOTICE OF A PUBLIC HEARING
REGARDING
NOT TO EXCEED $8,500,000
PUBLIC FINANCE AUTHORITY
ASSISTED LIVING REVENUE BONDS
(SENTER'S MEMORY CARE)
Exhibit B
NOTICE IS HEREBY GIVEN that, as required by Section 147(f) of the
lntemal Revenue Code of 1986, as amended (the "Code"), the Board of
Commissioners of Hamett County, North Carolina (the "County"), will hold a public
hearing at its regularly scheduled meeting on October 15, 2018, at 7 PM in the
Board of Commissioners· Meeting Room located at 420 McKinney Parkway,
Lillington. North Carolina 27546, or as soon as
practicable thereafter, conceming the proposed issuance by the Public
Finance Authority (the "Authority"), a commission organized under and
pursuant to the provisions of Sections 66.0301 , 66.0303 and 66.0304 of the
Wisconsin Statutes, of its Assisted Living Revenue Bonds, in one or more series or
issues (the "Bonds").
The Bonds are expected to be issued by the Authority in a maximum
principal amount not to exceed of $8,500,000. The proceeds from the sale of the
Bonds will be loaned to Fuquay-Varina Health Holdings, LLC and HP6 Fuquay-
Varina Health Investors, LLC, each a North Carolina limited liability company, of
which Regional Housing & Community SefVices Corporation, a California public-
service corporation and an organization described in Section 501(c)(3) of the Code,
is the sole member (collectively, the "Borrower"), and used to finance or refinance (I)
the acquisition and capital improvements to an assisted living facility to an
approximately 26,773 square foot, 50 unit (50 beds) facility to be located at 40 Rawls
Club Road, Fuquay-Varina , North Carolina 27526, including the acquisition of land,
certificates of need, licenses and certain predevelopment expenses associated with
the facility (collectively, the "Project"). and (ii) certain fees and costs associated with
the issuance of the Bonds. ,,·,' f'I.RY p ',,, ,' «,~.-··.:-··-.: & '-, ...... 00 .· :'.P" "'' ?,, '<-~.; ·!u' ', The Project will initially be owned and operated by the Borrower.
: : :$., ".!<,'.;. lP ~ ~ 1:-\~ • Q: ·;;, ,o 1ARY •;,,· •
0 ~\:Y, A--OJ ; 8 ~-:. : :he Bonds will be special limited obligations of the Authori'! payable sol_ely from the
_ • ,. ~ • joan repayments to be made by the Borrower to the Authority, and certain funds and
_ , ~ 'j:. ··.\.,PU 8 L \ ~}/ (J jeccounts established by the trust indenture for the Bonds .
.... ., ,7"?. ·.;'1..\s,o, ... -;.-.*;,,: ••• ~ ,""
My commission expires: July 23 2022'',, 1v;·;,;.",' .. -··~..i. ·,,,' A_t the time and place fixed f~r the public heari~g._ all persons who app~ar ~i~I be
' ',, t'T CQ\.1~ ,,' given a reasonable opportunity to express their views , both orally and 1n wnting, for
00012821 00036356
'' '•,,,,,,,,' •' or against the proposed issuance of the Bonds, the location and nature of the
Project and other related matters. The Board also intends at the October 15 , 2018,
meeting to consider and take action on a resolution
regarding the issuance of the Bonds by the Authority.
PARKER POE ADAMS & BERNSTEIN, LLP
POBOX389
The resolution will explicitly provide that: The County has no responsibility for the
payment of the principal of or interest on the Bonds or for any costs incurred by the
Borrower with respect to the Bonds or the Project. The County pledges neither its
taxing power nor revenues for the Bonds. The County has no responsibility for the
Borrower, the Project or for the success of the Project. 301 FAYETTEVILLE ST.
RALEIGH, NC 27601 Any person wishing to submit written comments regarding the proposed
issuance of the Bonds. the location and nature of the Project and other
related matters should do so by submitting comments to the Cleric to the Board no
later than 5:00 PM on October 15, 2018, at 420 M cKinney
Parlcway, Lillington , North Carolina 27546.
101518a HCBOC Page 272
Al~ M.ANDO ~ MEDIA COMPANY
consu lt. strategize . deliver .
Powered by McC latchy
The Nem & Observer
421 Fayetteville Stree~ Su,te 10~
Raleigh. NC 27601
Exhibit B
AFFIDAVIT OF PUBLICATION
Account ill Ad Number ldenlificaUon
109113 0003864226 Revenue Bonds (Senters Memory Care)
Attention:
PARKER POE ADAMS & BERNSTEI
301 FAYETIEVILLE ST, SUITE 1400
RALEIGH, NC 27601
NOTICE OF A PUBLIC HEARING
REGARDING
NOT TO EXCEED 18.!00,000
PUBLIC FINANCE AUTHORITY
ASSISTED LIVING REVENUE BONDS
(SENTER'S MEMORY CARE)
NOTICE IS HEREBY GIVEN that, as required bv Section 147(fl ol the Internal
Revenue COde of 1986, os amended (the "'Code''), the Boord of Commissioners of
Hornell County, North Carolina Uhe "Coiinr• , will h lie hearing at its
~f=!~f:'~'i"~Jz.t~«!be! .J!.111'_ -·
I~~ or as ioonOSiirciciicoblelhe oncern!ng
~:r':~~~~~u:~~01~'fh~~1:'o0:l!ron':h:, ·~~~PJ/,~~Jjo~.c~;~s~o:d %~8J~e~ r~
Wisconsin 51otutesl ot its Auisted Living Revenue Bonds, in one or more series
or is sues Uhe # Q_o~~'').
The Bonds ore expected to be Jssued by lhe Authority in o maximum principal
amount not to exceed of 58,500,000. Th• proceeds rrom lhe sale ot the Bonds will
be loaned to Fuquav-Vorino Heallh Holdings. LLC and HP6 Fuquar·Vorino
He alth lnveslors, LLC, eo<eh a North Carolina limlled llabntty company, ot which
R<:gionol Housing & CommunUv Services Corporation. o Colifomla public--service
corporotlon ond on organization described in Section 501 (c)(l) ot the Code, is the
sole member (coflectlvelv, the "Borrower">~ and used to fJnonce or refinance (i)
the acquisition ond capitol improvements to an assisted living facility to an OP·
proximately 26,m square foot, 50 unit (50 beds) fac ility to be located ol 40 Rawls
Club Road, Fuquov·Varina, North Carolina 27S26, including the ocquisition of
!~"!if:t:c,~fu~' (:1?~~f;:,sye: ,h~d.$~!Y~if..),d:::1ifl;~~'rt:~,~'ss a°~0c~:l;
ossociated with t he issuance of the Bonds .
The Proied will initially be owned and operated by th e Borrower.
The Bonds will be speciot limited obliga1ions of lhe Au1hori1v PO'IOble solely
from the loon repayments to be mode bv the Borrower to the Authority, and ter·
tain funds and accounts eslablished by the trust indenture for the Bonds.
At the rime and place f ixed for the public hearing, oll person s who appea r will
be given a reosonoble opportunUy 10 express their views, bath orally and in writ·
ing, for or against the proposed Issuance of the Bonds, the location and nature of
the Project and other related molters. The Board also lnlends ot the October 15,
2018, meeting to con sider ond loke ottion on o resolution regarding the Issuance
of the Bonds by the Authority.
The resolution will expliclllv provide lhal: The County has no re51lORS!blllty to<
Ille l>OVffleMI of the orincloat of or lnlen!st on Ille Bands or to< ony msls lnann!d
bV the Borrower with --1 lo the Bonds or the Pn,lect. The O>un!v Pledl>es nel·
ther Ito taxing -, nor """"'""" for the Bondo. The County has na res,,onolblll-
ty for the Borrowe,-, the Prolect or for the ouccassof1he Protect.
Any per5on wishing to submit written comments reg arding the proposed issu·
once of the Bonds. the loco11on a nd nature ol lhe ProiKI ond other related mot·
ters should do so bY submitting comments to lhe Clerk to the Board no later than
5:00 PM on October 15, 2018. at 420 McKinnev Parkway, Lillington. North Caroli·
na 27Sol6.
AddiHonol information concerning the Profect may be oblafned from Jeff Poley,
f.~fl;<,?:~~~~rir~-~~~t, Sulle 1400, Raleigh, NC 27601 ; Email Address:
N&O: September 26, 2018
PO Cols lines
2 60
STATE OF NORTH CAROLINA
COUNTY OF WAKE
Before the undersigned. a Notary Public of
Johnston County, North Carolina . duly
commissioned and authorized to administer
oaths, affirmations . etc., personally appeared
PAM OLENICZAK, who being duly swom or
affirmed , according to law, doth depose and
say that he or she is Accounts Receivable
Specialist of the News & Observer Publishing
Company, a COfJ)oralion organized and doing
business under the Laws of the State of
North Carolina, and publishing a newspaper
known as The News & Observer, wake
County and State aforesaid, the said
newspaper in which such notice, paper,
document, or legal advertisement was
published was, al the time of each and every
such publication, a newspaper meeting all of
the requirements and qualifications of Section
1-597 of the General Statutes of North
Carolina and was a qualified newspaper
within the meaning of Section 1-597 of the
General Statutes of North Carolina, and that
as such he or she makes this affidavit ; and is
familiar with the books, files and business of
said corporation and by reference to the files
of said publication the attached advertisement
----lnsertion(s)
Published On :
September 26, 2018
PAM OLENlCZAK, Accounts Recei.,(a!,le
Specialist
Sworn to and sub~bed before me this
27th day of September, 2018
My Commission Expires: 7110/2023
WENDY DAWSON
Notary Public f. fj J North Carolina
~°"'="'-:..,~nty
101518a HCBOC Page 273
Board Meeting
Agenda Item
MEETING DA TE: October 15, 2018
TO: HARNETT COUNTY BOARD OF COMMISSIONERS
SUBJE CT: FY2020 Community Transportation Program Application (HARTS)
REQUESTED BY: Barry Blevins, General Services Director
REQUEST :
Harnett Area Rural Transit Sytem (HARTS) requests a public hearing to allow citizens an
opportunity to comment on transportation needs and the proposed 5311 Community
Transportation Program application, to be submitted to the North Carolina Department of
Transportation, Public Transportation Division (NCDOT/PTD) no later than November 2,
2018. Following the public hearing, HARTS requests the Board of Commissioners to
consider and approve the application and resolution to apply for FY2020 funding. Requires
matching funds totaling $59,343. Finally, as required by NCDOT/PTD funding, HARTS
seeks a Board resolution to apply , enter an angreement with NCDOT and provide the
necess ary as surances and required match.
Specifically, the Section 5311 program intends to enhance the access of people in non-
urbanized areas to health care, shopping, education, employment, public services and
recreation . Section 53 11 as sists in the maintenance, development, improvement and use o f
public transportation systems in non-urbanized areas.
FINANCE OFFICER'S RECOMMENDATION :
COUNTY MANAGER'S RECOMMENDATION:
C:\Users\pamerson\De sktop\HARTS\BJLLI NG\FY 20 l 9-202 0\FY20 NCD0T\FY2020 53 11 ADMJN -OPERA TING
DOCUMENTS\COMPLETED\FY 2020 Agenda Form.docx Page
I of !
101518a HCBOC Page 274
PUBLIC HEARING NOTICE Section 5311 {ADTAP), 5310, 5339, 5307 and applicable State funding, or combination thereof. This is to inform the public that a public hearing will be held on the proposed Fiscal Year 2020 Community Transportation Program App11cat1on to be submitted to the North Carolina Department of Transportation no later than Noyembe( 2. 2018. The public hearing will be held on October 15. 2018 at 7:00 pm before the ttamett County Board of Comm1ssjoners. Those interested in attending the publie hearing and needi"!9 either auxiliary aids and services under the Americans with Olsabil1t1es Act (ADA) or a la~ua~ translator should contact LauY..Smitb on or before October 2,18. at telephone number 9HH514-4019 or via email at lsmith@harnett.org. The Community Transportation Program provides assistance to coordinate existing transportation programs operating in .t:ra.rnmt Cm.mty as well as provides transportation options and services for the communities within this service area. These services are cur-rently provided using demand response and subscription routes. Services are rendered by center-aisle. minivans, and light tranSJt vehicles. The total estimated amount reQUested for the period July 11 2019 through J!J!19 30. 2020 Pcoiect ..lQ1al Amount Local Share Adminlstratwe $279,820 $41,943 (15%) Operating (5311) s $ (50%) Capital (Vehicles & Other) $174,000 $17,400 (10%) 531 o Operating $ $ (50%) Other s s (%) -... .. ---TOTAL PROJECT $453,620 $59,343 Total Funding Request Total Local Share This appllcalion may be inspected at Harnen Area Rural Transit System (HARTS) Administration Office. 250 Alexander Onve. Lillington, NC 27546 from 8:00 AM -4:00 PM. Monday through Friday. Written comments should be directed to Mr. Larry Smith before ~1.JL. 1014/18 i I' I I AVISO DE AUDIENCIA PUBLICA Secclon 5311 (ADT AP), 5310, 5339. 5307 y la ffnanclacton aatatal apHcable, o comblnaclon de loa mllfflOII. Esto es para informar al pilbhco que una audiencia publica se llevara a cabo en el ano fiscal 2020 propuesto solicitud del programa de Transporte de ta Comunidad que se presentara al Departamento de Transporte de Carolina del Norte a mas tardar el 2 de noviembre de 2018. la audtencia publica se llevara a cabo el 15 de octubre , 2018 a las 7:00 PM antes de la Junta de Comision-ados del Condado de Harnett. Los interesados en asistir a la audiencia pubhca y la necesidad de cualquiera de las ayudas y servicios auxiliares bajo el Acta de America.nos con Oiscapacidades (ADA) o un traductor de idiomas debe ponerse en contacto con Larry Smith en tarde del 12 octubre. 201 e, al numero de tetetono 910-8 f 4-4019 o por correo electr6nico a tsmith@hamett.org, El Programa de Transporte Comunldad proporciona asistencia para coordinar los programas e,cistentes de transporte que operan en el condado de Hamett. asl como proporciona oPCiones de transporte y servicios para las comunidades dentro de esta area de servicio. Estos servicios se proporcionan actualmente el uso de respuesta de la demanda y las rutas de suscripcion. Los servicios se ptestan por furgonetas de pasillo central. minivans y vehiculos de transporte hgero. La cantidad total estimado solicitado para el perfodo 01 de Julio 2019 a 30 de Junlo 2,02 mil Proyecto Caotldad total Cgropartir lqcat AdmmistratJvo $279,620 $41,943 (15%) De funcionamiento (5311) (50%) Vehicutos de capital (Y otros) $174,000 $17,400 (10,,o) 5310 Operativo (50%) Ql(_o___ ( "lo) TOTAL DEL PAOYECTO $453,620 $59,343 Solicitud de financiacion total Compartir total Local Esta ap!icaci6n puede ser inspeccionado en el Sistema de Harnett area rural de Transite (HARTS) Oficma de Admrnistraci6n. 250 Alexander Drive, Lillington, NC 27546. de 8:00 am • 4 :00 pm. de lunes a viemes. Los comentarios escritos deben ser dingidas a Larry Smith el 15 de octubre. 2018. 10/4/18 101518a HCBOC Page 275
Unified Application Checklist
Applicant Name: MOS Reviewer:
N/A 5311 Documents to Submit MOS Approved Comments or Concerns
LJ 0 Indirect Cost Rate Verification LJ
0 D Job Descriptions (if changed) D
D 0 Deviated Fixed Route Material D
0 D Vehicle Insurance Certification D
0 D Insurance Auto Schedule D
D 0 Retail Estimate(s) or Proposal(s) D
D 0 Third Party Provider Contract D
D 0 Rental Lease Agreement D
D 0 Vehicle Lease Agreement D
D 0 Software Leases D
D 0 PTO Approval Letter for Software D
LJ
0 D 5311 Project Funding Request Form D
D 0 Online Budget D
0 D Project Funding Request Form D
101518a HCBOC Page 276
Unified Application Checklist
Applicant Name: County of Harnett MOS Reviewer:
N/A Master Documents to Submit MOS Approved Comments or Concerns
~ LJ Authorizing Resolution LJ
0 D Certs & Assurances D
0 D Title VI Certification D
0 D DBE Certification LJ
0
Anticipated DBE/MBE/WBE HUB
D D Vendor Awards
D Public Hearing Notice (newspaper D D copy)
0 LJ Public Hearing Record
D D Public Hearing Minutes D
D D Public Hearing Affidavit D
0 D Public Hearing Outreach D
0 D Local Share Certificate for Funding D
0 D Surface Transportation Providers List D
0 D TAB Composition List D
0 D EEO Form (if applicable) D
0 D Conflit of Interest Forms D
0 D System Description Form LJ .
0 D DUNS Verification D
0 D Delegation of Authority Form D
0 D Application Checklist D
101518a HCBOC Page 277
NORTH CAROLINA DEPARTMENT OF TRANSPORTATION PUBLIC TRANSPORTATION DIVISION DBE/MBE/WBE/HUB ANTICIPATED VENDOR A WARDS in FY 2020 APPLICANT'S NAME: COUNTY OF HARNETT MAILING ADDRESS: POST OFFICE BOX 759, LILLINGTON, NC 27546 VENDOR NUMBER: We expect to utilize the following list of DBE/MBE/WBE/HUB Vendors in FY 2020: DBE/MBE/WBE/HUB Mailing Address ID# from Vendor/Subcontractor's Name City, State, Zip NCDOT Website D The above list includes the DBE/MBE/WBE/HUB Vendors the applicant expects to utilize in FY 2020. !'8:1 The applicant does NOT expect to utilize any DBE/MBE/WBE/HUB Vendors in FY 2020. ~~a.', ,r \IV\~ V") borclDr1 SfJri11ye Signature of Authorized Official Date PERIOD COVERED From: JULY J, 2019 To: JUNE 301 2020 Describe Service/ Item to be Anticipated Purchased Expenditure($) TOTAL :111::IH N91S 101518a HCBOC Page 278
FISCAL VEAR 2020
Federal (FTA) and State (NCDOT) Certifications and Assurances for
Public Transportation Programs will be distributed upon receipt of
federal documents from the FTA.
Documents Include:
• Federal Certifications and Assurances
• Applicant and Attorney Affirmations
• Certifications and Restrictions on Lobbying
• Special Section 5333(b) Warranty
• Certification of Equivalent Service (if applicable due to
purchase of non-lift vehicle or a fleet with non-lift-equipped
vehicles in it.)
101518a HCBOC Page 279
DBE GOOD FAITH EFFORTS CERTIFICATION
This is to certify that in all purchase and contract selections County of Harnett is committed to and shall
make good faith efforts to purchase from and award contracts to Disadvantaged Business E nterprises
(DBEs).
DBE good faith efforts will include the following items that are indicated by check mark(s) or
narrative:
Required Check all
Description byPTD that apply
* D Write a letter/email to Certified DBEs in the service area to inform them of
purchase or contract opportunities;
* ~ Document telephone calls, emails and correspondence with or on behalf of
DBEs;
D Advertise purchase and contract opportunities on local TV Community Cable
Network:
* ~ Request purchase/contract price quotes/bids from DBEs;
0 Monitor newspapers for new businesses that are DBE eligible
Encourage interested eligible firm s to become NCDOT certified. Interested
* ~ firms should contact the office of contractual services at (919) 707-4800 for
more information
* 0 Encourage interested firms to contact the Office of Historically Underutilized
Bus inesses at (919) 807-2330 for more information
Con s ult NCDOT Certified DBE Directory. A DBE company will be listed in
* 0 the DBE Directory for each work type or area of specialization that it
performs . You may obtain a copy of this directory at
httos ://www .ebs .nc.govN endorDirectorv/defau lt.htm lhtm 1
D Other efforts: Describe:
D Other efforts: Describe:
You may obtain a copy of the USDOT Di sadvantaged Bus iness Enterprise Program Title 49 Part 26 at
https:/ /www .ebs.nc.govN endorDirectory/default.html
Reminder: Documentation of all good faith efforts shall be retained for a period of five (5) years following
the end of the fi scal year.
I certify that, to the be st of my knowledge, the above information describes the DBE good faith efforts.
Signature of Authorized Official Date
Gordon Springle, Chairman, Harnett County Board of Commissioners
Type Name and T itle of Authorized Official
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101518a HCBOC Page 280
FY 2020 Delegation of Authority
Date: ----------------
Gordon Springle Chairman, Board of Commissioners
(Authorized Official's TypedfPrinted Name) (Authorized Official's TAie and Agency)
as the des ignated party for County of Hamett, North Carolina
-----------~'---,,(G,....ra~nt-,e-cip,,....entl-:Applica--'-c"-n-tAg.,..-en-c:;,....) -------------
With authority to submit fundin g applications and enter into contracts with the North Carolina Department of
Transportation and execute all agreements and contracts with the NCDOT Public Transportation Division,
hereby delegate authority to the individual(s ) filling the positions as indicated below:
Primary Designee: Larry Smith, Transit Manager
(Name and Primary Oesignee's Position Tf!Se}
General Services/Harnett Area Rural Transit System
(Primary Designee's Agency)
Reimbursement Requests : D Yes D No
Budget Revi sion s: D Yes D No
Budget Amendments: D Yes D No
Period of Performance Extensions: 0 Yes D No
1 Other D Yes D No
Alternate Designee #1: Barry Blevins, Director of General Services
(M emate Oe~gnee's Name and Position Tftie)
General Services/Harnett Area Rural Transit System
(Alternate Oesignee's Agency)
Reimburse ment Requests: D Ye s D No
Budget Revisions: D Yes D No
Budget Amendments: D Yes D No
Period of Performance Extens ion s: D Yes D No
10ther 0 Yes D N o
Alternate Designee #2: Pam Amerson, Administrative Support Specialist
(Attemate Oe~'s Name and Position Tltte)
General Services/Hamett Area Rural Transit System
(Atternate Oesignee's Agency)
Reimbursement Requests: D Yes D No
Budget Revisions : D Ye s D No
Budget Amendments: D Yes D No
Period of Performance Extensions: 0 Yes D No
10ther D Yes D No
April 25 , 2018
101518a HCBOC Page 281
CTP Authorized Officials
~ . '$DO,MPJ' ' 'A .-.,sr .. 1 .. rs Titlfii , . "-• Vll .. ~-:-~·$ i ....... &. . .
Aaina , Disabilitv and Transit Services of Rockinaham Counti Executive Director Aaino , Disability and Transit Services of Rockinaham Countv
Alamance County Transoortation Authoritv Chairperson Alamance Countv Transoortation Authorliv
Albemarle Reaional Health Services District Health Director Albemarle Reaional Health Services
Alleohanv Countv Countv Manaaer Alleahanv Countv
Anso n Countv Chairoerson Anson Countv Board of Commissioners
AooalCART Chairperson AooalCART Authoritv Board
Ashe Countv Transportation Authority, Inc. Executive Director Ashe Countv Transoortation Authoritv, Inc.
Averv Countv Transportation Authority Chairperson Averv Countv Board of Commissioners
Beaufort County Developmental Center, Inc. Executive Director Beaufort Countv Developmental Center, Inc.
Bladen Countv Chairperson Bladen Countv Board of Commissioners
Brunswick Transit Svstem , Inc. Executive Director Brunswick Transit Svstem , Inc.
Buncombe Countv Chairoerson Buncombe Countv Board of Commissioners
Cabarrus Countv Countv Manaaer Cabarrus County
Caoe Fear Public Transportation Authority Chairperson Cape Fear Public Transoortation Authorliv
Carteret Countv Countv Manager Carteret Countv
Caswell Countv County Manager Caswell Countv
Chatham Transit Network Executive Director Chatham Transit Network
Cherokee Countv County Manaaer Cherokee Countv
Choanoke Public Transoortation Authority Chairperson Choanoke Public Transportation Authoritv
Cliv of Rockv Mount Mavor Citv of Rockv Mount
cliv of Salisburv Mavor City of Salisbury
Cit¥ of Wilson Deoutv Citv Manaaer Cttv of Wilson
Clav Countv Chairoerson Clav Countv Board of Commissioners
Columbus Countv Chairperson Columbus County Board of Commissioners
Communitv and Senior Services of Johnston Countv, Inc. Chairperson Communitv and Senior Services of Johnston Countv, Inc.
Craven Countv Chairperson Craven Countv Board of Commissioners
Cumberland County County Manaqer Cumberland Countv
Dare County County Manaqer Dare Countv
Davidson Countv County Manaaer Davidson County
Duolin County Chairperson Duplin Countv Board of Commissioners
Durham County Chairoerson Durham County Board of Commissioners
Eastern Band of Cherokee Indians Princioal Chief Eastern Band of Cherokee Indians
Gaston Countv Chairoerson Gaston Countv Board of Commissioners
Gates Countv Countv Manaaer Gates Countv
Goldsboro-Wavne Transportation Authoritv Chairperson Goldsboro-Wavne Transoortation Authoritv
Graham Countv County Finance Officer Graham Countv
Greene County County Manaaer Greene Countv
Guilford Countv County Manaaer Guilford County
Harnett County Chairperson Harnett County Board of Commissioners
Hoke County Chairoerson Hoke County Board of Commissioners
Hvde Countv Non-Profit Private Transoortation Coro ., Inc. Transoortation Coordinator Hvde County Non-Profit Private Transoortation Coro., Inc.
Iredell Countv Transoortation Director Iredell Countv Transit
Jackson Countv Countv Manaaer Jackson Countv
Kerr Area Transportation Authoritv Executive Director Kerr Area Transportation Authoritv
Lee Countv Chairoerson Lee Countv Board of Commissioners
Lenoir Countv Chairperson Lenoir Countv Board of Commissioners
Lincoln Countv County Manager Lincoln Countv
Macon Countv County Manager Macon Countv
Madison Countv Transportation Authority Chairperson Madison County Board of Commissioners
Martin County County Manaqer Martin Countv
McDowell CountyTransoortation Planning Board, Inc. President McDowell County Transoortation Plannina Board, Inc.
Mecklenbura Countv Countv Manaaer Mecklenbura County
Mitchell Countv Transportation Authoritv Chairoerson Mitchell County Board of Commissioners
Moore Countv Chairoerson Moore County Board of Commissioners
Mountain Proiects, Inc. Executive Director Mountain Proiects, Inc.
Onslow United Transit Svstem , Inc. President Onslow United Transit Svstem, Inc. Board
Oranae Countv Chairperson Oranae Countv Board of Commissioners
Pender Adult Services, Inc. Executive Director Pender Adult Services, Inc.
Person Countv Countv Manager Person Countv
Pitt Countv County Manager Pitt Countv
Polk Countv Transportation Authority Chairperson Polk Countv Board of Commissioners
Randolph Countv Senior Adults Association, Inc. Executive Director Randolph Countv Senior Adults Association, Inc.
Richmond lnteraaencv Transportation , Inc. Chairperson Richmond lnteraaencv Transportation, Inc.
Robeson County Chairoerson Robeson County Board of Commissioners
Rowan Couritv Countv Manaaer Rowan County
Page 1 of 2
101518a HCBOC Page 282
CTP Authorized Officials
S'~nsor . l'lffirJars 1'ltle. .Ai,itbprtzect Offl~laJ's AttAnN ' ' Rutherford Countv Countv Manaoer Rutherford County
Samoson Counlv Countv Manaoer Sampson County
Scotland County Countv Manaoer Scotland County
Stanlv Counlv County Manaaer Stanly County
Swain County Focal Point on Aaina. Inc. Transportation Director Swain County Focal Point on AainQ , Inc.
Transportation Administration of Cleveland County, Inc. President Transportation Administration of Cleveland Counlv, Inc.
Transylvania County Chairperson Transylvania County Board of Commissioners
Tyrrell Countv Countv Administrator Tvrrell Counlv
Union Couritv Countv Manaoer Union Countv
Wake Countv Chairoerson Wake County Board of Commissioners
Washinaton Countv Chairoerson Washington County Board of Commissioners
Western Carolina Community Action, Inc. Executive Director Western Carolina Community Action, Inc.
Western Piedmont Regional Transit Authority Executive Director Western Piedmont Regional Transit Authoritv
Wilkes Transoortation Authority Executive Director Wilkes Transportation Authority
Wilson County County Manaaer Wilson County
Yadkin Valley Economic Development District, Inc. Executive Director Yadkin Valley Economic Development District, Inc.
Yancev County Transportation Authoritv Transportation Director Yancev County Transportation
as of 9/25/2012
Page 2 of 2
101518a HCBOC Page 283
EEO QUESTIONNAIRE
Threshold Requirements: Any applicant, recipient, or sub-recipient is required to comply with program
requirements in Chapter Ill if it meets the following thresholds:
a. Employees 100 (+) or more transit-related employees*; and
b. Requests or receives capital or operating assistance under Sections 3, 4(i), or 9 of the FT A; assistance
under 23 U.S.C. 142(a)(2} or 23 U.S.C. 103(e}(4}, or any combination thereof, in excess of $1 million
in the previous Federal fiscal year; or
c. Request and receives planning assistance under Sections 8 and/or 9 in excess of $250,000 in the
previous Federal fiscal year.
Transit systems with 50 -99 employees must keep a plan on file for review at next site visit.
Name of Organization: Harnett Area Rural Transit System
____ State DOT ____ MPO ---'X-'-_Transit Agency ____ City
TrAMS ID:-------(if applicable)
1. How many employees do you have in your organization? 40
2. How many of those employees are *transit related? 40
*A transit related employee is an employee of an FTA applicant, recipient, or subrecipient who is involved in
an aspect of an agency's mass transit operation funded by FTA. For example, a city planner involved in a
planning bus routes would be counted as part of the recipient's work force, but a city planner involved in
land use would not be counted.
If EEO requirement is not applicable check here ___ _, sign at the bottom, and submit1 otherwise
complete remaining questions.
3 . How much did your organization receive in capital or operating assistance the previous fiscal year?
4. How much did your organization receive in planning assistance the previous fiscal year?
5. Does your agency submit an EEO Program? ___ Yes ---"-X-'--_No
If yes, what is the date of your last submission?---------
Page 1 of 3
101518a HCBOC Page 284
6. Do you contract out any of your transit services? ___ Yes ---'"X-'---No
If no, skip to question 7. If yes,
a. What is the name of agency (s)? -------------------
b. How much does the agency receive in capital or operating assistance? _____ _
c. How much does the agency receive in planning assistance?----------
d. How many transit employees does the agency have? ___________ _
e. Does the agency submit an EEO Program to you? ___ Ye s ___ _ No
If yes, what is the date of their last EEO submission?------------
7 . What is the date of your last Triennial Review (If applicable)? _:..:.M.:..:::a:..:..rc""h.!...:.;20::..:1::.:6::..._ _______ _
a. Were there any deficiencies? Yes X No
If yes, in what area(s) ------------------------
b. Are any of the deficiencies still open ___ Yes ___ No
If yes, in what area(s)? ______________________ _
8 . What i s the date of your last State Management review (If Applicable)? __ ...:.N=/-=-A,..__ ____ _
a. Were there any deficiencies? ___ Yes ____ No
If yes, in what area(s) --------------------------
b. Are any of the deficiencies still open ___ Yes ___ No
If yes, in what area(s)? ________________________ _
Page 2 of 3
101518a HCBOC Page 285
9. Has your agency participated in an EEO compliance review? ____ -'-"N'-"/A-'----------
lf yes,
a. Were there any deficiencies? ___ Yes ____ No
If yes, in what area(s) _________________________ _
b. Are any of the deficiencies still open ___ Yes "\, No
If yes, in what area(s)? ________________________ _
r state) that the foregoing is true and correct.
Date 1/ty£' Signature ..,..:,..-==--,£.....j:+-..,£-------~-
Title Transit Services Manager
Page 3 of3
101518a HCBOC Page 286
FY 2020 Facility Insurance Verification
Systems who have state and/or federal funding for their transit
facilities must document facility insurance enough to cover the
amount of funding involved in the project. Insurance
verification is a federal requirement and is included in our
oversight of grant funding.
101518a HCBOC Page 287
PUBLIC HEARING RECORD
Section 5311 (ADTAP), 5310, 5339, 5307 and applicable State funding, or combination thereof.
APPLICANT : County of Harnett
DATE: October 15, 2018
PLACE: Harnett County Administrative Building, 102 E Front St, Lillington, NC
TIME : 7:00PM
How many BOARD MEMBERS attended the public hearing?
How many members of the PUBLIC attended the public hearing?
Public Attendance Surveys
D (Attached)
D (Offered at Public Hearing but none completed)
I , the undersigned , representing (Legal Name of Applicant) __ do hereby certify to the North
Carolina Department of Transportation , that a Public Hearing was held as indicated above and
During the Public Hearing
D (NO public comments)
D (Public Comments were made and meeting minutes
will be submitted after board approval)
The estimated date for board approval of meeting minutes is:
Signature or Clerk to the Board
Margaret Regina Wheeler
Printed Name and Title
Date
------------
f Aff,x Seal Here :
. . '\ou,,o,,,,,,,,,,o,u,,,,,,,,o,,,,,,,,,,ouoo•o•ooo ou,ooonoo,o,,,00 000,0,0,,,,,,,,,,,,,,,,,,,,•
101518a HCBOC Page 288
Voluntary Title VI Public Involvement
Title VI of the Civil Right' s Act of 1964 requires North Carolina Department of
Transportation to gather statistical data on participants and beneficiaries of the agency's
federal-aid highway programs and activities. The North Carolina Department of
Transportation collects information on race, color, national origin and gender of the
attendees to this public meeting to ensure the inclusion of all segments of the population
affected by a proposed project.
The North Carol ina Department of Transportation wishes to clarify that this information
gathering process is completely voluntary and that you are not required to disclose the
statistical data requested in order to participate in this meeting. This form is a public
document.
The completed forms will be held on file at the North Carolina Department of
Transportation. For Further information regarding this process please contact Shantray
Dickens the Title VI Manager at telephone number 919 .508.1896 or email at
sddickens@ncdot.gov.
Project Name: I Date:
Meetin Location:
Name (please print) Gender:
D Male D Female
General ethnic identification categories ( check one)
D Caucasian I D Hispanic American D American Indian/ Al askan Native
D African American 1 D Asian/Pacific Islander Other:
Color: National Origin:
After you complete this form, please fold it and place it inside the designated box on the
registration table.
Thank you for your cooperation.
101518a HCBOC Page 289
LOCAL SHARE CERTIFICATION FOR FUNDING
COUNTY OF HARNETT
Requested Funding Amounts
Project
Administrative
5311 Operating (No State Match)
5310 Operating (No State Match)
5307 Operating
5307 Planning
Capital
Mobility Management
Total Amount
$279,620
$ __
$ __
$ __
$ __
$174,000
$ __
$ __
$ __
$ __
$ __
Local Share
$41,943 (15%)
$ (50%)
$ (50%)
$ (50%)
$ (20%)
$17,400 (10%)
$ (10%)
$ Lo/o)
$ L%)
$ Lo/o)
$ L%)
Funding programs covered are 5311, 5310, 5339 Bus and Bus Facilities, 5307 (Small fixed route , regional, and
consolidated urban-rural systems)
TOTAL $453,620
Total Funding Requests
The Local Share is available from the following sources:
Source of Funds
General Funds
TOTAL
Grant Applied To
$59,343
Total Local Share
Amount
$59,343
$ __
$ __
$ __
$ __
$ __
$ __
$ __
$59,343
** Fare box revenue is not an applicable source for local share funding
101518a HCBOC Page 290
FY 2020 Loca l Share Certificate (page 2)
I, the undersigned representing County of Harnett do hereby certify to the North Carolina
Department of Transportation , that the required local funds for the FY2020 Community
Transportation Program and 5307 Governors Apportionment will be ava ilable as of July 1,
2019, which has a period of performance of July 1, 2019-June 30 , 2020.
Signature of Authorized Official
Gordon Springle. Chairman. Harnett County Board of Commissioners
Type Name and Title of Authorized Official
Date
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101518a HCBOC Page 291
PUBLIC TRANSPORTATION PROGRAM RESOLUTION
FY 2020 RESOLUTION
Section 5311 (including ADTAP), 5310, 5339, 5307 and applicable State funding , or combim,tio
Applicant seek ing permission to apply for Public Transportation Program f unding, enter into agreem
Carolina Department of Transportation , provide the necessary assurances and the required local match .
A motion was made by and seconded by -------------for the
adoption of the following resolution , and upon being put to a vote was duly adopted .
WHEREAS , Article 28 of Chapter 136 of the North Carolina General Statutes a nd the Governor of North Carolina
have designated the North Carolina Department of Transportation (N CDOT) as the agency respons ible for
administering federal and state public transportation funds; and
WHEREAS , the North Carolina Department of Transportation will apply for a grant f rom the US Department of
Transportation , Federal Transit Administration and receives funds from the North Carolina General Assembly to
provide assistance for rural public transportation projects; and
WHEREAS , the purpose of these transportation funds is to provide grant monies to local agencies for the
provision of rural , small urban , and urban public transportation services consistent with the policy requirements of
each fund ing source for planning , community and agency involvement, service design , service alternatives ,
training and conference participation , reporting and other requirements (drug and alcohol testing policy and
program , disadvantaged business enterprise program, and fully allocated costs analysis); and
WHEREAS , the funds applied for may be Administrative , Operating , Plann ing , or Capital funds and will have
different percentages of federal , state, and local funds .
WHEREAS, non-Community Transportation applicants may apply for funding for "purchase-of-service" proj ects
under the Capital budget Section 5310 program.
WHEREAS , County of Harnett hereby assures and certifies that it will provide the required local matching funds ;
that its staff has the technical capacity to implement and manage the project(s), prepare required reports , obtain
required training , attend meetings and conferences ; and agrees to comply with the federal and state statutes ,
regulations , executive orders , Section 5333 (b) Warranty , and all administrative requirements related to the
applications made to and grants received from the Federal Transit Admin istration , as well as the provisions of
Section 1001 of Title 18 , U.S. C.
WHEREAS, the applicant has or will provide all annual certifications and assurances to the
State of North Carolina required for the project ;
Revi sed 04-26-18
101518a HCBOC Page 292
NOW, THEREFORE , be it resolved that the Chairman of Harnett County Board of Commissioners is he reby
authorized to submit grant application (s) for federal and state funding in response to NCDOT's calls for projects , make
the necessary assurances and certifications and be empowered to enter into an agreement with the NCDOT to provide
rural , small urban , and urban publ ic transportation services.
** The approved resolution allows the Authorized Representative to receive, sign, and return the contract{s) for
the grant(s) applied for without the contract(s) resubmitted to the applicants Board for review.
I Margaret Regina Wheeler, Clerk to the Board of Commissioners do hereby certify that the above is a true and
correct copy of an excerpt from the minutes of a meeting of the Harnett County Board of Commissioners duly held on
the 15th day of October, 2018.
Signature of Certifying Official
zU, '"-:a ,:,
* Note that the authorized official, certifying official, and notary public should be three separate individuals.
Ill z
Seal Subscribed and sworn to me (date) I Affvc Notary Seal Here I
; l Notary Public *
Printed Name and Address
My commission expires (date)
:ooooo,oo••••••••••••••••••o.••oooouooon oo ooooooooo,o o,,,,,,,,,,,,,,,,000,,,,,,,,,,,,,,,,,,,,,,;
2 Revised 04-26-18
101518a HCBOC Page 293
NCDOTPTD
PROJECT FUNDING REQUEST FORM
Project Funding Request Form
DATE SUBMITTED: I November 2, 2019
APPLICANrs LEGAL NAME: I county of Hamett
MPOorRPO
NCDOT DIVISION
BUDGET TYPE:
jFAMPO & CAMPO Mid-Carolina
!Division 6
GENERAL INFORMATION CURRENT FISCAL YEAR 2020
MAILING ADDRESS: PO Box 85 Lillington, NC 27546 FEDERAL FUNDING-HA $223,6961
STATE FUNDING $13,981 I
PHYSICAL ADDERSS: 250 Alexander Drive Lillington, NC
27546
LOCAL FUNDING $41 ,9431
OTHER FUNDING
CONTACT PERSON: ! Mr. Larry Smith
PHONE NUMBER: !910-814-4019 TOTAL GRANT AMOUNT $279,6201
FAX NUMBER: !910-814-4020
EMAIL ADDRESS : !lsmith@harnett.org
FOR OFFICE USE ONLY PROJECT LOCATION: !County of Harnett
PREPARED BY: I I FEDERAL PROGRAM?
STATE PROGRAM?
REQUEST RECOMMENDATION OR REJECTION !Click here
PROJECT or PROGRAM
PROJECT f PROGRAM DESCRIPTION (Fully describe project):
Hamett Area Rural Transit System (HARTS) is a public and human service transportation delivery system
operating within as well as outside of Hamett County, NC for the purpose of providing transportation for the
general public, elderly and disabled , low-income County citizens. Funding provided through NCDOT/PTD and in
concert with the County of Hamett allows the safe and efficient operation of transit services for those citizens
requesting transportation to places such as medical facilities , nutrition sites, senior centers, workplaces, grocery
stores and other human service needs. This budget will cover salaries for 4 administrative positions, drug testing ,
uniform rentals for our drivers, office supplies , trainings and meetings, travel , utilities, printing services, postage,
advertising, communications/radio equipment and services, subscriptions , as well as any indirect costs.
PROJECT I PROGRAM BENEFITS (Fully describe benefits):
Program benefits include access to medical facilities , food sources, universities, workplaces , workshops,
rehabilitation programs, senior centers and recreational facilitie s.
RESULT OF PROJECT/ PROGRAM IF NOT FUNDED (Fully describe results of project):
If the program was not funded, an estimated 17% of Hamett County's population would not have access to mu ch
needed transportation options . There is no other option available for certain nodes of the population in this rural
County.
101518a HCBOC Page 294
DATE SUBMITIED:
NCDOTPTD
PROJECT FUNDING REQUEST FORM
Project Funding Request Fonn
!November 2, 2019
APPLICANrs LEGAL NAME: I county of Hamett
MPOorRPO
NCDOT DIVISION
BUDGET TYPE:
jFAMPO & CAMPO Mid-Carolina
!Division 6
GENERAL INFORMATION CURRENT FISCAL YEAR 2020
MAILING ADDRESS: PO Box 85 Lillington, NC 27546 FEDERAL FUNDING-HA $139,2001
STATE FUNDING $17,4001
PHYSICAL ADDERSS: 250 Alexander Drive Lillington , NC
27546
LOCAL FUNDING $17,400!
OTHER FUNDING
CONTACT PERSON: !Mr. Larry Smith I
PHONE NUMBER: 1910-814-4019 I TOTAL GRANT AMOUNT $174,000l
FAX NUMBER: 1910-814-4020 I
EMAIL ADDRESS: !1smith@harnett.org I
FOR OFFICE USE ONLY PROJECT LOCATION: !county of Harnett
PREPARED BY: FEDERAL PROGRAM?
STATE PROGRAM?
REQUEST RECOMMENDATION OR REJECTION !Click here
PROJECT or PROGRAM
PROJECT/ PROGRAM DESCRIPTION (Fully describe project):
Hamett Area Rural Transit System (HARTS) is a public and human service transportation delivery system
operating within as well as outside of Hamett County, NC for the purpose of providing transportation for the
general public, elderly and disabled, low-income County citizens . Funding provided through NCDOT/PTD and in
concert with the County of Hamett allows the safe and efficient operation of transit services for those citizens
requesting transportation to places such as medical facilities, nutrition sites , senior centers , workplaces, grocery
stores and other human service needs. This budget will cover salaries for 4 administrative positions, drug testing,
uniform rentals for our drivers, office supplies , trainings and meetings, travel , utilities , printing services, postage,
advertising , communications/radio equipment and services. subscriptions, as well as any indirect costs.
PROJECT/ PROGRAM BENEFITS (Fully describe benefits):
Program benefits include access to medical facilities , food sources. universities, workplaces, workshops,
rehabilitation programs , senior centers and recreational facilities .
RESULT OF PROJECT/ PROGRAM IF NOT FUNDED (Fully describe results of project):
If the program wa s not funded , an estimated 17% of Harnett County's population would not have access to much
needed transportation options. There is no other option available for certain nodes of the population in this rural
County.
101518a HCBOC Page 295
FY 2020 Public Hearing Meeting Minutes
To support the combined program Resolution for FY 2020, a
copy of the minutes from your public hearing reflecting the
grant funds applied for must be uploaded into EBS as a
supporting document.
Final Board-approved minutes must be uploaded by December
15, 2018.
101518a HCBOC Page 296
PUBLIC HEARING NOTICE
Section 5311 (ADTAP), 5310, 5339, 5307 and applicable State funding, or combination thereof.
This is to inform the public that a public hearing will be held on the proposed Fiscal Year 2020
Community Transportation Program Application to be submitted to the North Carolina Department
of Transportation no later than November 2, 2018 . The public hearing will be held on October 15 ,
2018 at 7:00 PM before the Harnett County Board of Commissioners.
Those interested in attending the public hearing and needing e ither auxiliary aids and services
under the Americans with Disabilities Act (ADA) or a language translator should contact Larry
Smith on or before October 12 , 2018, at telephone number 910-814-4019 or via email at
lsmith@harnett.org.
The Community Transportation Program provides assistance to coordinate existing transportation
programs operating in Harnett County as well as provides transportation options and services for
the communities within this service area . These services are currently provided using demand
response and subscription routes . Services are rendered by center-a isle vans , minivans , and
light transit vehicles .
The total estimated amount requested for the period July 1, 2019 through June 30, 2020
Pro ject
Administrative
Operating ( 5311)
Capital (Vehicles & Other)
531 O Operating
Other
TOTAL PROJECT
Total Amount
$279,620
$
$174,000
$
$
$453,620
Total Funding Request
Local Share
$41,943
$
$17,400
$
$
$59,343
(15%)
(50%)
(10%)
(50%)
( %)
Total Local Share
This application may be inspected at Harnett Area Rural Transit System (HARTS) Administration
Office , 250 Alexander Drive, Lillington , NC 27546 from 8:00 AM -4:00 PM, Monday through
Friday. Written comments should be directed to Larry Smith before October 15, 2018.
101518a HCBOC Page 297
AVISO DE AUDIENCIA PUBLICA
Seccion 5311 (ADTAP), 5310, 5339, 5307 y la financiaci6n estatal aplicable, o combinacion de los
mismos.
Esto es para informar al publico que una audiencia publica se ffevara a cabo en el ario fiscal 2020
propuesto solicitud def programa de Transporte de fa Comunidad que se presentara al
Departamento de Transporte de Carolina def Norte a mas tardar el 2 de noviembre de 2018. La
audiencia publica se ffevara a cabo el 15 de octubre , 2018 a fas 7:00 PM antes de la Junta de
Comisionados def Condado de Harnett.
Los interesados en asist ir a fa audiencia publica y fa necesidad de cuafqu iera de fas ayudas y
servicios auxifiares bajo el Acta de Americanos con Discapacidades (ADA) o un traductor de
idiomas debe ponerse en contacto con Larry Smith en tarde def 12 octubre, 2018, al numero de
telefono 910-814-4019 o por correo efectr6nico a fsmith@harnett.org.
El Programa de Transporte Comunidad proporciona asistencia para coordinar los programas
existentes de transporte que operan en el condado de Harnett, asf como proporciona opciones
de transporte y servicios para fas comunidades dentro de esta area de servicio . Estos servicios
se proporcionan actuafmente el uso de respuesta de la demanda y fas rutas de suscripci6n . Los
servicios se prestan por furgonetas de pasiflo central , minivans y vehfcufos de transporte figero .
La cantidad total estimado solicitado para el perfodo 01 de julio 2019 a 30 de junio 2,02 mil
Proyecto Cantidad total Compartir focal
Administrative $ 279.620 $ 41.943 (15%)
De funcionamiento (5311) (50%)
Vehfcufos de capital (y otros) $174.000 $ 17.400 (10%)
531 0 operative
(50%)
otro ---------(%)
TOTAL DEL PROYECTO $ 453.620 $ 59.343
Solicitud de financiaci6n total Compartir total Local
Esta apficac i6n puede ser inspeccionado en el Sistema de Harnett area rural de Transite
(HARTS) Oficina de Administraci6n , 250 Alexander Drive , Lillington, NC 27546 , de 8 :00 am -4:00
pm, de funes a viernes . Los comentarios escritos deben ser dirigidas a Larry Smith el 15 de
octubre, 2018.
101518a HCBOC Page 298
PUBLIC HEARING OUTREACH
APPLICANT: COUNTY OF HARNETT
Provide a detailed description of public hearing outreach efforts by the applicant to inform the
public ESPECIALLY MINORITY, WOMEN, ELDERLY, DISABLED, LIMITED ENGLISH
PROFICIENCY-(LEP) AND LOW INCOME INDIVIDUALS about the scheduled public
hearing and the opportunity to comment on the proposed Community Transportation grant
application . Outreach may include efforts such as distribution of information on vehicles, at
human service agencies, at local community events , at public events, local organization , etc.
Click on gray box and begin typ ing the detailed description.
Public Hearing Notice was published in the Dunn Daily Record 1 O days prior to the Public
Hearing. All local government Human Services organizations were contacted and information
distributed . Transportation Advisory Board members were notified of the public hearing date
and place. The Public Hearing was posted on the Harnett County website, www.harnett.org.
101518a HCBOC Page 299
Surface Transportation Providers (operating in your service area) List all private transportation providers and indicate if represented by union. This information is generally available in your telephone directory or through the County's business licensing office. ff you contract out any part of your service or management/administration of your transit system and the contractor's employees are represented by a labor union, remember to include them here. Private Transportation Providers 1 Crossway Transportation 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 Surface Transportation Providers COUNTY OF HARNETT Legal Name of Applicant . ·---··-----···. ·-···-Union Representation [8J No D Yes D No D Yes D No D Yes D No D Yes D No D Yes D No D Yes D No D Yes D No D Yes D No D Yes D No D Yes D No D Yes D No D Yes D No D Yes D No D Yes D No D Yes D No D Yes D No D Yes D No D Yes D No D Yes D No D Yes D No D Yes D No D Yes D No D Yes D No D Yes D No D Yes If yes-Provide Name of Union and the affiliated Local Branch Number, (e.g. ACME Local #458) Page 1 of2 101518a HCBOC Page 300
Private Transportation Providers 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 Surface Transportation Providers COUNTY OF HARNETT Legal Name of Applicant -· Union Representation D No D Yes D No D Yes D No D Yes D No D Yes D No D Yes D No D Yes D No D Yes D No D Yes D No D Yes D No D Yes D No D Yes D No D Yes D No D Yes D No D Yes D No D Yes D No D Yes D No D Yes D No D Yes D No D Yes D No D Yes D No D Yes D No D Yes D No D Yes 0 No 0 Yes D No D Yes D No D Yes D No D Yes D No D Yes If yes -Provide Name of Union and the affiliated Local Branch Number, (e.g. ACME Local #458) Page 2 of2 101518a HCBOC Page 301
Check If New Sub-Recipient D
1. GENERAL INFORMATION
FY2020 COMMUNITY TRANSPORTATION PROGRAM GRANT APPLICATION
NORTH CAROLINA DEPARTMENT OF TRANSPORTATION
FEDERAL SECTION 5311 & STATE FUNDING
TRANSIT SYSTEM DESCRIPTION
APPLICANT'S LEGAL NAME: !._H_a_m_e_tt_C_o_un_ty~----------------~
APPLICANT'S CO NGRES SIONAL DI STR ICT: !2 If incorrect entercorrectprimarydistrict:j I
If Applicant's city is included in more than one district, enter primary district only
MAILING ADDRESS : ~IP_O_Bo_x_8_5-=.,,..---,,----,--------------~
PO Box or Street Address
!Lillingto n, NC 27546
City, State Zip (9-<Jigft zip)
PHYSICAL ADDRESS : ~!2_5_0_A_le_x_a_nd_e_r_D_ri_ve ________________ ~
Street Address
!Lillington , NC 27546
Cfty, State
TAXPAYER IDE NTIFICATION NUMBER : ~!5_6_-6_00_0_3_06 _________________ ~
DOING BUSINESS AS (OBA) NAME: ~IH_a_r_ne_tt_A_r_ea_R_u_ra_l _Tra_n_si_t S_y~s_te_m ___________ ~
Nonnal/y the transft system name, if different than applicant name
APP LICANT DUNS NUMBER : !091565986
~U-n.,..iq-ue-9,...·D::-:ig""'ft-n-um-be,--n,...·ss_u_edc-b,-y""D,-un.....,.& -=-era......,.ds-tree_t_..,.M.,..a-y .,-be-ob...,.,...ta.,..ined-..,..,free,---,of:-c,-ha_rg_e_a.,..t:~
http://fedgov.dnb.com/webform
DUNS NUMBER OF PARENT AGENCY: a..::IOc;:.9-',;15:..:6c.::;.59.c.;8;...;;6 _________________ _,
Required only if different t han Applicant
CONTACT PERSON : ~IL_a_rry~Sm_i_th _________________ ~
PHONE NUMBER: u!(_91_0~) _81_4_-4_0_19 ________________ ~
Area Code & Phone Number
FAX NUMBER : !(910) 814-4020
Area Code & Phone Number
EMAIL ADDRESS : jlsmith@harnett.org
SERVICE AREA'S CONGRESSIONAL DISTRICT: j 2 ,r incorrect enter correct primary district:!----
If Service Area is included in more than one district, enter primary district on y
SERVICE AREA: "'!H-"ac.cm;.;.;e:..;;tt;..;C;..;o;...;;u.;..;.nty...__ ___________________________ __.
FEDERAL FINAN CIAL ASSISTAN CE
TRANSPARENCY ACT (FFATA): F FATA mandates the disclosure of the names an d total compensation of the five most
highly compensated officers of an entity if:
• The Applicant received 80% or more of its annual gross revenue s in the preceding
fiscal year from the federal government (all federal sources, not just FTA); !fil!
• Those revenues were greater than $25M ; and
• The public does not have access to the information through Securities and Exchange
Commission or Internal Revenue Service filings as specified in FFATA.
Applicant should select "Yes· if they are subject to the reporting requirements of FFATA
and "No" if th ey are not subject to Executive Com pensation Reporting . ~ L.I __ ...;.N.;.:o:...._ _ _,
EXEC UTIVE CO MP ENSATION REPORTING: If "Yes" is selected above , enter the Nam es and Compensa tion amounts for the
top five officers of the Applicant.
1. $ ---------------------Enter full name Total compensation
2. $ ---------------------Enter full name Total compensation
3. ---------------------$
Enter full name Total compensation
4 . $ ---------------------Enter full name Total compensation
5. $ ---------------------Enter full name Total compensation
Page 1
101518a HCBOC Page 302
2. TYPE OF APPLICANT
3. TYPE OF TRANSIT SYSTEM
4. TYPE OF SERVICE -(check all that apply)
12bemand Response
0 Subscription
0 Deviated Fixed Route
5. SERVICE OPTIONS -(check all that apply)
0 General Public
0 Human Service
Public County Government
Single-County
0 Fixed Route
0 Other: (specify below)
0 Brokerage (Contractual service not a referral)
0 Other: (describe below)
6. PURCHASE SERVICE -List agencies that purchase service from the transit system. Note: List agency ONCE
Agency
1 Agency2
Name: County of Harnett Department of Social Service Name: Mid-Carolina Council on Aging
0 check if agency purchased service last year 0 Check if agency purchased service last year
List Programs Served : List Programs Served:
1) Medicaid 1) Medical Transportation
2) Work First 2) General Transportation
3) 3) _____________ _
4) 4) ______________ _
5 ) 5) ______________ _
Agency
3
Name: County of Harnett Health Department
0 Check if agency purchased service last year
List Programs Served:
1) Medical Transportation
2) _____________ _
3) ______________ _
4) _____________ _
5) ______________ _
Agency
5
Name: Joblink Career Center
0 Check if agency purchased service last year
List Programs Served:
1) Workforce Development
2) ______________ _
3) _____________ _
4) ______________ _
5) _____________ _
Agency
7
Name : Central Carolina Community College
0 check if agency purchased service last year
List Programs Served:
1) Education
2) Comprehensory Program
3) _____________ _
4) _____________ _
5) ______________ _
Agency
9 NC Department of Health & Human Services
0 Check if agency purchased service last year
List Programs Served :
1) Medical
2) _____________ _
3) _____________ _
4) _____________ _
5) ______________ _
Agency4
Name : Daymark Recovery Services
0 Check if agency purchased service last year
List Programs Served :
1) Psycho-Social Program
2) Substance Abuse Program
3) Rehabilitation
4) Medical
5) ______________ _
Agency6
Name: Johnston County Industries
0 C heck if agency purchased service last year
List Programs Served :
1) Employment
2) Vocational Rehabilitation
3) Worilshop
4) ______________ _
5) ______________ _
Agency 8
Name: NC Vocational Rehabilitation
0 Check if agency purchased service last year
List Programs Served :
1) Vocational Rehabilitation
2) ______________ _
3) ______________ _
4) ______________ _
5) ______________ _
Agency
10 Name: NC Division of Services for the Blind
0 Check if agency purchased service last year
List Programs Served:
1) Medical
2) Educational
3) _____________ _
4) ______________ _
5) ______________ _
O check box at left if you serve more than 1 O agencies and complete Continuation worksheet.
Page2
101518a HCBOC Page 303
7. REVENUE VEHICLE INVENTORY BY CATEGORY
-Important· (If a vehicle has been replaced and the transit system has received the title from PTO, the vehicle should
not be included in this inventory. Identify vehicles awaiting d isposition in 88 below.)
6 Center Aisle Van 0 20-Ft LTV (Cutaway) (no lift)
3 Conversion Van 0 20-Ft LTV (Cutaway) (w/lift)
11 Lift-Equipped Van 0 22-Ft LTV (Cutaway) (w/lift)
4 Minivan (no ramp) ---0 25-Ft LTV (Cutaway) (w/lift)
__ o_ Minivan (w/ramp) 0 28-Ft LTV (Cutaway) (w/lift)
0 Crossover (4/ All-wheel drive) ---0 Sedan
9 Transit Bus ---Other: (describe below)
8. FLEET SIZE
A. ACTIVE FLEET
27 Total~ Vehicles in Fleet
0 Backup Revenue Vehicles
11 Total Lift-Equipped Vehicles
B. INACTIVE FLEET
2 Enter number of vehicles awaiting disposition. This includes vehicles for which replacements have been received and titles have been
received from PTD. It also includes fleet reductions for which titles have been received from PTD.
9. DAYS AND HOURS OF SERVICE (Check all that apply and enter corresponding service hours):
DAYS Beginning f!me SERVICE HOURS
0 Seven (7) days per week
Q!
0 Mo nday -Friday
0Saturday
4:00AM
4:00AM
0 Sunday
0Holiday
10. SYSTEM MANAGEMENT & OPERATION
A. Is the Management/Administration of the transit system currently subcontracted?
If~. answer the following :
Name of the Management provider :
When will the new RFP process begin?
Are employees of the subcontractor represented by a labor organization (union)?
If so, provide the following :
Name of Union:
Example: Amalgamated Transit Union Local #1437
B. Is the Operation of th e transit system currently subcontracted?
If~. answer the following:
Name of the service provider:
When will the new RFP process begin?
Are employees of the subcontractor represented by a labor organization (union )?
If so, provide the following :
Name of Union:
Example: A malgamated Tran sff Union Local #1437
C . Does another public transit system contract with your system for any part of its service?
If~. answer the following:
Name of the public transit system :
Type of service that you provide:
A re employees of the~ transit system Q! its subcontracto r(s) represented by a labor union?
If so, provide the following:
Name of other system's subcontractor (if applicable):
Name of Union:
Example: Amalgamated Transit Union Local #1437
11. PUBLIC INVOLVEMENT -Please complete the chart below to document outreach efforts.
1)
2)
Organizations I Events Date /Time Location
Ending Time
6 :00 PM
6:00 PM
No
No
No
Number of
Attendees Primary Audience
Number nue VI Forms
Comple1ed
---,,-,.,
101518a HCBOC Page 304
3) ________________ +-----lf----------------------+---------.1------
4) ________________ +-----lf----------------------+-------1------
5)----------------+-----lf------------------+----+--------<1------
6) ________________ +-----lf----------------------+---------.1------
7) ________________ -1-------.---------------------+-------I------
8) ________________ ...._ __ --ll---------------------+---------.1------
9) _______________ -+---~1-----------------~1-----t-------1-------
10) ________________ ...._ __ --lf----------------------+---------.1------
11 ) ________________ -1-------.1---------------------+---------.1------
12) _______________ -t------,1-----------------~1-----t-------1-------
13) _______________ -t---~1----------------~l-----t-------1-------
14) _______________ -1-----l~----------------1~--+--------+------
15) _______________ _..__ __ __.L___ ______________ _.L___ __ ....._ _____ __._ _____ _
A. Is a governing board approved, formalized , public involvement plan in use?
If yes (complete questions below)
Is that plan evaluated and updated at least annually?
Does that plan have defined objectives?
Are those objectives being met?
If no -Describe below how the effectiveness of the public involvement efforts are evaluated and/or improved.
B . Describe Public Outreach Methods:
Select the ONE word that most accurately completes the sentence
Always Usually Sometimes Seldom Never
Information dissemination is Usually written.
Public meeting times are Usually between 8 AM and 5 PM.
Information is Usually available in an audible format.
Information is Usually available in a language other than English.
Reasonable access is Usually available for those with a disability.
Yes
Yes
Yes
Yes
Pag e 4
101518a HCBOC Page 305
12. ADMINISTRATIVE CHANGES -Describe administrative changes to be incorporated during FY2020 In the space below. A new job
description must be attached for (1) any new administrative positions or (2) any increase in the percentage of a position dedicated to transportation.
If NONE check here: 0 Check here if job descriplion(s) attached: D
13. SERVICE CHANGES -Describe any service changes and/or provide justification/need for expansion vehicle(sl in the space below.
If NONE check here : 0
FY2020 -Complete Project Funding Request Form for FY 2020
(Note : Include in your description the raUonale for the anticipated change in service. For example , the anticipated change is due to customer feedback, mar1<eting or other efforts.This narrative
should match what is included your proiect fundina request form)
How will the public be notified of the service channes described above?
How mu ch lead-time is aiven before service changes take effect?
Page 5
101518a HCBOC Page 306
FY2020 COMMUNITY TRANSPORTATION PROGRAM GRANT APPLICATION
NORTH CAROLINA DEPARTMENT OF TRANSPORTATION
FEDERAL SECTION 5311 & STATE FUNDING
TRANSIT SYSTEM DESCRIPTION CONTINUATION
APPLICANT'S LEGAL NAME : _H_a_rn_e_tt_C_o_u_n..._ty ________________ _
6A. PURCHASE SERVICE -List agencies that purchase service from the transit system. Note: List agency ONCE
(Continued)
Agency 11
Name: Harnett County Board of Education
0 Check if agency purchased service last year
List Programs Served :
1) Employment
2) ________________ _
3) ________________ _
4) ________________ _
5) ------------------
Agency 13
Name: Lillington Parks & Recreational
0 Check if agency purchased service last year
List Programs Served :
1) Recreational
2) Educational
3) ------------------4) _______________ ~
5) ________________ _
Agency 15
Name: D _C_h_e-ck-if_a_g-en_c_y_p_u-rc_h_a_s-ed-se-rv-ic_e_la_s_t-ye_a_r __ _
List Programs Served :
1) ________________ _
2) ________________ _
3) ________________ _
4) ________________ _
5)
Agency 17
Name :
------------------
D _C_h_e_c_k-if_a_g-en_c_y_p_u-rc_h_a_s-ed-se-rv-ic_e_la_s_t-ye_a_r __ _
List Programs Served :
1) ------------------2) ------------------3) ________________ _
4) ________________ _
5) ________________ _
Agency 19
Name : ------------------0 Check if agency purchased service last year
List Programs Served :
1) ________________ _
2) _______________ ~
3) ________________ _
4) ------------------5) ________________ _
Agency 12
Name: Harnett County Parks & Recreation
0 Check if agency purchased service last year
List Programs Served :
1) Recreational
2) Educational
3) ________________ _
4) _________________ _
5) ________________ ~
Agency 14
Name : Harnett Soil & Water Conservation
0 Check if agency purchased service last year
List Programs Served :
1 ) Recreational
2) ________________ ~
3) ________________ ~
4) ------------------5) ________________ _
Agency 16
Name : D --::C:-h-e-ck:--:-:if_a_g-en_c_y_p_u-rc....,.h_a_s-ed-,---s_e_rv-ic_e_l_a_st_y_e_a_r --
List Programs Served :
1) ------------------2) _______________ _
3) ________________ _
4) ________________ _
5) ________________ ~
Agency 18
Name: 0 --:C:-h_e_c,....k-:-:if_a_g-en_c_y_p_u-rc_h_a_s_e_d_s_e_rv_ic_e_l_a_st_y_e_a_r --
List Programs Served :
1) ________________ _
2) ------------------3) ________________ _
4) ________________ _
5) ________________ _
Agency 20
Name : --::-:-----,:--:-:-----,-----,-----------0 Check if agency purchased service last year
List Programs Served :
1) _______________ ~
2) _______________ _
3) _______________ ~
4) 5)---------------~
CTP2014 Page 7 101518a HCBOC Page 307
SECTION 5311, 5310, 5339, Consolidated Capital, 5307 or State Funds Call for Proiects TITLE VI PROGRAM REPORT Legal Name of Applicant: County of Harnett (Complete either Part A or Part B; and Part C) Part A-No complaints or Lawsuits Filed I certify that to the best of my knowledge, No complaints or lawsuits alleging discrimination have been filed against Harnett Area Rural Transit System (Transit System Name) during the period July 1, 2017 through June 30, 2018. Signature of Authorized Official Date Gordon Springle, Chairman, Harnett County Board of Commissioners Type Name and Title of Authorized Official Part B -Complaints or Lawsuits Filed I certify that to the best of my knowledge, the below described complaints or lawsuits alleging discrimination have been filed against __ Transit System Name) during the period July 1, 2017 through June 30, 2018. Complainant Name/Address/Telephone Date Description Status/Outcome Number (Attach an additional page if required.) Signature of Authorized Official Date Type Name and Title of Authorized Official Part C -Title VI Plan Do you currently have a Title VI Plan: Embedded with HARTS SSP Date of last plan update: August 2014 :IH:IH NOIS 101518a HCBOC Page 308
ACORD® CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DD/YYYY)
~ 09/27/2018
THIS CERTIFICATE IS ISSUED AS A MATIER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT Megan Unsworth, CIC, CSRM NAME:
Surry Insurance wgNJ0 Extl: (336) 386-8228 Irie~. Nol: (336) 386-4661
P. 0 . Box 128 E-MAIL megan .unsworth@surryinsurance.com ADDRESS :
INSURER(S) AFFORDING COVERAGE NAIC#
Dobson NC 27017-0128 INSURER A : The Charter Oak Fire Insurance Company 25615
INSURED INSURERB: Hamett County
County of Hamett INSURERC: New York Marine and General Insurance Company 16608
420 McKinney Parkway INSURERD: The Travelers Indemnity Company 25658
INSURER E:
Lillington NC 27546 INSURERF:
COVERAGES CERTIFICATE NUMBER· REVISION NUMBER· .
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOiVVITHSTANDING ANY REQUIREMENT , TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH TH IS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCR IBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR TYPE OF INSURANCE r&~hl%~1 r&~hl'6~1 LTR INSD WVD POLICY NUMBER LIMITS
l>C COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
II CLAIMS.MADE ~OCCUR VM,~'>~ '.c'i"~"'~V $ 1,000,000 PREMISES Ea occurrence\
l>C Public Officials liab MED EXP (Any one person) $
A l>C Law Enforcement liab y ZLP-41M78531 07/01/2018 07/01/2019 PERSONAL & ADV INJURY s 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 R POLICY DPRO· D LOG PRODUCTS -COMP/OP AGG $ 2 ,000,000
OTHER: $
AUTOMOBILE LIABILITY COMBI NED SINGLE LIMIT $ 1,000,000 !Ea accident) ~ ANY AUTO BODILY INJURY (Per person) $ -D OWNED SCHEDULED 810-2C413243 07/01/2018 07/01/2019 BODILY INJUR Y (Per accident) $ r AUTOS ONLY ~ AUTOS
HIRED NO N-OWNED PROPERTY DAMAGE ~ AUTOS ONLY AUTOS ONLY /Per accident) $
'-
~ HireCarPD Hired Car PD $ 200,000
w~ UMBRELLA LIAB
MOCCUR EACH OCCURRENCE s 4,000.000
D EXCESS LIAB CLAIM S-MADE ZUP-15T86503 07/01/2018 07/01/2019 AGGREGATE s 4 ,000,000
OED I >ell RETENTION s 1 O,OOO $
WORKERS COMPENSATION l~IPER i IIOTH-
AND EMPLOYERS" LIABILITY STATUTE ER YIN
B,C ANY PROPRIETOR/PARTNER/EXECUTIVE D NIA Qualified Self-lnsd/EPP00339 07/01 /2018 07 /01 /2019 E.L. EACH ACCIDENT s 1,000,000
OFFICER/MEMBER EXCLUDED?
(Mandatory In NH) E.L DISEASE -EA EMPLOYEE $ 1,000,000
If yes , describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $
Property (incl. Equip Breakdown) Blanket Bldg & BPP 3 17,860,888
D KTK-CMB-3J55219-5-18 07/01/2018 07/01/2019 Deductible 10,000
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
See Additional Remarks schedule for list of HARTS vehicles covered on the Automobile policy.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF TliE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
TliE EXPIRATION DATE THEREOF , NOTICE WILL BE DELIVERED IN
NC Department or Transportation ACCORDANCE WITH TliE POLICY PROVISIONS.
1550 MAIL SERVICE CENTER
AUTliORIZEO REPRESENTATIVE
Raleigh NC 27699 AA ·A-,, ~
I
,. (J
© 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
101518a HCBOC Page 309
AGENCY CUSTOMER ID:
LOC#:
ADDITIONAL REMARKS SCHEDULE
AGENCY NAMED INSURED
Surry Insurance Harnett County
POLICY NUMBER
810-2C413243
CARRIER I NAIC COOE
The Travelers Indemnity Company 25658 EFFECTIVE DATE: 07/01/2018
ADDITIONAL REMARKS
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
FORM NUMBER: 25 FORM TITLE : Certificate of Liability Insurance
2006 Dodge Caravan Mini HARTS 1D4GP24R76B625848
2008 Dodge Caravan Mini HARTS 1D8HN44R68B193848
2015 Ford E-350/Lift HARTS 1FDEE3FLOFDA15668
2015 Ford E-350/Lift HARTS 1FDEE3FL2FDA15669
2013 Ford E-350/Lift HARTS 1FDEE3FL4DDA30901
2013 Champion Van HARTS 1FDEE3FLXDDA79083
1999 Ford 25 foot 24 Pass HARTS 1FDXEOSOXHA26596
1998 Ford Cut-A-Way HARTS 1FDXE40SOXHA26596
2006 Ford Van Cut Away HARTS 1FDXE45P26DA28313
2007 Ford E-350 Van HARTS 1FTSS34L28DA63873
2013 Champion Van HARTS 1FTDEE3FLADOA30901
2009 Ford E-350 Van HARTS 1FTDS34L69DA39960
2014 Ford E350 HARTS 1FTDS3ELOEDA38701
2014 Ford E350
2014 Ford E350
HARTS 1FTDS3ELOEDA38702
HARTS 1FTDS3EL2EDA38703
2011 Ford E350 Super Cargo Van HARTS 1FTDS3ELSBDB31680
2011 Ford E350 Super Cargo Van HARTS 1FTDS3EL7BDB31681
2011 Ford E350T Van HARTS 1FTDS3ELXBDA98241
2008 Ford Econoline Van HARTS 1FTSS34L28DA63873
2006 Ford Econoline 138 Van HARTS 1FTSS34L36HA44982
2009 Ford E-350 Center Aisle HARTS 1FTSS34L39DA85530
2009 Ford Econoline Van HARTS 1FTSS34L69DA40257
2007 Ford Econoline Van HARTS 1FTSS34L77DA54875
2007 Ford Econoline Van HARTS 1FTSS34L77DA54876
2007 Ford Econoline Van HARTS 1FTSS34L77DA54877
2010 Dodge Minivan HARTS 2D4RN4DEOAR270314
2010 Dodge Minivan HARTS 2D4RN4DE9AR270313
2016 Ford Truck HARTS 1FDEE3FLSGDC30688
2016 Mobility Transportation W3X HARTS 1FTBW3XM2GKA84709
2016 Mobility Transportation W3X HARTS 1FTBW3XM9GKA84710
2016 Ford Transit 350 Van HARTS 1FTBW3XMSGKB15189
2017 Ford Transit 350 Lift Van HARTS 1FTBW3XM7HKA46507
2017 Ford Transit Van W3XC HARTS 1FTBW3XM1HKA37110
2017 Ford Transit Van W3XC HARTS 1FTBW3XM3HKA84655
2017 Ford Transit Van W3XC HARTS 1FTBW3XM5HKA84656
2018 Ford W3XC Transit van HARTS 1FTBW3XMXJKA37788
2018 Ford W3XC Transit Van HARTS 1FTBW3XM2JKB30479
Page 1 of 1
ACORD 101 (2008/01)
INS101 «2ooso1)
© 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
101518a HCBOC Page 310
SAM Search Resu lts
List of records match i ng your search for :
Record Status: Active
DUNS Number: 091565986
F unctional Area: Entity Management, Performance Information
!ENTITY !HARNETT, COUNTY OF NORTH CAROLINA Status: Active
DUNS: 091565986 +4: CAGE Code : 4G1EO DoDAAC :
Expiration Date : Jun 4, 2019 Has Active Exclusion?: No Debt Subject to Offset?: No
Address : 102 E FRONT ST
City: LILLINGTON State/Province: NORTH CAROLINA
ZIP Code: 27546-6683 Country: UNITED STATES
September 27, 2018 10 :19 AM https://www.sam.gov/ Page 1 of 1
101518a HCBOC Page 311
Page 1 of 1 5311 Transit Advisorv Board lTABl/Governina Board Composition Service Area Demographics Low Hispanic Elderly Minority Disabled Income or Latino Applicant: I Harnett County I 14% 32% 20% 11% 11% Number of Projected TAB Meetings for FY2020: D 2000 Census data used for Disabled Calculations 2005-2009 ACS Estimates used for Elderly & Low Income Calculations Number of TAB Meetings held in FY2019 as of: I I I 2010 Census data used for Minority & Origin Calculations This person knows the What best describes the role or position of this board member in the community? transportation needs of Board Service this group or groups. Select only one description per board member Check as many as apply Current Term Status I,) ·2 "' C TAB Member's Name Q. .l: "' "' .!:! "' .!!! Cl "t:J "t:J :a ::i: Cl) C .. Cl) Human Service or Transportation "S> Cl) ID w 0 C: Business Gvmt or Gvmt Affiliate Transit User :, .. C E E E "t:J Cl) Non-Profit Agency Provider D. 0 w 0 "t:J ~ I,) .. .. ~""O rn iv >, Cl) "t:J .E Cl) Cl) C Cl) "' .. ;: :a ·.:: ~ lo-lo-·s u .. Cl) 0 .. .. "' C Cl) "' ·e 3: Q. Cl) Cl) ""O "' C "' "' Cl) :i 0 ~ ~ Q. ->-(!) iii 0 :J ....J cc: ,... 1 Barry Blevins Government Staff 0 0 0 0 0 0 2013 2018 A 5 2 Carl Davis Government Staff 0 0 0 D D 0 2009 2018 A 9 3 Valerie Gilchrist Vocational Rehab D D 0 D D 0 2015 2018 A 3 4 Lisa Guy DSS 0 0 0 0 0 0 2007 2018 A 11 5 Mark Locklear Government Staff 0 0 0 D D D 2016 2018 A 2 6 Angela McCauley Government Staff 0 0 0 0 0 0 2016 2018 A 2 7 John Rouse Senior Services 0 0 0 0 0 0 2004 2018 A 14 8 Kitrane Sanders Employment Security 0 D D 0 D D 2014 2018 A 4 9 Mary Jane Sauls Senior Services 0 0 0 0 0 0 2002 2018 A 16 10 Larry Smith Government Staff 0 0 0 0 0 0 2016 2018 A 2 11 Gordon Sorinole Elected Official 0 0 0 0 0 0 2017 2018 A 1 12 Terri Strickland Government Staff 0 0 0 0 0 0 1992 2018 A 26 13 Eric Truesdale Veterans Admin D 0 0 0 D 0 1998 2018 A 20 14 Jotonia McLean Other 0 D D 0 D 0 2018 2018 A 0 15 D D D D D D 16 D D D D D D 17 D D D D D D 18 0 0 0 D D D 19 D D D D D D 20 D D D 0 D D 101518a HCBOC Page 312
Board Meeting
Agenda Item
Agenda Item ___ 1-1 __ :-
MEETING DATE: October 15, 2018
TO: HARNETT COUNTY BOARD OF COMMISSIONERS
SUBJECT : Former Benhaven Elementary School Project Ordinanace
REQUESTED BY: Barry A . Blevins
REQUEST:
General Services Director requests the Harnett County Board of Commissioners consider and
approve the Project Ordinance to demolish the former Benhaven Elementary School's
cafeteria/classrooms and renovate the remaining facilities to meet North Carolina Building
Codes. Anticipated expenses for the project is $1,900,000 and portions of this project will be
funded with the proceeds from the 2017 General Obligation School Bond.
FINANCE OFFICER'S RECOMMENDATION:
COUNTY MANAGER'S RECOMMENDATION:
C:\Users\gwheeler\AppData\Lo cal\Microsoft\Windows\INetCache\Conte nt.O utl ook\TPTEQCL V\18.09.26 -Benhave
Project O rdinance Agenda Request.docx Page 1 of 1
101518a HCBOC Page 313
~·~Harnett
~(~ COUNTY ~ NOR TH CAROLINA www.harnett.org
HARNETT COUNTY
PROJECT ORDINANCE
FORMERBENHAVENELEMENTARYSCHOOL
BE IT ORDAINED by the Board of Commissioners of Harnett County, North Carolina,
sitting as the governing board for Harnett County.
Section 1.
Section 2.
Section 3 .
Section 4.
Section 5.
Section 6.
This project will consist of the demolition of the cafeteria/classrooms and
the renovation of the remaining facilities to meet NC Building Codes.
This portion of the project will be funded with proceeds from the 2017
General Obligation School Bond funds.
The following amounts are hereby appropriated for this project:
Construction
Design & Constr. Admin
Demolition
Equipment/Furniture
Contingency
Land Acquisition (potential)
Total
$750,000.00
$250,000.00
$100,000.00
$200,000.00
$600,000.00
$100,000.00
$1.900.000.00
The following revenues are anticipated to be available to complete this
project:
2017 General Obligation School Bonds $1.900.000.00
The Finance Officer is hereby directed to maintain within the Hamett
County Capital Project Fund, sufficient specific detailed accounting
records.
Funds may be advanced from the General Fund for making payments as
due.
Page 1 of 2
101518a HCBOC Page 314
~~Harnett ~(~ COUNTY ~ NORTH CAROLINA www.harnett.org
Section 7. Copies of this capital project ordinance shall be furnished to the Clerk to
the Governing Board, and to the Budget Officer and the Finance Officer
for direction in carrying out this project.
Duly adopted this ____ day of _____ , 20_.
(SEAL) Gordon Springle, Chairman
Hamett County Board of Commissioners
ATTEST:
Margaret Regina Wheeler, Clerk to the Board
Hamett County Board of Commissioners
Page 2 of 2
101518a HCBOC Page 315
Agenda Item 13 6) Harnett County Veterans Services Activities Reporting Form Month/Year September 2018 Request For Service Correspondence Claimant Status Written Action Taken (Claims & Development) (Teleohone and In-Person) Out ... C: C: C 0 Cl) C: 'in .2 "' "' E C C: en "O en 0 Q. C. 0 0 Cl) C: c: en C: :::, ·c;; 0 :::, ; Q. QI ftS a. 0 0 Cl) :E ai ~ ftS z Q. C: :E Cl) C: 1/) 1/) .. C: I I 0 1/) ftS 1/) 0 w C: t _g C: 1/) ·c: 1/) ·-.. ftS C: C: 8. ca en 3 -"' 0 =: .c "O Cl) .. QI ftS .. Co ftS cu -.c -ai a. .. 8. e .. 0 0 0 Cl) ::: Cl) ::: Cl) Cl) I U. E !? t:: ~ 0 Cl) )( ~ .c ~ -.c ~ i:, 0 "O :::, .c 1/) DATE NAME a; CV -~ -~ ~ 0 0 a. 0 ~ i "O 0 0 Cl) :E ... u.. 0 0 0 c( u.. w VJ zm 1 263 122 99 58 12 118 7 23 57 1 2 3 11 61 2 3 GW-25 4 VN-40 5 OIF-34 6 K-10 ~ b7 --? / --------/ 7 PT-5 C. I/I.""' .-._/ ~ 8 WWll-4 Eric Truesdale 9 Harnett County Veterans Officer 10 Walk In: 137 11 Phone Calls: 263 12 Outreach : 11 13 14 15 16 17 18 19 Total 263 122 99 58 12 118 7 23 57 1 2 3 11 61 101518a HCBOC Page 316
July 1, 2018 -June 30, 2019
Front Desk -Check-in Aooointments
Health Clinics
Adult Women Wellness Clinic
Harnett County Department of Public Health
Activities Summary
Jul Aug Sep Oct Nov Dec Jan Feb
964 1197 886
4 3 2
Care Coordination for Children (CC4C) 241 258 241
Child Health -Sick Clinic 75 85 87
Child Health -Well Clinic 77 165 115
Countv Employee Health Clinic 138 145 94
Family Plannina 157 168 113
Immunizations 171 265 555
Maternity (Prenatal Clinic) 227 184 144
OB Care Manaaement (OBCM) 116 122 113
Postoartum Home Visits 20 11 11
Refer/Repeat Pao 0 0 0
STD Services 112 107 77
TB Services 178 220 124
Welcome Baby Home Visits 22 11 12
Total Services 1538 1744 1688 0 0 0 0 0
Reoortable Disease Cases
Tuberculosis 1 0 1
HIV -(Quarterlv reoort) 0 0 0
AIDS -(Quarterly report) 0 0 0
SYPHILIS -(Quarterly report) 2 0 0
OTHER STD's 52 50 32
Other (salmonella, campylobacter, etc) 13 1 2
Total Services 68 51 35
Health Education
Outreach 308 479 256
Laboratorv Clients 841 786 505
Laboratorv Tests 1346 1347 941
HIV Tests 161 157 90
WIC Active Partlcloation 2934 3150
Vital Statistics ~"!!-
Births In County 49 44 36 I !i
Births Out of County 111 133 135 i-
Deaths I 57 72 49 1
Environmental Health
# of Improvement Aoos Confirmed 17 24 28
Number of Permits Issued 36 41 24
Number of Completions 41 50 19
Number of Existina Permits 52 31 15
Reoair Permits Issued 3 3 3
Permits Denied 0 0 0
Food and Lodaina
Establishments lnspect'd/Reinsoected 55 86 66
Visits/ Critical Voliations Verfication 59 51 31
Private Water Suoolies
Aoolications Received 21 17 7
update d 10/04/2018
Agenda Item _ _.I...::,~~-
Mar Apr May Jun rrOTAL AVG.
3047 1015.7
9 3
740 246.67
247 82.333
357 119
an 125.67
438 146
991 330.33
555 185
351 117
42 14
0 0
296 98.667
522 174
45 15
0 0 0 0 4970 1656.7
2 0.6667
0 0
0 0
2 0.6667
134 44.667
16 5.3333
154 51.333
1043 347.67
2132 710.67
3634 1211.3
408 136
6084 3042
129 43
379 126.33
178 59.333
69 23
101 33.667
110 36.667
98 32.667
9 3
0 0
207 69
141 47
45 15
101518a HCBOC Page 317
MANAGEMENT
Town Manager, Nick Holcomb
Town Attorney, Alton Bain
Chief of Police, Matthew Hall
Public Works Director, Rodney Pleasant
Town Clerk, Karen Wooten
Recreation Director, Mike Collins
September 4, 2018
Harnett County Board of Commissioners
Post Office Box 759
420 McKinley Parkway
Lillington, NC 27546
Dear Harnett County Commissioners,
Proposed
GO' ().dd ~ 0 f'\
~:: a<A 0~es+ 4-P
Cor \) I COI
Commissioner Allen Mosoy
Commissioner J.D. Raynor
The Town of Coats is formally requesting assistance in offsetting the tipping fees
associated with our debris disposal from a storm on July 22nd of this year. This
powerful storm caused trees to fall, localized flooding, and structural wind damage
to several parts of the town. Our Town Manager and Public Works Director have
calculated that between July 22 and August 21 we have collected and disposed a
total of 303 tons of debris at the county landfill. This has cost $9,093 in tipping fees
as a direct result of this storm. We were very thankful that the Town of Dunn and
the Town of Angier sent equipment and personnel to help in the collection process.
We ask for this assistance because the tipping fees associated with the storm have
had a large impact on our budget. To put the cost of this storm in perspective, last
fiscal year we collected a total of 360 tons of brush and spent a total of $10,500 in
tipping fees. This one storm has nearly exhausted our landfill tipping fee budget for
the entire year. We are formally asking for any assistance that the County can give
in the tipping fees accrued as a direct result of the storm on July 22, 2018.
Respectfully,
Chris Coats
Mayor, Town of Coats
101518a HCBOC Page 318