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5 <br />Tt~e G~ai7tee shall complete tine fuliowiiig items, ~rohich have been attached to this Ct;r:tract, and s~.bmi: <br />them to kne Agency along r-i:li rive executed copies of this Gontrack. <br />(1) NC OpenBook Supplcmcnt.al hiFormation <br />[7} Signature,4uthoriztrtian Card <br />(.i) ~lec7onic Payment farm <br />~. Agency's Duties; TheAgencyshall paytlhe Grantee in t:,e manner anci in the ar-~aunts specifics inthc; <br />Contras; DQCU:rtents. The totGl amoi.nt p3it~ by the Agency to tie Gr¢:r:tee undLr Phis Conti~ct shall rq: <br />exr:eed s 2o.aao. This amount consists of $ 20.600 in F'edercl funds. tGFDA ~ 1 U.17r)) <br />x ] {1' There are no matching requiramcnts from the Grantee. <br />[ ] {2;i 'I'i~e Grantee's matching requirement is $ , ~~mict: shall eensist of: <br />[ ] In-kind [ ] Cash <br />[ ] Gash and In-kind [ ] Cash andfor In;tind <br />The cor.:ribufions from the Grantee shall be sot.rcr3d from non-fedsrGl funds. flny funds c;r;rrrrr:illeci <br />as matching Rands must be spent concurrently with the federal funds ativardrd in this Contract (i.3. <br />past expenditures prior to submission and approval of the Grantee's applic4tinn shall not ~e used 1. <br />The taLGl contract amount is $ <br />VI. Conflict of Interest Policy: <br />Tt~e Agency has determined that the Grantee is a c~avcrnrnental agency and is not subject to Iti.(;:.C;.S. <br />1 ~};ifi-B-?.:t(h). Therefor+e, the Grantee is nit required to file a Confl ct of Intrarc:sl Roticy ~vit:~ tl;e F+.gen~y <br />prior to the d sbursrtment of funds. <br />Vil. Statement of Nc Overdue Tax Debts: <br />T:ie f~gency hag deta:rrnined that the Grantee is a gavcmmt:ntal agency and is not subjt;ct to N.G.G_S. <br />43C• G-23{c). Therefore, the Grarrt~;e is not required to file a Statcr:cnt rff No Ot~ercue Tax ~e5ts .;rior <br />to tie disixirtiernen!S of funcs. <br />VIII. Reversion of Unexpended Funds <br />Any unt;xpenced grantfunos shall revert to the 1~cency upon te~minat•.an of this C[ir~ir.ect. <br />IX. Reporting Requirements: <br />~' 1 Sate fN_C_G_S. 143C-6-231 <br />The Agency has determined that the Grantee s a governmertal ~ncityano is not subject is t .c <br />State reporrting rc~u:rernents mandated by N.C.G.S. 143C-i:t-23. The^ePure, the Grantee dace <br />not haue to File annual electronic reports smith thr: N{: Office of State Budget t£ Nlanec omeri_ <br />(2) F,clency Reoortinn REauirPments <br />Interim Parforrr~ant;r; Reports: Grantees stsall submit tie Agej~~y's pr:,gramtnatic rr=;,c~~tinc; <br />:arms due April 1 ar~d 30 days after :he anniversary date of the 2ward until complctior. <br />Anntaal Performance and financial I~epcd;~: Grantees shall submit the Agency';; f~rac:rt_rn::~.31ic <br />~eportinf; farm and the: tin:irrci;~l reporting form si7 days after the e~ici of ltie f rsi. year Ot L•12 clan: <br />of the tally axccuterl Contract and each year thert;raftcr ,anti) t~ir hriai expiration date at the <br />Gon,ract peric}d. I i' the Cor~trac; period is ono year or less, only final I~erformince and flnan^ir~l <br />rt:lxnls are rertaired far the entire ;~rajec~ period_ <br />NGO f-ono C•~i~3 Contr7at C::,.+r_r~ <br />Eff. rJ/2G0 <br />Reviser. 7+20C; , a~1~7G4i. '. 2iU3 NCDaBcCS <br />Go~ren~~n~.ent~~l Ertities <br />f'a~7p 2 .~t G <br />