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RESOLUTION <br />DESIGNATION OF APPLICANT'S AGENT <br />North Cazolina Division of Emer enc Mana ement <br />Organization Name (hereafter named Organization) Disaster Number: <br />14 <br />Applicant's State Cognizant Agency for Single Audit purposes. (If Cognizant Agency is not assigned, please indicate): <br />Health and Human Services <br />Applicant's Fiscal Year (FY) Start <br />Month: Jul Da . 01 <br />Applicant's Federal Employer's Identification Number <br />56-6000327 <br />Applicant's Federal Information Processing Standards (PIPS) Number <br />NA <br />PRIMARY AGENT SECONDARY AGENT <br />Agent's Name Agent's Name <br />Organization Organization <br />Official Position Official Position <br />Financ irector Emer enc M mt. Director <br />Mailing Address Mailing Address <br />City ,State, Zip City ,State, Zip <br />Daytime Telephone Daytime Telephone <br />Facsimile Number Facsimile Number <br />Pager or Cellu[az Number Pager or Cellular Number <br />BE IT RESOLVED BY the governing bodyof the Organization (a public entity duly organized under the laws of the State of North Carolina) <br />that the above-named Primary and Secondary Agents are hereby authorized to execute and file applications for federal and/or state assistance on <br />behalf of the Organization for the purpose of obtaining certain state and federal financial assistance ands the Robert T. Stafford Disaster Relief <br />& Emergency Assistance Act, (Public law 93-288 as amended) or as otherwise available. BE IT FURTHER RESOLVED that the above-named <br />agents are authorized to represent and act for the Organization in all dealings with the State of North Carolina and the Federal Emergency <br />Management Agency for all matters pertaining to such disaster assistance required by the grant agreements and the assurances printed on the <br />reverse side hereof. BE IT FINALLY RESOLVED THAT the above-named agents are authorized to act severally. PASSED AND <br />APPROVED this der of , 20 <br />GOVERNING BODY CERTIFYING OFFICIAL <br />Name and Title Name <br />Donna Baker <br />Name and Title Official Position <br />Clerk to the Board <br />Name and Title Daytirne Telephone <br />919-245-2130 <br />CERTIFICATION <br />I, Bonner Baker ,(Name) duly appointed and Clerk to the Board (Title) <br />of the Governing Body, do hereby certify that the above is a true and correct copy of a resolution passed and <br />approved by the Goverzring Body of Orange County (Organization) on the 21st day of <br />January , 2003 <br />t~~x <br />Date: `Zc2 aY/~+ ~ Signature: <br />Rev. 06/02 <br />~/fit (21(03 <br />~~ ~~~-~ 9 <br />Sh <br />