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P~4~ - .z~ u l o~ <br />North Carolina Martin Luther King, Jr. Commission <br />1318 Mail Service Center, Raleigh, North Carolina 27699-1318 <br />Telephone: (919) 733-7996 <br />Fax: (919) 733-7940 <br />Grantee's Acceptance and Understanding <br />The North Carolina Martin Luther King, Jr. Commission is providing a grant in the amount of $1500 to Orange <br />County Human Rights and Relations Department for the 2002-2003 grant cycle. <br />This form assures the North Carolina Martin Luther King, Jr. Commission (Commission) that the Grantee will meet <br />all requirements listed below: <br />I . The grant will be used for the purpose specifically set forth in the submitted application. <br />2. The written final report will be completed and submitted to the Commission no later than September I5, <br />2003. <br />3. The grantee agrees to acknowledge on program literature and publicity information that partial funding was <br />received from the North Carolina Martin Luther King, Jr. Commission. <br />4. Records of receipts and disbursements will be maintained by Grantee and such books and records will be <br />made available to the Commission, or its representative, upon request. <br />~. This grant is not earmarked for transmittal to any other entity or person, whether on not mentioned in <br />Grantee's proposal or in any other communications with the Commission. Rather, Grantee accepts and will <br />retain full control of the grant's disposition and full responsibility for compliance with its terms and <br />conditions. <br />6. The Grantee acknowledges that there is no conflict of interest or appearance of conflict of interest between <br />the North Carolina Martin Luther King, Jr. Commission and the Grantee. <br />7. The person signing below certifies his or her authority to execute this agreement on behalf of Grantee. <br />IN W TNESS WHEREOF, this Grantee Acceptance and Understanding is duly executed this ~ day of <br />J ^, 2003. (~ j ~j <br />~PahfiQ. COta.h"~~ D~~,+. d? ~^\~a~n "~Q~~S ~' 11.Q.~o`1~~i~hS <br />Organization Name <br />~• b• ~ OlL 8 ~ 8 ~ ~1 11 f S IACro~t4 ~'l I V~. l_ . 'mil -)1~1 ~ <br />Mailing Address <br />56- 6 door a~ <br />T x Identification umbe- <br />ut o~ Representative Signature <br />~ F ~ ~ --- <br />Notary Public (official seal) <br />~Y CvrnmtSSloh <br />.~`'" N`~ ;-: ;any-' <br />q,Q . <br />_._ ~ <br />,,~y2.~BLIG •~ <br />,, ~ ~~ <br />., F• <br />C~~~J ass-aa~o <br />Area Code/Telephone Number <br />L` `ni• ~ Otfawts. ~a~-r 6oa/d o~ ~oww~ S~~ s~•rt <br />Title of Representa ve <br />F ~ c,~a- ,• ~ ~ 5 2 o a 3 <br />Date Notarized ~J <br />q`2aoG• <br />