Orange County NC Website
ATTACHMENT "A" <br /> Orange County Certifications —FY 2013 - 14 <br /> Outside Agency Performance Agreement <br /> Chief Contact,Administrators, Chief Executive Officer and Chief Financial Officer <br /> I certify that I have provided a list of the chief contact, administrators, chief executive <br /> officer and chief financial officer for my agency with this Agreement and that I will keep <br /> it current to the County of Orange. The list should be in writing with the name,title, <br /> residential address; phone and email address and if possible, fax number. <br /> Officers and Board of Directors <br /> I certify that I have provided a current list of the Officers and Board of Directors with this <br /> Agreement and that we will continue to update the list as changes occur. The list should <br /> be in writing,with the name,physical address,mailing address and if possible,phone, fax <br /> and email address. <br /> Budget Submission <br /> I certify that I have provided a budget for the period to be covered by funding Orange <br /> County, and that any substantive changes made to this budget have been in advance <br /> authorized in writing by Orange County. <br /> Annual Financial Review <br /> I certify that I have provided a copy of the latest annual Financial Review for our agency <br /> and the budget adopted by the agency for the fiscal years encompassing this Agreement. <br /> If not,please explain on a separate sheet of paper. <br /> Alignment with Organization's Mission <br /> I certify that the programs and services for which this funding is requested align with the <br /> mission of the organization. <br /> Intended Purpose <br /> I certify that the funds provided to the agency under the terms of this Agreement will be <br /> used for a public purpose and shall only be used for the purposes intended and any money <br /> not used for those purposes will be ptly returned to Orange County. <br /> f <br /> Certifi d Title: �yLec ,�� fir"--Date: I3 <br /> (Freedom House) <br /> Orange County Outside Agency Performance Agreement <br /> Page 8 of 8 <br />