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3 <br /> 7. Program Income <br /> a) Amount of existing program income: $ N/A <br /> b) Amount of anticipated program income: $ <br /> c) If program income exists or is anticipated,describe the proposed application(s): <br /> 8. Unpaid Costs and Unsettled Third Party Claims <br /> List any unpaid costs and unsettled third party claims against the recipient's grant. Describe the circumstances and amounts involved. <br /> N/A <br /> 9. Remarks(For DCA Use Only) <br /> 10. Certification of Recipient <br /> It is hereby certified that all activities undertaken by the Recipient with funds provided under the grant agreement identified on page I <br /> hereof,have,to the best of my knowledge,been carried out in accordance with the grant agreement;that proper provisions have been <br /> made by the Recipient for the payment of all unpaid costs and unsettled third parry claims identified on page 1 hereof;that the State <br /> of North Carolina is under no obligation to make any further payment to the Recipient under the grant agreement in excess of the <br /> amount identified on Line 7 hereof;and that every statement and amount set forth in this instrument is,to the best of my knowledge, <br /> true and correct as of this date. <br /> Date Typed Name and Title of Recipient's Signature of Recipient's <br /> Authorized Representative Authorized Representative <br /> Name: William Crowther <br /> Tide: Chair <br /> 11. DCA Approval <br /> This Certification of Completion is hereby approved. Therefore,I authorize cancellation of the unutilized contract commitment and <br /> related funds reservation and obligation of $ ,less$ previously authorized for <br /> cancellation(from Section 6,line 6,page 1). <br /> Date Typed Name and Title of DCA Authorized Official Signature of DCA Authorized Official <br /> William A.McNeil <br /> Director,Division of Community Assistance <br /> Page 2 <br />