Orange County NC Website
Section 6: DISOLMRE,OFPOTEN11ALOONRJCTSOFIN'I I' <br /> Are any of the Board Members or employees of the agency which will be carrying out this project,or <br /> membersof their immediate families,or their bud ness associates: <br /> a) Employees of or closely related to employees of the Town of Chapel Hill, Orange County, <br /> Carrboro,or Hillsborough? YES❑ NO❑ <br /> b)Members of or closely related to members of the governing bodies of Chapel Hill, Carrboro, <br /> Hillsborough, or Orange County? YES❑ NO❑ <br /> c)Current beneficiaries of the project/program for which funds are requested? <br /> YES❑ NO❑ <br /> d) Paid providers of goods or services to the program or having other financial interest in the <br /> program? YES❑ NO❑ <br /> If you have answered YESto any question, please provide a full explanation below. The existence of a <br /> potential conflict of interest does not necessarily make the project ineligible for funding, but the <br /> existence of an undisdosed conflict may result in the termination of any grant awarded. <br /> Page 9 of 9 <br />