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—Please return this copy to the Clerk to the Board's -! <br /> �ya�asrNg4 <br /> office for permanent agenda file. <br /> • W <br /> North Carolina Department of Public Safety <br /> Division of Emergency Management <br /> APPLICANT: Q r c, a (' h `� DISASTER: Se—v e r e w iv\�V_Y- a�'v,-� <br /> FEMA- y 162 -DR-NC <br /> PUBLIC ASSISTANCE CFDA#97.036 <br /> STATE—APPLICANT DISASTER ASSISTANCE AGREEMENT <br /> This Agreement made by and between the State of North Carolina,Dept. of Public Safety, <br /> Division of Emergency Management("the State")and (D r a n a-e C o u n i-\j _ <br /> '`("the Applicant")shall be effective on the date signed by the State and the Applicant. It shall <br /> apply to all disaster assistance funds provided by or through the State to the Applicant as a result <br /> of the disaster called 5 e.vere Winter i rYr1 ;and pursuant to the Disaster Declaration <br /> made by the President of the United States numbered FEMA- DR-NC. <br /> The designated representative of the Applicant(Applicant's Agent)certifies that: <br /> 1. He/She has legal authority to apply for assistance on behalf of the Applicant pursuant to a <br /> resolution duly adopted or passed by the Applicant's governing body. <br /> 2. The Applicant shall provide all necessary financial and managerial resources to meet the <br /> terms and conditions of receiving Federal and State disaster grant assistance. <br /> 3. The applicant shall use disaster assistance funds solely for the purpose for which these funds <br /> are provided and as approved by the Governor's Authorized Representative(GAR). <br /> 4. The Applicant is aware of and shall comply with cost-sharing requirements of Federal and <br /> State disaster assistance: specifically that Federal assistance is limited to 75%of eligible <br /> expenditures,and that State assistance is limited to 25%of the eligible costs. Alternate <br /> projects selected by the Applicant may be eligible for only 75%of the approved Federal share <br /> of estimated eligible costs. <br /> 5. The Applicant shall provide the following completed documentation to the State: <br /> • Designation of Applicant's Agent; <br /> • State-Applicant Disaster Assistance Agreement <br /> • Private Non-Profit Organization Certification(if required); <br /> • Summary of Documentation Form itemizing actual costs expended for large <br /> project payment requests;. <br /> • Monthly Progress Reports; <br /> • Copies of Single Audit Reports as applicable. RECEIVED APR <br /> 2 4 2014 <br /> /ue C- P/4 <br /> Reviewed 10/2312012 Nee 1 of 7 Rev.06/02 <br />