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r <br /> PART V(8) Form GHSP-D-03 <br /> ti <br /> ACCEPTANCE OF CONDITIONS <br /> This application <br /> highway safety y pron is approved for fiscal year� and authorization to proceed with this <br /> project is granted subject to the State and Federal laws and regulations applicable to <br /> the North Carolina Governor's Highway Safety Program and the conditions stated below. <br /> 1. Unless otherwise directed, applicants must submit Quarterly Progress Reports to the GHSP <br /> which reflect the status of project implementation and attainment of stated goals.Each progress <br /> report shall describe the project status quarterly and shall be submitted to GHSP no later than <br /> fifteen(1 5)days subsequent to the termination of each quarter.A Final Accomplishment Report <br /> (Form GHSP-D-10)must be submitted to the GHSP within thirty <br /> project unless otherwise directed. A (30)days of completion of the <br /> with a reminder notice advising date that each is due.will be mailed to Project Director along <br /> 2. Applicants making purchases or entering into contracts as provided for by this project must <br /> adhere to the policies and procedures of Attachment 0 of OMB Circular A-102 or A-110, <br /> whichever is applicable. <br /> 3. All Out-of-State travel must have rior <br /> Requests for a p approval of the Governor's Highway Safety Program. <br /> pproval (Form GHSP-A-17) should be submitted to GHSP at least two (2) weeks <br /> 4. Applicants must submit any proposed agreements for contractual services to the Governor's <br /> Highway Safety Program for final approval prior to acceptance. <br /> 5. Applicants shall account for program income related to projects <br /> with federal funds in accordance with Attachment E of OMB Circular A nanced in-102 or Attachment D of <br /> OMB Circular A-110, whichever is applicable. Program income earned during <br /> period shall be retained by the applicant and added the contract <br /> dad to t <br /> he.fun <br /> GHSP ds co <br /> and be used to further eligible program objectives. committed to the project by the <br /> 6. Local government applicants must complete Attachment 1 entitled "Local Governmental <br /> Resolution". <br /> • <br /> 7. Any continuation of this project with funds from the State of North Carolina is contingent upon <br /> f State funds being appropriated by the General Assembly specifically for that purpose. <br /> PROJECT DIRECTOR Read the above"Conditions"before si•nin• <br /> NAME <br /> TITLE <br /> ADDRESS <br /> Mary Babbitt-Cooke <br /> /IGE Health Promotion Coordin:tor 27278 <br /> P.o.BoX 8181 Hillsb. .u• NC TELEPHONE NUMBER <br /> AUTHO-!ZING OFFICIAL OF GOVERNMENTAL UNIT Read the above"Conditions 919 <br /> Ext 305 <br /> before al•nin, <br /> NAME <br /> TITLE <br /> Daniel B. Reimer ADDRESS <br /> SIGNATURE D i A C t• _ i <br /> g Al , :•. i <br /> i <br /> TELEPHONE NUMBER BER <br /> OFFICIAL OF GOVERNMENTAL UNIT AUTHORIZED TO RECEIVE FUNDS UNDER THIS PROJECT t II I <br /> NAME <br /> ADDRESS <br /> ORGANIZATION <br /> APPROVAL INFORMATION FOR GHSP USE ONLY <br /> APPROVAL DATE <br /> NliaIIIIIIIIITIIIIIIIIII <br />