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PART V(0) ACCEPTANCE OF CONDITIONS I ' Form GHSP-p-03 <br /> This application is approved for fiscal year <br /> highway safety project is granted subject to the State and Fedealdlawss and regulations to proceed with this <br /> the North Carolina Governor's Highway Safety Program and the conditions stated below. <br /> wpplicable to <br /> 1. Unless otherwise directed, applicants must submit ow. <br /> which reflect the status of project implementation and attainment of Progress d goal Eachh r GHSP <br /> report shall describe the project status quarterly and shall be submitted to GHSP no <br /> fifteen(1 S)days subsequent to the termination of each quarter.A Final Accomplishment p progress <br /> (Form GHSP-D-10)must be submitted to the GHSP within thirty later than <br /> Report <br /> project unless otherwise directed. A rt3►(30)days of completion of the <br /> Appropriate forms will be mailed to Project Director along <br /> with a reminder notice advising date that each is due. <br /> 2. Applicants making purchases or entering into contracts -s provided for by this adhere to the policies and procedures of Attachment 0 of OMB Circular A-102 or A-11 <br /> whichever is applicable, project must <br /> 0, <br /> 3. All Out-of-State travel must have prior approval Governor's <br /> Requests for approval (Form GHSP-A-17) hoould bbet ubmtted to GHSP at least two (2) week <br /> before the intended date of travel. weeks <br /> 4. Applicants must submit any proposed agreements for contractual services to the Gov <br /> Highway Safety Program for final approval prior to acceptance. ernar's <br /> S. Applicants shall account for program income related to projects financed in wh ole or in part <br /> with federal funds in accordance with Attachment E of OMB Circular A-102 or Attachment D of <br /> OMB Circular A-110, whichever is applicable. Program income earned during the contract <br /> period shall be retained by the applicant and added to the,funds committed to the project by the <br /> GHSP and be used to further eligible program objectives. <br /> 6. Local government applicants must complete Attachment 1 entitled "Local Governmental <br /> overnmen tal <br /> • <br /> 7. Any continuation of this project with funds from the State of North Carolina is contingent u <br /> State funds being appropriated by the General Assembly specifically for that purpose. pan <br /> • <br /> PROJECT DIRECTOR Read the above"Conditions"before si•nin• <br /> NAME__ <br /> TITLE <br /> ADDRESS <br /> Mary Bobbitt-Cooke <br /> Health RrWnotion Coordin- tor P•O,Box 8181,Hi11sborough27 C <br /> SIGNATURE - <br /> i TELEPHONE NUMBER <br /> AUTHOR! ING OFFICIAL OF GOVERNMENTAL UNIT Read the above"Conditions"before si•nin• Ext,305 <br /> NAME <br /> Daniel B. Reimer TITLE ADDRESS <br /> Director, Health Dept, p,p,gox 8181, Hillsborough, NC 27278 <br /> SIGNATURE <br /> Or 6 TELEPHONENUMBER <br /> OFFICIAL OF GOVERNMENTAL UNIT AUTHORIZED TO RECEIVE FUNDS UNDER THIS PROJECT Ext, 305 <br /> I <br /> TITLE <br /> . <br /> • <br /> ADDRESS <br /> ORGANIZATION <br /> APPROVAL INFORMATION FOR GHSP USE ONLY <br /> APPROVAL DATE <br /> iliaIIIIIIIIIIMIIIIIIIII <br />