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DocuSign Envelope ID:87560079-2786-4376-A189-DC48D9482BE7 <br /> NC DRPARTM T OF PUBLIC SAFETY <br /> Idol FOR PROFIT <br /> ° <br /> '` 'iDPS CONFLICT OF..INTEREST POLICY STATEMENT <br /> This document is only required from not for profit organizations ONLY:In accordance with <br /> . the N.C,G.S. 143C-6-23 (b) every Grantee shall file with the State agency/Grantor a copy of the <br /> Grantee's agency policy addressing conflicts.of interest that may arise involving the Grantee's <br /> management employees and the members of its board of directors or other governing body. The <br /> policy shall address situations in which any of these individuals may directly or indirectly benefit, <br /> except as the Grantee's employees or members of its board or other governing body,from the <br /> Grantee's disbursing of State funds and shall include actions to be taken by the Grantee or the II. <br /> individual, or both to avoid conflicts of interest and the appearance of impropriety. Agency <br /> conflict of interest policy shall be submitted to the Department of Public Safety(DPS)to avoid any <br /> delay with the disbursement ofDPSJCPCfunds. <br /> The Grantee shall submit this form(Not for Profit DPS Conflict of Interest Policy Statement Form <br /> DPS 13 001)along with the agency's conflict of interest policy when applying for finding. <br /> Accordingly, no member or board member of the private, nonprofit entity may receive <br /> directly.or indirectly, any funds received from the State of North Carolina, except for <br /> duly, authorized staff compensation and benefits, and reimbursement for expenses <br /> actually incurred in connection with the private, nonprofit entity's business and in <br /> accordance with final approved grant agreements. <br /> • <br /> WI-MR.EAS, Exchange Club Center for the_Prevention of Child Abuse of North <br /> Carolina,Inc. desires to require its Board of Directors and'managing employees to avoid <br /> conflicts of interest or the appearance of impropriety in the disbursement of State funds; <br /> THEREFORE, no member of the Board of Directors-or staff members of said private, <br /> • nonprofit entity shall participate' in the 'solicitation, negotiation, formation, award, <br /> arbitration,modification, or settlement of any contract or grant funded in whole or in part <br /> by State funds or of any dispute arising-Finder such contract or grant when the director or <br /> staff members stands to benefit, either directly or indirectly,from such grant or contract; <br /> PROVIDED, no member of the Board of Directors or staff members shall be deemed to <br /> benefit directly or indirectly from any contract or grant funded in whole or in part by State <br /> funds if he/she receives only the salary or stipend due to him/her in the normal course of <br /> employment with, or service to, said private,nonprofit entity. <br /> FURTHERMORE, said private,nonprofit entity has written conflict of interest policies <br /> and reporting procedures applicable to board members,staff members and volunteers who <br /> have any interest or any authority regarding the resources of the private,nonprofit entity. <br /> These policies have been communicated to board members, staffin.enbers and volunteers <br /> and full disclosure has been provided for any possible appearance of conflict of interest <br /> that may exist. <br /> Form DIPS 13.001 Not for Profit DPS Conflict of Interest Policy Statement <br /> Form structure last revised fuly 2014 <br /> NC Department of Public Safety Page 1 of 3 <br /> i1 <br />