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Contract Tracking (Funding from the Department) ADFP Trust Fund Tracking#:ADM-ADFP-16-015 <br /> This form should always be the first page of an offer or award package Tracking#: 17-E-088-ADFP <br /> submitted to Grants&Contracts Section for review and processing.The Contract#:t'7-p7 y 4103Y <br /> Grants&Contracts Section will issue the Tracking and Contract numbers. NCGrants ID#: <br /> The Division will add the NCGrants ID#and notify G&C of the ID#. Non Profit, and For Profit Grantees <br /> CONTRACT TRACKING FORM <br /> El Offer Date: 9/ 2016 2Z Award Date: <br /> 1. Division: Farmland Preservation <br /> 2. Project Leader/Contact: Dewitt Hardee Title: Pro ram Manager Phone: 919-707-3069 <br /> Email: dewift.hardee@ncagr.gov <br /> 3. Division Contact if different from Project Title: Administrative Officer Phone: 919-707-3071 <br /> Leader: Veronica Jamison <br /> Email: veronica.jamison@ncagr.gov <br /> 4. CRIS Program Name: Agricultural Development and Farmland Preservation <br /> 5. CRIS#: 1256 <br /> 6. Grantor Name: ADFP Trust Fund <br /> 7. Grantor Agreement/Contract#: <br /> 8. CFDA#and Fed Program Name: <br /> 9. Project Title: Orange County Crop Fund <br /> 10. Project Purpose:A revolving loan fund that will enable farmers, producers, and agribusinesses to maintain <br /> viable operations throughout the growing season, and will repay loans at the end of the year. <br /> **If salaries are included in the Contract amount, complete& attach page 1A for tracking purposes** <br /> 11. Project Period: October 1, 2016- September 30, 2018 <br /> 12. County of Primary Service: Orange <br /> 13._Type of Contract: Federal Pass Through Z State El Other(Explain) <br /> 14. Sub Award Amount: $32,500.00 <br /> 15. Match Required: Z yes Amount: $32,500.00 no <br /> **For required match, complete&attach Page 1A for tracking purposes <br /> 16. Are Indirect Costs Allowable? LJ Yes Z No <br /> **If Yes—written prior approval from Budget& Finance must be obtained and attached <br /> 17. Retainage 20 % of Total Contract Award Withheld: $6,500 Z No <br /> "Special Appropriations & Lump Sum < $100,000 or Waiver from Chief Deputy Commissioner on file <br /> 18. Equipment in the Amount of$5,000 and Over to be purchased 0 Yes ® No <br /> **If Yes, complete &attach page 1A for tracking purposes <br /> 19. Account#: 536406 20. Center#: 2108-1014-2017 <br /> 21. Grantee Name: Orange Coun 22. Is the Grantee ® New or❑ Existin <br /> 23. Grantee Type: Ll Non-Profit Z Governmental Private for Profit LJ Individual <br /> ❑ Other (Explain) <br /> 24. Grantee Tax ID: 56-6000327 25. Grantee DUNS: 091575191 <br /> 26. Tax Exempt Status Verified at Guidestar.or or IRS. ov- Initial & Date: 08/4/2017 VJ <br /> 27. Federal Debarment Status Verified at SAM.gov—Initial & Date: 11/10/2016 <br /> 28. Grantee Fiscal Year End: 06/30 29. G.S. State Reporting Due Date: <br /> (Grants &Contracts Section <br /> Offer/Award: L1 Yes 0 No 0 n/a Is the Grantee on the State's"Suspension of Funding List?" <br /> Tax Exempt Status Verified at Guidestar.org or IRS.gov- Initial & Date: <br /> Federal Debarment Status Verified at SAM.gov— Initial & Date: <br /> Attach this page to Page 1A, and/or Page 2 when amending or revising a current Contract, as applicable. <br /> Effective 7/1/07 <br /> Rev:7/14 <br />