2017-604 Co. Mgr. - NC Dept. of Agriculture and Consumer Services for the Orange County Crop Fund

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NWM cam,« AM Tear Fu Begin Date: Completed Date: NCDA&CS ADFP Trust Fund Contract Checklist Grantee: Orange County Project Title: Orange County Crop Fund ADFP Tracking#: ADM-ADFP-16-015 Contract#: /7- 07 ' 1639 NC Grants ID #: Contract Date :10/1/2016-9/30/2018 Grant Contract Amount: $32,500.00 1. Budget Officer will need to gather the following documents from the grantee's application and review for accuracy to be placed in the grantee's contract. Items that are incorrect, the Budget Officer should contact the grantee by phone and email to inform them of the correct documents needed. The Budget Officer should make sure all signatures are in BLUE INK. Initials Date ❑ N/A or ❑ Scope of Work ❑ N/A or ❑ Budget & Budget Narrative (Budget Officer will need to contact the grantee by phone and email to get the correct Budget based on the amount approved by the ADFP Trust Fund Advisory Committee). ❑ N/A or ❑ Certification of No Overdue Tax Debts (Non-Governmental Only) ❑ N/A or ❑ Certification Form and Current Conflict of Interest (Non-Governmental Only) ❑ N/A or ❑ 501 (C) (3) Certification Form and IRS Federal Tax Exempt Letter(Non-Governmental Only) ❑ N/A or ❑ Project Timeline (Budget Officer will need to contact the grantee by phone and email to get the correct Project Timeline based on the amount approved by the ADFP Trust Fund Advisory Committee). ❑ N/A or ❑ FPP Acceptance Letter by County (Plan Contracts Only) ❑ N/A or ❑ NC Openbook Supplemental Information * The Budget Officer shall have above documents checked and completed within 10 working days of assignment for each group of five. Assignment is triggered by ADFP Trust Fund Advisory Committee approval and availability of funds to issue the contract. Edited 08/14/2014 eh