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3 <br /> DESIGNATION OF APPLICANT'S AGENT <br /> AND APPLICANT ASSURANCES <br /> FOR PUBLIC ASSISTANCE <br /> ORGANIZATION NAME(HEREAFTER NAMED ORGANIZATION) <br /> Orange County <br /> PRIMARY AGENT SECONDARY AGENT <br /> AGENT'S NAME AGENT'S NAME <br /> Pascal Moore Sarah Pickhardt <br /> ORGANIZATION ORGANIZATION <br /> Finance and Administrative Services Emergency Services <br /> OFFICIAL POSITION Accountant OFFICIAL POSITION EOCManager COVID-19 <br /> MAILING ADDRESS405 Meadowlands Dr MAILING ADDRESS510 Meadowlands Dr <br /> CITY,STATE,ZIP Hillsborough, NC 27278 CITY,STATE,ZIP Hillsborough, NC 27278 <br /> DAYTIME TELEPHONE 919-245-2455 DAYTIME TELEPHONE 919-245-6138 I <br /> FACSIMILE NUMBER FACSIMILE NUMBER I <br /> PAGER OR CELLULAR NUMBER PAGER OR CELLULAR NUMBER <br /> THE ABOVE PRIMARY AND SECONDARY AGENTS ARE HEREBY AUTHORIZED TO EXECUTE AND FILE APPLICATION FOR <br /> PUBLIC ASSISTANCE ON BEHALF OF THE ORGANIZATION FOR THE PURPOSE OF OBTAINING CERTAIN STATE AND FEDERAL <br /> FINANCIAL ASSISTANCE UNDER THE ROBERT T. STAFFORD DISASTER RELIEF &EMERGENCY ASSISTANCE ACT,(PUBLIC <br /> LAW 93-288 AS AMENDED)OR OTHERWISE AVAILABLE. THIS AGENT IS AUTHORIZED TO REPRESENT AND ACT FOR THE <br /> ORGANIZATION IN ALL DEALINGS WITH THE STATE OF NORTH CAROLINA AND THE FEDERAL EMERGENCY MANAGEMENT <br /> AGENCY FOR MATTERS PERTAINING TO SUCH DISASTER ASSISTANCE REQUIRED BY THE AGREEMENTS AND ASSURANCES <br /> PRINTED ON THE SECOND ATTACHED PAGE. <br /> CHIEF FINANCIAL OFFICER CERTIFYING OFFICIAL <br /> NAME OFFICIAL'S NAME <br /> David Hunt <br /> ORGANIZATION ORGANIZATION <br /> Board of County Commisioners <br /> OFFICIAL POSITION OFFICIAL POSITION <br /> Deputy Clerk to the Board <br /> MAILING ADDRESS MAILING ADDRESS <br /> CITY,STATE,ZIP CITY,STATE,ZIP <br /> DAYTIME TELEPHONE DAYTIME TELEPHONE <br /> 919-245-2126 <br /> FACSIMILE NUMBER FACSIMILE NUMBER <br /> PAGER OR CELLULARNUMBER PAGER OR CELLULAR NUMBER <br /> APPLICANT'S STATE COGNIZANT AGENCY FOR SINGLE AUDIT PURPOSES(IF A COGNIZANT AGENCY IS NOT ASSIGNED,PLEASE INDICATE): <br /> APPLICANT'S FISCAL YEAR(FY)START <br /> MONTH: DAY: <br /> APPLICANT'S FEDERAL EMPLOYER'S IDENTIFICATION NUMBER 56-600327 <br /> APPLICANT'S STATE PAYEE IDENTIFICATION NUMBER <br /> CERTIFYING OFFICIAL'S SIGNATURE <br /> 4/7/2020 North Carolina Division of Emergency Management-Designation of Applicant's Agent Page 1 of 2 <br />