OTHER-2020-006 Tab 6 Document - Laserfiche WebLink

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DISCLOSURE REPORT 1 . Applicant/ Recipient Name , Address , and Phone : Orange County, NC PO Box 8181, Hillsborough, NC 27278 919 - 245 -2490 2 . Check One : ® Initial Report ❑ Update Report 3 . Social Security Number or Employer ID Number : 56- 60000327 4 . Project Name and Location : Emergency Housing Assistance — Orange County ( countywide ) 5 . Total Amount requested / received ( including anticipated program income ) : $ 900 , 000 6 . Other government assistance . ( Check One ) . No other government assistance is , or is expected to be , provided for this project X All other government assistance provided for this project is listed on the table below/attached page ( s ) . ( Note : Disclosures must be complete and accurate but , need to be made only once for this report . If assistance is reported in the Sources and Uses disclosure section , then it need not also be reported here . If there is assistance reportable here , but reported only in the Sources and Uses disclosure , ( check here ) : X Assistance is disclosed in Sources and Uses Attachments Agency Name and Address Program and Type of Amount Requested / Received Assistance Orange County, NC Coronavirus Relief Fund $ 1 , 000 , 000 PO Box 8181 Hillsborough , NC 27278 7 . Interested Parties . ( Check One ) : X No parties have a reportable financial interest in this project . Interested parties include developers , contractors , consultants , individuals , entities including units of government with a financial interest greater than $ 50 , 000 or 10 percent of the assistance ( whichever is lower; being a party to a contract procured under Federal procurement regulations at 2 CFR Part 200 does not, by itself, constitute a reportable financial interest ) . All parties with a reportable financial interest are listed on table below/ attached page ( s ) . Name and Address Type of Participation Interest ($ and %) 8