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7. Program Income <br />a) Amount of existing program income: $ O <br />5 <br />b) Amount of anticipated program income: $ ~ <br />c) If'program income exists or is anticipated, describe the proposed application(s): <br />8. Unpaid Costs and Unsettled Third Party Claims <br />List any unpaid costs and unsettled third party claims against the recipient's grant.. Describe the circumstances and amounts involved, <br />N/A <br />9. Remarks (For DCA Use Only) <br /> <br />10. Certi[ication of Recipient <br />It is hereby certified that all activities undertaken by the Recipient with funds provided under the scant agreement identified on page I <br />hereof, have , to the best of my knowledge, been carried out in accordance with the grant agreement; that proper provisions have been <br />made by the Recipient for the payment of all unpaid costs and unsettled thud patty claims identified on page I hereof; that the Slate <br />of North Cazolina is under no obligation to make any further payment to the Recipient unde: the grant agreement in excess of the <br />amount identified on Line 7 hereof; and that every statement and amount se[ forth in this instrument is, to the best of my knowledge, <br />true and correct as of this date. <br />Date Typed Name and Title of Recipient's Signantre of Recipient's <br /> Authorized Representative _ Authorized Representative <br /> Name: Barry Jacobs <br /> Title: Chair, Bd. of County Comm. ~ <br /> <br />II. DCA Approval <br />This Certification of Completion is hereby approved. Therefore, I authorize cancellation of the unutilized contract commitment and <br />related funds reservation and obligation of $ ,less $ previously authorized for <br />cancellation (from Section 6, line 6, page 1). <br />Date Typed Name and Title of DCA Authorized Official Signature of DCA Authorized Official ' <br /> Wiliiam A. McNeil <br /> Director, Division of'Community Assistance ~ <br />Page 2 <br />