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7. Pro am Income <br />a) Amount of existing program income: $ 0 <br />b) Amount of anticipated program income: $ ~ C <br />c) If program income exists or is anticipated, describe the proposed application(s): <br />8. Un aid Costs and Unsettled Third Pa Claims <br />List any unpaid costs and unsettled third party claims against the recipient's grant. Describe the circumstances and amounts involved, <br />I~/A <br />9. Remarks nor DCA Use Onl <br /> <br />10. Certification of Recipient <br />It is hereby certified that all activities undertaken by the Recipient with funds provided under the grant agreement identified on page 1 <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 third party claims identified on page I hereof; that the State of <br />North Carolina is under no obligation to make any further payment to the Recipient under the grant agreement in excess of the amount <br />identified on Line 7 hereof; and that every statement and amount set forth in this instnunent is, to the best of my knowledge, true and <br />correct as of this date. <br />Date Typed Name and Title of Recipient's Signature of Recipient's <br /> Authorized Representative Authorized Representative <br /> Name: Barry Jacobs <br /> <br /> Title: nralr,Or`ur~ Oxmty Bj of Ctntirissiorpss ~ <br />11. DCA A royal <br />This Certification of Completion is hereby approved, Therefore, I authorize cancellation of the unutilized contract commiunent and <br />related funds reservation and obligation of $ ,less $ previously authorized for <br />cancellation (from Section 6, line 6, a e 1). <br />Date Typed Name and Title of DCA Authorized Official Signature of DCA Authorized Official <br /> William A, McNeil <br /> Director, Division of Community Assistance ~ <br />Page 2 <br />