Agenda Packet July 18 2016PERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
MEETING AGENDA
304 South Morgan Street, Room 215
Roxboro, NC 27573-5245
336-597-1720
Fax 336-599-1609
July 18, 2016
9:00am
CALL TO ORDER…………………………………………………... Chairman Newell
INVOCATION
PLEDGE OF ALLEGIANCE
DISCUSSION/ADJUSTMENT/APPROVAL OF AGENDA
RECOGNITION
ITEM #1
Resolution of Appreciation …………………………………………. Chairman Newell
Reed Marston, Person County Retiree
PUBLIC HEARING:
ITEM #2
An Amendment to Person County’s Ambulance
Franchise Ordinance …………………………………………………... Douglas Young
ITEM #3
Consideration to Approve Person County’s Ambulance
Franchise Ordinance ……………………………………………….. Chairman Newell
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PUBLIC HEARING:
A Quasi-Judicial Zoning decision whereby witnesses are to be sworn in and subject
to cross examination, no ex parte communication and requires findings of fact.
ITEM #4
Request by Whitt Town Solar LLC for a Special Use
Permit for a solar farm (electrical generating facility) on Whitt
Town Road, Roxboro Township, Tax Map 104 Parcel 4 ……………... Mike Ciriello
ITEM #5
Consideration to Grant or Deny a Request by Whitt Town
Solar LLC for a Special Use Permit for a solar farm
(electrical generating facility) on Whitt Town Road, Roxboro
Township, Tax Map 104, Parcel 4 ………………………………….. Chairman Newell
INFORMAL COMMENTS
The Person County Board of Commissioners established a 10 minute segment
which is open for informal comments and/or questions from citizens of this
county on issues, other than those issues for which a public hearing has been
scheduled. The time will be divided equally among those wishing to comment.
It is requested that any person who wishes to address the Board, register with
the Clerk to the Board prior to the meeting.
ITEM #6
DISCUSSION/ADJUSTMENT/APPROVAL OF CONSENT AGENDA
A. Approval of Minutes of June 7, 2016,
B. Approval of Minutes of June 20, 2016,
C. Budget Amendment #1,
D. Budget Amendment CIP,
E. EMS Operational Medical Director Contract,
F. Consideration to change the Board of Commissioners regular scheduled
meeting time of the September 6, 2016 from 7:00pm to 9:00am,
G. Request for temporary road closure of Glenn Fogleman Road,
H. Funding Allocation Correction for Person County JCPC FY 2016-2017,
I. Fire and Rescue Corrective Action Responses,
J. DSS Attorney Contracts for legal services,
K. Tax Adjustments for the month of July 2016
a. Tax Releases, and
b. NC Vehicle Tax System pending refunds
UNFINISHED BUSINESS:
NEW BUSINESS:
ITEM #7
A Resolution to Grant an Advance Life Support Service
Ambulance Franchise to North State Medical Transports, Inc.,
And a Resolution to Grant Basic Life Support Service Ambulance
Franchise to Regional One, Inc. ………………………………………. Douglas Young
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ITEM #8
Person County Environmental Issues Advisory Committee
Recommendations and Request for the Board of Commissioners
to adopt a Resolution for Improving Roadside Cleanup in Person
County, a Resolution for Education and Action on Recycle Materials,
a Resolution to Re-stimulate the Adopt a Highway Program and a
Resolution for County-wide Mandatory Recycling ………….. Commissioner Jeffers
ITEM #9
Request by the U.S. Motto Action Committee for the Board of
Commissioners to adopt a Resolution Supporting the display of the
National motto “In God We Trust” in prominent locations ……… Chairman Newell
ITEM #10
Resolution Approving a Purchase of 911 Computer Aided
Dispatch System pursuant to General Statute 143-129(g)
Piggyback Exception ………………………………………………….. Douglas Young
ITEM #11
Tax Collector Settlement ………………………………………………… Russell Jones
ITEM #12
Order to Collect Taxes …………………………………………………… Russell Jones
ITEM #13
Rock Athletic Complex Outfield Renovation and Irrigation Options …….. John Hill
ITEM #14
Review the Request for Proposals for County Employee
Benefits Brokers ……………………………………………………………. Heidi York
ITEM #15
Designation of Voting Delegate to NC Association of
County Commissioners Annual Conference ………………………. Chairman Newell
CHAIRMAN’S REPORT
MANAGER’S REPORT
COMMISSIONER REPORTS/COMMENTS
CLOSED SESSION #1
A motion to enter Closed Session per General Statute 143-318.11(a)(5) for the purpose
to consider the acquisition or lease of real property with the following individuals
permitted to attend: County Manager, Heidi York, Clerk to the Board, Brenda
Reaves, County Attorney, Ron Aycock, and Summer Intern, Ellis Johnson.
Note: All Items on the Agenda are for Discussion and Action as deemed appropriate
by the Board.
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RESOLUTION OF APPRECIATION
WHEREAS, Reed Marston has served the people of Person County
during his tenure working for Person County’s General
Services Department as a Grounds Maintenance
Supervisor; and
WHEREAS, Reed Marston has served the citizens of Person County
with honor, integrity, sincerity and dedication, providing
accurate, concise services for thirteen years, June, 2003 –
June, 2016; and
WHEREAS, Reed Marston has earned the respect and admiration of all
who have known him and worked with him throughout his
career; and
WHEREAS, the County of Person recognizes the many contributions
Reed Marston has made to the County and offers him
sincere best wishes for his retirement.
NOW, THEREFORE, I, David Newell, Sr., Chairman of the Person County
Board of Commissioners, do hereby extend this Resolution of Appreciation
to Reed Marston for continually striving to make Roxboro and Person
County a better place to live and work.
Adopted the 18th day of July, 2016.
____________________________________
David Newell, Sr., Chairman
Person County Board of Commissioners
Attest:
____________________________________
Brenda B. Reaves
Clerk to the Board
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PERSON COUNTY
AMBULANCE FRANCHISE ORDINANCE
Proposed for Adoption July 18, 2016
WHEREAS, North Carolina General Statute Section 153A-250 provides that a
county may by ordinance franchise ambulance services provided in the county to the
public at large; and
WHEREAS, said General Statute requires the holding of a public hearing after
publication of notice of the hearing; and
WHEREAS, the Person County Board of Commissioners has previously adopted
an ambulance franchise ordinance on September 15, 2008, and
WHEREAS, the Board of County Commissioners finds that it is necessary and
desirable to adopt a replacement ambulance franchise ordinance in order to generally
update said ordinance and
WHEREAS, this board has held the required public hearing after proper notice
was published in the Courier Times, a newspaper of general circulation serving Person
County, on June 29, 2016 and July 6, 2016. (Copy of notice Attached as Exhibit A); and
WHEREAS, this board finds it necessary to assure the provision of adequate
and continuing ambulance service and to preserve, protect, and promote the public
health, safety, and welfare of the citizens of Person County to enact this Ordinance
which shall be known as “Person County Ambulance Franchise Ordinance”.
NOW THEREFORE, be it ordained as follows:
SECTION I. Franchise Required
1.1 No person either as owner, agent or otherwise, shall furnish, operate,
conduct, maintain, advertise or otherwise be engaged in or profess to be
engaged in the business or service of emergency and/or non-emergency
transportation of patients within the geographic boundaries of Person
County unless the person holds a valid permit for each ambulance used in
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such business or service issued by the North Carolina Department of
Health and Human Services, Division of Health Service Regulation, Office
of Emergency Medical Services and has been granted a franchise for the
operation of such business or service by the County pursuant to this
Ordinance.
1.2 No person shall drive, attend, or permit a vehicle to be operated for
ambulance purposes within the County of Person unless he or she holds a
currently valid credential as an emergency medical technician (Basic,
Intermediate or paramedic) issued by NC OEMS.
1.3 No franchise shall be required for:
(A) Any entity rendering assistance to Person County Emergency
Services or a franchised ambulance service in the case of a major
catastrophe or emergency when existing ambulance services are
insufficient to provide necessary services; or,
(B) Any entity operated from a location or headquarters outside of
Person County in order to transport patients who are picked up
beyond the limits of Person County, but no such entity shall be
used to pick up patients within Person County for transportation to
locations within Person County or other locations unless it is
rendering assistance as referred to in 1.3 (A) above; or,
(C) Law Enforcement Personnel; or
(D) The operation of the Person County owned ambulance service.
SECTION II. Application for Franchise
2.1 Application for a franchise to operate ambulances in the County shall be
made upon such forms as may be prepared or prescribed by the County
and shall contain:
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(A) The name and address of the applicant and of the owner of the
ambulances. If the owner is a corporation, a certified copy of the
articles of incorporation shall be included with the application.
(B) The trade or other fictitious names, if any, under which the
applicant does business, along with a certified copy of an assumed
name certificate stating such name or articles of incorporation
stating such name.
(C) A resume of the training and experience of the applicant, its agents
and employees in the transportation and care of patients.
(D) A description (make, type, year of manufacture, and serial number)
of each ambulance owned and operated by the applicant and an
inventory of equipment to be carried on each ambulance that will
guarantee certification as such per current NC OEMS rules and
regulations. If an ambulance(s) to be used in the provision of the
proposed franchised service is not owned by the applicant at the
time of the submission of the application, a full description of such
ambulance(s) shall be provided including all information required
above except for a specific serial number. A franchise may not be
granted until such ambulance is acquired by the applicant, but a
certification may be issued that all conditions for the franchise have
been met except for the ownership of the ambulance.
(E) The location and description of the place or places of business from
which the applicant intends to operate.
(F) An audited financial statement of the applicant in such form and in
such detail as may be required by the County.
(G) A description of the applicant’s capability to provide twenty-four (24)
hour coverage, seven days per week for the district covered by the
franchise applied for, and an accurate estimate of the minimum and
maximum times for a response to calls within such district.
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(H) The criminal record, if any, of the applicant; provided that if
applicant is a corporation, the criminal record, if any, of the officers,
directors and supervising employees thereof, including General
Manager or Director.
(I) Any information that the County shall deem reasonably necessary
for a fair determination of the capability of the applicant to provide
ambulance service in the County in accordance with the
requirements of State laws and the provisions of this ordinance.
(J) The geographic portion of the County that the applicant desires to
operate within.
2.2 An applicant may make application for a franchise to operate either
advanced life support or basic life support transportation service. The
applicant must specify which level of transportation service they are
applying for.
SECTION III. Granting of Franchise
3.1 Upon receipt of an application for a franchise, the County shall schedule a
time and place for hearing the applicant. Within thirty days after hearing,
the County shall cause such an investigation as it may deem necessary to
be made of the applicant and his proposed operations.
3.2 A franchise may be granted to one or more franchisees if the County finds
that:
(A) The public convenience and necessity require the proposed
ambulance service. In determining whether the public convenience
and necessity require the proposed ambulance service, the Board
will consider and investigate the statements made in the
application, the adequacy of the existing ambulance service, the
financial responsibility, experience, and character of the applicant,
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and the ability of the existing ambulance providers to provide any
necessary additional services, and other factors pertinent to such
determination.
(B) Each ambulance of the applicant, the required equipment and the
premises designated in the application, have been either certified
by the County and or the State of North Carolina or are eligible for
such certification per current NC OEMS rules and regulations.
(C) Only duly credentialed Emergency Medical Technicians are
employed in such capacities.
SECTION IV. Term of Franchise
4.1 The County may issue a franchise to an owner of an ambulance service,
to be valid for a term not to exceed five years. However, a franchise once
granted may be extended for additional five year terms upon written
application and documentation establishing that the franchisee is in full
compliance with all Person County and NC OEMS rules and regulations
and that valid permits have been issued by NC OEMS for each ambulance
being operated and that a current provider license has been issued to the
franchisee by NC OEMS.
4.2 No franchise granted may be sold, assigned or transferred to or in any
way vest in any person other than the applicant to whom the franchise is
granted. Provided however, a sale, assignment or transfer of an
ambulance service to a relative or to a business entity where all of the
ownership interests are owned by relatives of the applicant shall not be
considered a sale, assignment or transfer under this ordinance and shall
not result in a termination of the franchise.
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SECTION V. Standards for Ambulance Franchise
5.1 Each franchised ambulance service shall comply at all times with the
requirements of this Ordinance, the franchise granted hereunder, all
applicable State and Local Laws relating to health, sanitation, safety,
equipment, and ambulance design, the current Person County EMS
System Plan and all other laws and ordinances.
5.2 Any change of ownership of a franchised ambulance service without the
approval of the County shall terminate the franchise and shall require a
new application and a new franchise and conformance with all the
requirements of this Ordinance as upon original franchise issuance.
Provided however a change in ownership resulting in the acquisition of an
ownership interest by a relative of the applicant or a business entity where
all of the ownership interests are owned by a relative of the applicant shall
not be considered a change of ownership under this ordinance.
SECTION VI. Standards for Drivers, Attendants, Vehicles and Equipment
6.1 Standards for drivers, attendants, vehicles and equipment as developed
and adopted by the North Carolina Medical Care Commission and
enforced by NC OEMS in accordance with Chapter 131E, Article 7 and
Chapter 143, Article 56 of the North Carolina General Statutes and
Chapter 10A of the North Carolina Administrative Code, Subchapter 13P
are incorporated herein as part of this Ordinance. All drivers, attendants,
vehicles and equipment shall meet the specifications and qualifications of
the above mentioned rules, regulations and standards.
6.2 It shall be the responsibility of the franchisee to ensure that the provisions
of this section are observed as required.
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6.3 Proof of compliance with this section shall be made available to the
Director of Person County Emergency Services on an annual basis.
SECTION VII. Standards for Communications
7.1 Each ambulance must be equipped with a mobile two-way VHF radio
mobile or portable 800 mhz radio which must be in operative condition at
all times. The VHF and 800 mhz radios must have a minimum of 25 watts
operating power and programed with the channels/groups required by the
Director of Emergency Services four channels that are programmable to
the following frequencies: Statewide EMS, Person Memorial Hospital,
Person County EMS primary dispatch and an internal operational
frequency capable of dispatching their units. Other frequencies as needed
are acceptable but not required by franchise.
7.2 Each ambulance service shall provide the County a copy of the Federal
Communications Commission License authorizing the use of the
communication equipment owned and operated by that service.
7.3 Each base of operations must have at least one open/toll free telephone
line. Telephone numbers must be available to Person County Emergency
Services, and Person County Communications, county businesses and
citizens free of charge to the caller.
SECTION VIII. Insurance
8.1 No ambulance franchise shall be issued under this Ordinance, nor shall
such franchise be valid after issuance, nor shall any ambulance be
operated in the County unless there is at all times in force and effect
insurance coverage, issued by an insurance company licensed to do
business in the State of North Carolina, for each and every ambulance
owned and/or operated by or for the ambulance service providing for the
payment of damages:
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(A) In the sum of $ 1,000,000 for injury to or death of individuals in
accidents resulting from any cause for which the owner of said
vehicle would be liable on account of liability imposed on him by
law, regardless of whether the ambulance was being driven by the
owner or his agent and,
(B) In the sum of $ 1,000,000 for the loss of or damage to the property
of another, including personal property.
8.2 Proof of insurance coverage shall be made available to the Director of
Person County Emergency Services on an annual basis.
SECTION IX. Rates and Charges
9.1 Person County shall, in accordance with North Carolina General Statute
Section 153A-250(a)(6) establish and from time to time revise a schedule
of rates, fees, and charges that may be charged by franchised operators.
Such rates, fees and charges shall be applicable to and uniform for all
providers public, private and non-profit.
9.2 Person County has the right to audit the financial records of each
franchised operator for charges for patient services.
SECTION X. Violations
10.1 In the event of a violation of any section of this Ordinance or of any term
or condition of a franchise issued hereunder, the violator may be assessed
a civil penalty by the County Manager in the amount of five hundred
dollars for each violation. Each day that a violation continues shall be
deemed a separate violation. A violator shall be entitled to a hearing
before the County Manager on the assessment of any penalty. Any civil
penalty may be recovered in the nature of a debt if the violator does not
pay the penalty within ten days after being notified of a hearing decision.
If the civil penalty is not paid within the ten days as provided for above, the
County may suspend or revoke the franchise.
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10.2 As provided in North Carolina General Statute 153A-123, Person County
may seek an injunction, abatement order or any other appropriate remedy
to insure compliance with this Ordinance.
10.3 Nothing herein shall prevent Person County from proceeding in a criminal
action against any person, firm or corporation for violating any provision of
this Ordinance or any term or condition of a franchise granted hereunder
as provided in North Carolina General Statute 14.4.
10.4 Upon suspension, revocation, or termination of a franchise granted
hereunder, such franchised ambulance service immediately shall cease
operations. Upon suspension, revocation, or termination of a driver’s
license or emergency medical technician credential such person shall
cease to drive an ambulance or provide medical care in conjunction with
an ambulance service, or attend and ambulance and no person shall
employ or permit such individual to drive an ambulance or provide medical
care in conjunction with an ambulance service.
SECTION XI. Enforcement
11.1 The Director of Emergency Services for Person County or his designee
shall be the agent for the county for purposes of making inspections of
drivers, attendants, vehicles and equipment; to aid the board of
commissioners in determining compliance with this ordinance; and of
investigations into alleged violations of the articles of this ordinance.
11.2 Person County Department of Emergency Services shall be the enforcing
agency for the regulations contained in this Ordinance. Such office will:
(A) Receive all franchise proposals from potential providers.
(B) Study each proposal for conformance to this Ordinance.
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(C) Make recommendations to the Board of Commissioners concerning
the award or non-award of the franchise.
(D) Inspect the premises, vehicles, equipment, and personnel of
franchisees to assure compliance to this Ordinance and to perform
any other inspections that may be required.
(E) Recommend temporary or permanent suspension of a franchise in
the event of noncompliance with the franchise terms of this
Ordinance to the County Manager. Appeal from final decisions of
the County Manager shall be to the Board of Commissioners.
Appeal to the Board of County Commissioners must be filed with
the Clerk to the Board within seven days of the Manager’s final
decision.
(F) Recommend to the County Manager the imposition of
misdemeanor or civil penalties as provided herein or recommend
such other courses of action as may be warranted by the violation
or infraction, provided however the appeal processes to the Board
of County Commissioners set out in section X shall apply.
(G) Receive complaints from the public, other enforcing agencies, and
ambulance services regarding franchise infractions.
SECTION XII. Territorial Jurisdiction
12.1 The provisions of this Ordinance shall apply to all areas within the
geographic confines of Person County including areas within a city unless
the city area has been excluded by the County or a city pursuant to
GS153A-250(c).
SECTION XIII. Miscellaneous
13.1 The County may inspect a franchisee’s records, premises and equipment
at any time during normal daytime business hours after reasonable notice
to the franchisee, in order to insure compliance with this Ordinance and
any franchise granted hereunder. Nothing contained in this ordinance
shall authorize violation of any valid Federal or State law or regulation.
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13.2 The franchisee shall report the number of calls and runs during the month
by the 10th day of the following month to the Director of Emergency
Services. The report shall be in writing and shall contain the following at a
minimum:
(A) the number of emergency calls for the month
(B) the number of routine calls for the month
(C) the total number of calls for the month including calls that
otherwise do not meet criteria above
(D) transports by destinations: (PMH, nursing home, residence or out
of county facility)
(E) delays in calls for service: (number of delays, average delay time,
reason for delay)
SECTION XIV. Definitions
14.1 “Advanced Life Support” means the assessment, intervention and or
transport of a patient performed by an ALS crew as part of a response that
was necessary because the patient’s reported condition at the time of
dispatch was such that only an ALS crew was qualified to perform the
assessment and or perform an intervention or procedure that is in
accordance with state and local laws, required to be done by an
Intermediate or Paramedic.
14.2 “Ambulance” means any privately or publicly owned motor vehicle, aircraft
or vessel that is especially designed, constructed or modified and
equipped and is intended to be used for and is maintained or operated for
the transportation on the streets or highways, waterways, or airways of
this State of persons who are sick, injured, wounded, or otherwise
incapacitated or helpless.
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14.3 “Basic Life Support” means the provision of BLS service with medically
necessary supplies and services, including ambulance transport by
personnel qualified in accordance with State and local laws at the level of
an EMT-Basic.
14.4 “Breach” means the violation of or failure to comply with a provision of this
ordinance.
14.5 “Business Entity” means a corporation, a general partnership, a limited
partnership, or a limited liability company.
14.6 “County” means the County of Person Board of Commissioners or a
designated representative.
14.7 “Emergency Transportation” means the operation of an ambulance in
order to provide medical care and transportation of a patient who is in
need of immediate medical treatment in order to prevent loss of life or
further aggravation of physiological or psychological illness or injury.
Emergency transportation may occur at the ALS or BLS level.
14.8 “Franchise” shall mean a permit issued by the County to a person for the
operation of an ambulance service.
14.9 “Franchisee” shall mean any person having been issued a franchise by
the County for the operation of an ambulance service.
14.10 “NC OEMS” shall mean the North Carolina Office of Emergency Medical
Services. NC OEMS is a section of the Division of Health Service
Regulation of the NC Department of Health and Human Services, located
at 701 Barbour Drive, Raleigh, NC 27603. NC OEMS has enforcement
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oversight in the rules and regulations governing EMS operations in the
state of NC as created and adopted by the NC Medical Care Commission.
14.11 “Non-Emergency / Routine Transportation” means the operation of an
ambulance for any purpose other than an emergency transport as defined
above. Non-Emergency transportation may occur at the ALS or BLS level.
14.12 “Owner” shall mean any person or entity that owns or operates an
ambulance service.
14.13 “Patient” shall mean an individual, who is sick, injured, wounded, or
otherwise is incapacitated or helpless.
14.14 “Person” shall mean any individual, firm, partnership, association,
corporation, company, group of individuals acting together for a common
purpose, or organizations of any kind, including any governmental agency
other than the United States.
14.15 “Relative” shall mean any of the following:
(A) A spouse or the spouse's lineal ancestor or descendant.
(B) A lineal ancestor or a lineal descendant.
(C) A brother or sister, or the lineal descendant of a brother or sister.
For the purposes of this sub-subdivision, the term brother or sister
includes stepbrother or stepsister.
(D) An aunt or an uncle.
(E) A spouse of a person listed in paragraphs a. through d. For the
purpose of this subdivision, an adoptive or adopted relative is a
relative and the term "spouse" includes a surviving spouse.
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This Ordinance shall be effective upon adoption by the Board of Commissioners and will
supersede any previous versions of the Ambulance Franchise Ordinance.
Adopted this the 18th day of July, 2016.
____________________________ __________________________
Brenda B. Reaves, CMC David Newell, Sr.
Clerk to the Board Chairman
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PUBLIC HEARING NOTICE
The Person County Board of Commissioners hereby gives
notice of its intent to amend its current Ambulance Franchise
Ordinance to update statutory and technical references and to
provide for allowing two ambulance providers to operate in the
County in order to insure adequate coverage for all citizens. The
Board of Commissioners will hold a Public Hearing on July 18,
2016 at 9:00am to receive public comment on an amended
Ambulance Franchise Ordinance.
The meeting will be held in the Commissioners’ meeting
room 215 in the County Office Building, 304 S. Morgan Street,
Roxboro, NC 27573.
Brenda B. Reaves
Clerk to the Board
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PERSON COUNTY PLANNING BOARD
PUBLIC HEARING NOTICE
The Person County Board of County Commissioners will hold a public
hearing on Monday, July 18, 2016 at 9:00 a.m. in Room 215 of the
Person County Office Building at 304 South Morgan Street (please
enter through side door), Roxboro, North Carolina to hear the
following:
1. Request by Whitt Town Solar LLC for a Special Use Permit for a
solar farm (electrical generating facility) on Whitt Town Road,
Roxboro Township, and Tax Map 104 Parcel 4.
Citizens will have an opportunity to speak regarding the above requests.
Site-specific information is on file with the Person County Planning and
Zoning Department, 325 S. Morgan Street, Suite B.
Mike Ciriello, AICP
Planning Director
Publish Legal: July 6 and July 13, 2016
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AGENDA ABSTRACT
Meeting Date: JULY 11, 2016
Agenda Title: SPECIAL USE PERMIT REQUEST SUP.02.2016
SOLAR ENERGY GENERATOR
Background: WHITT TOWN ROAD, SR 1149
TAX MAP 140 PARCEL 4
ROXBORO TOWNSHIP
RURAL CONSERVATION DISTRICT (RC)
Summary Information: The County has received an application from Whitt Town Solar LLC
for a solar energy generator on Whitt Town Road. The company plans to lease the 43.4 acre tract.
Electrical Generating Facilities are allowed with a Special Use Permit in the Rural Conservation
District.
Attached to this report is a site plan which shows the proposed solar panels, six inverters and
access to the site. The solar farm will contain rows of Photovoltaic (PV) cell panels mounted on
posts set in the ground individually. The plans show approximately 21,660 solar panels
manufactured by Canadian Solar (model: 6X-300P). Each panel has a 300 watt capacity. The
power is then sold through a Power Purchase Agreement to Duke Energy Progress. This site is not
equipped to store power and does not involve known hazardous materials.
This site will not require a well or septic system. The use will be unmanned and only visited
periodically for routine maintenance. Due to the construction of the solar panels, water is able to
flow through them.
The Person County Land Use Plan’s “Future Land Use Map” shows this area as Suburban
Residential. It is defined as Residential land uses including subdivisions and manufactured home
parks at densities of 1-3 dwelling units per acre; commercial, office, industrial, public/institutional
uses meeting locational criteria. Locational criteria for non-residential uses within this land use
category would include frontage and access to a major State highway or secondary road,
proximity to similar uses and spatial separation from non-compatible uses such as existing
residential development. Land uses within this category could develop with or without public
sewer.
The Planning Board held a Public Hearing on June 9, 2016 and voted 6 to 0 to recommend approval
of the Special Use Permit with staff comments, that it met the Findings of Fact and that it was in
keeping with the Comprehensive Plan.
Recommended Action: Vote to approve or deny the rezoning
Submitted By: Michael Ciriello, AICP, Planning Director
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RANDY & TANYA EAKES
9994-00-56-0909.000
249/821
WOODED
ZONING: R
EMILY R BRANN
9994-00-57-0668.000
22453
RESIDENTIAL
ZONING: R
CRAIG & TRACY WRENN
9994-00-67-8942.000
AGRICULTURAL
ZONING: R
JAMES E RAMSEY
9994-00-66-8379.000
410/72
RESIDENTIAL/WOODED
ZONING: R
BRENDA B BLALOCK
9994-00-55-3095.000
207/201
RESIDENTIAL/WOODED
ZONING: R
CLARENCE & DIANA BURCH
9994-00-46-5177.000
466/156
AGRICULTURAL/WOODED
ZONING: R
CLARENCE & DIANA BURCH
9994-00-36-9536.000
287/723
RESIDENTIAL
ZONING: R
CLARENCE & JACQUELINE
RIMMER
9994-00-36-6848.000
260/353
RESIDENTIAL
ZONING: R
CLARENCE & JACQUELINE RIMMER
9994-00-37-3314.000
244/41
RESIDENTIAL/AGRICULTURAL
ZONING: R
PATRICIA M BURCH
9994-00-36-1643.000
107/293
RESIDENTIAL/AGRICULTURAL
ZONING: R
JOHNNIE & JOYCE CHAMBERS
9994-00-38-8548.000
301/829
WOODED/AGRICULTURAL
ZONING: R
WHITT TOWN RDJURISDICTIONAL
STREAM
JURISDICTIONAL
WETLAND
SECURITY FENCE
6' HIGH WITH 3
STRAND BARBED WIRE
EXISTING ELECTRICAL
PARCEL BOUNDARY
30' WIDE 96' SITE
ACCESS PATH WITH 96'
TURN AROUND
GRAVEL AND GRASS
USABLE ARRAY AREA
PROPOSED LOCATION OF PANELS.
EXACT LOCATION SUBJECT TO
CHANGE BASED ON ADDITIONAL
ENGINEERING AND TO BE SHOWN
ON CONSTRUCTION LEVEL SITE PLAN
PROPOSED POINT OF
INTERCONNECTION UTILITY
POLE
POTENTIAL WETLAND/STREAM
CROSSING - LOCATION AND SIZE
TO BE DETERMINED BASED ON
ADDTIOINAL SURVEY/ENGINEERING
EXISTING TREELINE (TYP)
EXISTING POND (TYP)
20' ZONING SETBACK
25' ZONING SETBACK
40' ZONING SETBACK
PARCEL BOUNDARY (TYP)
EXISTING STRUCTURES (TYP)
BUFFER IS MEASURED LANDWARD FROM THE
NORMAL POOL EVALUATION OF IMPOUNDED
STRUCTURES AND FROM THE BANK OF EACH
SIDE OF PERENNIAL STREAMS OR RIVERS
50' BUFFER
PROPOSED TREELINE (TYP.)
10'EXISTING VEGETATION TO
REMAIN IN SHADE REGION
POSSIBLE AREA
FOR TEMPORARY
SKIMMER BASIN
POSSIBLE AREA
FOR TEMPORARY
SKIMMER BASIN
POSSIBLE AREA
FOR TEMPORARY
SKIMMER BASIN
POSSIBLE AREA
FOR TEMPORARY
SKIMMER BASIN
30' WIDE ACCESS PATH
TO BE CONSTRUCTED
OF NATIVE
COMPACTED SOIL
ROWS OF PANELS TO BE
SPACED 9-13 FEET APART.
PANELS ARE APPROXIMATELY
THREE FEET WIDE (SEE DETAIL)
CALL OUT LEADER100.0PROPERTY OWNERPIN #
33% GROUND COVERRATIO TRACKER BLOCK
40% GROUND COVERRATIO TRACKER BLOCK
50% GROUND COVERRATIO TRACKER BLOCK
UTILITY POLE WITH RECLOSER
DUKE ENERGY PROGRESSPOINT OF INTERCONNECTION SEQUENCE
EXISTING UTILITY POLE (TYP)
CUSTOMER POLE WITH GOAB SWITCHCUSTOMER POLE WITH METER CUSTOMER POLE FUSED CUTOUTSOVERHEAD TO UNDERGROUND TRANSITION
57 MODULES3 STRINGS OF 19 .3 GCR SINGLE INVERTER PAD (TYP)DOUBLE INVERTER PAD (TYP)
UTILITY POLE WITH METER & DISCONNECTPOINT OF INTERCONNECTION
EQUIPMENT PADS
THINFILM1257mm x 977 mm4v16 PORTRAIT20° TILT
EXISTING CONDITION ITEMS
CONSTRAINTS FILES
LANDOWNER CONSTRAINTS AREA - (TYPE, LOCATION)XXXNEIGHBOR CONSTRAINTS AREA - (TYPE, LOCATION)XXXZONING CONSTRAINTSSETBACKS:FRONT = XX'SIDE = XX'REAR = XX'EXAMPLE: "FENCE ALLOWED WITHIN SETBACK"OTHER CONSTRAINTS"NO INVERTERS WITHIN 150' OF PROPERTY LINE"OR"NO BUILDING DURING THESE MONTHS BECAUSE OF THE SHARP BEAKED OWL"ETC.
CALL OUT LEADERARRAY AREA MUST BE CONTAINEDWITHIN BUILDING SETBACK (TYP.)SITE ACCESS
RACKING AREABUILDING SETBACKSDISTURBED AREA
EXCLUSION ZONE (LIST REASON FOR EXCLUSION)BUFFER (FROM STREAMS/WETLANDS ETC)PROPOSED EASEMENTVEGETATIVE BUFFER
INDICATE LEVEL OF CONFIDENCE IE "SHOWN IN ZONING SITE PLAN" OR "DRIVEWAY PERMIT OBTAINED"
INDICATE LEVEL OF CONFIDENCE IE "CONFIRMED BY UTILITY ENGINEER"POINT OF INTERCONNECTION
FENCELINE (IF STRICTLY DICTATED BY ZONING SITE PLAN)PROJECT SPECIFICATIONS:TOTAL USABLE AREA: ± XX.XX ACRESMODULE TECHNOLOGY: POLY OR THIN FILMMW AC: X.XXXMW DC: X.XXXRACKING: TRACKING OR FIXED TILT(DEGREE AND/OR GCR)MODULE ORIENTATION: TWO IN PORTRAIT,4 IN LANDSCAPECOLLECTOR BAND WIDTH: X.XXXCLEAR ROW SPACING: X.XXXSHADING ANGLE: X.XXX
76 MODULES4 STRINGS OF 19 RBI - <15% E-W SLOPESNEXTrackerCS6X-P (1954 mm x 982 mm)INDEPENDENT ROWSATICS6X-P (1954 mm x 982 mm)(UP TO 40° SCEW ANGLE)
TERRASMART - <30% E-W SLOPES
38 MODULES2 STRINGS OF 19
.5 GCR .4 GCR
72 CELL POLY1960 mm x 992mm2v19 PORTRAIT20° TILT
72 CELL POLY1960 mm x 992mm6V6 LANDSCAPE20° TILTSOLARFLEX - 10% E-W SLOPES
TOTAL CONSTRAINTS: DISTURBED AREA = X.X AC ARRAY AREA = X.X ACUTILITY EASEMENT - ENCROACHMENT PERMIT NEEDEDSTREAM CROSSLING LOCATIONINDICATE IF IMPACT PERMIT HAS BEEN OBTAINED OR NOT
SEAL
CHECKED BY:
DRAWN BY:
DATE:
PROJECT CYPRESS CREEKRENEWABLES3250 OCEAN PARK BLVD :: SUITE 355 :: SANTA MONICA, CA 90405REVISIONSDATEDESCRIPTIONREV5432
A
B
C
D
1 6 7 8 90
54321 6 7 8 90
A
B
C
D
E
F
G
E
F
G
H
10
10
A
B
C
D
E
F
G
H
CONSULTANT
WHITT TOWN ROADROXBORO, NC 27574WHITT TOWN SOLAR, LLC05-17-16
XXX
G 0.0
JLS
ZONING
SITE PLAN
N
GRAPHIC SCALE
100'0 100'
1" = 100'
NORTH
SITE
VICINITY MAP
LENGTH
VARIES
PER
DESIGN
PV MODULES
POST SPACING
VARIES
FRONT ELEVATION
TYPICAL RACK ELEVATION DETAIL
(NOT TO SCALE)
PV MODULES
+/-2'-7"
MAX HEIGHT 12'
+/-22'-3" ROW SPACING MAY VARY
CROSS SECTION
TYPICAL RACK SECTION DETAIL
(NOT TO SCALE)
GENERAL NOTES
PIN #OWNER DB/PG SITE ADDRESS
9994-00-56-0909 EARL & TANYA EAKES 249 / 821 WHITT TOWN RD
ROXBORO, NC 27574
CURRENT LAND USE ACRES
WOODED ± 43.2 AC
TAX PARCEL TAX PARCEL
PROPOSED ZONING TOWNSHIP MAP NUMBER RECORD NUMBER
RC ROXBORO 1044 9472
PRELIMINARY PRELIMINARY PRELIMINARY
PROPOSED USE LEASE AREA DISTURBED AREA SOLAR AREA
SOLAR ENERGY SYSTEM ± 43.2 AC ± 43.2 AC ± 35.37 AC
*PRELIMINARY ARE SUBJECT TO CHANGE
PARCEL LINE SETBACKS REQUIRED
FRONT ROAD 40 FT
MIN. FRONT YARD 25 FT
MIN. SIDE YARD 20 FT
MIN. REAR YARD 25 FT
SITE DATA
LEGEND
EXISTING CONDITIONS
BUILDING SETBACK
EASEMENTS
OVERHEADELECTRICAL
STRUCTURES
TREELINE
STREAM / CREEK
MAJOR CONTOURS
MINOR CONTOURS
PROPERTY LINES
RIGHT-OF-WAY
STREET CENTERLINE
WETLAND
PROPOSED CONDITIONS
SECURITY FENCE
SITE ACCESS
STREAM CROSSING
1. THE PURPOSE OF THIS PLAN IS FOR ZONING REVIEW AND APPROVAL BY PERSON
COUNTY, NC TO CONSTRUCT A SOLAR ENERGY SYSTEM.
2. THIS PLAN WAS PRODUCED UTILIZING GIS RESOURCES AND INFORMATION FROM
MULTIPLE SOURCES, INCLUDING PERSON COUNTY GIS, AND BING MAPS.
3. THE SUBJECT PROPERTY DOES NOT LIE WITHIN A SPECIAL FLOOD HAZARD AS SHOWN
ON THE FLOOD INSURANCE RATE MAP (COMMUNITY PANEL 3710999400J,
DATED06-04-07) PUBLISHED BY THE FEDERAL EMERGENCY MANAGEMENT AGENCY
(FEMA).
4. THE LOCATIONS OF PROPOSED IMPROVEMENTS, INCLUDING BUT NOT LIMITED TO:
FENCING, SOLAR ARRAY RACKING, INVERTER/TRANSFORMER PADS, OVERHEAD POLES
AND LINES, ETC., SHOWN ARE APPROXIMATE AND ARE SUBJECT TO MODIFICATION DUE
TO SITE CONDITIONS, ADDITIONAL PERMITTING REQUIREMENTS, EQUIPMENT
SPECIFICATIONS, AND/OR OTHER CONSTRAINTS.
5. PROJECT AREA, INCLUDING CONSTRUCTION STAGING AREAS, WILL BE CLEARED AND
GRUBBED AS NECESSARY, RETAINING PRE-DEVELOPMENT DRAINAGE PATTERNS TO
THE BEST EXTENT POSSIBLE. CONSTRUCTION STAGING AND AREAS SUBJECT TO
RUTTING DURING CONSTRUCTION WILL BE TEMPORARILY STABILIZED WITH GRAVEL.
SOIL CONDITIONS AND EQUIPMENT LOADS WILL DETERMINE FINAL DESIGN.
6. ALL DIMENSIONS SHOWN ARE AT 90 DEGRESS UNLESS OTHERWISE NOTED.
7. CONTRACTOR SHALL CALL AT LEAST 72 HOURS PRIOR TO BEGINNING CONSTRUCTION
OR EXCAVATION TO HAVE EXISTING UTILITIES LOCATED. ADDITIONLLY, CONTRACTOR
SHALL CONTACT ANY LOCAL UTILITIES THAT PROVIDE THEIR OWN LOCATOR SERVICES.
8. CONTRACTOR SHALL MAINTAIN ACCESS AND UTILITY SERVICES TO ANY REMAINING
BUILDING(S) OR ADJACENT BUILDING(S) THROUGHOUT THE DEMOLITION AND
CONSTRUCTION PHASES. EXISTING IMPROVEMENTS DAMAGED DURING
CONSTRUCTION SHALL BE REPLACED/RESTORED TO THE SATISFACTION OF THE
OWNER BY THE CONTRACTOR RESPONSIBLE FOR THE DAMAGE.
9. THE CONTRACTOR SHALL BE FULLY RESPONSIBLE TO PROVIDE SIGNS, BARRICADES,
WARNING LIGHTS, GUARD RAILS, AND EMPLOY FLAGGERS AS NECESSARY WHEN
CONSTRUCTION ENDANGERS EITHER VEHICULAR OR PEDESTRIAN TRAFFIC. THESE
DEVICES SHALL REMAIN IN PLACE UNTIL THE TRAFFIC MAY PROCEED NORMALLY
AGAIN.
GENERAL NOTES
PROPOSED TREE LINE
PROPOSED BASIN
LIMIT OF DISTURBANCE
49
June 7, 2016
1
PERSON COUNTY BOARD OF COMMISSIONERS JUNE 7, 2016
MEMBERS PRESENT OTHERS PRESENT
David Newell, Sr. Heidi York, County Manager
Tracey L. Kendrick
Jimmy B. Clayton Brenda B. Reaves, Clerk to the Board
Kyle W. Puryear
B. Ray Jeffers
The Board of Commissioners for the County of Person, North Carolina, met in
recessed session on Tuesday, June 7, 2016 at 9:00am in the Commissioners’ meeting room
in the Person County Office Building for the purpose of a budget work session.
Chairman Newell called the recessed meeting to order.
County Manager, Heidi York asked the Assistant Finance Director and Budget
Manager, Laura Jensen to update the Board on the following technical budget adjustments.
Ms. Jensen presented the following noted revenues and expenditures which offset for a
balanced budget.
Revenues Amount
PATS Admin ‐ Transportation Grant ($17,700.00)
Emergency Mgmt ‐ Tier II Fee Grant ($104.00)
Self‐Funded Health Ins ‐ Premiums $162,219.00
Self‐Funded Health Ins ‐ Misc Contributions $2,000.00
Consolidated E911 Fees $483,430.00
Emergency Telephone Systems ‐ Fund Balance
Match for CAD project $16,000.00
TOTAL $645,845.00
50
June 7, 2016
2
The Board moved the budget discussion to the recommended vehicles in the
Manager’s budget and asked the departmental directors to address the need, the recorded
maintenance and state whether the vehicle would last another year. The list of the
Manager’s recommended vehicles are as follows:
Expenditures Amount
PATS Operations ‐ RGP & EDTAP Exp ($6,799.00)
PATS Operations ‐ M&R/Vehicle ($10,901.00)
Emergency Mgmt ‐ Tier II Fee Grant ($104.00)
Self‐Funded Health Ins ‐ Admin ($2,127.00)
Self‐Funded Health Ins ‐ Claims Exp $166,346.00
Emergency Telephone Systems ‐ Cont.
Serv.$43,000.00
Emergency Telephone Systems ‐
Telephone $76,440.00
Emergency Telephone Systems ‐ Cap
Out $5k+$379,990.00
TOTAL $645,845.00
51
June 7, 2016
3
Vehicles
Department
Model
Year Description
Actual
Mileage
Criteria
Mileage Replace With
Price
Estimate
Last
Another
Year
Animal
Services 2007 F-150 4 X 4 132,252 100,000 F-150 4 X 4 $ 31,594
No
General
Services 2007 F-150 4 X 4 107,417 100,000 F-150 4 X 4 $ 31,594
Yes
Social
Services* 2005
Dodge
Caravan 121,424 120,000
Dodge
Caravan $ 24,916
No
2009
Dodge
Charger 148,133 120,000 Taurus $ 24,386
No
Tax 2002 Ford Explorer 103,262 120,000 Ford Escape $ 23,284 No
Sheriff 2008
Dodge
Charger 105,110 90,000
Dodge
Charger $ 28,500
No
2008
Dodge
Charger 118,905 90,000
Dodge
Charger $ 28,500
No
2012 Ford F-150 111,734 100,000 Ford F-150 $ 28,500 Yes
2012
Dodge
Charger 95,563 90,000
Dodge
Charger $ 28,500
No
EMS/911 2009 Ambulance 173,873 250,000 Ambulance $ 227,900 No
Economic Dev 2001 Expedition 147,368 120,000 Ford Exped $ 37,086 Yes
PATS** 2008 Van 157,738 100,000 Van $ 58,500 No
2008 Van 154,334 100,000 Van $ 58,500 No
2008 Van 160,040 100,000 Van $ 58,500 No
TOTAL $ 690,260
*DSS – 50% or 75% reimbursed by state
**PATS- 90% reimbursed by state
Chairman Newell estimated of the $690,260 proposed for new vehicles,
approximately $158,000 was estimated to be reimbursed by the state thereby leaving a net
cost of $532,265.
A motion was made by Chairman Newell and carried 5-0 to establish a Vehicle
Fund and appropriate $600,000 for fiscal year 2016-2017 and direct the County Manager
to evaluate the vehicles on an individual basis as opposed to the flat mileage criteria.
Chairman Newell recommended staff to calculate the costs of life of each vehicle.
Ms. Jensen stated upon establishing a vehicle fund and appropriating funds, the
revenues from the sale of surplus vehicles could be added to grow the fund noting any
revenue from the sale of PATS vehicles was mandated to be used in the PATS budget for
maintenance and repair use.
52
June 7, 2016
4
The action above for a vehicle fund created a surplus in the recommended budget
of $90,260 at this point in the budget work session.
The Board then moved to further discuss positions that were not included in the
Recommended Budget. Commissioner Jeffers stated in the Board’s last work session, he
noted his preference to replace the eliminated Assistant Register of Deeds positon with a
Deputy Register of Deeds position and to fund for the remainder of the fiscal year 2016-
2017.
Ms. York provided information to the Board for a Deputy Register of Deeds at a
grade 61 would require $24,543 additional funding for fiscal year 2017. The 12-month
recurring cost for this position would be $42,074 which included salary, benefits and
supplies.
Ms. York stated her recommendation was to cut the position at the staff transition
and for staff to evaluate after a trial period noting the evaluation would be easier when the
positon was vacated. Ms. York stated she had discussed peak part-time assistance with the
Register of Deeds Elect.
Chairman Newell stated if a staff-filled position was terminated and eligible for
unemployment, the maximum amount paid is $350 per week for a period of 24 weeks. The
cost of unemployment payout x 120% is the cost to the county. Ms. York added that the
County Personnel Policy has a provision for a reduction in force positions paying out any
accumulated sick leave.
Register of Deeds Amanda Garrett stated that under the bond of the Register of
Deeds, staff serve either as an Assistant or a Deputy and supplementing with a part-time
staff who was not trained, deputized nor sworn-in would provide a liability to the county.
Ms. Garrett noted with $20,000 coming out of the Register of Deeds Technology Fund, her
budget presented as a flat budget. Ms. York added the $20,000 supplements the Register
of Deeds budget in the contracted services line.
A motion was made by Commissioner Jeffers and carried 4-1 to fund a Register
of Deeds Deputy position for the remaining of Fiscal Year 2017 at $24,543 using surplus
funds from the recommended budget for vehicles. Vice Chairman Kendrick cast the lone
dissenting vote.
Assistant County Manager, Sybil Tate provided an overview at this point of the
Recommended Budget Running Total. The HALO position that was inadvertently left out
of the Recommended Budget was included back into the budget at a cost of $56,633. Also,
$1,763 had to be added to the Inspections budget to cover the costs of fire alarm installation
for the County Office Building. Ms. Tate noted the two following savings to the budget:
$46,900 in an adjustment in tax value for Spuntech in the economic catalyst fund and $950
reduction for the Clerk of Court’s software.
53
June 7, 2016
5
With the savings of $90,260 from the recommend vehicle budget and Board
appropriation of $24,543 for the Deputy Register of Deeds position, the running total was
a surplus of $55,171.
Chairman Newell asked the Board if there were any other positions the Board
wished to discuss. Commissioner Clayton asked Chairman Newell, in his role with
Economic Development, if he thought there was a need to extend the current part-time
Senior Administrative Assistant to full-time. Chairman Newell opined that moving the
part-time position to full-time would increase staff workload efficiency, continuity and
security of the Economic Development office. Vice Chairman Kendrick and
Commissioner Puryear stated opposition to moving the position to full-time.
A motion was made by Chairman Newell and carried 3-2 to make the Economic
Development Senior Administrative Assistant position full-time in fiscal year 2017. The
additional funds to budget for Fiscal Year 2017 was $28,975 with 12-month recurring costs
for salary, benefits, and supplies at $44,980. Chairman Newell and Commissioners
Clayton and Jeffers voted in favor of the motion. Vice Chairman Kendrick and
Commissioner Puryear voted in opposition to the motion.
The Board turned its discussions to the funding for volunteer fire departments.
A motion was made by Chairman Newell to approve the funding for Volunteer
Fire Departments (VFDs) as presented however, Chairman Newell withdrew the motion
noting his opinion that the County should establish a fire fund for reimbursement as the
current trip reimbursement based on call volume ranged from $85 to $644 per call.
Commissioner Jeffers suggested a fire commission be established to evaluate funding
criteria for the Fiscal Year 2017-2018 noting the lateness to change the criteria for Fiscal
Year 2016-2017.
Vice Chairman Kendrick asked if the VFDs audit was skipped for year 2 of the
current contract which was confirmed by the Manager and Finance Director. Finance
Director, Amy Wehrenberg stated the audit evaluated was for Fiscal Year 2014. By
skipping the audit requirement for Fiscal Year 2015, it will be due again following the
close of Fiscal Year 2016. Ms. Wehrenberg stated there were no funds appropriated for
this audit in the budget however, the Board could direct staff to release a Request for
Proposals and appropriate based on the bids at the mid-year.
It was the consensus of the Board to further discuss the funding for the VFDs after
all other items had been discussed.
54
June 7, 2016
6
The next item for Board discussion was the request for funding from Roxboro Area
Chamber of Commerce for its Personality event.
A motion was made by Commissioner Puryear to appropriate $3,000 to the
Roxboro Area Chamber of Commerce for its Personality event. Commissioner Puryear
amended his motion to appropriate $2,500 instead of $3,000. The amended motion
failed 2-3. Commissioners Puryear and Jeffers voted in support of the amended motion.
Chairman Newell, Vice Chairman Kendrick and Commissioner Clayton voted against the
amended motion.
The Board then reviewed each departmental budget in the Recommended Budget
with staff answering questions that arose.
A motion was made by Chairman Newell and carried 3-2 to appropriate $11,000
to the General Services’ budget for contracted lawn maintenance at the Person County
Museum. Chairman Newell and Commissioners Clayton and Jeffers voted in favor of the
motion. Vice Chairman Kendrick and Commissioner Puryear voted against the motion.
When reviewing the Special Appropriations budget, Vice Chairman Kendrick
addressed the $100,000 funding appropriation to the Senior Center in the following motion.
A motion was made by Vice Chairman Kendrick and failed 2-3 to reduce the
$100,000 appropriation to $75,000 for the Person County Senior Center. Vice Chairman
Kendrick and Chairman Newell voted in support of the motion. Commissioners Puryear,
Clayton and Jeffers voted against the motion.
A motion was made by Chairman Newell and carried 5-0 to fund an additional
$5,000 to Drug Court making the total appropriation in the Fiscal Year 2016-2017 at
$15,000.
Commissioner Puryear asked for the Board’s consideration to have the Person
County Schools’ Superintendent, Danny Holloman address the Board on any final funding
requests. Mr. Holloman stated that regardless of the enrollment of the Person County
Schools, the local funding in the current expense appropriation was shared among the
approximately 5,700 students (inclusive of the charter schools). Mr. Holloman wanted the
Board to understand that amount per pupil expenditure followed the student regardless of
the school of choice.
55
June 7, 2016
7
Mr. Holloman stated the Senate was taking away the start-up funding for the
comprehensive innovative high school or otherwise known as early college. Mr. Holloman
said Person County Schools was supposed to receive $1.5M over a 5-year period for Person
County Early College to begin classes in August 2016. Mr. Holloman noted they are in a
holding mode.
Mr. Holloman told the Board he had already cut positons through attrition or by
sharing positons between two schools.
Mr. Holloman confirmed that Bethel Hill will not have a sixth grade next school
year noting that some students will be enrolled at Roxboro Community School and some
will come to Person County Schools.
Mr. Holloman spoke to the issue with older textbooks not being replaced noting
they are moving more toward digital literacy with the laptops noting they can’t afford to
buy the textbooks.
Mr. Holloman suggested the Board to review House Bill 539 impacting funding for
nutrition and transportation for choice schools.
Mr. Holloman stated the Board of Education’s fund balance has less than $1M.
Commissioner Puryear asked Mr. Holloman if his technology capital request was
for $767,476 to which he confirmed noting his initial request was $419,000 but revised to
increase by pulling out other technology related expenses from the current expense. Ms.
Wehrenberg added that the initial request for technology was confirmed as one-time capital
expense but some of the other items added later, were in her opinion, more recurring
expenses and therefore not recommended in the Manager’s budget.
A motion was made by Commissioner Puryear to increase the Capital Technology
Fund for Person County Schools by $200,000 for a one-time non-recurring appropriation
from the General Fund. Chairman Newell stated there was $300,000 appropriated in the
Capital Improvement Plan (CIP) for parking lot paving that will only cost $90,000 and
suggested using those surplus CIP funds toward the motion on the floor versus using the
General Fund. Commissioner Puryear agreed to amend his motion to increase the Capital
Technology Fund for Person County Schools by $200,000 for a one-time non-recurring
appropriation using CIP surplus funds. The amended motion passed unanimously.
Chairman Newell called for a brief recess at 12:02pm. The meeting was called
back in session as 12:09pm.
56
June 7, 2016
8
Chairman Newell asked if there were any board members wishing to discuss
Piedmont Community College (PCC).
Vice Chairman Kendrick made a motion to reduce PCC’s budget in the amount of
$10,000 for the Small Business Incubator. Vice Chairman Kendrick explained his research
found that these funds went toward supplies only.
Commissioner Clayton asked the Board to consider Dr. Walter Bartlett, President
of PCC to address the motion on the floor. Dr. Bartlett stated the local funds were not used
for personnel however the $10,000 was used for expenses that were not eligible to be paid
with state funding, such as supplies, heating/air, utilities, telephone, and insurance. Dr.
Bartlett said $241,000 in state funding was used to support the Business Development
Entrepreneurial Center (BDEC) and approximately $26,000 in funds was needed to cover
the expenses that the state would not cover. Dr. Bartlett noted that both the City and the
County assisted with the $26,000 funding covering approximately $13,000.
The motion on the floor failed 1-4. Vice Chairman Kendrick was the only member
of the Board to support the motion.
The Board asked the County Manager about the water and sewer construction
reserve fund revenue that was potentially owed by the City of Roxboro to the County. Ms.
York stated she was waiting to hear back from the City Manager following their budget
work.
Chairman Newell led the group in the budget discussion related to the Volunteer
Fire Departments. Chairman Newell asked the County Manager the status of the running
budget total with the adjustments thus far. Ms. York said the budget was to the good in the
amount of $10,196.
Commissioners Jeffers suggested appropriating an additional $15,000 to
Timberlake Volunteer Fire Department, an additional $3,500 to Triple Springs Volunteer
Fire Department, and an additional $1,500 to Semora Volunteer Fire Department using the
budget surplus funds of $10,196 and $9,804 from undesignated contingency. The
undesignated contingency was budgeted at $50,000 and this appropriation would leave
$40,196.
Ms. York noted taking Timberlake Volunteer Fire Department over $50,000 in their
appropriation would change their grant funding match criteria from a 3-to-1 to a 50/50.
Chairman Newell and Commissioner Jeffers stated Timberlake Volunteer Fire Department
was in great need for the additional funding.
57
June 7, 2016
9
A motion was made by Chairman Newell and carried 5-0 to appropriate an
additional $15,000 to Timberlake Volunteer Fire Department, an additional $3,500 to
Triple Springs Volunteer Fire Department, and an additional $1,500 to Semora Volunteer
Fire Department using the budget surplus funds of $10,196 and $9,804 from undesignated
contingency as well as reduce the appropriation from $600,000 to $500,000 for the Vehicle
Fund with the surplus to be added to undesignated contingency.
A motion was made by Commissioner Jeffers and carried 5-0 to direct staff to
bring the Board at its next meeting a Fiscal Year 2016-2017 Budget Ordinance reflecting
all changes for a balanced budget.
The running list of budget adjustments discussed at the work session are as follows:
58
June 7, 2016
10
ADJOURNMENT:
A motion was made by Commissioner Jeffers and carried 5-0 to adjourn the
meeting at 12:46pm.
_____________________________ ______________________________
Brenda B. Reaves David Newell, Sr.
Clerk to the Board Chairman
(Draft Board minutes are subject to Board approval).
59
June 20, 2016
1
PERSON COUNTY BOARD OF COMMISSIONERS JUNE 20, 2016
MEMBERS PRESENT OTHERS PRESENT
David Newell, Sr. Heidi York, County Manager
Tracey L. Kendrick C. Ronald Aycock, County Attorney
Jimmy B. Clayton Brenda B. Reaves, Clerk to the Board
Kyle W. Puryear
B. Ray Jeffers
The Board of Commissioners for the County of Person, North Carolina, met in
regular session on Monday, June 20, 2016 at 9:00am in the Commissioners’ meeting room
in the Person County Office Building.
Chairman Newell called the meeting to order. Commissioner Clayton gave an
invocation and Vice Chairman Kendrick led the group in the Pledge of Allegiance.
DISCUSSION/ADJUSTMENT/APPROVAL OF AGENDA:
Chairman Newell requested to add a Closed Session to discuss potential acquisition
of property to the agenda as well as announced that the EMS Operational Medical Director
Contract item should be removed from the agenda.
A motion was made by Commissioner Jeffers and carried 5-0 to add a Closed
Session to discuss the acquisition of property to the agenda, to remove the item for the
EMS Operational Medical Director Contract from the agenda and to approve the agenda
as adjusted.
INFORMAL COMMENTS:
The following individual appeared before the Board to make informal comments:
Mr. John Hill, Director of the Recreation, Arts and Parks Department of 425 Long
Avenue, Roxboro announced that the Little League All Stars would have Person County
representatives in the upcoming weeks. Mr. Hill stated the youth boys, ages 7-8, 9-10 and
11-12 would be traveling to Wilson, NC and youth girls will be traveling to Wilmington,
NC for the Little League All Stars tournaments.
60
June 20, 2016
2
DISCUSSION/ADJUSTMENT/APPROVAL OF CONSENT AGENDA:
A motion was made by Vice Chairman Kendrick and carried 5-0 to approve the
Consent Agenda with the following items:
A. Approval of Minutes of May 23, 2016,
B. Approval of Minutes of June 6, 2016,
C. Budget Amendment #20,
D. Timberlake Firefighters’ Relief Fund Board of Trustees Appointments,
E. United Way Grant for FY2016-2017 Sherriff’s G.R.E.A.T. Summer Camp,
F. Renewal of Joint Use Agreements between Person County and the Board of
Education,
G. Tax Adjustments for the month of June 2016
a. Tax Releases, and
b. NC Vehicle Tax System pending refunds
NEW BUSINESS:
SENIOR CENTER DESIGN DEVELOPMENT UPDATE:
County Manager, Heidi York asked Ms. Kristen Hess, of HH Architecture, to give
the Board an update on the progress of the design development for the Senior Center. Ms.
Hess reported the results of the Geotechnical Exploration that had been completed for the
site, provided updated drawings and a floor plan of the Senior Center and the Public Park,
spoke to the second public input meeting that was conducted on May 11th as well as
addressed the discussion held with the Roxboro City Council on May 10th.
Ms. Hess noted that after receiving results from the Geotechnical Exploration
Reports, significant changes were required to the structural and civil engineering design to
address the poor soil conditions located on the site. She said the natural soils under the
location of the existing building are suitable for handling the loads of the new fill and new
building. However, the soils in the area of the site that are currently open are comprised
of unsuitable fill to handle new building loads. Additional work will need to be done in
order for the ground to be able to handle the new loads and to prevent differential settlement
between the two areas of the new building. Ms. Hess stated their structural engineer
proposed the use of aggregate piers to stabilize the soil. This system consists of drilling
holes in the unsuitable soil and filling them with stone using vibration to compact the
stone. After the piers are in place, a typical foundation system can be used. After
performing a cost analysis with the project structural engineer and civil engineer, Ms. Hess
determined this was a more cost effective option than excavating the unsuitable soil and
replacing with the proper fill. It is also more suitable to the conditions of the site since the
building is close to the property lines, making excavation difficult. Ms. Hess noted these
changes have had an impact on the cost of the facility, which was reflected in the estimate.
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Ms. Hess reviewed the updated design development estimate which included any
items that may be considered optional as alternates for the project.
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Chairman Newell expressed his concerns about increasing costs to the Senior
Center project at the Depot Street site and inquired about the feasibility of alternative sites.
Ms. Hess noted her willingness to assist in evaluating alternative sites for the design
development should the County have sites to be evaluated.
Commissioner Jeffers asked Ms. Hess to recap her discussion with the Roxboro
City Council. Ms. Hess stated the city officials had no issues with the design however
stated preferences with three areas: a) the border wall located between the parking lot and
the facility was to stay intact and may be improved upon at all the cost to the County; City
officials expressed interest in having the historical wall commemorated with a plaque; b)
the parking spaces that face the building that are proposed to be sloped to avoid having
steps at the entrance of the facility may be altered with the understanding that all costs and
future maintenance of said parking spaces will become the responsibility of the County;
and, c) the City requested to review updated drawings on the effect of the proposed covered
canopy concept; once the drawings are complete, Ms. Hess stated they will be submitted
to the City officials.
A motion was made and amended by Vice Chairman Kendrick and carried 5-0 to
table moving forward with the Senior Center project until such time the Board can review
options before an additional appropriation was made for the soil remediation, and to direct
the County Manager to form an evaluation team to review other site options within a three
month timeframe. Commissioner Jeffers volunteered to serve on the evaluation team
noting that Chairman Newell and Senior Center representative, Maynell Harper should also
be included.
PERSON COUNTY JUVENILE CRIME PREVENTION COUNCIL FUNDING
RECOMMENDATIONS FOR FISCAL YEAR 2016-2017:
Juvenile Crime Prevention Council (JCPC) Chairman, John Hill told the Board that
each year, funding was made available through the North Carolina Department of Public
Safety/Division of Juvenile Justice to Person County and its JCPC to be utilized to address
the needs of youth at-risk for delinquency as well as adjudicated undisciplined and
delinquent youth in Person County. The funding comes in the form of a county allocation.
All 100 counties in the State of North Carolina are allocated funds based on the population
of youth in the county between the ages of 10 and 17. Person County will receive $123,213
in its allocation from the North Carolina Department of Juvenile Justice and Delinquency
Prevention in Fiscal Year 2017.
Annually, the JCPC Board conducts a planning process, which includes an array of
legislated tasks: a review of the community risk factors and the risk levels of youth in the
community; an assessment of the needs of the target populations; a review of the service
resources available to address those needs; the identification of service gaps; and the
strategic development of a plan to structure a seamless continuum of service programming
to address the target population needs. As part of the development of the needed services
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identified in the continuum, there is a Request for Proposal (RFP) process that is completed
by the JCPC Board. Non-profits and government entities may apply for the opportunity to
provide services per the guidelines of the RFP. The JCPC Board reviews all requests and
awards are made to service providers to address service needs identified by the JCPC
Board. The JCPC Board makes its recommendation of expenditures of the allocation and
presents its written annual planning documents to the Person County Board of County
Commissioners for its approval. The JCPC Board performs this function as an extension
of the Board of County Commissioners in its fulfillment of the legislated duties imposed
upon them through general statute.
Additionally, on an on-going basis, the JCPC evaluates the performance of its
funded programs by annually monitoring each program through on-site visits and also
monthly through program reporting at the local, monthly JCPC meetings. The JCPC is also
charged with the tasks of increasing public awareness of the causes of delinquency,
addressing strategies to intervene and appropriately responding to and treating the needs of
juveniles while at the same time reducing juvenile recidivism. The JCPC stands ready to
respond to the changing needs of youth and service delivery in the community.
Mr. Hill stated the Person County Juvenile Crime Prevention Council met on March
9, 2016 and voted to approve the DJJ allocation to be distributed in the following manner
for the 2016-2017 fiscal year.
Program DJJ Funds County Cash Requested
4-H YES Community Service $ 45,417 $16,510
Roots & Wings Interpersonal Skills 28,525 2,852
Roots & Wings Teen Court 20,500 2,050
Root & Wings Parenting Program 12,000 0
Person County Learning Academy 10,656 2,131
Administrative Fund 6,115 0
Unallocated to go to program _____0 _____0
Total $123,213 $23,543
A motion was made by Commissioner Puryear and carried 5-0 to approve the
Juvenile Crime Prevention Council funding recommendation for Fiscal Year 2016-2017 as
presented.
FISCAL YEAR 2016-2017 BUDGET ORDINANCE:
County Manager, Heidi York and Finance Director, Amy Wehrenberg presented
the Fiscal Year 2016-2017 Budget Ordinance for adoption by the Board. Ms. York stated
General Statute 159-13(a) directs that the annual budget must be adopted by July 1. The
budget ordinance may be adopted at any regular or special meeting at which a quorum is
present, by a majority of those present and voting having fulfilled the legal requirements
including the conducting of a public hearing. The Budget Ordinance outlined the total
General Fund Appropriations of $59,497,684.
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A motion was made by Commissioner Jeffers and carried 5-0 to adopt the Fiscal
Year 2016-2017 Budget Ordinance as presented.
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MT. TIRZAH TOWER EXEMPTION:
Assistant County Manager, Sybil Tate stated the State of NC has agreed to construct
a tower at Mt. Tirzah in order to improve public safety communication for the State and
the County. Previously, the State required counties to exempt the State from local tower
construction regulations and fees, and as a result, Person County included an exemption
for the State in the Cell Tower Ordinance. However, since the last tower was constructed,
the State has repealed their requirement for counties to exempt the State and the County
has repealed its Cell Tower Ordinance.
Ms. Tate presented the State’s request for an exemption from the Planning
Department’s $5,000 cell tower construction fee noting the State would still comply with
Planning and Zoning regulations and pay the $50 permitting fee.
Commissioner Clayton suggested staff to review the Planning Department’s fee of
$5,000 to ensure it was comparable to other counties and a reasonable fee for the services
provided.
A motion was made by Commissioner Puryear and carried 5-0 to exempt the State
of NC from the Planning Department’s cell tower construction fee.
DESIGNATE NACO VOTING DELEGATE FOR THE 2016 ANNUAL
CONFERENCE:
Voting Credentials for the 2016 Annual Conference to be held July 22-25, 2016, in
Los Angeles, CA, must be submitted by July 1, 2016 in order for Person County’s delegate
to participate in the association’s annual election of officers and policy adoption.
Chairman Newell asked the Board to designate Commissioner Clayton or
Commissioner Jeffers as Person County’s delegate with the other designated as the
alternate.
A motion was made by Commissioner Clayton and carried 5-0 to designate
Commissioner Jeffers as Person County’s voting delegate for the 2016 NACo Annual
Conference. By acclamation Commissioner Clayton will serve as the alternate.
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APPOINTMENTS TO BOARDS AND COMMITTEES:
Clerk to the Board, Brenda Reaves requested Board nomination for appointment as
deemed appropriate to the following boards and committees. The Person County Board of
Commissioners solicited volunteers to fill positions on the following boards, commissions,
authorities, and committees through advertisement in the Courier-Times edition dated May
14, 2016 with notice to submit applications by the deadline on June 7, 2016. The
highlighted boards denote a competitive board and are eligible for the informal interview
process should the Board desire this process to aid them in making appointments. Should
the Board be interested in holding the informal interview process for some or all the
competitive boards, please direct the Clerk to organize and inform the applicants of the
informal interview date as set by the Board.
Ms. Reaves presented interested citizen applications for consideration for
appointments. The Board of Commissioners are encouraged to recruit citizens to fill the
current vacancies for those which no applications have been received.
Adult Care Home Community Advisory Committee
1-Year Initial Term; 3-Year Reappointment: 3 positions available
1) Cornelia Jay requested reappointment
Board of Adjustment
3-Year Term: 2 positons and 1 position for an alternate for an unspecified term
1) Felicia Swann requested reappointment
Board of Health
3-Year Term:
1 position for a dentist; 1) Dr. Jeffrey Noblett requested reappointment
1 position from the general public; 1) Dr. Stephen D. Saunders requested reappointment
Environmental Issues Advisory Committee
3-Year Term; 1 position available on each of the following County’s townships
Allensville Township: 1) Jason Torian requested reappointment
Bushy Fork: 1) no application(s)
Cunningham: 1) no application(s)
Flat River: 1) no application(s)
Home Health and Hospice Advisory Committee
3-Year Term: 1 position for a nurse
1) Janine Wall requested reappointment
Industrial Facilities and Pollution Control Financing Authority
6-Year Term: 2 positions available – no application(s)
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Juvenile Crime Prevention Council
1-Year Initial Term: 2-Year Reappointment
1 position for a substance abuse professional: no application(s),
1 position for a person under the age of 21: no applications(s),
1 position for a representative of United Way: 1) Kelly Foti requested reappointment
2-Year Term:
1 position for a Juvenile Defense Attorney: no application(s),
1 position for a representative or person affiliated with Mental Health: no application(s),
1 position for a citizen-at-large: 1) Margaret Bradsher requested reappointment
Kerr Tar Regional Council of Government Board
2 positions as well as 2 alternates for citizens-at-large with an affiliation to represent the
private sector business, minority or the retired community for an unspecified term.
1) Kenneth Perry requested appointment
Nursing Home Advisory Committee
1-Year Initial Term: 3-Year Reappointment; 2 positions available: no application(s)
Person Area Transportation System Board
3-Year Term:
1 position available for a representative of private industry: no application(s),
1 position available for a representative of economic development: no application(s), and
1 position available for a citizen at-large: no application(s)
Person-Caswell Lake Authority
3-Year Term: 1 position available
1) Lindsay “Tommy” Wagstaff, Jr., requested reappointment
Planning Board
3-Year Term: 2 positions available
1) Derrick Smith requested appointment
2) W. Barry Walker requested reappointment
Recreation Advisory Board
3-Year Term: 2 positions available
1) Donald Long requested reappointment
2) Arnold Ashley requested reappointment
Voluntary Agriculture District Board
3-Year Term: 1 position available on each of the following County’s townships
Allensville Township: 1) Kenny Griffin requested reappointment
Olive Hill Township: 1) Bruce Whitfield requested reappointment
Roxboro Township: 1) Arch (Chip) Stone III requested reappointment
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Workforce Development Board
1-Year Initial Term; 2-Year Reappointment
3 positions available representing business,
1) Nikki Ward requested reappointment
2) Derrick Sims requested reappointment
3) Eva McDougal requests reappointment
1 position available representing higher education
1) Dr. Walter Bartlett requested reappointment
1 position available representing adult education: no application(s),
1 position available for a representative of a registered apprenticeship program: no
application(s), and
1 position available for a member or an officer of organized labor: no application(s)
A motion was made by Vice Chairman Kendrick and carried 5-0 to reappoint
Cornelia Jay to the Adult Care Home Community Advisory Committee for a 3-year term;
to reappoint Felicia Swann to the Board of Adjustment for a 3-year term; to reappoint Dr.
Jeffrey Noblett (dentist representative) and Dr. Stephen D. Saunders (general public
representative) to the Board of Health, both for a 3-year term; to reappoint Jason Torian to
the Environmental Issues Advisory Committee for a 3-year term; to reappoint Janine Wall
(nurse representative) to the Home Health and Hospice Advisory Committee for a 3-year
term; to reappoint Kelly Foti (United Way representative) and Margaret Bradsher (citizen
representative) to the Juvenile Crime Prevention Council, each for a 2-year term; to appoint
Kenneth Perry to the Kerr Tar Regional Council of Government Board; to reappoint
Lindsay “Tommy” Wagstaff, Jr. to the Person-Caswell Lake Authority for a 3-year term;
to appoint Derrick Smith and reappoint W. Barry Walker to the Planning Board, both for a
2-year term; to reappoint Donald Long and Arnold Ashley to the Recreation Advisory
Board, both for a 3-year term; to reappoint Kenny Griffin (Allensville Township
representative), Bruce Whitfield (Olive Hill Township representative) and Arch “Chip”
Stone, III (Roxboro Township representative) to the Voluntary Agriculture District Board,
each for a 3-year term; to reappoint business representatives Nicki Ward, Derrick Sims and
Eva McDougal as well as higher education representative, Dr. Walter Bartlett to the
Workforce Development Board.
Library Advisory Board
3-Year Term: 1 position available
1) Anne Gibson requested appointment
2) Ernest Avery requested appointment
3) Gean Gentry requested appointment
A motion was made by Commissioner Jeffers and carried 5-0 to appoint Anne
Gibson to the Library Advisory Board for a 3-year term.
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It was the consensus of the Board to schedule and hold informal interviews with
the applicants of the ABC Board, the Piedmont Community College Board of Trustees and
the Social Services Board starting at 6:00pm on August 1, 2016 and directed the Clerk to
the Board to inform all applicants listed below.
ABC Board
3-Year Term: 1 position available
1) Garland Graves, Jr. requested appointment
2) Michael Laws requested reappointment
3) Norman Carden requested appointment
Piedmont Community College Board of Trustees
4-Year Term: 1 position available
1) Bayard Crumpton requested reappointment
2) Jason Torian requested appointment
Social Services Board
3-Year Term: 1 position available
1) Treco Lea-Jeffers requested appointment
2) Elbert Franklin Dickens requested appointment
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911 CAD PRODUCT PROCUREMENT PUBLIC NOTICE:
Emergency Services Director, Doug Young stated the Department of Emergency
Services was looking into replacing its current 911 Computer Aided Dispatch (CAD)
system. The current CAD system has been in place since 1996. With improvements to
911 technology over the years, additional feature functionalities are needed to better serve
our residents. In order to receive better savings for the purchase of the system, Mr. Young
requested Board consideration for a piggy back procurement method be allowed to acquire
the 911 CAD system. Mr. Young noted the NC 911 Board has approved the 911 CAD
system to be fully funded with State 911 funds.
County Attorney, Ron Aycock told the Board that NC law authorizes Counties to
"piggyback" onto other public contracts including out of state contracts so long as that
state's purchasing laws are substantially equivalent to the NC laws and the contract is no
more than one year old. Mr. Aycock noted the Johnson County, Missouri contract with the
vendor, SunGard, was entered into on July 23, 2015 and that the Missouri law was
substantially equivalent to the NC law related to procurement rules. Mr. Aycock stated
that Person County qualified under the state law to piggyback once a public announcement
was authorized to advertise the 911 CAD piggyback procurement.
A motion was made by Commissioner Clayton and carried 5-0 to authorize the
advertisement of the 911 Computer Aided Dispatch System Piggyback Procurement
Notice.
CALL FOR PUBLIC HEARING TO AMEND PERSON COUNTY’S
AMBULANCE FRANCHISE ORDINANCE:
Emergency Services Director, Doug Young noted that the previously franchised
ambulance provider, Wilson Ambulance Services, was no longer providing Ambulance
Services in Person County. Mr. Young stated that before the County franchises another
operator(s), it is desirable to update the statutory and technical references in the County’s
Ambulance Franchise Ordinance. Mr. Young said that the proposed amendment to the
ordinance provided for franchising one or more operators to insure efficient and effective
service as well as a modicum of competition.
The state law requires a notice of intent to adopt, amend or repeal of an ordinance
be published in two successive weeks in a local newspaper and that a public hearing be
held prior to such adoption. Mr. Young requested Board consideration to authorize the
publication of the public hearing notice for a public hearing to be held on July 18, 2016 at
9:00am reflecting intent to amend Person County’s Ambulance Franchise Ordinance.
A motion was made by Vice Chairman Kendrick and carried 5-0 to call for a
Public Hearing for a proposed amendment to Person County’s Ambulance Franchise
Ordinance at the Board’s July 18, 2016 meeting at 9:00am and to authorize publication of
the public hearing notice.
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CHAIRMAN’S REPORT:
Chairman Newell directed the County Manager to expedite review process for the
Senior Center alternate site options.
MANAGER’S REPORT:
County Manager, Heidi York offered the Board the opportunity to attend an
Economic Development course on June 28, 2016 at the Vance-Granville Community
College Civic Center.
COMMISSIONER REPORT/COMMENTS:
Commissioner Clayton reported that he and Vice Chairman Kendrick met with a
group from the NC State Agency of Department Environment Quality (DEQ) and
discussed topics related to storm water regulations and Falls Lake rules. Commissioner
Clayton stated the requested change for the threshold from ½ acre to 1 acre of disturbed
property to trigger storm water planning was supported by the DEQ however the decision
will be made by the General Assembly. Commissioner Clayton noted he also attended an
Upper Neuse River Basin Association meeting noting sampling was being continued.
Commissioner Clayton further noted that he saw the Secretary of Commerce and discussed
Person County assets for potential economic projects.
Vice Chairman Kendrick encouraged the group to contact Person County
legislators related to the undue burden with restrictions created with the mandated rules.
Commissioner Puryear reported his attendance to the 100th year celebration of the
business of the S.P. Gentry family as well as an event honoring Donald and Becky Wilson
with a named scholarship and the honor of Mr. Wilson receiving the Long Leaf Pine award
presented by Representative Larry Yarborough.
Commissioner Jeffers inquired about the effect of the proposed legislation
prohibiting internet equipment on towers to which the Assistant County Manager, Sybil
Tate, stated the legislation was not yet introduced noting staff were prepared with
comments and edits.
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CLOSED SESSION #1
A motion was made by Vice Chairman Kendrick and carried 5-0 to enter Closed
Session per General Statute 143-318.11(a)(6) at 9:57am for the purpose to discuss
personnel with the following individuals permitted to attend: County Manager, Heidi York
and Clerk to the Board, Brenda Reaves.
CLOSED SESSION #2
A motion was made by Commissioner Puryear and carried 5-0 to enter Closed
Session per General Statute 143-318.11(a)(5) at 9:57am for the purpose to consider the
acquisition or lease of real property with the following individuals permitted to attend:
County Manager, Heidi York, Clerk to the Board, Brenda Reaves, County Attorney, Ron
Aycock, Economic Development Director, Stuart Gilbert, and Summer Intern, Ellis
Johnson.
Chairman Newell called the Closed Sessions to order at 10:00am.
A motion was made by Vice Chairman Kendrick and carried 5-0 to return to open
session at 10:22am.
A motion was made by Chairman Newell and carried 5-0 to increase the County
Manager’s salary for a merit increase of 3% for her annual evaluation.
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ADJOURNMENT:
A motion was made by Vice Chairman Kendrick and carried 5-0 to adjourn the
meeting at 10:22am.
_____________________________ ______________________________
Brenda B. Reaves David Newell, Sr.
Clerk to the Board Chairman
(Draft Board minutes are subject to Board approval).
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7/18/2016
Dept./Acct No.Department Name Amount
Incr / (Decr)
EXPENDITURES Economic Catalyst Fund 58,000
REVENUES Economic Catalyst Fund
Intergovernmental Revenues 58,000
Explanation:
BUDGET AMENDMENT
Receipt of NC Rural Center pass through funds for GKN ($58,000)
BA 180
Dept./Acct No.Department Name Amount
Incr / (Decr)
EXPENDITURES CIP Project Fund
County Projects 523,763
PCC Projects 189,000
School Projects 838,925
Non-Profit Agencies Projects 41,842
Transfer to Other Funds 230,329
REVENUES CIP Project Fund
Interest Earnings 1,600
Transfer from General Fund 2,047,259
Fund Balance Appropriation (225,000)
Explanation:
Account Number Account Description
$Revenues
incr. (decr.)
(cr.) dr.
$Expenditures
incr. (decr.)
dr. (cr.)
41020-381491 Interest Earnings 1,600
41070-398010 Transfer from General Fund (old projects) (91,683)
41070-398010 Transfer from General Fund (new projects) 2,138,942
41090-399991 Fund Balance Appropriation (old projects) (300,000)
41090-399991 Fund Balance Appropriation (new projects) 75,000
Old Projects
4104260-559800 Multi-Jurisdictional Industrial Park (172,000)
4104260-559900 County Telephone System (90,000)
4104260-599900 Future CIP Projects (8,412)
4109821-401013 Transfer to Debt Service Fund (119,671)
New Projects
4104260-599900 Future CIP Projects 10,000
4104260-558000 New Roof-Gen Svcs Maint Bldg 35,537
4104260-558100 New Roof-Library 72,986
4104260-558200 New Roof-Allensville, Helena, HM, Longhurst, Mayo Park 114,582
4104260-558300 New Roof-Airport Terminal 40,770
4109821-401044 Transfer to Public Safety Tower & Broadband Project 100,000
4104260-558400 Animal Svcs-Resurface Floors 62,800
4104260-558500 Animal Svcs-Install A/C 82,500
4104260-558600 Tax Office-Appraisal/Collection Software 375,000
4105921-580000 PCC-Upgrade Campus HVAC Systems 72,000
4105921-580100 PCC-Emergency Communication System 117,000
4105911-570000 Schools-Repave Bus Lot-SMS 90,000
4105911-570100 Schools-ADA Upgrades-Oak Lane Elem 75,000
4105911-570200 Schools-ADA Upgrades-North Elem 150,000
4105911-570300 Schools-Chiller Replacement-PHS 300,000
4105911-570400 Schools-New Roof-North Elem 223,925
4106140-570000 Museum-New Roof-Long House & Medical Office 41,842
4109821-401046 Transfer to Senior Center Project-Contingency 250,000
Totals 1,823,859 1,823,859
BUDGET AMENDMENT
Upon a majority vote, the Board of Commissioners of Person County approved the CIP for FY 2016-17 on April 18,
2016.
The fund balance appropriation from the General Fund was approved as part of the 2016-2017 Adopted Budget.
The transactions below are the approved budget amounts for the new project revenues and expenditures in the CIP
Project Fund, as well as the closeout of completed projects. These were not budgeted during FY 2016 since they
did not take effect until July 1, 2016.
BUDGET ADJUSTMENT
BA-CIP81
AGENDA ABSTRACT
Meeting Date: July 18, 2016
Agenda Title: EMS Operational Medical Director Contract
Summary of Information: The County currently has a contract with Dr. Dan Phillips, MD as
the County’s EMS Operational Medical Director (OMD) as required by North Carolina Office of
EMS regulations. Dr. Phillip’s contract ends July 31, 2016 and he has notified our Emergency
Services Director that he is not able to continue being the County’s OMD but remain in a
supportive role.
Dr. Kimberly Yarborough, MD, a Person County resident has agreed to be the County’s OMD
for our EMS system as mentioned in the attached 2 year Contract.
Recommended Action: It is the staff’s recommendation to approve the Contract.
Submitted By: Douglas Young, Emergency Services Director
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NORTH CAROLINA)
PERSON COUNTY)
AGREEMENT
THIS AGREEMENT is made and entered into this 1st day of August, 2016, by and between Person
County, North Carolina ("The EMS System"), HEREINAFTER REFERED TO AS “EMS SYSTEM”
and Kimberly Yarborough, MD Medical Director HEREINAFTER REFERED TO AS “MD”. This
agreement supersedes all previous agreements BETWEEN the parties.
WITNESSETH
For the purpose and subject to the terms and conditions hereinafter set forth, The EMS System hereby
contracts with MD for the services to The EMS System in accordance with the terms of this Agreement.
I.
The services to be performed by MD shall be as follows:
1. Training and instructional courses for ambulance and emergency medical personnel of
The EMS System.
2. Medical advice to ambulance and emergency personnel of The EMS System.
3. Perform the duties and responsibilities listed for a Medical Director as enumerated in
the title 10- Department of Health and Human Resources, Chapter 3 Facility Services, Sub-
Chapter 13P Office of Emergency Medical Services regulations Section .0400 Medical
Oversight.
II.
The services of MD shall begin on August 1, 2016 and shall be provided until June 30, 2018; provided
that either party shall have the right to terminate this Agreement for services upon-thirty (30) days-
notice in writing to the other party. At the end of the first term, the Agreement shall be automatically
renewed for additional one- year term (s) unless either party provides thirty {30) days prior written
notice to terminate. In the event that the Agreement is terminated, all payment amounts for each year
shall be prorated based upon the length of service in the fiscal year.
III.
As full compensation for MD's services the EMS System agrees to pay the Medical Director the sum of
$15,000 annually. The EMS System also agrees to pay for travel to one Medical Director’s workshop per year
as mandated by North Carolina Office of Emergency Medical Services and mileage incurred for travel when
performing medical director duties.
Medical Direction services will be provided by the qualified personnel, MD, as directed by North Carolina
Office of Emergency Medical Services.
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The EMS SYSTEM will provide...
• Payment of $15,000.00 per year for the Medical Director (in monthly installments)
and reimbursement for travel via personally owned vehicle at the standard county
rate for activities related to medical director related duties.
• Necessary patient care and system performance information and administrative
support to perform the medical director oversight duties as specified in this
agreement and NC Law. ·
• Personal protective gear and communications equipment (e.g. radio) to allow
field response and communication with The EMS System in the field.
IV.
MD shall bill the EMS System for services rendered during the preceding thirty (30) days. The EMS
System shall pay all such bills within the following ten (10) days.
MD shall operate as an independent contractor. Each party the to the extent permitted by law,
agrees to hold the other harmless from and against any and all third party claims, expenses
(including attorney fees), co st or liability for the negligent acts or omissions of the other party, its
employees, and officers and agents.
MD shall not be treated as an employee of The EMS System with respect to the services performed
hereunder. The EMS System shall not be responsible for federal or state tax withholding or
unemployment or worker's compensation coverage. MD is fully responsible for the payment of any and
all taxes arising from the payment of monies under this agreement.
MD shall not be treated as an employee of The EMS System with respect to the services performed
hereunder for purposes of eligibility for, or participation in, and employee pension, health, or
other fringe benefit plan of the EMS System
The EMS System shall not be liable to MD for any expenses paid or incurred unless otherwise
agreed in writing.
The EMS System will maintain, at its sole expense general and professional liability insurance coverage
against suits and claims arising out o f the acts or omissions of The EMS System, its employees, officers
and agents. This insurance coverage shall have limits of not less than $1,000,000 per claim, $3,000,000
in the aggregate. The EMS System will notify MD immediately of any adverse change in insurance
coverage.
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A. Professional Liability Insurance: MD shall maintain professional malpractice liability insurance
coverage against lawsuits and claims arising out of the acts or omissions. This insurance coverage shall
have limits of not less than $1,000,000 per claim. The EMS System agrees to provide the MD an amount
of not to exceed $5000.00 per anum as a contribution towards her malpractice liability insurance.
B. Other Insurance Requirements: MD shall:
1. Prior to commencement of services, furnish The EMS System with properly executed
certificates of insurance which shall clearly evidence all insurance required in this section and
provide that such insurance shall not be cancelled, allowed to expire, or be materially reduced
in coverage except on thirty (30) days prior written notice to The EMS System
2. Provide certified copies of endorsements and policies, if requested by The EMS System,
in lieu of or in addition to certificates of insurance.
3. Replace certificates, policies, and endorsements for any such insurance expiring prior to
completion of the services.
4. Maintain such ·insurance from the time services commence until services are completed.
5. Place such insurance with insurers authorized to do business in North Carolina and
having A.M. Best Company ratings of not less than A: VII or an equivalent program of
self-insurance. Any alternatives to these requirements shall require written approval of
The EMS System's Risk Manager.
85
MD cannot execute authority to enter into contracts or agreements on behalf of The EMS
System.
MD declares that it has complied with all federal, state and local laws regarding business permits,
certificates and licenses they may be required to carry out the services to be performed under this
agreement.
This Agreement is governed by the laws of North Carolina.
IN WITNESS WHEREOF, The EMS System and MD have set their hands and seals as of the day and
year first written above.
EMS SYSTEM
PERSON COUNTY, NORTH CAROLINA
By: ________________________________
David Newell, Chairman
Board of Commissioners
Attest
_________________________
Brenda B. Reaves
Clerk to the Board
(SEAL) By: ___________________________________ Kimberly Yarborough, MD
86
AGENDA ABSTRACT
Meeting Date: July 18, 2016
Agenda Title: Consideration to change the Board of Commissioners regular scheduled
meeting time of the September 6, 2016 from 7:00pm to 9:00am
Summary of Information:
I request Board consideration to change the time of the Board’s September 6, 2016 regular
scheduled to be changed from 7:00pm to be held at 9:00am.
Recommended Action:
A motion by the Board to change the meeting time of the Board of Commissioners’ September 6,
2016 meeting to be held at 9:00am in their usual meeting room 215.
Submitted By: Commissioner Kyle Puryear
87
AGENDA ABSTRACT
Meeting Date: July 18, 2016
Agenda Title: Request for temporary road closure - Glenn Fogleman Road
Summary of Information: In November of this year, PC PRIDE plans to hold the second annual
Earthtastic 5K race. Last year’s event, held in Uptown Roxboro, focused primarily on raising
awareness about recycling in Person County. The focus of this year’s event will be raising funds for
the newly formed Environmental Club at Helena Elementary School. The group would like to hold
this year’s event in Timberlake on Glen Fogleman Road. The NCDOT requires “written
acknowledgement and approval by all local governments whose jurisdiction the event is being held
in,” in order to proceed.
Recommended Action: Written approval of the temporary closure of Glenn Fogleman Road from
8:00 a.m. until 10:00 a.m. on November 12, 2016.
Submitted By: Jason Torian, PC PRIDE
88
AGENDA ABSTRACT
Meeting Date: July 18, 2016
Agenda Title: Funding Allocation Correction for Person County JCPC for FY2016-2017
Summary of Information:
Due to the funding allocation grid having an inadvertent mistake, I’m resubmitting the request with
the corrected fund distribution. The correction reflects that according to the program agreement
there is NO Person County funding match to the Person County Learning Academy program. The
correction also reflects that the consultant has consolidated all “Roots and Wings” program
components. There are no changes to the funding allocation to the Roots and Wings program. This
correction has been confirmed by the NC Department of Correction / Division of Juvenile Justice
Consultant. Funding allocation history below:
Each year, funding is made available through the North Carolina Department of Public Safety / Division
of Juvenile Justice to Person County and its Juvenile Crime Prevention Council (JCPC) to be utilized to
address the needs of youth at-risk for delinquency as well as adjudicated undisciplined and delinquent
youth in Person County. The funding comes in the form of a county allocation. All 100 counties in the
State of North Carolina are allocated funds based on the population of youth in the county between the
ages of 10 and 17. Person County will receive $123,213 in its allocation from the North Carolina
Department of Juvenile Justice and Delinquency Prevention in FY17.
Annually, the JCPC Board conducts a planning process, which includes an array of legislated tasks: a
review of the community risk factors and the risk levels of youth in the community; an assessment of the
needs of the target populations; a review of the service resources available to address those needs; the
identification of service gaps; and the strategic development of a plan to structure a seamless continuum
of service programming to address the target population needs. As part of the development of the needed
services identified in the continuum, there is a Request for Proposal (RFP) process that is completed by
the JCPC Board. Non-profits and government entities may apply for the opportunity to provide services
per the guidelines of the RFP. The JCPC Board reviews all requests and awards are made to service
providers to address service needs identified by the JCPC Board. The JCPC Board makes its
recommendation of expenditures of the allocation and presents its written annual planning documents to
the Person County Board of County Commissioners for its approval. The JCPC Board performs this
function as an extension of the Board of County Commissioners in its fulfillment of the legislated duties
imposed upon them through general statute.
Additionally, on an on-going basis, the JCPC evaluates the performance of its funded programs by
annually monitoring each program through on-site visits and also monthly through program reporting at
the local, monthly JCPC meetings. The JCPC is also charged with the tasks of increasing public
awareness of the causes of delinquency, addressing strategies to intervene and appropriately responding to
and treating the needs of juveniles while at the same time reducing juvenile recidivism. The JCPC stands
ready to respond to the changing needs of youth and service delivery in the community.
Recommended Action:
The Person County Juvenile Crime Prevention Council met on March 9, 2016 and voted to approve the
DJJ allocation to be distributed in the following manner for the 2016-2017 fiscal year.
89
2014-2015 Recommendation from Person County JCPC Council
Program DJJDP Funds County Cash Requested
4-H YES $ 90,000 $23,307
Roots & Wings Parenting Program 12,000 0
Roots & Wings Mentoring Program 8,000 0
G.R.E.A.T. Program (Sheriff’s Dept) 0 0
Central Children’s Home 0 0
Administrative Fund 13,213 0
Total $123,213 $23,307
2015-2016 Recommendation from Person County JCPC Council
Program DJJDP Funds County Cash Requested
4-H YES $ 91,764 $23,543
Roots & Wings Parenting Program 12,000 0
Roots & Wings Mentoring Program 11,000 0
Administrative Fund 5,500 0
Unallocated to go to programs 2,949 0
Total $123,213 $23,543
(Previously Submitted) 2016-2017 Recommendation from Person County JCPC Council
Program DJJDP Funds County Cash Requested
4-H YES Community Service $ 45,417 $16,510
Roots & Wings Interpersonal Skills 28,525 2,852
Roots & Wings Teen Court 20,500 2,050
Root & Wings Parenting Program 12,000 0
Person County Learning Academy 10,656 2,131
Administrative Fund 6,115 0
Unallocated to go to program _____0 _____0
Total $123,213 $23,543
(Corrected Allocation) 2016-2017 Recommendation from Person County JCPC Council
Program DJJDP Funds County Cash Requested
4-H YES Community Service $ 45,417 $18,641
Roots & Wings Interpersonal Skills,
Teen Court, Parenting Program 61,025 4,902
Person County Learning Academy 10,656 0
Administrative Fund 6,115 0
Unallocated to go to program _____0 _____0
Total $123,213 $23,543
Submitted By: John Hill, JCPC member representative and former JCPC Chairperson
90
$41,557 Rate:20%
OTHER OTHER
# Program Provider DPS-JCPC
Funding
County Cash
Match
Local Cash
Match
Local In-
Kind
State/
Federal
Funds Total
% Non
DPS-JCPC
Program
Revenues
1
Person County 4H YES Program - Community
Service and Restitution $45,417 $18,641 $2,600 $66,658 32%
2
Roots and Wings - Interpersonnal Skill Building,
Teen Court, and Parenting $61,025 $4,902 $7,303 $73,230 17%
3 Person County Learning Academy $10,656 $8,111 $18,767 43%
4 Administrative $6,115 $6,115
5
6
7
8
9
10
11
12
13
14
15
16
17
18
TOTALS:$123,213 $23,543 $7,303 $10,711 $164,770 25%
County
2016-2017 .
Amount of Unallocated Funds
Amount of funds reverted back to DPS Chairperson, Juvenile Crime Prevention Council (Date)
Discretionary Funds added
check type initial plan update final
Chairperson, Board of County Commissioners (Date)
or County Finance Officer
Reviewed by_____________________________________
Area Consultant Date
Reviewed by_____________________________________
Program Assistant Date
Verified by_____________________________________
Designated State Office Staff Date ver 03/04/2016
-----DPS Use Only-----
DPS JCPC funds must be committed with a Program Agreement submitted in NC Allies and electronically signed by authorized officials.
LOCAL FUNDING
The above plan was derived through a planning process by the Person
Juvenile Crime Prevention Council and represents the County’s Plan for use of these funds in FY
Person County
NC DPS - Community Programs - County Funding Plan
Available Funds: $$123,213 Local Match: $
91
CONSENT AGENDA ABSTRACT
Meeting date:
July 18, 2016
Agenda Title:
Fire and Rescue Corrective Action Responses
Summary of Information:
To include for review the Corrective Action Plans submitted by all Volunteer Fire and
Rescue Agencies in response to the audit findings for FY2014 as presented by County-
contracted auditors, Winston, Williams, Creech, & Evans, LLP. This response meets
the requirement in the Fire and Rescue Agency contracts under Section III(D) that
states,
“Should there be any related findings, the Department will be required to
submit a corrective action plan for the County Board of Commissioner’s
consideration before further County funding will be released for the following
year.”
As requested by the County Manager, I have reviewed the corrective action plan from
each agency and found them to be complete and appropriate in their responses to the
Auditors’ findings. It is my assessment that as a result of the audit, many departments
have put some of the recommended procedures/policies in place to strengthen their
internal controls and financial structure.
Recommended Action:
To approve the information received that fulfills the Volunteer Fire and Rescue
Agencies’ contractual obligation and allows for the release of their operational
allotments.
Submitted By:
Amy Wehrenberg, Finance Director
92
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96
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98
99
100
101
102
103
104
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Meeting Date: July 18, 2016
Please include this information in the agenda packet for the Person County
Commissioners meeting (Consent Agenda) on July 18, 2016 at 9:00 a.m.
Agenda Title: DSS Attorney Contracts
Summary of Information: Contracts for legal services to be paid at an hourly rate to
agency’s primary attorney, Tom Fitzgerald, and secondary attorneys, Walter Cates, Julie
Ramsey, and Joe Weinberger. There are separate contracts for Child Support services
therefore two contracts per attorney are attached.
Recommended Action: Approval
Submitted By: Carlton B. Paylor, Sr., MBA
Director, Person County Department of Social Services
106
Meeting Date: July 18, 2016 Summary of Information: Contracts for legal services to be paid at an hourly rate to agency’s primary attorney, Tom Fitzgerald, and secondary attorneys, Walter Cates, Julie Ramsey, and Joe Weinberger. There are separate contracts for Child Support services therefore two contracts per attorney are required. Primary $135 per hr Thomas L. Fitzgerald Agency Provides counsel on Foster Care, Adoption and Child Protective Services, and Adult Protective Services Primary $135 per hrThomas L. Fitzgerald Child Support Provides counsel on Child Support Services In case of a conflict of interest with the primary attorney, a secondary attorney is utilized. Secondary#1 $75 per hr Joseph C. Weinberger, Jr. Agency Provides counsel on Foster Care, Adoption and Child Protective Services, and Adult Protective Services Secondary#1 $75 per hr Joseph C. Weinberger, Jr. Child Support Provides counsel on Child Support Services Secondary#2 $75 per hr Walter B. Cates Agency Provides counsel on Foster Care, Adoption and Child Protective Services, and Adult Protective Services Secondary#2 $75 per hr Walter B. Cates Child Support Provides counsel on Child Support Services Secondary#3 $75 per hr Julie A. Ramsey Agency Provides counsel on Foster Care, Adoption and Child Protective Services, and Adult Protective Services Secondary#3 $75 per hr Julie A. Ramsey Child Support Provides counsel on Child Support Services 107
DEPARTMENT OF SOCIAL SERVICES
Post Office Box 770
355B South Madison Boulevard
Roxboro, North Carolina 27573-0770
(336) 599-8361
Fax (336) 597-9339
To: Heidi York
From: Carlton B. Paylor, Sr.
Re: Changes to Attorney Contracts for FY 2016-2017
Date: July 5, 2016
Effective for the State Fiscal Year 2017, the Division of Social Services has been updated in accordance
with the Omni Circular-CFR Title 2, Grants and Agreements, Part 200. Below are the resulting changes
to DSS Attorney Contracts. http://www.maximus.com/sites/default/files/MAXIMUS_2%20CFR%20200.pdf
Funding has not changed.
Primary Attorney Contracts:
Page 1: Added:
Contract Documents:
Certification of Eligibility Under the Iran Divestment Act (Attachment N)
Page 10: Changed:
fifty-five cents ($0.55) per mile for travel to fifty-four cents ($0.54) per mile for travel
Page 27: Added:
Attachment N
Secondary Attorney Contracts:
Page 1: Added:
Contract Documents:
Certification of Eligibility Under the Iran Divestment Act (Attachment N)
Page 27: Added:
Attachment N
PERSON COUNTY
108
Contract # 1006
Joe Weinberger, Jr.
Page 1
Contract # 1006 Fiscal Year Begins July 1, 2016 Ends June 30, 2017
This contract is hereby entered into by and between the Person County Department of Social
Services (the "County") and Joseph Weinberger, Jr. (the "Contractor") (referred to collectively
as the “Parties”). The Contractor’s federal tax identification number is 56-153 8949.
Contract Documents: This Contract consists of the following documents:
This contract
The General Terms and Conditions (Attachment A)
The Scope of Work, description of services, and rate (Attachment B)
Federal Certification Regarding Drug-Free Workplace & Certification Regarding Nondiscrimination (Attachment C)
Conflict of Interest (Attachment D)
No Overdue Taxes (Attachment E)
Federal Certification Regarding Lobbying (Attachment G)
Federal Certification Regarding Debarment (Attachment H)
HIPAA Business Associate Addendum (Attachment I)
State Certification (Attachment M)
Certification of Eligibility Under the Iran Divestment Act (Attachment N)
These documents constitute the entire agreement between the Parties and supersede all prior
oral or written statements or agreements.
Precedence among Contract Documents: In the event of a conflict between or among the
terms of the Contract Documents, the terms in the Contract Document with the highest relative
precedence shall prevail. The order of precedence shall be the order of documents as listed in
Paragraph 1, above, with the first-listed document having the highest precedence and the last-
listed document having the lowest precedence. If there are multiple Contract Amendments, the
most recent amendment shall have the highest precedence and the oldest amendment shall
have the lowest precedence.
Effective Period: This contract shall be effective on July 1, 2016 and shall terminate on
June 30, 2017. This contract must be twelve months or less.
Contractor’s Duties: The Contractor shall provide the services and in accordance with the
approved rate as described in Attachment B, Scope of Work.
County’s Duties: The County shall pay the Contractor in the manner and in the amounts
specified in the Contract Documents.
[ x ] a. There are no matching requirements from the Contractor.
[ ] b. The Contractor’s matching requirement is $__________, which shall consist of:
[ ] In-kind [ ] Cash [ ] Cash and In-kind [ ] Cash and/or In-kind
The contributions from the Contractor shall be sourced from non-federal funds.
The total contract amount including any Contractor match shall not exceed 1,000 hours
collectively for all attorneys under contract. Rate of compensation for Secondary Attorney
Joseph Weinberger, Jr. is $75 per hour.
109
Contract # 1006
Joe Weinberger, Jr.
Page 2
Reversion of Funds:
Any unexpended grant funds shall revert to the County Department of Social Services upon
termination of this contract.
Reporting Requirements:
Contractor shall comply with audit requirements as described in N.C.G.S. § 143C-6-22 & 23 and
OMB Circular- CFR Title 2 Grants and Agreements, Part 200, and shall disclose all information
required by 42 USC 455.104, or 42 USC 455.105, or 42 USC 455.106.
Payment Provisions:
Payment shall be made in accordance with the Contract Documents as described in the Scope
of Work, Attachment B.
Contract Administrators: All notices permitted or required to be given by one Party to the
other and all questions about the contract from one Party to the other shall be addressed and
delivered to the other Party’s Contract Administrator. The name, post office address, street
address, telephone number, fax number, and email address of the Parties’ respective initial
Contract Administrators are set out below. Either Party may change the name, post office
address, street address, telephone number, fax number, or email address of its Contract
Administrator by giving timely written notice to the other Party.
For the County: For the Contractor:
Wendy Bowman, Accounting Technician
Person County Department of Social Services Joseph Weinberger, Jr., Attorney
P.O. Box 770 P.O. Box 1215
355B South Madison Boulevard 114 North Main Street
Roxboro, NC 27573 Roxboro, NC 27573
(336) 599-8361 (336) 599-4959
Supplementation of Expenditure of Public Funds: The Contractor assures that funds
received pursuant to this contract shall be used only to supplement, not to supplant, the total
amount of federal, state and local public funds that the Contractor otherwise expends for
contract services and related programs. Funds received under this contract shall be used to
provide additional public funding for such services; the funds shall not be used to reduce the
Contractor’s total expenditure of other public funds for such services.
Disbursements: As a condition of this contract, the Contractor acknowledges and agrees to
make disbursements in accordance with the following requirements:
(a) Implement adequate internal controls over disbursements;
(b) Pre-audit all vouchers presented for payment to determine:
Validity and accuracy of payment
Payment due date
Adequacy of documentation supporting payment
Legality of disbursement
(c) Assure adequate control of signature stamps/plates;
(d) Assure adequate control of negotiable instruments; and
(e) Implement procedures to insure that account balance is solvent and reconcile the
account monthly.
110
Contract # 1006
Joe Weinberger, Jr.
Page 3
Outsourcing to Other Countries: The Contractor certifies that it has identified to the County
all jobs related to the contract that have been outsourced to other countries, if any. The
Contractor further agrees that it will not outsource any such jobs during the term of this contract
without providing notice to the County.
Federal Certifications: Individuals and Organizations receiving federal funds must ensure
compliance with certain certifications required by federal laws and regulations. The contractor is
hereby complying with Certifications regarding Nondiscrimination, Drug-Free Workplace
Requirements, Environmental Tobacco Smoke, Debarment, Suspension, Ineligibility and
Voluntary Exclusion Lower Tier Covered Transactions, and Lobbying. These assurances and
certifications are to be signed by the contractor’s authorized representative.
Signature Warranty: The undersigned represent and warrant that they are authorized to bind
their principals to the terms of this agreement.
Signature Warranty:
The undersigned represent and warrant that they are authorized to bind their principals to the terms of this
agreement.
The Contractor and the County have executed this contract in duplicate originals, with one original being retained by
each party.
Joseph Weinberger, Jr., Attorney At Law
____________________________ _________________________
Signature Date
PERSON COUNTY
David Newell, Sr.
____________________________ _________________________
Chairman, County Commissioners Date
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
Act.
______________________________ ___________________________
Amy Wehrenberg, County Finance Director Date
111
Contract # 1006
Joe Weinberger, Jr.
Page 4
ATTACHMENT A
General Terms and Conditions
Relationships of the Parties
Independent Contractor: The Contractor is and shall be deemed to be an independent contractor in the performance of
this contract and as such shall be wholly responsible for the work to be performed and for the supervision of its employees.
The Contractor represents that it has, or shall secure at its own expense, all personnel required in performing the services
under this agreement. Such employees shall not be employees of, or have any individual contractual relationship with the
County.
Subcontracting: The Contractor shall not subcontract any of the work contemplated under this contract without prior written
approval from the County. Any approved subcontract shall be subject to all conditions of this contract. Only the
subcontractors specified in the contract documents are to be considered approved upon award of the contract. The County
shall not be obligated to pay for any work performed by any unapproved subcontractor. The Contractor shall be responsible
for the performance of all of its subcontractors.
Assignment: No assignment of the Contractor's obligations or the Contractor's right to receive payment hereunder shall be
permitted. However, upon written request approved by the issuing purchasing authority, the County may: Forward the
Contractor's payment check(s) directly to any person or entity designated by the Contractor, or Include any person or entity
designated by Contractor as a joint payee on the Contractor's payment check(s). In no event shall such approval and action
obligate the County to anyone other than the Contractor and the Contractor shall remain responsible for fulfillment of all
contract obligations.
Beneficiaries: Except as herein specifically provided otherwise, this contract shall inure to the benefit of and be binding
upon the parties hereto and their respective successors. It is expressly understood and agreed that the enforcement of the
terms and conditions of this contract, and all rights of action relating to such enforcement, shall be strictly reserved to the
County and the named Contractor. Nothing contained in this document shall give or allow any claim or right of action
whatsoever by any other third person. It is the express intention of the County and Contractor that any such person or entity,
other than the County or the Contractor, receiving services or benefits under this contract shall be deemed an incidental
beneficiary only.
Indemnity and Insurance
Indemnification: The Contractor agrees to indemnify and hold harmless the County and any of their officers, agents and
employees, from any claims of third parties arising out or any act or omission of the Contractor in connection with the
performance of this contract.
Insurance: During the term of the contract, the Contractor at its sole cost and expense shall provide commercial insurance
of such type and with such terms and limits as may be reasonably associated with the contract. As a minimum, the
Contractor shall provide and maintain the following coverage and limits:
Worker’s Compensation - The contractor shall provide and maintain Worker’s Compensation Insurance as required
by the laws of North Carolina, as well as employer’s liability coverage with minimum limits of $500,000.00, covering all
of Contractor’s employees who are engaged in any work under the contract. If any work is sublet, the Contractor shall
require the subcontractor to provide the same coverage for any of his employees engaged in any work under the
contract.
Commercial General Liability - General Liability Coverage on a Comprehensive Broad Form on an occurrence basis in
the minimum amount of $1,000,000.00 Combined Single Limit. (Defense cost shall be in excess of the limit of liability.)
Automobile Liability Insurance: The Contractor shall provide automobile liability insurance with a combined single
limit of $500,000.00 for bodily injury and property damage; a limit of $500,000.00 for uninsured/under insured
motorist coverage; and a limit of $2,000.00 for medical payment coverage. The Contractor shall provide this insurance
for all automobiles that are:
(a) owned by the Contractor and used in the performance of this contract;
(b) hired by the Contractor and used in the performance of this contract; and
(c) Owned by Contractor’s employees and used in performance of this contract (“non-owned vehicle insurance”).
Non-owned vehicle insurance protects employers when employees use their personal vehicles for work
purposes. Non-owned vehicle insurance supplements, but does not replace, the car-owner’s liability insurance.
112
Contract # 1006
Joe Weinberger, Jr.
Page 5
The Contractor is not required to provide and maintain automobile liability insurance on any vehicle – owned,
hired, or non-owned -- unless the vehicle is used in the performance of this contract.
(d) The insurance coverage minimums specified in subparagraph (a) are exclusive of defense costs.
(e) The Contractor understands and agrees that the insurance coverage minimums specified in subparagraph (a) are
not limits, or caps, on the Contractor’s liability or obligations under this contract.
(f) The Contractor may obtain a waiver of any one or more of the requirements in subparagraph (a) by
demonstrating that it has insurance that provides protection that is equal to or greater than the coverage and
limits specified in subparagraph (a). The County shall be the sole judge of whether such a waiver should be
granted.
(g) The Contractor may obtain a waiver of any one or more of the requirements in paragraph (a) by demonstrating
that it is self-insured and that its self-insurance provides protection that is equal to or greater than the coverage
and limits specified in subparagraph (a). The County shall be the sole judge of whether such a waiver should be
granted.
(h) Providing and maintaining the types and amounts of insurance or self-insurance specified in this paragraph is a
material obligation of the Contractor and is of the essence of this contract.
(i) The Contractor shall only obtain insurance from companies that are authorized to provide such coverage and
that are authorized by the Commissioner of Insurance to do business in the State of North Carolina. All such
insurance shall meet all laws of the State of North Carolina.
(j) The Contractor shall comply at all times with all lawful terms and conditions of its insurance policies and all
lawful requirements of its insurer.
(k) The Contractor shall require its subcontractors to comply with the requirements of this paragraph.
(l) The Contractor shall demonstrate its compliance with the requirements of this paragraph by submitting
certificates of insurance to the County before the Contractor begins work under this contract.
Transportation of Clients by Contractor:
The contractor will maintain Insurance requirements if required as noted under Article 7 Rule R2-36 of the North Carolina
Utilities Commission.
Default and Termination
Termination without Cause: The County may terminate this contract without cause by giving 30 days written notice to the
Contractor.
Termination for Cause: If, through any cause, the Contractor shall fail to fulfill its obligations under this contract in a timely
and proper manner, the County shall have the right to terminate this contract by giving written notice to the Contractor and
specifying the effective date thereof. In that event, all finished or unfinished deliverable items prepared by the Contractor
under this contract shall, at the option of the County, become its property and the Contractor shall be entitled to receive just
and equitable compensation for any satisfactory work completed on such materials, minus any payment or compensation
previously made. Notwithstanding the foregoing provision, the Contractor shall not be relieved of liability to the County for
damages sustained by the County by virtue of the Contractor’s breach of this agreement, and the County may withhold any
payment due the Contractor for the purpose of setoff until such time as the exact amount of damages due the County from
such breach can be determined. In case of default by the Contractor, without limiting any other remedies for breach
available to it, the County may procure the contract services from other sources and hold the Contractor responsible for any
excess cost occasioned thereby. The filing of a petition for bankruptcy by the Contractor shall be an act of default under this
contract.
Waiver of Default: Waiver by the County of any default or breach in compliance with the terms of this contract by the
Provider shall not be deemed a waiver of any subsequent default or breach and shall not be construed to be modification of
the terms of this contract unless stated to be such in writing, signed by an authorized representative of the County and the
Contractor and attached to the contract.
Availability of Funds: The parties to this contract agree and understand that the payment of the sums specified in this
contract is dependent and contingent upon and subject to the appropriation, allocation, and availability of funds for this
purpose to the County.
Force Majeure: Neither party shall be deemed to be in default of its obligations hereunder if and so long as it is prevented
from performing such obligations by any act of war, hostile foreign action, nuclear explosion, riot, strikes, civil insurrection,
earthquake, hurricane, tornado, or other catastrophic natural event or act of God.
113
Contract # 1006
Joe Weinberger, Jr.
Page 6
Survival of Promises: All promises, requirements, terms, conditions, provisions, representations, guarantees, and warranties
contained herein shall survive the contract expiration or termination date unless specifically provided otherwise herein, or
unless superseded by applicable Federal or State statutes of limitation.
Intellectual Property Rights
Copyrights and Ownership of Deliverables: All deliverable items produced pursuant to this contract are the exclusive
property of the County. The Contractor shall not assert a claim of copyright or other property interest in such deliverables.
Federal Intellectual Property Bankruptcy Protection Act: The Parties agree that the County shall be entitled to all rights and
benefits of the Federal Intellectual Property Bankruptcy Protection Act, Public Law 100-506, codified at 11 U.S.C. 365 (n)
and any amendments thereto.
Compliance with Applicable Laws
Compliance with Laws: The Contractor shall comply with all laws, ordinances, codes, rules, regulations, and licensing
requirements that are applicable to the conduct of its business, including those of federal, state, and local agencies having
jurisdiction and/or authority.
Title VI, Civil Rights Compliance: In accordance with Federal law and U.S. Department of Agriculture (USDA) and U.S.
Department of Health and Human Services (HHS) policy, this institution is prohibited from discriminating on the basis of
race, color, national origin, sex, age or disability. Under the Food Stamp Act and USDA policy, discrimination is prohibited
also on the basis of religion or political beliefs.
Equal Employment Opportunity: The Contractor shall comply with all federal and State laws relating to equal employment
opportunity.
Health Insurance Portability and Accountability Act (HIPAA): The Contractor agrees that, if the County determines that
some or all of the activities within the scope of this contract are subject to the Health Insurance Portability and Accountability
Act of 1996, P.L. 104-91, as amended (“HIPAA”), or its implementing regulations, it will comply with the HIPAA
requirements and will execute such agreements and practices as the County may require to ensure compliance.
(a) Data Security: The Contractor shall adopt and apply data security standards and procedures that comply with all
applicable federal, state, and local laws, regulations, and rules.
(b) Duty to Report: The Contractor shall report a suspected or confirmed security breach to the local Department of
Social Services/Human Services Contract Administrator within twenty-four (24) hours after the breach is first
discovered, provided that the Contractor shall report a breach involving Social Security Administration data or
Internal Revenue Service data within one (1) hour after the breach is first discovered.
(c) Cost Borne by Contractor: If any applicable federal, state, or local law, regulation, or rule requires the Contractor
to give written notice of a security breach to affected persons, the Contractor shall bear the cost of the notice.
Trafficking Victims Protection Act of 2000: The Contractor will comply with the requirements of Section 106(g) of the
Trafficking Victims Protection Act of 2000, as amended (22 U.S.C. 7104).
Executive Order # 24: It is unlawful for any vendor, contractor, subcontractor or supplier of the state to make gifts or to give
favors to any state employee. For additional information regarding the specific requirements and exemptions, contractors
are encouraged to review Executive Order 24 and G.S. Sec. 133-32.
Confidentiality
Confidentiality: Any information, data, instruments, documents, studies or reports given to or prepared or assembled by the
Contractor under this agreement shall be kept as confidential and not divulged or made available to any individual or
organization without the prior written approval of the County. The Contractor acknowledges that in receiving, storing,
processing or otherwise dealing with any confidential information it will safeguard and not further disclose the information
except as otherwise provided in this contract.
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Oversight
Access to Persons and Records: The State Auditor shall have access to persons and records as a result of all contracts or
grants entered into by State agencies or political subdivisions in accordance with General Statute 147-64.7. Additionally, as
the State funding authority, the Department of Health and Human Services shall have access to persons and records as a
result of all contracts or grants entered into by State agencies or political subdivisions.
Record Retention: Records shall not be destroyed, purged or disposed of without the express written consent of the
Division. State basic records retention policy requires all grant records to be retained for a minimum of five years or until all
audit exceptions have been resolved, whichever is longer. If the contract is subject to federal policy and regulations, record
retention may be longer than five years since records must be retained for a period of three years following submission of the
final Federal Financial Status Report, if applicable, or three years following the submission of a revised final Federal
Financial Status Report. Also, if any litigation, claim, negotiation, audit, disallowance action, or other action involving this
Contract has been started before expiration of the five-year retention period described above, the records must be retained
until completion of the action and resolution of all issues which arise from it, or until the end of the regular five-year period
described above, whichever is later. The record retention period for Temporary Assistance for Needy Families (TANF) and
MEDICAID and Medical Assistance grants and programs must be retained for a minimum of ten years.
Warranties and Certifications
Date and Time Warranty: The Contractor warrants that the product(s) and service(s) furnished pursuant to this contract
(“product” includes, without limitation, any piece of equipment, hardware, firmware, middleware, custom or commercial
software, or internal components, subroutines, and interfaces therein) that perform any date and/or time data recognition
function, calculation, or sequencing will support a four digit year format and will provide accurate date/time data and leap
year calculations. This warranty shall survive the termination or expiration of this contract.
Certification Regarding Collection of Taxes: G.S. 143-59.1 bars the Secretary of Administration from entering into contracts
with vendors that meet one of the conditions of G.S. 105-164.8(b) and yet refuse to collect use taxes on sales of tangible
personal property to purchasers in North Carolina. The conditions include: (a) maintenance of a retail establishment or
office; (b) presence of representatives in the State that solicit sales or transact business on behalf of the vendor; and (c)
systematic exploitation of the market by media-assisted, media-facilitated, or media-solicited means. The Contractor certifies
that it and all of its affiliates (if any) collect all required taxes.
E-Verify
Pursuant to G.S. 143-48.5 and G.S. 147-33.95(g), the undersigned hereby certifies that the Contractor named below, and the
Contractor’s subcontractors, complies with the requirements of Article 2 of Chapter 64 of the NC General Statutes, including
the requirement for each employer with more than 25 employees in North Carolina to verify the work authorization of its
employees through the federal E-Verify system." E-Verify System Link: www.uscis.gov
Miscellaneous
Choice of Law: The validity of this contract and any of its terms or provisions, as well as the rights and duties of the parties
to this contract, are governed by the laws of North Carolina. The Contractor, by signing this contract, agrees and submits,
solely for matters concerning this Contract, to the exclusive jurisdiction of the courts of North Carolina and agrees, solely for
such purpose, that the exclusive venue for any legal proceedings shall be the county is which the contract originated. The
place of this contract and all transactions and agreements relating to it, and their situs and forum, shall be the county where
the contract originated, where all matters, whether sounding in contract or tort, relating to the validity, construction,
interpretation, and enforcement shall be determined.
Amendment: This contract may not be amended orally or by performance. Any amendment must be made in written form
and executed by duly authorized representatives of the County and the Contractor.
Severability: In the event that a court of competent jurisdiction holds that a provision or requirement of this contract
violates any applicable law, each such provision or requirement shall continue to be enforced to the extent it is not in
violation of law or is not otherwise unenforceable and all other provisions and requirements of this contract shall remain in
full force and effect.
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Headings: The Section and Paragraph headings in these General Terms and Conditions are not material parts of the
agreement and should not be used to construe the meaning thereof.
Time of the Essence: Time is of the essence in the performance of this contract.
Key Personnel: The Contractor shall not replace any of the key personnel assigned to the performance of this contract
without the prior written approval of the County. The term “key personnel” includes any and all persons identified as such
in the contract documents and any other persons subsequently identified as key personnel by the written agreement of the
parties.
Care of Property: The Contractor agrees that it shall be responsible for the proper custody and care of any property
furnished to it for use in connection with the performance of this contract and will reimburse the County for loss of, or
damage to, such property. At the termination of this contract, the Contractor shall contact the County for instructions as to
the disposition of such property and shall comply with these instructions.
Travel Expenses: Reimbursement to the Contractor for travel mileage, meals, lodging and other travel expenses incurred in
the performance of this contract shall not exceed the rates established in County policy.
Sales/Use Tax Refunds: If eligible, the Contractor and all subcontractors shall: (a) ask the North Carolina Department of
Revenue for a refund of all sales and use taxes paid by them in the performance of this contract, pursuant to G.S. 105-
164.14; and (b) exclude all refundable sales and use taxes from all reportable expenditures before the expenses are entered
in their reimbursement reports.
Advertising: The Contractor shall not use the award of this contract as a part of any news release or commercial advertising.
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ATTACHMENT B – Scope of Work Federal Tax Id. 56-153 8949
NORTH CAROLINA
DUPLICATE ORIGINAL
PERSON COUNTY
LEGAL SERVICES AGREEMENT
THIS Agreement, made and entered into this the 1st day of July, 2016, by and between
the PERSON COUNTY DEPARTMENT OF SOCIAL SERVICES, hereinafter referred to as
Agency, and Joseph Weinberger, Jr., Attorney at Law, hereinafter referred to as Attorney.
W I T N E S S E T H :
THAT WHEREAS, the Agency has determined that it has need for legal services and
consultation beyond those presently being provided by the county attorney;
AND WHEREAS, the Attorney is a member in a reputable law firm with an office in
Person County, North Carolina, and has expertise in the field of social services law, rules and
regulations, and the Agency is desirous of obtaining such legal services from said Attorney on a
continuing basis;
NOW, THEREFORE, it is hereby agreed that the Attorney shall provide legal services to
the Agency in the nature of consultations, interpretation of social services laws and regulations
and drafting of legal documents when necessary on the following terms and conditions:
1
The Attorney shall make himself available and on call to the Agency on a prompt basis
for the purposes herein above described until June 30, 2017. At the end of said period, the
arrangement herein described will be analyzed by the parties hereto to determine if same is
effective and fair to all parties concerned and revised or terminated accordingly as deemed
necessary.
2
The Agency shall pay for such legal services to the Attorney the sum of seventy-five
dollars ($75.00) per hour for out of court time and seventy-five dollars ($75.00) per hour for in
court time for each hour of legal services performed, same to be due and payable on or before the
10th of each month upon due submission by the Attorney of a statement of work detailing the
hours of work performed and the nature of such legal work.
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3
The Attorney will assist the Agency in maintaining records of the legal services provided
as same are necessary for the agency in filing its reports and funding statements.
4
It is understood and agreed that the legal services provided pursuant to this contract will
be in addition to those provided by the county attorney and not in substitution nor duplication of
such services by the county attorney.
5
It is specifically agreed that Attorney is an independent contractor and shall perform the
legal services herein provided according to his own judgment and method and shall not be
subject to control of the Agency except as to the result of his work.
6
The Attorney shall not under any circumstance be considered an employee of the
Agency. The Agency shall not withhold federal or state taxes from sums paid to the Attorney
pursuant to this agreement.
IN WITNESS WHEREOF, the parties have executed this agreement in duplicate
originals, one of which is retained by each of the parties hereto, on the day and year first above
written.
Joseph Weinberger, Jr., Attorney At Law
____________________________ _________________________
Signature Date
David Newell, Sr.
____________________________ _________________________
Chairman, County Commissioners Date
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ATTACHMENT C
CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS
AND CERTIFICATION REGARDING NONDISCRIMINATION
Person County Department of Social Services
I. By execution of this Agreement the Contractor certifies that it will provide a drug-free workplace by:
A. Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession or use of a controlled substance is prohibited in the Contractor’s workplace and specifying the actions that will be taken against employees for violation of
such prohibition;
B. Establishing a drug-free awareness program to inform employees about: (1) The dangers of drug abuse in the workplace; (2) The Contractor’s policy of maintaining a drug-free workplace; (3) Any available drug counseling, rehabilitation, and employee assistance programs; and
(4) The penalties that may be imposed upon employees for drug abuse violations
occurring in the workplace;
C. Making it a requirement that each employee be engaged in the performance of the agreement be given a copy of the statement required by paragraph (A); D. Notifying the employee in the statement required by paragraph (A) that, as a condition of employment under the agreement, the employee will:
(1) Abide by the terms of the statement; and
(2) Notify the employer of any criminal drug statute conviction for a violation occurring in the workplace no later than five days after such conviction;
E. Notifying the County within ten days after receiving notice under subparagraph (D)(2) from an employee or otherwise receiving actual notice of such conviction; F. Taking one of the following actions, within 30 days of receiving notice under
subparagraph (D)(2), with respect to any employee who is so convicted:
(1) Taking appropriate personnel action against such an employee, up to and including termination; or (2) Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State, or local health, law enforcement, or other appropriate agency; and
Making a good faith effort to continue to maintain a drug-free workplace through
implementation of paragraphs (A), (B), (C), (D), (E), and (F).
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The site(s) for the performance of work done in connection with the specific agreement are
listed below:
114 North Main Street, Roxboro, NC 27573
Contractor will inform the County of any additional sites for performance of work under this agreement. False certification or violation of the certification shall be grounds for suspension of payment,
suspension or termination of grants, or government-wide Federal suspension or debarment
45 C.F.R. Section 82.510. Section 4 CFR Part 85, Section 85.615 and 86.620.
Certification Regarding Nondiscrimination
The Vendor certifies that it will comply with all Federal statutes relating to nondiscrimination.
These include but are not limited to: (a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352)
which prohibits discrimination on the basis of race, color or national origin; (b) Title IX of the
Education Amendments of 1972, as amended (20 U.S.C. §§1681-1683, and 1685-1686), which
prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as
amended (29 U.S.C. §794), which prohibits discrimination on the basis of handicaps; (d) the Age
Discrimination Act of 1975, as amended (42 U.S.C. §§6101-6107), which prohibits
discrimination on the basis of age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L.
92-255), as amended, relating to nondiscrimination on the basis of drug abuse; (f) the
Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of
1970 (P.L. 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or
alcoholism; (g) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. §§3601 et seq.), as
amended, relating to nondiscrimination in the sale, rental or financing of housing; (h) the Food
Stamp Act and USDA policy, which prohibit discrimination on the basis of religion and political
beliefs; and (i) the requirements of any other nondiscrimination statutes which may apply to this
Agreement.
Joseph Weinberger, Jr., Attorney At Law
____________________________ _________________________
Signature Date
David Newell, Sr.
____________________________ _________________________
Chairman, County Commissioners Date
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ATTACHMENT D:
CONFLICT OF INTEREST
The Board of Directors/Trustees or other governing persons, officers, employees or agents are to avoid
any conflict of interest, even the appearance of a conflict of interest. The Organization‘s Board of
Directors/Trustees or other governing body, officers, staff and agents are obligated to always act in the
best interest of the organization. This obligation requires that any Board member or other governing
person, officer, employee or agent, in the performance of Organization duties, seek only the furtherance
of the Organization mission. At all times, Board members or other governing persons, officers, employees
or agents, are prohibited from using their job title, the Organization's name or property, for private profit or
benefit.
A. The Board members or other governing persons, officers, employees, or agents of the Organization
should neither solicit nor accept gratuities, favors, or anything of monetary value from current or potential
contractors/vendors, persons receiving benefits from the Organization or persons who may benefit from
the actions of any Board member or other governing person, officer, employee or agent. This is not
intended to preclude bona-fide Organization fund raising-activities.
B. A Board or other governing body member may, with the approval of Board or other governing body,
receive honoraria for lectures and other such activities while not acting in any official capacity for the
Organization. Officers may, with the approval of the Board or other governing body, receive honoraria for
lectures and other such activities while on personal days, compensatory time, annual leave, or leave
without pay. Employees may, with the prior written approval of their supervisor, receive honoraria for
lectures and other such activities while on personal days, compensatory time, annual leave, or leave
without pay. If a Board or other governing body member, officer, employee or agent is acting in any
official capacity, honoraria received in connection with activities relating to the Organization are to be paid
to the Organization.
C. No Board member or other governing person, officer, employee, or agent of the Organization shall
participate in the selection, award, or administration of a purchase or contract with a vendor where, to his
knowledge, any of the following has a financial interest in that purchase or contract:
1. The Board member or other governing person, officer, employee, or agent;
2. Any member of their family by whole or half blood, step or personal relationship or relative-in-law;
3. An organization in which any of the above is an officer, director, or employee;
4. A person or organization with whom any of the above individuals is negotiating or has any
arrangement concerning prospective employment or contracts.
D. Duty to Disclosure -- Any conflict of interest, potential conflict of interest, or the appearance of a
conflict of interest is to be reported to the Board or other governing body or one’s supervisor immediately.
E. Board Action -- When a conflict of interest is relevant to a matter requiring action by the Board of
Directors/Trustees or other governing body, the Board member or other governing person, officer,
employee, or agent (person(s)) must disclose the existence of the conflict of interest and be given the
opportunity to disclose all material facts to the Board and members of committees with governing board
delegated powers considering the possible conflict of interest. After disclosure of all material facts, and
after any discussion with the person, he/she shall leave the governing board or committee meeting while
the determination of a conflict of interest is discussed and voted upon. The remaining board or committee
members shall decide if a conflict of interest exists. In addition, the person(s) shall not participate in the
final deliberation or decision regarding the matter under consideration and shall leave the meeting during
the discussion of and vote of the Board of Directors/Trustees or other governing body.
F. Violations of the Conflicts of Interest Policy -- If the Board of Directors/Trustees or other governing
body has reasonable cause to believe a member, officer, employee or agent has failed to disclose actual
or possible conflicts of interest, it shall inform the person of the basis for such belief and afford the person
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an opportunity to explain the alleged failure to disclose. If, after hearing the person's response and after
making further investigation as warranted by the circumstances, the Board of Directors/Trustees or other
governing body determines the member, officer, employee or agent has failed to disclose an actual or
possible conflict of interest, it shall take appropriate disciplinary and corrective action.
G. Record of Conflict -- The minutes of the governing board and all committees with board delegated
powers shall contain:
1. The names of the persons who disclosed or otherwise were found to have an actual or possible
conflict of interest, the nature of the conflict of interest, any action taken to determine whether a
conflict of interest was present, and the governing board's or committee's decision as to whether
a conflict of interest in fact existed.
2. The names of the persons who were present for discussions and votes relating to the transaction
or arrangement that presents a possible conflict of interest, the content of the discussion,
including any alternatives to the transaction or arrangement, and a record of any votes taken in
connection with the proceedings.
NOTARIZED CONFLICT OF INTEREST POLICY
Joseph Weinberger, Jr., Attorney At Law
_________________________________ _________________________
Signature Date
NORTH CAROLINA
PERSON COUNTY
I, __________________________, a Notary Public of said County and State do hereby certify that Joseph Weinberger,
Jr., Attorney at Law, personally appeared before me this date and acknowledged the due execution of the foregoing
agreement for the purposes therein expressed and by that authority duly given and as the act of the Organization,
affirmed that the foregoing Conflict of Interest Policy was adopted by the Board of Directors/Trustees or other
governing body in a meeting held on the __________ day of ___________, _________.
Sworn to and subscribed before me this _________ day of ______________________, 2016.
___________________________
Notary Public
My Commission expires: __________________
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ATTACHMENT E – OVERDUE TAXES
Joe Weinberger, Jr.
Attorney and Counselor at Law
ll4 NORTH MAIN STREET
P.O. BOX l2l5
ROXBORO, NORTH CAROLINA 27573
JOE WEINBERGER, JR. TELEPHONE
336-599-2239
FAX 336-599-2239
E-MAIL wein@osinc.net
______________, 2016
To: Person County Department of Social Services
Certification:
I, Joseph Weinberger, Jr., certify that I do not have any overdue tax debts, as defined by N.C.G.S. 105-243.1,
at the federal, State, or local level. I further understand that any person who makes a false statement in
violation of N.C.G.S. 143C-6-23(c) is guilty of a criminal offense punishable as provided by N.C.G.S.)
143C-10-1b.
Sworn Statement:
I, Joseph Weinberger, Jr., being duly sworn, say that the foregoing certification is true, accurate and complete
to the best of my knowledge and was made and subscribed by me. I also acknowledge and understand that any
misuse of State funds will be reported to the appropriate authorities for further action.
Joseph Weinberger, Jr., Attorney At Law
____________________________ _________________________
Signature Date
NORTH CAROLINA
PERSON COUNTY
Sworn to and subscribed before me this _________ day of ______________________, 2016.
___________________________
Notary Public
My Commission expires: __________________
____________________
1 G.S. 105-243.1 defines: Overdue tax debt. – Any part of a tax debt that remains unpaid 90 days or more after the notice of final
assessment was mailed to the taxpayer. The term does not include a tax debt, however, if the taxpayer entered into an installment
agreement for the tax debt under G.S. 105-237 within 90 days after the notice of final assessment was mailed and has not failed to
make any payments due under the installment agreement.”
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ATTACHMENT G
Person County Department of Social Services
Certification Regarding Lobbying
Certification for Contracts, Grants, Loans and Cooperative Agreements
The undersigned certifies, to the best of his or her knowledge and belief, that:
(1) No Federal appropriated funds have been paid or will be paid by or on behalf of the undersigned, to any
person for influencing or attempting to influence an officer or employee of any Federal, state or local
government agency, a Member of Congress, a Member of the General Assembly, an officer or employee of
Congress, an officer or employee of the General Assembly, an employee of a Member of Congress, or an
employee of a Member of the General Assembly in connection with the awarding of any Federal or state
contract, the making of any Federal or state grant, the making of any Federal or state loan, the entering into
of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any
Federal or state contract, grant, loan, or cooperative agreement.
(2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for
influencing or attempting to influence an officer or employee of any Federal, state or local government
agency, a Member of Congress, a Member of the General Assembly, an officer or employee of Congress,
an officer or employee of the General Assembly, an employee of a Member of Congress, or an employee of
a Member of the General Assembly in connection with the awarding of any Federal or state contract, the
making of any Federal or state grant, the making of any Federal or state loan, the entering into of any
cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any
Federal or state contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit
Standard
Form LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions.
(3) The undersigned shall require that the language of this certification be included in the award documents for
all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and
cooperative agreements) and that all subrecipients shall certify and disclose accordingly.
(4) This certification is a material representation of fact upon which reliance was placed when this transaction
was made or entered into. Submission of this certification is a prerequisite for making or entering into this
transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required
certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each
such failure.
Notwithstanding other provisions of federal OMB Circulars-CFR Title 2, Grants and Agreements, Part 200, costs
associated with the following activities are unallowable:
Paragraph A.
(1) Attempts to influence the outcomes of any Federal, State, or local election, referendum, initiative, or
similar procedure, through in kind or cash contributions, endorsements, publicity, or similar activity;
(2) Establishing, administering, contributing to, or paying the expenses of a political party, campaign, political
action committee, or other organization established for the purpose of influencing the outcomes of
elections;
(3) Any attempt to influence: (i) The introduction of Federal or State legislation; or (ii) the enactment or
modification of any pending Federal or State legislation through communication with any member or
employee of the Congress or State legislature (including efforts to influence State or local officials to
engage in similar lobbying activity), or with any Government official or employee in connection with a
decision to sign or veto enrolled legislation;
(4) Any attempt to influence: (i) The introduction of Federal or State legislation; or (ii) the enactment or
modification of any pending Federal or State legislation by preparing, distributing or using publicity or
propaganda, or by urging members of the general public or any segment thereof to contribute to or
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participate in any mass demonstration, march, rally, fundraising drive, lobbying campaign or letter writing
or telephone campaign; or
(5) Legislative liaison activities, including attendance at legislative sessions or committee hearings, gathering
information regarding legislation, and analyzing the effect of legislation, when such activities are carried on
in support of or in knowing preparation for an effort to engage in unallowable lobbying.
The following activities as enumerated in Paragraph B are excepted from the coverage of Paragraph A:
Paragraph B.
(1) Providing a technical and factual presentation of information on a topic directly related to the performance
of a grant, contract or other agreement through hearing testimony, statements or letters to the Congress or a
State legislature, or subdivision, member, or cognizant staff member thereof, in response to a documented
request (including a Congressional Record notice requesting testimony or statements for the record at a
regularly scheduled hearing) made by the recipient member, legislative body or subdivision, or a cognizant
staff member thereof; provided such information is readily obtainable and can be readily put in deliverable
form; and further provided that costs under this section for travel, lodging or meals are unallowable unless
incurred to offer testimony at a regularly scheduled Congressional hearing pursuant to a written request for
such presentation made by the Chairman or Ranking Minority Member of the Committee or Subcommittee
conducting such hearing.
(2) Any lobbying made unallowable by subparagraph A (3) to influence State legislation in order to directly
reduce the cost, or to avoid material impairment of the organization's authority to perform the grant,
contract, or other agreement.
(3) Any activity specifically authorized by statute to be undertaken with funds from the grant, contract, or other
agreement.
Paragraph C.
(1) When an organization seeks reimbursement for indirect costs, total lobbying costs shall be separately
identified in the indirect cost rate proposal, and thereafter treated as other unallowable activity costs in
accordance with the procedures of subparagraph B.(3).
(2) Organizations shall submit, as part of the annual indirect cost rate proposal, a certification that the
requirements and standards of this paragraph have been complied with.
(3) Organizations shall maintain adequate records to demonstrate that the determination of costs as being
allowable or unallowable pursuant to this section complies with the requirements of this Circular.
(4) Time logs, calendars, or similar records shall not be required to be created for purposes of complying with
this paragraph during any particular calendar month when: (1) the employee engages in lobbying (as
defined in subparagraphs (a) and (b)) 25 percent or less of the employee's compensated hours of
employment during that calendar month, and (2) within the preceding five-year period, the organization has
not materially misstated allowable or unallowable costs of any nature, including legislative lobbying costs.
When conditions (1) and (2) are met, organizations are not required to establish records to support the
allowability of claimed costs in addition to records already required or maintained. Also, when conditions
(1) and (2) are met, the absence of time logs, calendars, or similar records will not serve as a basis for
disallowing costs by contesting estimates of lobbying time spent by employees during a calendar month.
(5) Agencies shall establish procedures for resolving in advance, in consultation with OMB, any significant
questions or disagreements concerning the interpretation or application of this section. Any such advance
resolution shall be binding in any subsequent settlements, audits or investigations with respect to that grant
or contract for purposes of interpretation of this Circular; provided, however, that this shall not be
construed to prevent a contractor or grantee from contesting the lawfulness of such a determination.
Paragraph D.
Executive lobbying costs. Costs incurred in attempting to improperly influence either directly or indirectly, an
employee or officer of the Executive Branch of the Federal Government to give consideration or to act
regarding a sponsored agreement or a regulatory matter are unallowable. Improper influence means any
influence that induces or tends to induce a Federal employee or officer to give consideration or to act regarding
a federally sponsored agreement or regulatory matter on any basis other than the merits of the matter.
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Joseph Weinberger, Jr., Attorney At Law
____________________________ _________________________
Signature Date
David Newell, Sr.
____________________________ _________________________
Chairman, County Commissioners Date
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ATTACHMENT H
PERSON COUNTY DEPARTMENT OF SOCIAL SERVICES
CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY
AND VOLUNTARY EXCLUSION-LOWER TIER COVERED TRANSACTIONS
Instructions for Certification
1. By signing and submitting this proposal, the prospective lower tier participant is providing the
certification set out below.
2. The certification in this clause is a material representation of the fact upon which reliance was
placed when this transaction was entered into. If it is later determined that the prospective lower
tier participant knowingly rendered an erroneous certification, in addition to other remedies
available to the Federal Government, the department or agency with which this transaction
originated may pursue available remedies, including suspension and/or debarment.
3. The prospective lower tier participant will provide immediate written notice to the person to
whom the proposal is submitted if at any time the prospective lower tier participant learns that its
certification was erroneous when submitted or has become erroneous by reason of changed
circumstances.
4. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered
transaction," "participant," "person," "primary covered transaction," "principal," "proposal," and
"voluntarily excluded," as used in this clause, have the meanings set out in the Definitions and
Coverage sections of rules implementing Executive Order 12549. You may contact the person to
which this proposal is submitted for assistance in obtaining a copy of those regulations.
5. The prospective lower tier participant agrees by submitting this proposal that, should the
proposed covered transaction be entered into, it shall not knowingly enter any lower tier covered
transaction with a person who is debarred, suspended, determined ineligible or voluntarily
excluded from participation in this covered transaction unless authorized by the department or
agency with which this transaction originated.
6. The prospective lower tier participant further agrees by submitting this proposal that it will
include this clause titled "Certification Regarding Debarment, Suspension, Ineligibility and
Voluntary Exclusion - Lower Tier Covered Transaction," without modification, in all lower tier
covered transactions and in all solicitations for lower tier covered transactions.
7. A participant in a covered transaction may rely upon a certification of a prospective
participant in a lower tier covered transaction that it is not debarred, suspended, ineligible, or
voluntarily excluded from covered transaction, unless it knows that the certification is erroneous.
A participant may decide the method and frequency of which it determines the eligibility of its
principals. Each participant may, but is not required to, check the Nonprocurement List.
8. Nothing contained in the foregoing shall be construed to require establishment of a system of
records in order to render in good faith the certification required by this clause. The knowledge
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and information of a participant is not required to exceed that which is normally possessed by a
prudent person in the ordinary course of business dealings.
9. Except for transactions authorized in paragraph 5 of these instructions, if a participant in a
covered transaction knowingly enters into a lower tier covered transaction with a person who is
suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in
addition to other remedies available to the Federal Government, the department or agency with
which this transaction originated may pursue available remedies, including suspension, and/or
debarment.
Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower
Tier Covered Transactions
(1) The prospective lower tier participant certifies, by submission of this proposal, that neither it
nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or
voluntarily excluded from participation in this transaction by any Federal department or agency.
(2) Where the prospective lower tier participant is unable to certify to any of the statements in this
certification, such prospective participant shall attach an explanation to this proposal.
Joseph Weinberger, Jr., Attorney At Law
____________________________ _________________________
Signature Date
David Newell, Sr.
____________________________ _________________________
Chairman, County Commissioners Date
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ATTACHMENT I
PERSON COUNTY
DEPARTMENT OF SOCIAL SERVICES
BUSINESS ASSOCIATE ADDENDUM
This Agreement is made effective the 1st day of July, 2016, by and between Person County
Department of Social Services (“Covered Entity”) and Joseph Weinberger, Jr., Attorney at Law
(“Business Associate”) (collectively the “Parties”).
1. BACKGROUND
a. Covered Entity and Business Associate are parties to a contract entitled Legal Services
Contract (the “Contract”), whereby Business Associate agrees to perform certain services for or
on behalf of Covered Entity.
b. Covered Entity is an organizational unit of Person County as the Person County Department
of Social Services (DSS) as a health care component for purposes of the HIPAA Privacy Rule.
c. The relationship between Covered Entity and Business Associate is such that the Parties
believe Business Associate is or may be a “business associate” within the meaning of the HIPAA
Privacy Rule.
d. The Parties enter into this Business Associate Addendum to the Contract with the intention of
complying with the HIPAA Privacy Rule provision that a covered entity may disclose protected
health information to a business associate, and may allow a business associate to create or
receive protected heath information on its behalf, if the covered entity obtains satisfactory
assurances that the business associate will appropriately safeguard the information.
2. DEFINITIONS
Unless some other meaning is clearly indicated by the context, the following terms shall have the
following meaning in this Agreement:
a. “HIPAA” means the Administrative Simplification Provisions, Sections 261 through 264, of
the federal Health Insurance Portability and Accountability Act of 1996, Public Law 104-191.
b. “Individual” shall have the same meaning as the term “individual” in 45 CFR160.103 and
shall include a person who qualifies as a personal representative in accordance with 45 CFR
164.502(g).
c. “Privacy Rule” shall mean the Standards for Privacy of Individually Identifiable Health
Information at 45 CFR part 160 and part 164, subparts A and E.
d. “Protected Health Information” shall have the same meaning as the term “protected health
information” in 45 CFR 160.103, limited to the information created or received by Business
Associate from or on behalf of Covered Entity.
e. “Required By Law” shall have the same meaning as the term “required by law” in 45 CFR
164.103.
f. “Secretary” shall mean the Secretary of the United States Department of Health and Human
Services or his designee.
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g. Unless otherwise defined in this Agreement, terms used herein shall have the same meaning
as those terms have in the Privacy Rule.
3. OBLIGATIONS OF BUSINESS ASSOCIATE
a. Business Associate agrees to not use or disclose Protected Health Information other than as
permitted or required by this Agreement or as Required By Law.
b. Business Associate agrees to use appropriate safeguards to prevent use or disclosure of the
Protected Health Information other than as provided for by this Agreement.
c. Business Associate agrees to mitigate, to the extent practicable, any harmful effect that is
known to Business Associate of a use or disclosure of Protected Health Information by Business
Associate in violation of the requirements of this Agreement.
d. Business Associate agrees to report to Covered Entity any use or disclosure of the Protected
Health Information not provided for by this Agreement of which it becomes aware.
e. Business Associate agrees to ensure that any agent, including a subcontractor, to whom it
provides Protected Health Information received from, or created or received by Business
Associate on behalf of Covered Entity agrees to the same restrictions and conditions that apply
through this Agreement to Business Associate with respect to such information.
f. Business Associate agrees to provide access, at the request of Covered Entity, to Protected
Health Information in a Designated Record Set to Covered Entity or, as directed by Covered
Entity, to an Individual in order to meet the requirements under 45 CFR 164.524.
g. Business Associate agrees, at the request of the Covered Entity, to make any amendment(s) to
Protected Health Information in a Designated Record Set that the Covered Entity directs or
agrees to pursuant to 45 CFR 164.526.
h. Unless otherwise prohibited by law, Business Associate agrees to make internal practices,
books, and records, including policies and procedures and Protected Health Information, relating
to the use and disclosure of Protected Health Information received from, or created or received
by Business Associate on behalf of Covered Entity, available to the Covered Entity, or to the
Person County Department of Social Services, in a time and manner designated by the
Secretary, for purposes of determining Covered Entity's compliance with the Privacy Rule.
i. Business Associate agrees to document such disclosures of Protected Health Information and
information related to such disclosures as would be required for Covered Entity to respond to a
request by an Individual for an accounting of disclosures of Protected Health Information in
accordance with 45 CFR 164.528, and to provide this information to Covered Entity or an
Individual to permit such a response.
4. PERMITTED USES AND DISCLOSURES
a. Except as otherwise limited in this Agreement or by other applicable law or agreement, if the
Contract permits, Business Associate may use or disclose Protected Health Information to
perform functions, activities, or services for, or on behalf of, Covered Entity as specified in the
Contract, provided that such use or disclosure:
1) would not violate the Privacy Rule if done by Covered Entity; or
2) would not violate the minimum necessary policies and procedures of the Covered
Entity.
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b. Except as otherwise limited in this Agreement or by other applicable law or agreements, if the
Contract permits, Business Associate may use Protected Health Information as necessary for the
proper management and administration of the Business Associate or to carry out the legal
responsibilities of the Business Associate.
c. Except as otherwise limited in this Agreement or by other applicable law or agreements, if the
Contract permits, Business Associate may disclose Protected Health Information for the proper
management and administration of the Business Associate, provided that:
1) disclosures are Required By Law; or
2) Business Associate obtains reasonable assurances from the person to whom the
information is disclosed that it will remain confidential and will be used or further
disclosed only as Required By Law or for the purpose for which it was disclosed to the
person, and the person notifies the Business Associate of any instances of which it is
aware in which the confidentiality of the information has been breached.
d. Except as otherwise limited in this Agreement or by other applicable law or agreements, if the
Contract permits, Business Associate may use Protected Health Information to provide data
aggregation services to Covered Entity as permitted by 45 CFR 164.504(e)(2)(i)(B).
e. Notwithstanding the foregoing provisions, Business Associate may not use or disclose
Protected Health Information if the use or disclosure would violate any term of the Contract or
other applicable law or agreements.
5. TERM AND TERMINATION
a. Term. This Agreement shall be effective as of the effective date stated above and shall
terminate when the Contract terminates.
b. Termination for Cause. Upon Covered Entity's knowledge of a material breach by Business
Associate, Covered Entity may, at its option:
1) Provide an opportunity for Business Associate to cure the breach or end the violation,
and terminate this Agreement and services provided by Business Associate, to the extent
permissible by law, if Business Associate does not cure the breach or end the violation
within the time specified by Covered Entity;
2) Immediately terminate this Agreement and services provided by Business Associate,
to the extent permissible by law; or
3) If neither termination nor cure is feasible, report the violation to the Secretary as
provided in the Privacy Rule.
c. Effect of Termination.
1) Except as provided in paragraph (2) of this section or in the Contract or by other
applicable law or agreements, upon termination of this Agreement and services provided
by Business Associate, for any reason, Business Associate shall return or destroy all
Protected Health Information received from Covered Entity, or created or received by
Business Associate on behalf of Covered Entity. This provision shall apply to Protected
Health Information that is in the possession of subcontractors or agents of Business
Associate. Business Associate shall retain no copies of the Protected Health Information.
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2) In the event that Business Associate determines that returning or destroying the
Protected Health Information is not feasible, Business Associate shall provide to Covered
Entity notification of the conditions that make return or destruction not feasible. Business
Associate shall extend the protections of this Agreement to such Protected Health
Information and limit further uses and disclosures of such Protected Health Information
to those purposes that make the return or destruction infeasible, for so long as Business
Associate maintains such Protected Health Information.
6. GENERAL TERMS AND CONDITIONS
a. This Agreement amends and is part of the Contract.
b. Except as provided in this Agreement, all terms and conditions of the Contract shall remain in
force and shall apply to this Agreement as if set forth fully herein.
c. In the event of a conflict in terms between this Agreement and the Contract, the interpretation
that is in accordance with the Privacy Rule shall prevail. In the event that a conflict then
remains, the Contract terms shall prevail so long as they are in accordance with the Privacy Rule.
d. A breach of this Agreement by Business Associate shall be considered sufficient basis for
Covered Entity to terminate the Contract for cause.
Joseph Weinberger, Jr., Attorney At Law
____________________________ _________________________
Signature Date
David Newell, Sr.
____________________________ _________________________
Chairman, County Commissioners Date
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Attachment M
State Certification
Contractor Certifications Required by North Carolina Law
Instructions
The person who signs this document should read the text of the statutes listed below and consult with
counsel and other knowledgeable persons before signing.
The text of Article 2 of Chapter 64 of the North Carolina General Statutes can be found online at:
http://www.ncga.state.nc.us/EnactedLegislation/Statutes/PDF/ByArticle/Chapter_64/Article_2.pdf
The text of G.S. 105-164.8(b) can be found online at:
http://www.ncga.state.nc.us/EnactedLegislation/Statutes/PDF/BySection/Chapter_105/GS_105-
164.8.pdf
The text of G.S. 143-48.5 (S.L. 2013-418, s. 2.(d)) can be found online at:
http://www.ncga.state.nc.us/Sessions/2013/Bills/House/PDF/H786v6.pdf
The text of G.S. 143-59.1 can be found online at:
http://www.ncga.state.nc.us/EnactedLegislation/Statutes/PDF/BySection/Chapter_143/GS_143-
59.1.pdf
The text of G.S. 143-59.2 can be found online at:
http://www.ncga.state.nc.us/EnactedLegislation/Statutes/PDF/BySection/Chapter_143/GS_143-
59.2.pdf
The text of G.S. 147-33.95(g) (S.L. 2013-418, s. 2.(e)) can be found online at:
http://www.ncga.state.nc.us/Sessions/2013/Bills/House/PDF/H786v6.pdf
Certifications
(1) Pursuant to G.S. 143-48.5 and G.S. 147-33.95(g), the undersigned hereby certifies that the
Contractor named below, and the Contractor’s subcontractors, complies with the requirements of
Article 2 of Chapter 64 of the NC General Statutes, including the requirement for each employer
with more than 25 employees in North Carolina to verify the work authorization of its employees
through the federal E-Verify system." E-Verify System Link: www.uscis.gov
Local government is specifically exempt from Article 2 of Chapter 64 of the North Carolina
General Statutes. However, local government is subject to and must comply with North Carolina
General Statute §153A-99.1., which states in part as follows:
Counties Must Use E-Verify. - Each county shall register and participate in E-Verify to verify the
work authorization of new employees hired to work in the United States.
(2) Pursuant to G.S. 143-59.1(b), the undersigned hereby certifies that the Contractor named below
is not an “ineligible Contractor” as set forth in G.S. 143-59.1(a) because:
(a) Neither the Contractor nor any of its affiliates has refused to collect the use tax levied
under Article 5 of Chapter 105 of the General Statutes on its sales delivered to North
Carolina when the sales met one or more of the conditions of G.S. 105-164.8(b); and
(b) [check one of the following boxes]
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Neither the Contractor nor any of its affiliates has incorporated or reincorporated
in a “tax haven country” as set forth in G.S. 143-59.1(c)(2) after December 31,
2001; or
The Contractor or one of its affiliates has incorporated or reincorporated in a “tax
haven country” as set forth in G.S. 143-59.1(c)(2) after December 31, 2001 but
the United States is not the principal market for the public trading of the stock of
the corporation incorporated in the tax haven country.
(3) Pursuant to G.S. 143-59.2(b), the undersigned hereby certifies that none of the Contractor’s
officers, directors, or owners (if the Contractor is an unincorporated business entity) has been
convicted of any violation of Chapter 78A of the General Statutes or the Securities Act of 1933 or
the Securities Exchange Act of 1934 within 10 years immediately prior to the date of the bid
solicitation.
(4) The undersigned hereby certifies further that:
(a) He or she is a duly authorized representative of the Contractor named below;
(b) He or she is authorized to make, and does hereby make, the foregoing certifications on
behalf of the Contractor; and
(c) He or she understands that any person who knowingly submits a false certification in
response to the requirements of G.S. 143-59.1 and -59.2 shall be guilty of a Class I
felony.
Contractor’s Name: Joseph Weinberger, Jr.
Signature of Contractor’s Authorized Agent
Date
Printed Name of Contractor’s Authorized Agent
Joseph Weinberger, Jr.
Title
Attorney at Law
Signature of Witness
Title
Printed Name of Witness
Date
The witness should be present when the Contractor’s Authorized Agent signs this certification and should
sign and date this document immediately thereafter.
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Attachment N
CERTIFICATION OF
ELIGIBILITY
Under the Iran
Divestment Act
Pursuant to G.S. 147-86.59, any person identified as engaging in investment activities in
Iran, determined by appearing on the Final Divestment List created by the State
Treasurer pursuant to G.S. 147-86.58, is ineligible to contract with the State of North
Carolina or any political subdivision of the State. The Iran Divestment Act of 2015, G.S.
147-86.55 et seq.* requires that each vendor, prior to contracting with the State certify,
and the undersigned on behalf of the Vendor does hereby certify, to the following:
1. that Joseph Weinberger, Jr., Attorney At Law, is not identified on the Final
Divestment List of entities that the State Treasurer has determined engages in
investment activities in Iran;
2. that Joseph Weinberger, Jr., Attorney At Law, shall not utilize on any contract with
the State agency any subcontractor that is identified on the Final Divestment List;
and
3. that Joseph Weinberger, Jr., Attorney At Law, is authorized to make this Certification.
Joseph Weinberger, Jr., Attorney At Law
____________________________ _________________________
Signature Date
* Note: Enacted by Session Law 2015‐118 as G.S. 143C‐55 et seq., but has been renumbered for
codification at the direction of the Revisor of Statutes.
The State Treasurer’s Final Divestment List can be found on the State Treasurer’s website at the address:
https://www.nctreasurer.com/inside‐the‐department/OpenGovernment/Pages/Iran‐Divestment‐Act‐Resources.aspx
and will be updated every 180 days. For questions about the Department of State Treasurer’s Iran Divestment
Policy, please contact Meryl Murtagh at Meryl.Murtagh@nctreasurer.com or (919) 814‐3852.
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Contract # 1007 Fiscal Year Begins July 1, 2016 Ends June 30, 2017
This contract is hereby entered into by and between the Person County Department of Social
Services (the "County") and Joseph Weinberger, Jr. (the "Contractor") (referred to collectively
as the “Parties”). The Contractor’s federal tax identification number is 56-153 8949.
Contract Documents: This Contract consists of the following documents:
This contract
The General Terms and Conditions (Attachment A)
The Scope of Work, description of services, and rate (Attachment B)
Federal Certification Regarding Drug-Free Workplace & Certification Regarding Nondiscrimination (Attachment C)
Conflict of Interest (Attachment D)
No Overdue Taxes (Attachment E)
Federal Certification Regarding Lobbying (Attachment G)
Federal Certification Regarding Debarment (Attachment H)
HIPAA Business Associate Addendum (Attachment I)
State Certification (Attachment M)
Certification of Eligibility Under the Iran Divestment Act (Attachment N)
These documents constitute the entire agreement between the Parties and supersede all prior
oral or written statements or agreements.
Precedence among Contract Documents: In the event of a conflict between or among the
terms of the Contract Documents, the terms in the Contract Document with the highest relative
precedence shall prevail. The order of precedence shall be the order of documents as listed in
Paragraph 1, above, with the first-listed document having the highest precedence and the last-
listed document having the lowest precedence. If there are multiple Contract Amendments, the
most recent amendment shall have the highest precedence and the oldest amendment shall
have the lowest precedence.
Effective Period: This contract shall be effective on July 1, 2016 and shall terminate on
June 30, 2017. This contract must be twelve months or less.
Contractor’s Duties: The Contractor shall provide the services and in accordance with the
approved rate as described in Attachment B, Scope of Work.
County’s Duties: The County shall pay the Contractor in the manner and in the amounts
specified in the Contract Documents.
[ x ] a. There are no matching requirements from the Contractor.
[ ] b. The Contractor’s matching requirement is $__________, which shall consist of:
[ ] In-kind [ ] Cash [ ] Cash and In-kind [ ] Cash and/or In-kind
The contributions from the Contractor shall be sourced from non-federal funds.
The total contract amount including any Contractor match shall not exceed 1,000 hours
collectively for all attorneys under contract. Rate of compensation for Secondary Attorney
Joseph Weinberger, Jr. is $75 per hour.
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Reversion of Funds:
Any unexpended grant funds shall revert to the County Department of Social Services upon
termination of this contract.
Reporting Requirements:
Contractor shall comply with audit requirements as described in N.C.G.S. § 143C-6-22 & 23 and
OMB Circular- CFR Title 2 Grants and Agreements, Part 200, and shall disclose all information
required by 42 USC 455.104, or 42 USC 455.105, or 42 USC 455.106.
Payment Provisions:
Payment shall be made in accordance with the Contract Documents as described in the Scope
of Work, Attachment B.
Contract Administrators: All notices permitted or required to be given by one Party to the
other and all questions about the contract from one Party to the other shall be addressed and
delivered to the other Party’s Contract Administrator. The name, post office address, street
address, telephone number, fax number, and email address of the Parties’ respective initial
Contract Administrators are set out below. Either Party may change the name, post office
address, street address, telephone number, fax number, or email address of its Contract
Administrator by giving timely written notice to the other Party.
For the County: For the Contractor:
Wendy Bowman, Accounting Technician
Person County Department of Social Services Joseph Weinberger, Jr., Attorney
P.O. Box 770 P.O. Box 1215
355B South Madison Boulevard 114 North Main Street
Roxboro, NC 27573 Roxboro, NC 27573
(336) 599-8361 (336) 599-4959
Supplementation of Expenditure of Public Funds: The Contractor assures that funds
received pursuant to this contract shall be used only to supplement, not to supplant, the total
amount of federal, state and local public funds that the Contractor otherwise expends for
contract services and related programs. Funds received under this contract shall be used to
provide additional public funding for such services; the funds shall not be used to reduce the
Contractor’s total expenditure of other public funds for such services.
Disbursements: As a condition of this contract, the Contractor acknowledges and agrees to
make disbursements in accordance with the following requirements:
(a) Implement adequate internal controls over disbursements;
(b) Pre-audit all vouchers presented for payment to determine:
Validity and accuracy of payment
Payment due date
Adequacy of documentation supporting payment
Legality of disbursement
(c) Assure adequate control of signature stamps/plates;
(d) Assure adequate control of negotiable instruments; and
(e) Implement procedures to insure that account balance is solvent and reconcile the
account monthly.
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Outsourcing to Other Countries: The Contractor certifies that it has identified to the County
all jobs related to the contract that have been outsourced to other countries, if any. The
Contractor further agrees that it will not outsource any such jobs during the term of this contract
without providing notice to the County.
Federal Certifications: Individuals and Organizations receiving federal funds must ensure
compliance with certain certifications required by federal laws and regulations. The contractor is
hereby complying with Certifications regarding Nondiscrimination, Drug-Free Workplace
Requirements, Environmental Tobacco Smoke, Debarment, Suspension, Ineligibility and
Voluntary Exclusion Lower Tier Covered Transactions, and Lobbying. These assurances and
certifications are to be signed by the contractor’s authorized representative.
Signature Warranty: The undersigned represent and warrant that they are authorized to bind
their principals to the terms of this agreement.
Signature Warranty:
The undersigned represent and warrant that they are authorized to bind their principals to the terms of this
agreement.
The Contractor and the County have executed this contract in duplicate originals, with one original being retained by
each party.
Joseph Weinberger, Jr., Attorney At Law
____________________________ _________________________
Signature Date
PERSON COUNTY
David Newell, Sr.
____________________________ _________________________
Chairman, County Commissioners Date
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
Act.
______________________________ ___________________________
Amy Wehrenberg, County Finance Director Date
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ATTACHMENT A
General Terms and Conditions
Relationships of the Parties
Independent Contractor: The Contractor is and shall be deemed to be an independent contractor in the performance of
this contract and as such shall be wholly responsible for the work to be performed and for the supervision of its employees.
The Contractor represents that it has, or shall secure at its own expense, all personnel required in performing the services
under this agreement. Such employees shall not be employees of, or have any individual contractual relationship with the
County.
Subcontracting: The Contractor shall not subcontract any of the work contemplated under this contract without prior written
approval from the County. Any approved subcontract shall be subject to all conditions of this contract. Only the
subcontractors specified in the contract documents are to be considered approved upon award of the contract. The County
shall not be obligated to pay for any work performed by any unapproved subcontractor. The Contractor shall be responsible
for the performance of all of its subcontractors.
Assignment: No assignment of the Contractor's obligations or the Contractor's right to receive payment hereunder shall be
permitted. However, upon written request approved by the issuing purchasing authority, the County may: Forward the
Contractor's payment check(s) directly to any person or entity designated by the Contractor, or Include any person or entity
designated by Contractor as a joint payee on the Contractor's payment check(s). In no event shall such approval and action
obligate the County to anyone other than the Contractor and the Contractor shall remain responsible for fulfillment of all
contract obligations.
Beneficiaries: Except as herein specifically provided otherwise, this contract shall inure to the benefit of and be binding
upon the parties hereto and their respective successors. It is expressly understood and agreed that the enforcement of the
terms and conditions of this contract, and all rights of action relating to such enforcement, shall be strictly reserved to the
County and the named Contractor. Nothing contained in this document shall give or allow any claim or right of action
whatsoever by any other third person. It is the express intention of the County and Contractor that any such person or entity,
other than the County or the Contractor, receiving services or benefits under this contract shall be deemed an incidental
beneficiary only.
Indemnity and Insurance
Indemnification: The Contractor agrees to indemnify and hold harmless the County and any of their officers, agents and
employees, from any claims of third parties arising out or any act or omission of the Contractor in connection with the
performance of this contract.
Insurance: During the term of the contract, the Contractor at its sole cost and expense shall provide commercial insurance
of such type and with such terms and limits as may be reasonably associated with the contract. As a minimum, the
Contractor shall provide and maintain the following coverage and limits:
Worker’s Compensation - The contractor shall provide and maintain Worker’s Compensation Insurance as required
by the laws of North Carolina, as well as employer’s liability coverage with minimum limits of $500,000.00, covering all
of Contractor’s employees who are engaged in any work under the contract. If any work is sublet, the Contractor shall
require the subcontractor to provide the same coverage for any of his employees engaged in any work under the
contract.
Commercial General Liability - General Liability Coverage on a Comprehensive Broad Form on an occurrence basis in
the minimum amount of $1,000,000.00 Combined Single Limit. (Defense cost shall be in excess of the limit of liability.)
Automobile Liability Insurance: The Contractor shall provide automobile liability insurance with a combined single
limit of $500,000.00 for bodily injury and property damage; a limit of $500,000.00 for uninsured/under insured
motorist coverage; and a limit of $2,000.00 for medical payment coverage. The Contractor shall provide this insurance
for all automobiles that are:
(a) owned by the Contractor and used in the performance of this contract;
(b) hired by the Contractor and used in the performance of this contract; and
(c) Owned by Contractor’s employees and used in performance of this contract (“non-owned vehicle insurance”).
Non-owned vehicle insurance protects employers when employees use their personal vehicles for work
purposes. Non-owned vehicle insurance supplements, but does not replace, the car-owner’s liability insurance.
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The Contractor is not required to provide and maintain automobile liability insurance on any vehicle – owned,
hired, or non-owned -- unless the vehicle is used in the performance of this contract.
(d) The insurance coverage minimums specified in subparagraph (a) are exclusive of defense costs.
(e) The Contractor understands and agrees that the insurance coverage minimums specified in subparagraph (a) are
not limits, or caps, on the Contractor’s liability or obligations under this contract.
(f) The Contractor may obtain a waiver of any one or more of the requirements in subparagraph (a) by
demonstrating that it has insurance that provides protection that is equal to or greater than the coverage and
limits specified in subparagraph (a). The County shall be the sole judge of whether such a waiver should be
granted.
(g) The Contractor may obtain a waiver of any one or more of the requirements in paragraph (a) by demonstrating
that it is self-insured and that its self-insurance provides protection that is equal to or greater than the coverage
and limits specified in subparagraph (a). The County shall be the sole judge of whether such a waiver should be
granted.
(h) Providing and maintaining the types and amounts of insurance or self-insurance specified in this paragraph is a
material obligation of the Contractor and is of the essence of this contract.
(i) The Contractor shall only obtain insurance from companies that are authorized to provide such coverage and
that are authorized by the Commissioner of Insurance to do business in the State of North Carolina. All such
insurance shall meet all laws of the State of North Carolina.
(j) The Contractor shall comply at all times with all lawful terms and conditions of its insurance policies and all
lawful requirements of its insurer.
(k) The Contractor shall require its subcontractors to comply with the requirements of this paragraph.
(l) The Contractor shall demonstrate its compliance with the requirements of this paragraph by submitting
certificates of insurance to the County before the Contractor begins work under this contract.
Transportation of Clients by Contractor:
The contractor will maintain Insurance requirements if required as noted under Article 7 Rule R2-36 of the North Carolina
Utilities Commission.
Default and Termination
Termination without Cause: The County may terminate this contract without cause by giving 30 days written notice to the
Contractor.
Termination for Cause: If, through any cause, the Contractor shall fail to fulfill its obligations under this contract in a timely
and proper manner, the County shall have the right to terminate this contract by giving written notice to the Contractor and
specifying the effective date thereof. In that event, all finished or unfinished deliverable items prepared by the Contractor
under this contract shall, at the option of the County, become its property and the Contractor shall be entitled to receive just
and equitable compensation for any satisfactory work completed on such materials, minus any payment or compensation
previously made. Notwithstanding the foregoing provision, the Contractor shall not be relieved of liability to the County for
damages sustained by the County by virtue of the Contractor’s breach of this agreement, and the County may withhold any
payment due the Contractor for the purpose of setoff until such time as the exact amount of damages due the County from
such breach can be determined. In case of default by the Contractor, without limiting any other remedies for breach
available to it, the County may procure the contract services from other sources and hold the Contractor responsible for any
excess cost occasioned thereby. The filing of a petition for bankruptcy by the Contractor shall be an act of default under this
contract.
Waiver of Default: Waiver by the County of any default or breach in compliance with the terms of this contract by the
Provider shall not be deemed a waiver of any subsequent default or breach and shall not be construed to be modification of
the terms of this contract unless stated to be such in writing, signed by an authorized representative of the County and the
Contractor and attached to the contract.
Availability of Funds: The parties to this contract agree and understand that the payment of the sums specified in this
contract is dependent and contingent upon and subject to the appropriation, allocation, and availability of funds for this
purpose to the County.
Force Majeure: Neither party shall be deemed to be in default of its obligations hereunder if and so long as it is prevented
from performing such obligations by any act of war, hostile foreign action, nuclear explosion, riot, strikes, civil insurrection,
earthquake, hurricane, tornado, or other catastrophic natural event or act of God.
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Survival of Promises: All promises, requirements, terms, conditions, provisions, representations, guarantees, and warranties
contained herein shall survive the contract expiration or termination date unless specifically provided otherwise herein, or
unless superseded by applicable Federal or State statutes of limitation.
Intellectual Property Rights
Copyrights and Ownership of Deliverables: All deliverable items produced pursuant to this contract are the exclusive
property of the County. The Contractor shall not assert a claim of copyright or other property interest in such deliverables.
Federal Intellectual Property Bankruptcy Protection Act: The Parties agree that the County shall be entitled to all rights and
benefits of the Federal Intellectual Property Bankruptcy Protection Act, Public Law 100-506, codified at 11 U.S.C. 365 (n)
and any amendments thereto.
Compliance with Applicable Laws
Compliance with Laws: The Contractor shall comply with all laws, ordinances, codes, rules, regulations, and licensing
requirements that are applicable to the conduct of its business, including those of federal, state, and local agencies having
jurisdiction and/or authority.
Title VI, Civil Rights Compliance: In accordance with Federal law and U.S. Department of Agriculture (USDA) and U.S.
Department of Health and Human Services (HHS) policy, this institution is prohibited from discriminating on the basis of
race, color, national origin, sex, age or disability. Under the Food Stamp Act and USDA policy, discrimination is prohibited
also on the basis of religion or political beliefs.
Equal Employment Opportunity: The Contractor shall comply with all federal and State laws relating to equal employment
opportunity.
Health Insurance Portability and Accountability Act (HIPAA): The Contractor agrees that, if the County determines that
some or all of the activities within the scope of this contract are subject to the Health Insurance Portability and Accountability
Act of 1996, P.L. 104-91, as amended (“HIPAA”), or its implementing regulations, it will comply with the HIPAA
requirements and will execute such agreements and practices as the County may require to ensure compliance.
(a) Data Security: The Contractor shall adopt and apply data security standards and procedures that comply with all
applicable federal, state, and local laws, regulations, and rules.
(b) Duty to Report: The Contractor shall report a suspected or confirmed security breach to the local Department of
Social Services/Human Services Contract Administrator within twenty-four (24) hours after the breach is first
discovered, provided that the Contractor shall report a breach involving Social Security Administration data or
Internal Revenue Service data within one (1) hour after the breach is first discovered.
(c) Cost Borne by Contractor: If any applicable federal, state, or local law, regulation, or rule requires the Contractor
to give written notice of a security breach to affected persons, the Contractor shall bear the cost of the notice.
Trafficking Victims Protection Act of 2000: The Contractor will comply with the requirements of Section 106(g) of the
Trafficking Victims Protection Act of 2000, as amended (22 U.S.C. 7104).
Executive Order # 24: It is unlawful for any vendor, contractor, subcontractor or supplier of the state to make gifts or to give
favors to any state employee. For additional information regarding the specific requirements and exemptions, contractors
are encouraged to review Executive Order 24 and G.S. Sec. 133-32.
Confidentiality
Confidentiality: Any information, data, instruments, documents, studies or reports given to or prepared or assembled by the
Contractor under this agreement shall be kept as confidential and not divulged or made available to any individual or
organization without the prior written approval of the County. The Contractor acknowledges that in receiving, storing,
processing or otherwise dealing with any confidential information it will safeguard and not further disclose the information
except as otherwise provided in this contract.
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Oversight
Access to Persons and Records: The State Auditor shall have access to persons and records as a result of all contracts or
grants entered into by State agencies or political subdivisions in accordance with General Statute 147-64.7. Additionally, as
the State funding authority, the Department of Health and Human Services shall have access to persons and records as a
result of all contracts or grants entered into by State agencies or political subdivisions.
Record Retention: Records shall not be destroyed, purged or disposed of without the express written consent of the
Division. State basic records retention policy requires all grant records to be retained for a minimum of five years or until all
audit exceptions have been resolved, whichever is longer. If the contract is subject to federal policy and regulations, record
retention may be longer than five years since records must be retained for a period of three years following submission of the
final Federal Financial Status Report, if applicable, or three years following the submission of a revised final Federal
Financial Status Report. Also, if any litigation, claim, negotiation, audit, disallowance action, or other action involving this
Contract has been started before expiration of the five-year retention period described above, the records must be retained
until completion of the action and resolution of all issues which arise from it, or until the end of the regular five-year period
described above, whichever is later. The record retention period for Temporary Assistance for Needy Families (TANF) and
MEDICAID and Medical Assistance grants and programs must be retained for a minimum of ten years.
Warranties and Certifications
Date and Time Warranty: The Contractor warrants that the product(s) and service(s) furnished pursuant to this contract
(“product” includes, without limitation, any piece of equipment, hardware, firmware, middleware, custom or commercial
software, or internal components, subroutines, and interfaces therein) that perform any date and/or time data recognition
function, calculation, or sequencing will support a four digit year format and will provide accurate date/time data and leap
year calculations. This warranty shall survive the termination or expiration of this contract.
Certification Regarding Collection of Taxes: G.S. 143-59.1 bars the Secretary of Administration from entering into contracts
with vendors that meet one of the conditions of G.S. 105-164.8(b) and yet refuse to collect use taxes on sales of tangible
personal property to purchasers in North Carolina. The conditions include: (a) maintenance of a retail establishment or
office; (b) presence of representatives in the State that solicit sales or transact business on behalf of the vendor; and (c)
systematic exploitation of the market by media-assisted, media-facilitated, or media-solicited means. The Contractor certifies
that it and all of its affiliates (if any) collect all required taxes.
E-Verify
Pursuant to G.S. 143-48.5 and G.S. 147-33.95(g), the undersigned hereby certifies that the Contractor named below, and the
Contractor’s subcontractors, complies with the requirements of Article 2 of Chapter 64 of the NC General Statutes, including
the requirement for each employer with more than 25 employees in North Carolina to verify the work authorization of its
employees through the federal E-Verify system." E-Verify System Link: www.uscis.gov
Miscellaneous
Choice of Law: The validity of this contract and any of its terms or provisions, as well as the rights and duties of the parties
to this contract, are governed by the laws of North Carolina. The Contractor, by signing this contract, agrees and submits,
solely for matters concerning this Contract, to the exclusive jurisdiction of the courts of North Carolina and agrees, solely for
such purpose, that the exclusive venue for any legal proceedings shall be the county is which the contract originated. The
place of this contract and all transactions and agreements relating to it, and their situs and forum, shall be the county where
the contract originated, where all matters, whether sounding in contract or tort, relating to the validity, construction,
interpretation, and enforcement shall be determined.
Amendment: This contract may not be amended orally or by performance. Any amendment must be made in written form
and executed by duly authorized representatives of the County and the Contractor.
Severability: In the event that a court of competent jurisdiction holds that a provision or requirement of this contract
violates any applicable law, each such provision or requirement shall continue to be enforced to the extent it is not in
violation of law or is not otherwise unenforceable and all other provisions and requirements of this contract shall remain in
full force and effect.
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Headings: The Section and Paragraph headings in these General Terms and Conditions are not material parts of the
agreement and should not be used to construe the meaning thereof.
Time of the Essence: Time is of the essence in the performance of this contract.
Key Personnel: The Contractor shall not replace any of the key personnel assigned to the performance of this contract
without the prior written approval of the County. The term “key personnel” includes any and all persons identified as such
in the contract documents and any other persons subsequently identified as key personnel by the written agreement of the
parties.
Care of Property: The Contractor agrees that it shall be responsible for the proper custody and care of any property
furnished to it for use in connection with the performance of this contract and will reimburse the County for loss of, or
damage to, such property. At the termination of this contract, the Contractor shall contact the County for instructions as to
the disposition of such property and shall comply with these instructions.
Travel Expenses: Reimbursement to the Contractor for travel mileage, meals, lodging and other travel expenses incurred in
the performance of this contract shall not exceed the rates established in County policy.
Sales/Use Tax Refunds: If eligible, the Contractor and all subcontractors shall: (a) ask the North Carolina Department of
Revenue for a refund of all sales and use taxes paid by them in the performance of this contract, pursuant to G.S. 105-
164.14; and (b) exclude all refundable sales and use taxes from all reportable expenditures before the expenses are entered
in their reimbursement reports.
Advertising: The Contractor shall not use the award of this contract as a part of any news release or commercial advertising.
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ATTACHMENT B – Scope of Work Federal Tax Id. 56-153 8949
STATE OF NORTH CAROLINA )
)
) CONTRACT FOR LEGAL SERVICES
)
COUNTY OF Person )
THIS CONTRACT made and entered into this the 1st day of July, 2016, by and
between the Person County Commissioners, party of the first part, and Joseph
Weinberger, Jr., Attorney, party of the second part;
W I T N E S S E T H :
The parties hereby agree that the party of the second part shall provide legal
services to the party of the first part pursuant to the following mutual covenants:
1. This Contract shall begin July 1, 2016, and unless sooner terminated by 30
days’ notice of either party shall exist and continue through June 30, 2017.
2. Said party of the second part, upon reasonable notice, is to be available for
consultation, legal advice and for representation as requested by the Child Support
Enforcement Agency on all legal matters arising from the duties of the party of the first
part under Sections 128 through 140 of Chapter 110 of the North Carolina General
Statutes and Title 42 of the United States Code, Sections 651 through 660 and the
federal regulations lawfully promulgated pursuant thereto.
3. Said party of the second part, agrees to comply with all the requirements of
Sections 128 through 140 of Chapter 110 of the North Carolina General Statutes, Title
42 of the United States Code, Sections 651 through 660, and the regulations
promulgated pursuant thereto relating to the performance of program legal services
including, but not limited to, maintaining such records as are required by the party of the
first part, to make said records available for federal or state audit if required, and to
make financial, statistical, and program progress reports as are required.
4. For his services under this contract, the party of the first part agrees to pay
the party of the second part seventy-five dollars ($75.00) per hour for out of court time
and seventy-five dollars ($75.00) per hour for in court time for each hour spent by the
party of the second part providing legal services under the Child Support Enforcement
Program. Such hourly rate shall encompass all expenses, including, but not limited to,
those for salary, supplies, office space, heating and maintenance for office space,
telephone service, long-distance telephone calls, and travel. The party of the second
part is not to be reimbursed for any extraordinary expense incident to performing the
services included under this agreement; except, that the party of the first part agrees to
pay all court costs and filing fees which are required to be paid in conjunction with
services provided by the attorney under this agreement.
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5. It is specifically agreed that the party of the second part is an independent
contractor and the party of the second part shall perform the services herein provided
according to his own judgment and method and shall not be subject to the control of the
party of the first part except as to the result of his work.
6. The party of the second part shall not under any circumstance be considered
an employee of the party of the first part. The party of the first part shall not withhold
federal or state taxes from sums to be paid to the party of the second part pursuant to
this agreement.
IN TESTIMONY WHEREOF, said parties have executed this contract in triplicate
originals, one of which is to be retained by the party of the first part, one of which is to
be retained by the parties of the second part, and one of which is to be filed with Child
Support Enforcement Section, Division of Social Services of the Department of Human
Resources, Raleigh, North Carolina.
Joseph Weinberger, Jr., Attorney At Law
____________________________ _________________________
Signature Date
David Newell, Sr.
____________________________ _________________________
Chairman, County Commissioners Date
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ATTACHMENT C
CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS
AND CERTIFICATION REGARDING NONDISCRIMINATION
Person County Department of Social Services
I. By execution of this Agreement the Contractor certifies that it will provide a drug-free workplace by:
A. Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession or use of a controlled substance is prohibited in the Contractor’s workplace and specifying the actions that will be taken against employees for violation of
such prohibition;
B. Establishing a drug-free awareness program to inform employees about: (1) The dangers of drug abuse in the workplace; (2) The Contractor’s policy of maintaining a drug-free workplace; (3) Any available drug counseling, rehabilitation, and employee assistance programs; and
(4) The penalties that may be imposed upon employees for drug abuse violations
occurring in the workplace;
C. Making it a requirement that each employee be engaged in the performance of the agreement be given a copy of the statement required by paragraph (A); D. Notifying the employee in the statement required by paragraph (A) that, as a condition of employment under the agreement, the employee will:
(1) Abide by the terms of the statement; and
(2) Notify the employer of any criminal drug statute conviction for a violation occurring in the workplace no later than five days after such conviction;
E. Notifying the County within ten days after receiving notice under subparagraph (D)(2) from an employee or otherwise receiving actual notice of such conviction; F. Taking one of the following actions, within 30 days of receiving notice under
subparagraph (D)(2), with respect to any employee who is so convicted:
(1) Taking appropriate personnel action against such an employee, up to and including termination; or (2) Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State, or local health, law enforcement, or other appropriate agency; and
Making a good faith effort to continue to maintain a drug-free workplace through
implementation of paragraphs (A), (B), (C), (D), (E), and (F).
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The site(s) for the performance of work done in connection with the specific agreement are
listed below:
114 North Main Street, Roxboro, NC 27573
Contractor will inform the County of any additional sites for performance of work under this agreement. False certification or violation of the certification shall be grounds for suspension of payment,
suspension or termination of grants, or government-wide Federal suspension or debarment
45 C.F.R. Section 82.510. Section 4 CFR Part 85, Section 85.615 and 86.620.
Certification Regarding Nondiscrimination
The Vendor certifies that it will comply with all Federal statutes relating to nondiscrimination.
These include but are not limited to: (a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352)
which prohibits discrimination on the basis of race, color or national origin; (b) Title IX of the
Education Amendments of 1972, as amended (20 U.S.C. §§1681-1683, and 1685-1686), which
prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as
amended (29 U.S.C. §794), which prohibits discrimination on the basis of handicaps; (d) the Age
Discrimination Act of 1975, as amended (42 U.S.C. §§6101-6107), which prohibits
discrimination on the basis of age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L.
92-255), as amended, relating to nondiscrimination on the basis of drug abuse; (f) the
Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of
1970 (P.L. 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or
alcoholism; (g) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. §§3601 et seq.), as
amended, relating to nondiscrimination in the sale, rental or financing of housing; (h) the Food
Stamp Act and USDA policy, which prohibit discrimination on the basis of religion and political
beliefs; and (i) the requirements of any other nondiscrimination statutes which may apply to this
Agreement.
Joseph Weinberger, Jr., Attorney At Law
____________________________ _________________________
Signature Date
David Newell, Sr.
____________________________ _________________________
Chairman, County Commissioners Date
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ATTACHMENT D:
CONFLICT OF INTEREST
The Board of Directors/Trustees or other governing persons, officers, employees or agents are to avoid
any conflict of interest, even the appearance of a conflict of interest. The Organization‘s Board of
Directors/Trustees or other governing body, officers, staff and agents are obligated to always act in the
best interest of the organization. This obligation requires that any Board member or other governing
person, officer, employee or agent, in the performance of Organization duties, seek only the furtherance
of the Organization mission. At all times, Board members or other governing persons, officers, employees
or agents, are prohibited from using their job title, the Organization's name or property, for private profit or
benefit.
A. The Board members or other governing persons, officers, employees, or agents of the Organization
should neither solicit nor accept gratuities, favors, or anything of monetary value from current or potential
contractors/vendors, persons receiving benefits from the Organization or persons who may benefit from
the actions of any Board member or other governing person, officer, employee or agent. This is not
intended to preclude bona-fide Organization fund raising-activities.
B. A Board or other governing body member may, with the approval of Board or other governing body,
receive honoraria for lectures and other such activities while not acting in any official capacity for the
Organization. Officers may, with the approval of the Board or other governing body, receive honoraria for
lectures and other such activities while on personal days, compensatory time, annual leave, or leave
without pay. Employees may, with the prior written approval of their supervisor, receive honoraria for
lectures and other such activities while on personal days, compensatory time, annual leave, or leave
without pay. If a Board or other governing body member, officer, employee or agent is acting in any
official capacity, honoraria received in connection with activities relating to the Organization are to be paid
to the Organization.
C. No Board member or other governing person, officer, employee, or agent of the Organization shall
participate in the selection, award, or administration of a purchase or contract with a vendor where, to his
knowledge, any of the following has a financial interest in that purchase or contract:
1. The Board member or other governing person, officer, employee, or agent;
2. Any member of their family by whole or half blood, step or personal relationship or relative-in-law;
3. An organization in which any of the above is an officer, director, or employee;
4. A person or organization with whom any of the above individuals is negotiating or has any
arrangement concerning prospective employment or contracts.
D. Duty to Disclosure -- Any conflict of interest, potential conflict of interest, or the appearance of a
conflict of interest is to be reported to the Board or other governing body or one’s supervisor immediately.
E. Board Action -- When a conflict of interest is relevant to a matter requiring action by the Board of
Directors/Trustees or other governing body, the Board member or other governing person, officer,
employee, or agent (person(s)) must disclose the existence of the conflict of interest and be given the
opportunity to disclose all material facts to the Board and members of committees with governing board
delegated powers considering the possible conflict of interest. After disclosure of all material facts, and
after any discussion with the person, he/she shall leave the governing board or committee meeting while
the determination of a conflict of interest is discussed and voted upon. The remaining board or committee
members shall decide if a conflict of interest exists. In addition, the person(s) shall not participate in the
final deliberation or decision regarding the matter under consideration and shall leave the meeting during
the discussion of and vote of the Board of Directors/Trustees or other governing body.
F. Violations of the Conflicts of Interest Policy -- If the Board of Directors/Trustees or other governing
body has reasonable cause to believe a member, officer, employee or agent has failed to disclose actual
or possible conflicts of interest, it shall inform the person of the basis for such belief and afford the person
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an opportunity to explain the alleged failure to disclose. If, after hearing the person's response and after
making further investigation as warranted by the circumstances, the Board of Directors/Trustees or other
governing body determines the member, officer, employee or agent has failed to disclose an actual or
possible conflict of interest, it shall take appropriate disciplinary and corrective action.
G. Record of Conflict -- The minutes of the governing board and all committees with board delegated
powers shall contain:
1. The names of the persons who disclosed or otherwise were found to have an actual or possible
conflict of interest, the nature of the conflict of interest, any action taken to determine whether a
conflict of interest was present, and the governing board's or committee's decision as to whether
a conflict of interest in fact existed.
2. The names of the persons who were present for discussions and votes relating to the transaction
or arrangement that presents a possible conflict of interest, the content of the discussion,
including any alternatives to the transaction or arrangement, and a record of any votes taken in
connection with the proceedings.
NOTARIZED CONFLICT OF INTEREST POLICY
Joseph Weinberger, Jr.
_________________________________ _________________________
Signature Date
NORTH CAROLINA
PERSON COUNTY
I, __________________________, a Notary Public of said County and State do hereby certify that Joseph Weinberger,
Jr., Attorney at Law, personally appeared before me this date and acknowledged the due execution of the foregoing
agreement for the purposes therein expressed and by that authority duly given and as the act of the Organization,
affirmed that the foregoing Conflict of Interest Policy was adopted by the Board of Directors/Trustees or other
governing body in a meeting held on the __________ day of ___________, _________.
Sworn to and subscribed before me this _________ day of ______________________, 2016.
___________________________
Notary Public
My Commission expires: __________________
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ATTACHMENT E – OVERDUE TAXES
Joe Weinberger, Jr.
Attorney and Counselor at Law
ll4 NORTH MAIN STREET
P.O. BOX l2l5
ROXBORO, NORTH CAROLINA 27573
JOE WEINBERGER, JR. TELEPHONE
336-599-2239
FAX 336-599-2239
E-MAIL wein@osinc.net
______________, 2016
To: Person County Department of Social Services
Certification:
I, Joseph Weinberger, Jr., certify that I do not have any overdue tax debts, as defined by N.C.G.S. 105-243.1,
at the federal, State, or local level. I further understand that any person who makes a false statement in
violation of N.C.G.S. 143C-6-23(c) is guilty of a criminal offense punishable as provided by N.C.G.S.)
143C-10-1b.
Sworn Statement:
I, Joseph Weinberger, Jr., being duly sworn, say that the foregoing certification is true, accurate and complete
to the best of my knowledge and was made and subscribed by me. I also acknowledge and understand that any
misuse of State funds will be reported to the appropriate authorities for further action.
Joseph Weinberger, Jr., Attorney At Law
____________________________ _________________________
Signature Date
NORTH CAROLINA
PERSON COUNTY
Sworn to and subscribed before me this _________ day of ______________________, 2016.
___________________________
Notary Public
My Commission expires: __________________
____________________
1 G.S. 105-243.1 defines: Overdue tax debt. – Any part of a tax debt that remains unpaid 90 days or more after the notice of final
assessment was mailed to the taxpayer. The term does not include a tax debt, however, if the taxpayer entered into an installment
agreement for the tax debt under G.S. 105-237 within 90 days after the notice of final assessment was mailed and has not failed to
make any payments due under the installment agreement.”
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ATTACHMENT G
Person County Department of Social Services
Certification Regarding Lobbying
Certification for Contracts, Grants, Loans and Cooperative Agreements
The undersigned certifies, to the best of his or her knowledge and belief, that:
(1) No Federal appropriated funds have been paid or will be paid by or on behalf of the undersigned, to any
person for influencing or attempting to influence an officer or employee of any Federal, state or local
government agency, a Member of Congress, a Member of the General Assembly, an officer or employee of
Congress, an officer or employee of the General Assembly, an employee of a Member of Congress, or an
employee of a Member of the General Assembly in connection with the awarding of any Federal or state
contract, the making of any Federal or state grant, the making of any Federal or state loan, the entering into
of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any
Federal or state contract, grant, loan, or cooperative agreement.
(2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for
influencing or attempting to influence an officer or employee of any Federal, state or local government
agency, a Member of Congress, a Member of the General Assembly, an officer or employee of Congress,
an officer or employee of the General Assembly, an employee of a Member of Congress, or an employee of
a Member of the General Assembly in connection with the awarding of any Federal or state contract, the
making of any Federal or state grant, the making of any Federal or state loan, the entering into of any
cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any
Federal or state contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit
Standard
Form LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions.
(3) The undersigned shall require that the language of this certification be included in the award documents for
all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and
cooperative agreements) and that all subrecipients shall certify and disclose accordingly.
(4) This certification is a material representation of fact upon which reliance was placed when this transaction
was made or entered into. Submission of this certification is a prerequisite for making or entering into this
transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required
certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each
such failure.
Notwithstanding other provisions of federal OMB Circulars-CFR Title 2, Grants and Agreements, Part 200, costs
associated with the following activities are unallowable:
Paragraph A.
(1) Attempts to influence the outcomes of any Federal, State, or local election, referendum, initiative, or
similar procedure, through in kind or cash contributions, endorsements, publicity, or similar activity;
(2) Establishing, administering, contributing to, or paying the expenses of a political party, campaign, political
action committee, or other organization established for the purpose of influencing the outcomes of
elections;
(3) Any attempt to influence: (i) The introduction of Federal or State legislation; or (ii) the enactment or
modification of any pending Federal or State legislation through communication with any member or
employee of the Congress or State legislature (including efforts to influence State or local officials to
engage in similar lobbying activity), or with any Government official or employee in connection with a
decision to sign or veto enrolled legislation;
(4) Any attempt to influence: (i) The introduction of Federal or State legislation; or (ii) the enactment or
modification of any pending Federal or State legislation by preparing, distributing or using publicity or
propaganda, or by urging members of the general public or any segment thereof to contribute to or
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participate in any mass demonstration, march, rally, fundraising drive, lobbying campaign or letter writing
or telephone campaign; or
(5) Legislative liaison activities, including attendance at legislative sessions or committee hearings, gathering
information regarding legislation, and analyzing the effect of legislation, when such activities are carried on
in support of or in knowing preparation for an effort to engage in unallowable lobbying.
The following activities as enumerated in Paragraph B are excepted from the coverage of Paragraph A:
Paragraph B.
(1) Providing a technical and factual presentation of information on a topic directly related to the performance
of a grant, contract or other agreement through hearing testimony, statements or letters to the Congress or a
State legislature, or subdivision, member, or cognizant staff member thereof, in response to a documented
request (including a Congressional Record notice requesting testimony or statements for the record at a
regularly scheduled hearing) made by the recipient member, legislative body or subdivision, or a cognizant
staff member thereof; provided such information is readily obtainable and can be readily put in deliverable
form; and further provided that costs under this section for travel, lodging or meals are unallowable unless
incurred to offer testimony at a regularly scheduled Congressional hearing pursuant to a written request for
such presentation made by the Chairman or Ranking Minority Member of the Committee or Subcommittee
conducting such hearing.
(2) Any lobbying made unallowable by subparagraph A (3) to influence State legislation in order to directly
reduce the cost, or to avoid material impairment of the organization's authority to perform the grant,
contract, or other agreement.
(3) Any activity specifically authorized by statute to be undertaken with funds from the grant, contract, or other
agreement.
Paragraph C.
(1) When an organization seeks reimbursement for indirect costs, total lobbying costs shall be separately
identified in the indirect cost rate proposal, and thereafter treated as other unallowable activity costs in
accordance with the procedures of subparagraph B.(3).
(2) Organizations shall submit, as part of the annual indirect cost rate proposal, a certification that the
requirements and standards of this paragraph have been complied with.
(3) Organizations shall maintain adequate records to demonstrate that the determination of costs as being
allowable or unallowable pursuant to this section complies with the requirements of this Circular.
(4) Time logs, calendars, or similar records shall not be required to be created for purposes of complying with
this paragraph during any particular calendar month when: (1) the employee engages in lobbying (as
defined in subparagraphs (a) and (b)) 25 percent or less of the employee's compensated hours of
employment during that calendar month, and (2) within the preceding five-year period, the organization has
not materially misstated allowable or unallowable costs of any nature, including legislative lobbying costs.
When conditions (1) and (2) are met, organizations are not required to establish records to support the
allowability of claimed costs in addition to records already required or maintained. Also, when conditions
(1) and (2) are met, the absence of time logs, calendars, or similar records will not serve as a basis for
disallowing costs by contesting estimates of lobbying time spent by employees during a calendar month.
(5) Agencies shall establish procedures for resolving in advance, in consultation with OMB, any significant
questions or disagreements concerning the interpretation or application of this section. Any such advance
resolution shall be binding in any subsequent settlements, audits or investigations with respect to that grant
or contract for purposes of interpretation of this Circular; provided, however, that this shall not be
construed to prevent a contractor or grantee from contesting the lawfulness of such a determination.
Paragraph D.
Executive lobbying costs. Costs incurred in attempting to improperly influence either directly or indirectly, an
employee or officer of the Executive Branch of the Federal Government to give consideration or to act
regarding a sponsored agreement or a regulatory matter are unallowable. Improper influence means any
influence that induces or tends to induce a Federal employee or officer to give consideration or to act regarding
a federally sponsored agreement or regulatory matter on any basis other than the merits of the matter.
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Joseph Weinberger, Jr., Attorney At Law
____________________________ _________________________
Signature Date
David Newell, Sr.
____________________________ _________________________
Chairman, County Commissioners Date
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ATTACHMENT H
PERSON COUNTY DEPARTMENT OF SOCIAL SERVICES
CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY
AND VOLUNTARY EXCLUSION-LOWER TIER COVERED TRANSACTIONS
Instructions for Certification
1. By signing and submitting this proposal, the prospective lower tier participant is providing the
certification set out below.
2. The certification in this clause is a material representation of the fact upon which reliance was
placed when this transaction was entered into. If it is later determined that the prospective lower
tier participant knowingly rendered an erroneous certification, in addition to other remedies
available to the Federal Government, the department or agency with which this transaction
originated may pursue available remedies, including suspension and/or debarment.
3. The prospective lower tier participant will provide immediate written notice to the person to
whom the proposal is submitted if at any time the prospective lower tier participant learns that its
certification was erroneous when submitted or has become erroneous by reason of changed
circumstances.
4. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered
transaction," "participant," "person," "primary covered transaction," "principal," "proposal," and
"voluntarily excluded," as used in this clause, have the meanings set out in the Definitions and
Coverage sections of rules implementing Executive Order 12549. You may contact the person to
which this proposal is submitted for assistance in obtaining a copy of those regulations.
5. The prospective lower tier participant agrees by submitting this proposal that, should the
proposed covered transaction be entered into, it shall not knowingly enter any lower tier covered
transaction with a person who is debarred, suspended, determined ineligible or voluntarily
excluded from participation in this covered transaction unless authorized by the department or
agency with which this transaction originated.
6. The prospective lower tier participant further agrees by submitting this proposal that it will
include this clause titled "Certification Regarding Debarment, Suspension, Ineligibility and
Voluntary Exclusion - Lower Tier Covered Transaction," without modification, in all lower tier
covered transactions and in all solicitations for lower tier covered transactions.
7. A participant in a covered transaction may rely upon a certification of a prospective
participant in a lower tier covered transaction that it is not debarred, suspended, ineligible, or
voluntarily excluded from covered transaction, unless it knows that the certification is erroneous.
A participant may decide the method and frequency of which it determines the eligibility of its
principals. Each participant may, but is not required to, check the Nonprocurement List.
8. Nothing contained in the foregoing shall be construed to require establishment of a system of
records in order to render in good faith the certification required by this clause. The knowledge
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and information of a participant is not required to exceed that which is normally possessed by a
prudent person in the ordinary course of business dealings.
9. Except for transactions authorized in paragraph 5 of these instructions, if a participant in a
covered transaction knowingly enters into a lower tier covered transaction with a person who is
suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in
addition to other remedies available to the Federal Government, the department or agency with
which this transaction originated may pursue available remedies, including suspension, and/or
debarment.
Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower
Tier Covered Transactions
(1) The prospective lower tier participant certifies, by submission of this proposal, that neither it
nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or
voluntarily excluded from participation in this transaction by any Federal department or agency.
(2) Where the prospective lower tier participant is unable to certify to any of the statements in this
certification, such prospective participant shall attach an explanation to this proposal.
Joseph Weinberger, Jr., Attorney At Law
____________________________ _________________________
Signature Date
David Newell, Sr.
____________________________ _________________________
Chairman, County Commissioners Date
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ATTACHMENT I
PERSON COUNTY
DEPARTMENT OF SOCIAL SERVICES
BUSINESS ASSOCIATE ADDENDUM
This Agreement is made effective the 1st day of July, 2016, by and between Person County
Department of Social Services (“Covered Entity”) and Joseph Weinberger, Jr., Attorney at Law
(“Business Associate”) (collectively the “Parties”).
1. BACKGROUND
a. Covered Entity and Business Associate are parties to a contract entitled Legal Services
Contract (the “Contract”), whereby Business Associate agrees to perform certain services for or
on behalf of Covered Entity.
b. Covered Entity is an organizational unit of Person County as the Person County Department
of Social Services (DSS) as a health care component for purposes of the HIPAA Privacy Rule.
c. The relationship between Covered Entity and Business Associate is such that the Parties
believe Business Associate is or may be a “business associate” within the meaning of the HIPAA
Privacy Rule.
d. The Parties enter into this Business Associate Addendum to the Contract with the intention of
complying with the HIPAA Privacy Rule provision that a covered entity may disclose protected
health information to a business associate, and may allow a business associate to create or
receive protected heath information on its behalf, if the covered entity obtains satisfactory
assurances that the business associate will appropriately safeguard the information.
2. DEFINITIONS
Unless some other meaning is clearly indicated by the context, the following terms shall have the
following meaning in this Agreement:
a. “HIPAA” means the Administrative Simplification Provisions, Sections 261 through 264, of
the federal Health Insurance Portability and Accountability Act of 1996, Public Law 104-191.
b. “Individual” shall have the same meaning as the term “individual” in 45 CFR160.103 and
shall include a person who qualifies as a personal representative in accordance with 45 CFR
164.502(g).
c. “Privacy Rule” shall mean the Standards for Privacy of Individually Identifiable Health
Information at 45 CFR part 160 and part 164, subparts A and E.
d. “Protected Health Information” shall have the same meaning as the term “protected health
information” in 45 CFR 160.103, limited to the information created or received by Business
Associate from or on behalf of Covered Entity.
e. “Required By Law” shall have the same meaning as the term “required by law” in 45 CFR
164.103.
f. “Secretary” shall mean the Secretary of the United States Department of Health and Human
Services or his designee.
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g. Unless otherwise defined in this Agreement, terms used herein shall have the same meaning
as those terms have in the Privacy Rule.
3. OBLIGATIONS OF BUSINESS ASSOCIATE
a. Business Associate agrees to not use or disclose Protected Health Information other than as
permitted or required by this Agreement or as Required By Law.
b. Business Associate agrees to use appropriate safeguards to prevent use or disclosure of the
Protected Health Information other than as provided for by this Agreement.
c. Business Associate agrees to mitigate, to the extent practicable, any harmful effect that is
known to Business Associate of a use or disclosure of Protected Health Information by Business
Associate in violation of the requirements of this Agreement.
d. Business Associate agrees to report to Covered Entity any use or disclosure of the Protected
Health Information not provided for by this Agreement of which it becomes aware.
e. Business Associate agrees to ensure that any agent, including a subcontractor, to whom it
provides Protected Health Information received from, or created or received by Business
Associate on behalf of Covered Entity agrees to the same restrictions and conditions that apply
through this Agreement to Business Associate with respect to such information.
f. Business Associate agrees to provide access, at the request of Covered Entity, to Protected
Health Information in a Designated Record Set to Covered Entity or, as directed by Covered
Entity, to an Individual in order to meet the requirements under 45 CFR 164.524.
g. Business Associate agrees, at the request of the Covered Entity, to make any amendment(s) to
Protected Health Information in a Designated Record Set that the Covered Entity directs or
agrees to pursuant to 45 CFR 164.526.
h. Unless otherwise prohibited by law, Business Associate agrees to make internal practices,
books, and records, including policies and procedures and Protected Health Information, relating
to the use and disclosure of Protected Health Information received from, or created or received
by Business Associate on behalf of Covered Entity, available to the Covered Entity, or to the
Person County Department of Social Services, in a time and manner designated by the
Secretary, for purposes of determining Covered Entity's compliance with the Privacy Rule.
i. Business Associate agrees to document such disclosures of Protected Health Information and
information related to such disclosures as would be required for Covered Entity to respond to a
request by an Individual for an accounting of disclosures of Protected Health Information in
accordance with 45 CFR 164.528, and to provide this information to Covered Entity or an
Individual to permit such a response.
4. PERMITTED USES AND DISCLOSURES
a. Except as otherwise limited in this Agreement or by other applicable law or agreement, if the
Contract permits, Business Associate may use or disclose Protected Health Information to
perform functions, activities, or services for, or on behalf of, Covered Entity as specified in the
Contract, provided that such use or disclosure:
1) would not violate the Privacy Rule if done by Covered Entity; or
2) would not violate the minimum necessary policies and procedures of the Covered
Entity.
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b. Except as otherwise limited in this Agreement or by other applicable law or agreements, if the
Contract permits, Business Associate may use Protected Health Information as necessary for the
proper management and administration of the Business Associate or to carry out the legal
responsibilities of the Business Associate.
c. Except as otherwise limited in this Agreement or by other applicable law or agreements, if the
Contract permits, Business Associate may disclose Protected Health Information for the proper
management and administration of the Business Associate, provided that:
1) disclosures are Required By Law; or
2) Business Associate obtains reasonable assurances from the person to whom the
information is disclosed that it will remain confidential and will be used or further
disclosed only as Required By Law or for the purpose for which it was disclosed to the
person, and the person notifies the Business Associate of any instances of which it is
aware in which the confidentiality of the information has been breached.
d. Except as otherwise limited in this Agreement or by other applicable law or agreements, if the
Contract permits, Business Associate may use Protected Health Information to provide data
aggregation services to Covered Entity as permitted by 45 CFR 164.504(e)(2)(i)(B).
e. Notwithstanding the foregoing provisions, Business Associate may not use or disclose
Protected Health Information if the use or disclosure would violate any term of the Contract or
other applicable law or agreements.
5. TERM AND TERMINATION
a. Term. This Agreement shall be effective as of the effective date stated above and shall
terminate when the Contract terminates.
b. Termination for Cause. Upon Covered Entity's knowledge of a material breach by Business
Associate, Covered Entity may, at its option:
1) Provide an opportunity for Business Associate to cure the breach or end the violation,
and terminate this Agreement and services provided by Business Associate, to the extent
permissible by law, if Business Associate does not cure the breach or end the violation
within the time specified by Covered Entity;
2) Immediately terminate this Agreement and services provided by Business Associate,
to the extent permissible by law; or
3) If neither termination nor cure is feasible, report the violation to the Secretary as
provided in the Privacy Rule.
c. Effect of Termination.
1) Except as provided in paragraph (2) of this section or in the Contract or by other
applicable law or agreements, upon termination of this Agreement and services provided
by Business Associate, for any reason, Business Associate shall return or destroy all
Protected Health Information received from Covered Entity, or created or received by
Business Associate on behalf of Covered Entity. This provision shall apply to Protected
Health Information that is in the possession of subcontractors or agents of Business
Associate. Business Associate shall retain no copies of the Protected Health Information.
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2) In the event that Business Associate determines that returning or destroying the
Protected Health Information is not feasible, Business Associate shall provide to Covered
Entity notification of the conditions that make return or destruction not feasible. Business
Associate shall extend the protections of this Agreement to such Protected Health
Information and limit further uses and disclosures of such Protected Health Information
to those purposes that make the return or destruction infeasible, for so long as Business
Associate maintains such Protected Health Information.
6. GENERAL TERMS AND CONDITIONS
a. This Agreement amends and is part of the Contract.
b. Except as provided in this Agreement, all terms and conditions of the Contract shall remain in
force and shall apply to this Agreement as if set forth fully herein.
c. In the event of a conflict in terms between this Agreement and the Contract, the interpretation
that is in accordance with the Privacy Rule shall prevail. In the event that a conflict then
remains, the Contract terms shall prevail so long as they are in accordance with the Privacy Rule.
d. A breach of this Agreement by Business Associate shall be considered sufficient basis for
Covered Entity to terminate the Contract for cause.
Joseph Weinberger, Jr., Attorney At Law
____________________________ _________________________
Signature Date
David Newell, Sr.
____________________________ _________________________
Chairman, County Commissioners Date
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Attachment M
State Certification
Contractor Certifications Required by North Carolina Law
Instructions
The person who signs this document should read the text of the statutes listed below and consult with
counsel and other knowledgeable persons before signing.
The text of Article 2 of Chapter 64 of the North Carolina General Statutes can be found online at:
http://www.ncga.state.nc.us/EnactedLegislation/Statutes/PDF/ByArticle/Chapter_64/Article_2.pdf
The text of G.S. 105-164.8(b) can be found online at:
http://www.ncga.state.nc.us/EnactedLegislation/Statutes/PDF/BySection/Chapter_105/GS_105-
164.8.pdf
The text of G.S. 143-48.5 (S.L. 2013-418, s. 2.(d)) can be found online at:
http://www.ncga.state.nc.us/Sessions/2013/Bills/House/PDF/H786v6.pdf
The text of G.S. 143-59.1 can be found online at:
http://www.ncga.state.nc.us/EnactedLegislation/Statutes/PDF/BySection/Chapter_143/GS_143-
59.1.pdf
The text of G.S. 143-59.2 can be found online at:
http://www.ncga.state.nc.us/EnactedLegislation/Statutes/PDF/BySection/Chapter_143/GS_143-
59.2.pdf
The text of G.S. 147-33.95(g) (S.L. 2013-418, s. 2.(e)) can be found online at:
http://www.ncga.state.nc.us/Sessions/2013/Bills/House/PDF/H786v6.pdf
Certifications
(1) Pursuant to G.S. 143-48.5 and G.S. 147-33.95(g), the undersigned hereby certifies that the
Contractor named below, and the Contractor’s subcontractors, complies with the requirements of
Article 2 of Chapter 64 of the NC General Statutes, including the requirement for each employer
with more than 25 employees in North Carolina to verify the work authorization of its employees
through the federal E-Verify system." E-Verify System Link: www.uscis.gov
Local government is specifically exempt from Article 2 of Chapter 64 of the North Carolina
General Statutes. However, local government is subject to and must comply with North Carolina
General Statute §153A-99.1., which states in part as follows:
Counties Must Use E-Verify. - Each county shall register and participate in E-Verify to verify the
work authorization of new employees hired to work in the United States.
(2) Pursuant to G.S. 143-59.1(b), the undersigned hereby certifies that the Contractor named below
is not an “ineligible Contractor” as set forth in G.S. 143-59.1(a) because:
(a) Neither the Contractor nor any of its affiliates has refused to collect the use tax levied
under Article 5 of Chapter 105 of the General Statutes on its sales delivered to North
Carolina when the sales met one or more of the conditions of G.S. 105-164.8(b); and
(b) [check one of the following boxes]
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Neither the Contractor nor any of its affiliates has incorporated or reincorporated
in a “tax haven country” as set forth in G.S. 143-59.1(c)(2) after December 31,
2001; or
The Contractor or one of its affiliates has incorporated or reincorporated in a “tax
haven country” as set forth in G.S. 143-59.1(c)(2) after December 31, 2001 but
the United States is not the principal market for the public trading of the stock of
the corporation incorporated in the tax haven country.
(3) Pursuant to G.S. 143-59.2(b), the undersigned hereby certifies that none of the Contractor’s
officers, directors, or owners (if the Contractor is an unincorporated business entity) has been
convicted of any violation of Chapter 78A of the General Statutes or the Securities Act of 1933 or
the Securities Exchange Act of 1934 within 10 years immediately prior to the date of the bid
solicitation.
(4) The undersigned hereby certifies further that:
(a) He or she is a duly authorized representative of the Contractor named below;
(b) He or she is authorized to make, and does hereby make, the foregoing certifications on
behalf of the Contractor; and
(c) He or she understands that any person who knowingly submits a false certification in
response to the requirements of G.S. 143-59.1 and -59.2 shall be guilty of a Class I
felony.
Contractor’s Name: Joseph Weinberger, Jr.
Signature of Contractor’s Authorized Agent
Date
Printed Name of Contractor’s Authorized Agent
Joseph Weinberger, Jr.
Title
Attorney at Law
Signature of Witness
Title
Printed Name of Witness
Date
The witness should be present when the Contractor’s Authorized Agent signs this certification and should
sign and date this document immediately thereafter.
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Attachment N
CERTIFICATION OF
ELIGIBILITY
Under the Iran
Divestment Act
Pursuant to G.S. 147-86.59, any person identified as engaging in investment activities in
Iran, determined by appearing on the Final Divestment List created by the State
Treasurer pursuant to G.S. 147-86.58, is ineligible to contract with the State of North
Carolina or any political subdivision of the State. The Iran Divestment Act of 2015, G.S.
147-86.55 et seq.* requires that each vendor, prior to contracting with the State certify,
and the undersigned on behalf of the Vendor does hereby certify, to the following:
1. that Joseph Weinberger, Jr., Attorney At Law, is not identified on the Final
Divestment List of entities that the State Treasurer has determined engages in
investment activities in Iran;
2. that Joseph Weinberger, Jr., Attorney At Law, shall not utilize on any contract with
the State agency any subcontractor that is identified on the Final Divestment List;
and
3. that Joseph Weinberger, Jr., Attorney At Law, is authorized to make this Certification.
Joseph Weinberger, Jr., Attorney At Law
____________________________ _________________________
Signature Date
* Note: Enacted by Session Law 2015‐118 as G.S. 143C‐55 et seq., but has been renumbered for
codification at the direction of the Revisor of Statutes.
The State Treasurer’s Final Divestment List can be found on the State Treasurer’s website at the address:
https://www.nctreasurer.com/inside‐the‐department/OpenGovernment/Pages/Iran‐Divestment‐Act‐Resources.aspx
and will be updated every 180 days. For questions about the Department of State Treasurer’s Iran Divestment
Policy, please contact Meryl Murtagh at Meryl.Murtagh@nctreasurer.com or (919) 814‐3852.
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Contract # 1008 Fiscal Year Begins July 1, 2016 Ends June 30, 2017
This contract is hereby entered into by and between the Person County Department of Social
Services (the "County") and Thomas L. Fitzgerald (the "Contractor") (referred to collectively as
the “Parties”). The Contractor’s federal tax identification number is 20-2272 781.
Contract Documents: This Contract consists of the following documents:
This contract
The General Terms and Conditions (Attachment A)
The Scope of Work, description of services, and rate (Attachment B)
Federal Certification Regarding Drug-Free Workplace & Certification Regarding Nondiscrimination (Attachment C)
Conflict of Interest (Attachment D)
No Overdue Taxes (Attachment E)
Federal Certification Regarding Lobbying (Attachment G)
Federal Certification Regarding Debarment (Attachment H)
HIPAA Business Associate Addendum (Attachment I)
State Certification (Attachment M)
Certification of Eligibility Under the Iran Divestment Act (Attachment N)
These documents constitute the entire agreement between the Parties and supersede all prior
oral or written statements or agreements.
Precedence among Contract Documents: In the event of a conflict between or among the
terms of the Contract Documents, the terms in the Contract Document with the highest relative
precedence shall prevail. The order of precedence shall be the order of documents as listed in
Paragraph 1, above, with the first-listed document having the highest precedence and the last-
listed document having the lowest precedence. If there are multiple Contract Amendments, the
most recent amendment shall have the highest precedence and the oldest amendment shall
have the lowest precedence.
Effective Period: This contract shall be effective on July 1, 2016 and shall terminate on
June 30, 2017. This contract must be twelve months or less.
Contractor’s Duties: The Contractor shall provide the services and in accordance with the
approved rate as described in Attachment B, Scope of Work.
County’s Duties: The County shall pay the Contractor in the manner and in the amounts
specified in the Contract Documents.
[ x ] a. There are no matching requirements from the Contractor.
[ ] b. The Contractor’s matching requirement is $__________, which shall consist of:
[ ] In-kind [ ] Cash [ ] Cash and In-kind [ ] Cash and/or In-kind
The contributions from the Contractor shall be sourced from non-federal funds.
The total contract amount including any Contractor match shall not exceed 1,000 hours
collectively for all attorneys under contract. Rate of compensation for Primary Attorney Thomas
L. Fitzgerald is $135 per hour.
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Reversion of Funds:
Any unexpended grant funds shall revert to the County Department of Social Services upon
termination of this contract.
Reporting Requirements:
Contractor shall comply with audit requirements as described in N.C.G.S. § 143C-6-22 & 23 and
OMB Circular- CFR Title 2 Grants and Agreements, Part 200, and shall disclose all information
required by 42 USC 455.104, or 42 USC 455.105, or 42 USC 455.106.
Payment Provisions:
Payment shall be made in accordance with the Contract Documents as described in the Scope
of Work, Attachment B.
Contract Administrators: All notices permitted or required to be given by one Party to the
other and all questions about the contract from one Party to the other shall be addressed and
delivered to the other Party’s Contract Administrator. The name, post office address, street
address, telephone number, fax number, and email address of the Parties’ respective initial
Contract Administrators are set out below. Either Party may change the name, post office
address, street address, telephone number, fax number, or email address of its Contract
Administrator by giving timely written notice to the other Party.
For the County: For the Contractor:
Wendy Bowman, Accounting Technician
Person County Department of Social Services Thomas L. Fitzgerald, Attorney
P.O. Box 770 P.O. Box 1519
355B South Madison Boulevard 22 Court Street
Roxboro, NC 27573 Roxboro, NC 27573
(336) 599-8361 (336) 599-2567
Supplementation of Expenditure of Public Funds: The Contractor assures that funds
received pursuant to this contract shall be used only to supplement, not to supplant, the total
amount of federal, state and local public funds that the Contractor otherwise expends for
contract services and related programs. Funds received under this contract shall be used to
provide additional public funding for such services; the funds shall not be used to reduce the
Contractor’s total expenditure of other public funds for such services.
Disbursements: As a condition of this contract, the Contractor acknowledges and agrees to
make disbursements in accordance with the following requirements:
(a) Implement adequate internal controls over disbursements;
(b) Pre-audit all vouchers presented for payment to determine:
Validity and accuracy of payment
Payment due date
Adequacy of documentation supporting payment
Legality of disbursement
(c) Assure adequate control of signature stamps/plates;
(d) Assure adequate control of negotiable instruments; and
(e) Implement procedures to insure that account balance is solvent and reconcile the
account monthly.
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Outsourcing to Other Countries: The Contractor certifies that it has identified to the County
all jobs related to the contract that have been outsourced to other countries, if any. The
Contractor further agrees that it will not outsource any such jobs during the term of this contract
without providing notice to the County.
Federal Certifications: Individuals and Organizations receiving federal funds must ensure
compliance with certain certifications required by federal laws and regulations. The contractor is
hereby complying with Certifications regarding Nondiscrimination, Drug-Free Workplace
Requirements, Environmental Tobacco Smoke, Debarment, Suspension, Ineligibility and
Voluntary Exclusion Lower Tier Covered Transactions, and Lobbying. These assurances and
certifications are to be signed by the contractor’s authorized representative.
Signature Warranty: The undersigned represent and warrant that they are authorized to bind
their principals to the terms of this agreement.
Signature Warranty:
The undersigned represent and warrant that they are authorized to bind their principals to the terms of this
agreement.
The Contractor and the County have executed this contract in duplicate originals, with one original being retained by
each party.
Thomas L. Fitzgerald, Attorney At Law
____________________________ _________________________
Signature Date
PERSON COUNTY
David Newell, Sr.
____________________________ _________________________
Chairman, County Commissioners Date
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
Act.
______________________________ ___________________________
Amy Wehrenberg, County Finance Director Date
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ATTACHMENT A
General Terms and Conditions
Relationships of the Parties
Independent Contractor: The Contractor is and shall be deemed to be an independent contractor in the performance of
this contract and as such shall be wholly responsible for the work to be performed and for the supervision of its employees.
The Contractor represents that it has, or shall secure at its own expense, all personnel required in performing the services
under this agreement. Such employees shall not be employees of, or have any individual contractual relationship with the
County.
Subcontracting: The Contractor shall not subcontract any of the work contemplated under this contract without prior written
approval from the County. Any approved subcontract shall be subject to all conditions of this contract. Only the
subcontractors specified in the contract documents are to be considered approved upon award of the contract. The County
shall not be obligated to pay for any work performed by any unapproved subcontractor. The Contractor shall be responsible
for the performance of all of its subcontractors.
Assignment: No assignment of the Contractor's obligations or the Contractor's right to receive payment hereunder shall be
permitted. However, upon written request approved by the issuing purchasing authority, the County may: Forward the
Contractor's payment check(s) directly to any person or entity designated by the Contractor, or Include any person or entity
designated by Contractor as a joint payee on the Contractor's payment check(s). In no event shall such approval and action
obligate the County to anyone other than the Contractor and the Contractor shall remain responsible for fulfillment of all
contract obligations.
Beneficiaries: Except as herein specifically provided otherwise, this contract shall inure to the benefit of and be binding
upon the parties hereto and their respective successors. It is expressly understood and agreed that the enforcement of the
terms and conditions of this contract, and all rights of action relating to such enforcement, shall be strictly reserved to the
County and the named Contractor. Nothing contained in this document shall give or allow any claim or right of action
whatsoever by any other third person. It is the express intention of the County and Contractor that any such person or entity,
other than the County or the Contractor, receiving services or benefits under this contract shall be deemed an incidental
beneficiary only.
Indemnity and Insurance
Indemnification: The Contractor agrees to indemnify and hold harmless the County and any of their officers, agents and
employees, from any claims of third parties arising out or any act or omission of the Contractor in connection with the
performance of this contract.
Insurance: During the term of the contract, the Contractor at its sole cost and expense shall provide commercial insurance
of such type and with such terms and limits as may be reasonably associated with the contract. As a minimum, the
Contractor shall provide and maintain the following coverage and limits:
Worker’s Compensation - The contractor shall provide and maintain Worker’s Compensation Insurance as required
by the laws of North Carolina, as well as employer’s liability coverage with minimum limits of $500,000.00, covering all
of Contractor’s employees who are engaged in any work under the contract. If any work is sublet, the Contractor shall
require the subcontractor to provide the same coverage for any of his employees engaged in any work under the
contract.
Commercial General Liability - General Liability Coverage on a Comprehensive Broad Form on an occurrence basis in
the minimum amount of $1,000,000.00 Combined Single Limit. (Defense cost shall be in excess of the limit of liability.)
Automobile Liability Insurance: The Contractor shall provide automobile liability insurance with a combined single
limit of $500,000.00 for bodily injury and property damage; a limit of $500,000.00 for uninsured/under insured
motorist coverage; and a limit of $2,000.00 for medical payment coverage. The Contractor shall provide this insurance
for all automobiles that are:
(a) owned by the Contractor and used in the performance of this contract;
(b) hired by the Contractor and used in the performance of this contract; and
(c) Owned by Contractor’s employees and used in performance of this contract (“non-owned vehicle insurance”).
Non-owned vehicle insurance protects employers when employees use their personal vehicles for work
purposes. Non-owned vehicle insurance supplements, but does not replace, the car-owner’s liability insurance.
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The Contractor is not required to provide and maintain automobile liability insurance on any vehicle – owned,
hired, or non-owned -- unless the vehicle is used in the performance of this contract.
(d) The insurance coverage minimums specified in subparagraph (a) are exclusive of defense costs.
(e) The Contractor understands and agrees that the insurance coverage minimums specified in subparagraph (a) are
not limits, or caps, on the Contractor’s liability or obligations under this contract.
(f) The Contractor may obtain a waiver of any one or more of the requirements in subparagraph (a) by
demonstrating that it has insurance that provides protection that is equal to or greater than the coverage and
limits specified in subparagraph (a). The County shall be the sole judge of whether such a waiver should be
granted.
(g) The Contractor may obtain a waiver of any one or more of the requirements in paragraph (a) by demonstrating
that it is self-insured and that its self-insurance provides protection that is equal to or greater than the coverage
and limits specified in subparagraph (a). The County shall be the sole judge of whether such a waiver should be
granted.
(h) Providing and maintaining the types and amounts of insurance or self-insurance specified in this paragraph is a
material obligation of the Contractor and is of the essence of this contract.
(i) The Contractor shall only obtain insurance from companies that are authorized to provide such coverage and
that are authorized by the Commissioner of Insurance to do business in the State of North Carolina. All such
insurance shall meet all laws of the State of North Carolina.
(j) The Contractor shall comply at all times with all lawful terms and conditions of its insurance policies and all
lawful requirements of its insurer.
(k) The Contractor shall require its subcontractors to comply with the requirements of this paragraph.
(l) The Contractor shall demonstrate its compliance with the requirements of this paragraph by submitting
certificates of insurance to the County before the Contractor begins work under this contract.
Transportation of Clients by Contractor:
The contractor will maintain Insurance requirements if required as noted under Article 7 Rule R2-36 of the North Carolina
Utilities Commission.
Default and Termination
Termination without Cause: The County may terminate this contract without cause by giving 30 days written notice to the
Contractor.
Termination for Cause: If, through any cause, the Contractor shall fail to fulfill its obligations under this contract in a timely
and proper manner, the County shall have the right to terminate this contract by giving written notice to the Contractor and
specifying the effective date thereof. In that event, all finished or unfinished deliverable items prepared by the Contractor
under this contract shall, at the option of the County, become its property and the Contractor shall be entitled to receive just
and equitable compensation for any satisfactory work completed on such materials, minus any payment or compensation
previously made. Notwithstanding the foregoing provision, the Contractor shall not be relieved of liability to the County for
damages sustained by the County by virtue of the Contractor’s breach of this agreement, and the County may withhold any
payment due the Contractor for the purpose of setoff until such time as the exact amount of damages due the County from
such breach can be determined. In case of default by the Contractor, without limiting any other remedies for breach
available to it, the County may procure the contract services from other sources and hold the Contractor responsible for any
excess cost occasioned thereby. The filing of a petition for bankruptcy by the Contractor shall be an act of default under this
contract.
Waiver of Default: Waiver by the County of any default or breach in compliance with the terms of this contract by the
Provider shall not be deemed a waiver of any subsequent default or breach and shall not be construed to be modification of
the terms of this contract unless stated to be such in writing, signed by an authorized representative of the County and the
Contractor and attached to the contract.
Availability of Funds: The parties to this contract agree and understand that the payment of the sums specified in this
contract is dependent and contingent upon and subject to the appropriation, allocation, and availability of funds for this
purpose to the County.
Force Majeure: Neither party shall be deemed to be in default of its obligations hereunder if and so long as it is prevented
from performing such obligations by any act of war, hostile foreign action, nuclear explosion, riot, strikes, civil insurrection,
earthquake, hurricane, tornado, or other catastrophic natural event or act of God.
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Survival of Promises: All promises, requirements, terms, conditions, provisions, representations, guarantees, and warranties
contained herein shall survive the contract expiration or termination date unless specifically provided otherwise herein, or
unless superseded by applicable Federal or State statutes of limitation.
Intellectual Property Rights
Copyrights and Ownership of Deliverables: All deliverable items produced pursuant to this contract are the exclusive
property of the County. The Contractor shall not assert a claim of copyright or other property interest in such deliverables.
Federal Intellectual Property Bankruptcy Protection Act: The Parties agree that the County shall be entitled to all rights and
benefits of the Federal Intellectual Property Bankruptcy Protection Act, Public Law 100-506, codified at 11 U.S.C. 365 (n)
and any amendments thereto.
Compliance with Applicable Laws
Compliance with Laws: The Contractor shall comply with all laws, ordinances, codes, rules, regulations, and licensing
requirements that are applicable to the conduct of its business, including those of federal, state, and local agencies having
jurisdiction and/or authority.
Title VI, Civil Rights Compliance: In accordance with Federal law and U.S. Department of Agriculture (USDA) and U.S.
Department of Health and Human Services (HHS) policy, this institution is prohibited from discriminating on the basis of
race, color, national origin, sex, age or disability. Under the Food Stamp Act and USDA policy, discrimination is prohibited
also on the basis of religion or political beliefs.
Equal Employment Opportunity: The Contractor shall comply with all federal and State laws relating to equal employment
opportunity.
Health Insurance Portability and Accountability Act (HIPAA): The Contractor agrees that, if the County determines that
some or all of the activities within the scope of this contract are subject to the Health Insurance Portability and Accountability
Act of 1996, P.L. 104-91, as amended (“HIPAA”), or its implementing regulations, it will comply with the HIPAA
requirements and will execute such agreements and practices as the County may require to ensure compliance.
(a) Data Security: The Contractor shall adopt and apply data security standards and procedures that comply with all
applicable federal, state, and local laws, regulations, and rules.
(b) Duty to Report: The Contractor shall report a suspected or confirmed security breach to the local Department of
Social Services/Human Services Contract Administrator within twenty-four (24) hours after the breach is first
discovered, provided that the Contractor shall report a breach involving Social Security Administration data or
Internal Revenue Service data within one (1) hour after the breach is first discovered.
(c) Cost Borne by Contractor: If any applicable federal, state, or local law, regulation, or rule requires the Contractor
to give written notice of a security breach to affected persons, the Contractor shall bear the cost of the notice.
Trafficking Victims Protection Act of 2000: The Contractor will comply with the requirements of Section 106(g) of the
Trafficking Victims Protection Act of 2000, as amended (22 U.S.C. 7104).
Executive Order # 24: It is unlawful for any vendor, contractor, subcontractor or supplier of the state to make gifts or to give
favors to any state employee. For additional information regarding the specific requirements and exemptions, contractors
are encouraged to review Executive Order 24 and G.S. Sec. 133-32.
Confidentiality
Confidentiality: Any information, data, instruments, documents, studies or reports given to or prepared or assembled by the
Contractor under this agreement shall be kept as confidential and not divulged or made available to any individual or
organization without the prior written approval of the County. The Contractor acknowledges that in receiving, storing,
processing or otherwise dealing with any confidential information it will safeguard and not further disclose the information
except as otherwise provided in this contract.
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Oversight
Access to Persons and Records: The State Auditor shall have access to persons and records as a result of all contracts or
grants entered into by State agencies or political subdivisions in accordance with General Statute 147-64.7. Additionally, as
the State funding authority, the Department of Health and Human Services shall have access to persons and records as a
result of all contracts or grants entered into by State agencies or political subdivisions.
Record Retention: Records shall not be destroyed, purged or disposed of without the express written consent of the
Division. State basic records retention policy requires all grant records to be retained for a minimum of five years or until all
audit exceptions have been resolved, whichever is longer. If the contract is subject to federal policy and regulations, record
retention may be longer than five years since records must be retained for a period of three years following submission of the
final Federal Financial Status Report, if applicable, or three years following the submission of a revised final Federal
Financial Status Report. Also, if any litigation, claim, negotiation, audit, disallowance action, or other action involving this
Contract has been started before expiration of the five-year retention period described above, the records must be retained
until completion of the action and resolution of all issues which arise from it, or until the end of the regular five-year period
described above, whichever is later. The record retention period for Temporary Assistance for Needy Families (TANF) and
MEDICAID and Medical Assistance grants and programs must be retained for a minimum of ten years.
Warranties and Certifications
Date and Time Warranty: The Contractor warrants that the product(s) and service(s) furnished pursuant to this contract
(“product” includes, without limitation, any piece of equipment, hardware, firmware, middleware, custom or commercial
software, or internal components, subroutines, and interfaces therein) that perform any date and/or time data recognition
function, calculation, or sequencing will support a four digit year format and will provide accurate date/time data and leap
year calculations. This warranty shall survive the termination or expiration of this contract.
Certification Regarding Collection of Taxes: G.S. 143-59.1 bars the Secretary of Administration from entering into contracts
with vendors that meet one of the conditions of G.S. 105-164.8(b) and yet refuse to collect use taxes on sales of tangible
personal property to purchasers in North Carolina. The conditions include: (a) maintenance of a retail establishment or
office; (b) presence of representatives in the State that solicit sales or transact business on behalf of the vendor; and (c)
systematic exploitation of the market by media-assisted, media-facilitated, or media-solicited means. The Contractor certifies
that it and all of its affiliates (if any) collect all required taxes.
E-Verify
Pursuant to G.S. 143-48.5 and G.S. 147-33.95(g), the undersigned hereby certifies that the Contractor named below, and the
Contractor’s subcontractors, complies with the requirements of Article 2 of Chapter 64 of the NC General Statutes, including
the requirement for each employer with more than 25 employees in North Carolina to verify the work authorization of its
employees through the federal E-Verify system." E-Verify System Link: www.uscis.gov
Miscellaneous
Choice of Law: The validity of this contract and any of its terms or provisions, as well as the rights and duties of the parties
to this contract, are governed by the laws of North Carolina. The Contractor, by signing this contract, agrees and submits,
solely for matters concerning this Contract, to the exclusive jurisdiction of the courts of North Carolina and agrees, solely for
such purpose, that the exclusive venue for any legal proceedings shall be the county is which the contract originated. The
place of this contract and all transactions and agreements relating to it, and their situs and forum, shall be the county where
the contract originated, where all matters, whether sounding in contract or tort, relating to the validity, construction,
interpretation, and enforcement shall be determined.
Amendment: This contract may not be amended orally or by performance. Any amendment must be made in written form
and executed by duly authorized representatives of the County and the Contractor.
Severability: In the event that a court of competent jurisdiction holds that a provision or requirement of this contract
violates any applicable law, each such provision or requirement shall continue to be enforced to the extent it is not in
violation of law or is not otherwise unenforceable and all other provisions and requirements of this contract shall remain in
full force and effect.
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Headings: The Section and Paragraph headings in these General Terms and Conditions are not material parts of the
agreement and should not be used to construe the meaning thereof.
Time of the Essence: Time is of the essence in the performance of this contract.
Key Personnel: The Contractor shall not replace any of the key personnel assigned to the performance of this contract
without the prior written approval of the County. The term “key personnel” includes any and all persons identified as such
in the contract documents and any other persons subsequently identified as key personnel by the written agreement of the
parties.
Care of Property: The Contractor agrees that it shall be responsible for the proper custody and care of any property
furnished to it for use in connection with the performance of this contract and will reimburse the County for loss of, or
damage to, such property. At the termination of this contract, the Contractor shall contact the County for instructions as to
the disposition of such property and shall comply with these instructions.
Travel Expenses: Reimbursement to the Contractor for travel mileage, meals, lodging and other travel expenses incurred in
the performance of this contract shall not exceed the rates established in County policy.
Sales/Use Tax Refunds: If eligible, the Contractor and all subcontractors shall: (a) ask the North Carolina Department of
Revenue for a refund of all sales and use taxes paid by them in the performance of this contract, pursuant to G.S. 105-
164.14; and (b) exclude all refundable sales and use taxes from all reportable expenditures before the expenses are entered
in their reimbursement reports.
Advertising: The Contractor shall not use the award of this contract as a part of any news release or commercial advertising.
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ATTACHMENT B – Scope of Work Federal Tax Id. 20-2272-781
NORTH CAROLINA
DUPLICATE ORIGINAL
PERSON COUNTY
LEGAL SERVICES AGREEMENT
THIS Agreement, made and entered into this the 1st day of July, 2016, by
and between the PERSON COUNTY DEPARTMENT OF SOCIAL SERVICES,
hereinafter referred to as Agency, and Thomas L. Fitzgerald, Attorney at Law,
hereinafter referred to as Attorney.
W I T N E S S E T H :
THAT WHEREAS, the Agency has determined that it has need for legal services
and consultation beyond those presently being provided by the county attorney;
AND WHEREAS, the Attorney is a member of a reputable law firm with an office
in Person County, North Carolina, and has expertise in the field of social services law,
rules and regulations, and the Agency is desirous of obtaining such legal services from
said Attorney on a continuing basis;
NOW, THEREFORE, it is hereby agreed that the Attorney shall provide legal
services to the Agency in the nature of consultations, interpretation of social services
laws and regulations and drafting of legal document when necessary on the following
terms and conditions:
1
The Attorney shall make himself available and on call to the Agency on a prompt
basis for the purposes herein above described until June 30, 2017. At the end of said
period, the arrangement herein described will be analyzed by the parties hereto to
determine if same is effective and fair to all parties concerned and revised or terminated
accordingly as deemed necessary.
2
The Agency shall pay for such legal services to the Attorney the sum of one hundred
thirty-five dollars ($135.00) per hour for out of court time and one hundred thirty-five
dollars ($135.00) per hour for in court time for each hour of legal services performed,
same to be due and payable on or before the 10th of each month upon due submission
by the Attorney of a statement of work detailing the hours of work performed and the
nature of such legal work. Such hourly rate shall encompass all expenses, including,
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but not limited to, those for salary, supplies, office space, heating and maintenance for
office space, telephone service, long-distance telephone calls, and travel. The party of
the second part is not to be reimbursed for any extraordinary expense incident to
performing the services included under this agreement; except, that the party of the first
part agrees to pay all court costs and filing fees which are required to be paid in
conjunction with services provided by the attorney under this agreement.
3
The Attorney will assist the Agency in maintaining records of the legal services
provided as same are necessary for the agency in filing its reports and funding
statements.
4
The party of the second part shall notify the Agency when a conflict of interest
arises for the Attorney. In all such cases, referral shall be made to another attorney with
whom the Department has contracted for secondary employment for the provision of
legal services when conflicts arise.
5
It is understood and agreed that the legal services provided pursuant to this
contract will be in addition to those provided by the county attorney and not in
substitution nor duplication of such services by the county attorney.
6
The party of the second part further agrees to attend seminars regarding
Protective Services and other matters related to Social Services as part of his duty to
the agency in addition to Child Support Enforcement training. Further, the party of the
first part agrees to compensate the party of the second part at the hourly rate of fifty-five
dollars ($55.00) for each hour that the party of the second part spends in training up to
but not to exceed the amount of four hundred forty dollars ($440.00) per day.
Reimbursement shall be made in the amount of fifty-four cents ($0.54) per mile for
travel and expenses not to exceed a total of three hundred twenty-five dollars ($325.00)
per year.
7
It is specifically agreed that the Attorney is an independent contractor and shall
perform the legal services herein provided according to his own judgment and method
and shall not be subject to control of the Agency except as to the result of his work.
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8
The Attorney shall not under any circumstance be considered an employee of the
Agency. The Agency shall not withhold federal or state taxes from sums paid to the
Attorney pursuant to this agreement.
IN WITNESS WHEREOF, the parties have executed this agreement in duplicate
originals, one of which is retained by each of the parties hereto, on the day and year
first above written.
Thomas L. Fitzgerald, Attorney At Law
____________________________ _________________________
Signature Date
David Newell, Sr.
____________________________ _________________________
Chairman, County Commissioners Date
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ATTACHMENT C
CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS
AND CERTIFICATION REGARDING NONDISCRIMINATION
Person County Department of Social Services
I. By execution of this Agreement the Contractor certifies that it will provide a drug-free workplace by:
A. Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession or use of a controlled substance is prohibited in the Contractor’s workplace and specifying the actions that will be taken against employees for violation of
such prohibition;
B. Establishing a drug-free awareness program to inform employees about: (1) The dangers of drug abuse in the workplace; (2) The Contractor’s policy of maintaining a drug-free workplace; (3) Any available drug counseling, rehabilitation, and employee assistance programs; and
(4) The penalties that may be imposed upon employees for drug abuse violations
occurring in the workplace;
C. Making it a requirement that each employee be engaged in the performance of the agreement be given a copy of the statement required by paragraph (A); D. Notifying the employee in the statement required by paragraph (A) that, as a condition of employment under the agreement, the employee will:
(1) Abide by the terms of the statement; and
(2) Notify the employer of any criminal drug statute conviction for a violation occurring in the workplace no later than five days after such conviction;
E. Notifying the County within ten days after receiving notice under subparagraph (D)(2) from an employee or otherwise receiving actual notice of such conviction; F. Taking one of the following actions, within 30 days of receiving notice under
subparagraph (D)(2), with respect to any employee who is so convicted:
(1) Taking appropriate personnel action against such an employee, up to and including termination; or (2) Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State, or local health, law enforcement, or other appropriate agency; and
Making a good faith effort to continue to maintain a drug-free workplace through
implementation of paragraphs (A), (B), (C), (D), (E), and (F).
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The site(s) for the performance of work done in connection with the specific agreement are
listed below:
22 Court Street, Roxboro, NC 27573
Contractor will inform the County of any additional sites for performance of work under this agreement. False certification or violation of the certification shall be grounds for suspension of payment,
suspension or termination of grants, or government-wide Federal suspension or debarment
45 C.F.R. Section 82.510. Section 4 CFR Part 85, Section 85.615 and 86.620.
Certification Regarding Nondiscrimination
The Vendor certifies that it will comply with all Federal statutes relating to nondiscrimination.
These include but are not limited to: (a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352)
which prohibits discrimination on the basis of race, color or national origin; (b) Title IX of the
Education Amendments of 1972, as amended (20 U.S.C. §§1681-1683, and 1685-1686), which
prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as
amended (29 U.S.C. §794), which prohibits discrimination on the basis of handicaps; (d) the Age
Discrimination Act of 1975, as amended (42 U.S.C. §§6101-6107), which prohibits
discrimination on the basis of age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L.
92-255), as amended, relating to nondiscrimination on the basis of drug abuse; (f) the
Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of
1970 (P.L. 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or
alcoholism; (g) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. §§3601 et seq.), as
amended, relating to nondiscrimination in the sale, rental or financing of housing; (h) the Food
Stamp Act and USDA policy, which prohibit discrimination on the basis of religion and political
beliefs; and (i) the requirements of any other nondiscrimination statutes which may apply to this
Agreement.
Thomas L. Fitzgerald, Attorney At Law
____________________________ _________________________
Signature Date
David Newell, Sr.
____________________________ _________________________
Chairman, County Commissioners Date
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ATTACHMENT D:
CONFLICT OF INTEREST
The Board of Directors/Trustees or other governing persons, officers, employees or agents are to avoid
any conflict of interest, even the appearance of a conflict of interest. The Organization‘s Board of
Directors/Trustees or other governing body, officers, staff and agents are obligated to always act in the
best interest of the organization. This obligation requires that any Board member or other governing
person, officer, employee or agent, in the performance of Organization duties, seek only the furtherance
of the Organization mission. At all times, Board members or other governing persons, officers, employees
or agents, are prohibited from using their job title, the Organization's name or property, for private profit or
benefit.
A. The Board members or other governing persons, officers, employees, or agents of the Organization
should neither solicit nor accept gratuities, favors, or anything of monetary value from current or potential
contractors/vendors, persons receiving benefits from the Organization or persons who may benefit from
the actions of any Board member or other governing person, officer, employee or agent. This is not
intended to preclude bona-fide Organization fund raising-activities.
B. A Board or other governing body member may, with the approval of Board or other governing body,
receive honoraria for lectures and other such activities while not acting in any official capacity for the
Organization. Officers may, with the approval of the Board or other governing body, receive honoraria for
lectures and other such activities while on personal days, compensatory time, annual leave, or leave
without pay. Employees may, with the prior written approval of their supervisor, receive honoraria for
lectures and other such activities while on personal days, compensatory time, annual leave, or leave
without pay. If a Board or other governing body member, officer, employee or agent is acting in any
official capacity, honoraria received in connection with activities relating to the Organization are to be paid
to the Organization.
C. No Board member or other governing person, officer, employee, or agent of the Organization shall
participate in the selection, award, or administration of a purchase or contract with a vendor where, to his
knowledge, any of the following has a financial interest in that purchase or contract:
1. The Board member or other governing person, officer, employee, or agent;
2. Any member of their family by whole or half blood, step or personal relationship or relative-in-law;
3. An organization in which any of the above is an officer, director, or employee;
4. A person or organization with whom any of the above individuals is negotiating or has any
arrangement concerning prospective employment or contracts.
D. Duty to Disclosure -- Any conflict of interest, potential conflict of interest, or the appearance of a
conflict of interest is to be reported to the Board or other governing body or one’s supervisor immediately.
E. Board Action -- When a conflict of interest is relevant to a matter requiring action by the Board of
Directors/Trustees or other governing body, the Board member or other governing person, officer,
employee, or agent (person(s)) must disclose the existence of the conflict of interest and be given the
opportunity to disclose all material facts to the Board and members of committees with governing board
delegated powers considering the possible conflict of interest. After disclosure of all material facts, and
after any discussion with the person, he/she shall leave the governing board or committee meeting while
the determination of a conflict of interest is discussed and voted upon. The remaining board or committee
members shall decide if a conflict of interest exists. In addition, the person(s) shall not participate in the
final deliberation or decision regarding the matter under consideration and shall leave the meeting during
the discussion of and vote of the Board of Directors/Trustees or other governing body.
F. Violations of the Conflicts of Interest Policy -- If the Board of Directors/Trustees or other governing
body has reasonable cause to believe a member, officer, employee or agent has failed to disclose actual
or possible conflicts of interest, it shall inform the person of the basis for such belief and afford the person
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an opportunity to explain the alleged failure to disclose. If, after hearing the person's response and after
making further investigation as warranted by the circumstances, the Board of Directors/Trustees or other
governing body determines the member, officer, employee or agent has failed to disclose an actual or
possible conflict of interest, it shall take appropriate disciplinary and corrective action.
G. Record of Conflict -- The minutes of the governing board and all committees with board delegated
powers shall contain:
1. The names of the persons who disclosed or otherwise were found to have an actual or possible
conflict of interest, the nature of the conflict of interest, any action taken to determine whether a
conflict of interest was present, and the governing board's or committee's decision as to whether
a conflict of interest in fact existed.
2. The names of the persons who were present for discussions and votes relating to the transaction
or arrangement that presents a possible conflict of interest, the content of the discussion,
including any alternatives to the transaction or arrangement, and a record of any votes taken in
connection with the proceedings.
NOTARIZED CONFLICT OF INTEREST POLICY
Thomas L. Fitzgerald, Attorney At Law
_________________________________ _________________________
Signature Date
NORTH CAROLINA
PERSON COUNTY
I, __________________________, a Notary Public of said County and State do hereby certify that Thomas L. Fitzgerald,
Attorney at Law, personally appeared before me this date and acknowledged the due execution of the foregoing
agreement for the purposes therein expressed and by that authority duly given and as the act of the Organization,
affirmed that the foregoing Conflict of Interest Policy was adopted by the Board of Directors/Trustees or other
governing body in a meeting held on the __________ day of ___________, _________.
Sworn to and subscribed before me this _________ day of ______________________, 2016.
___________________________
Notary Public
My Commission expires: __________________
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ATTACHMENT E – OVERDUE TAXES
THOMAS L. FITZGERALD
ATTORNEY AT LAW
22 COURT STREET
P.O. BOX 1519
ROXBORO, NORTH CAROLINA 27573
(336) 599-2567
Fax (336) 599-5782
______________, 2016
To: Person County Department of Social Services
Certification:
I, Thomas L. Fitzgerald, certify that I do not have any overdue tax debts, as defined by N.C.G.S. 105-243.1, at
the federal, State, or local level. I further understand that any person who makes a false statement in violation
of N.C.G.S. 143C-6-23(c) is guilty of a criminal offense punishable as provided by N.C.G.S.) 143C-10-1b.
Sworn Statement:
I, Thomas L. Fitzgerald, being duly sworn, say that the foregoing certification is true, accurate and complete to
the best of my knowledge and was made and subscribed by me. I also acknowledge and understand that any
misuse of State funds will be reported to the appropriate authorities for further action.
Thomas L. Fitzgerald, Attorney At Law
____________________________ _________________________
Signature Date
NORTH CAROLINA
PERSON COUNTY
Sworn to and subscribed before me this _________ day of ______________________, 2016.
___________________________
Notary Public
My Commission expires: __________________
____________________
1 G.S. 105-243.1 defines: Overdue tax debt. – Any part of a tax debt that remains unpaid 90 days or more after the notice of final
assessment was mailed to the taxpayer. The term does not include a tax debt, however, if the taxpayer entered into an installment
agreement for the tax debt under G.S. 105-237 within 90 days after the notice of final assessment was mailed and has not failed to
make any payments due under the installment agreement.”
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ATTACHMENT G
Person County Department of Social Services
Certification Regarding Lobbying
Certification for Contracts, Grants, Loans and Cooperative Agreements
The undersigned certifies, to the best of his or her knowledge and belief, that:
(1) No Federal appropriated funds have been paid or will be paid by or on behalf of the undersigned, to any
person for influencing or attempting to influence an officer or employee of any Federal, state or local
government agency, a Member of Congress, a Member of the General Assembly, an officer or employee of
Congress, an officer or employee of the General Assembly, an employee of a Member of Congress, or an
employee of a Member of the General Assembly in connection with the awarding of any Federal or state
contract, the making of any Federal or state grant, the making of any Federal or state loan, the entering into
of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any
Federal or state contract, grant, loan, or cooperative agreement.
(2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for
influencing or attempting to influence an officer or employee of any Federal, state or local government
agency, a Member of Congress, a Member of the General Assembly, an officer or employee of Congress,
an officer or employee of the General Assembly, an employee of a Member of Congress, or an employee of
a Member of the General Assembly in connection with the awarding of any Federal or state contract, the
making of any Federal or state grant, the making of any Federal or state loan, the entering into of any
cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any
Federal or state contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit
Standard
Form LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions.
(3) The undersigned shall require that the language of this certification be included in the award documents for
all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and
cooperative agreements) and that all subrecipients shall certify and disclose accordingly.
(4) This certification is a material representation of fact upon which reliance was placed when this transaction
was made or entered into. Submission of this certification is a prerequisite for making or entering into this
transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required
certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each
such failure.
Notwithstanding other provisions of federal OMB Circulars-CFR Title 2, Grants and Agreements, Part 200, costs
associated with the following activities are unallowable:
Paragraph A.
(1) Attempts to influence the outcomes of any Federal, State, or local election, referendum, initiative, or
similar procedure, through in kind or cash contributions, endorsements, publicity, or similar activity;
(2) Establishing, administering, contributing to, or paying the expenses of a political party, campaign, political
action committee, or other organization established for the purpose of influencing the outcomes of
elections;
(3) Any attempt to influence: (i) The introduction of Federal or State legislation; or (ii) the enactment or
modification of any pending Federal or State legislation through communication with any member or
employee of the Congress or State legislature (including efforts to influence State or local officials to
engage in similar lobbying activity), or with any Government official or employee in connection with a
decision to sign or veto enrolled legislation;
(4) Any attempt to influence: (i) The introduction of Federal or State legislation; or (ii) the enactment or
modification of any pending Federal or State legislation by preparing, distributing or using publicity or
propaganda, or by urging members of the general public or any segment thereof to contribute to or
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participate in any mass demonstration, march, rally, fundraising drive, lobbying campaign or letter writing
or telephone campaign; or
(5) Legislative liaison activities, including attendance at legislative sessions or committee hearings, gathering
information regarding legislation, and analyzing the effect of legislation, when such activities are carried on
in support of or in knowing preparation for an effort to engage in unallowable lobbying.
The following activities as enumerated in Paragraph B are excepted from the coverage of Paragraph A:
Paragraph B.
(1) Providing a technical and factual presentation of information on a topic directly related to the performance
of a grant, contract or other agreement through hearing testimony, statements or letters to the Congress or a
State legislature, or subdivision, member, or cognizant staff member thereof, in response to a documented
request (including a Congressional Record notice requesting testimony or statements for the record at a
regularly scheduled hearing) made by the recipient member, legislative body or subdivision, or a cognizant
staff member thereof; provided such information is readily obtainable and can be readily put in deliverable
form; and further provided that costs under this section for travel, lodging or meals are unallowable unless
incurred to offer testimony at a regularly scheduled Congressional hearing pursuant to a written request for
such presentation made by the Chairman or Ranking Minority Member of the Committee or Subcommittee
conducting such hearing.
(2) Any lobbying made unallowable by subparagraph A (3) to influence State legislation in order to directly
reduce the cost, or to avoid material impairment of the organization's authority to perform the grant,
contract, or other agreement.
(3) Any activity specifically authorized by statute to be undertaken with funds from the grant, contract, or other
agreement.
Paragraph C.
(1) When an organization seeks reimbursement for indirect costs, total lobbying costs shall be separately
identified in the indirect cost rate proposal, and thereafter treated as other unallowable activity costs in
accordance with the procedures of subparagraph B.(3).
(2) Organizations shall submit, as part of the annual indirect cost rate proposal, a certification that the
requirements and standards of this paragraph have been complied with.
(3) Organizations shall maintain adequate records to demonstrate that the determination of costs as being
allowable or unallowable pursuant to this section complies with the requirements of this Circular.
(4) Time logs, calendars, or similar records shall not be required to be created for purposes of complying with
this paragraph during any particular calendar month when: (1) the employee engages in lobbying (as
defined in subparagraphs (a) and (b)) 25 percent or less of the employee's compensated hours of
employment during that calendar month, and (2) within the preceding five-year period, the organization has
not materially misstated allowable or unallowable costs of any nature, including legislative lobbying costs.
When conditions (1) and (2) are met, organizations are not required to establish records to support the
allowability of claimed costs in addition to records already required or maintained. Also, when conditions
(1) and (2) are met, the absence of time logs, calendars, or similar records will not serve as a basis for
disallowing costs by contesting estimates of lobbying time spent by employees during a calendar month.
(5) Agencies shall establish procedures for resolving in advance, in consultation with OMB, any significant
questions or disagreements concerning the interpretation or application of this section. Any such advance
resolution shall be binding in any subsequent settlements, audits or investigations with respect to that grant
or contract for purposes of interpretation of this Circular; provided, however, that this shall not be
construed to prevent a contractor or grantee from contesting the lawfulness of such a determination.
Paragraph D.
Executive lobbying costs. Costs incurred in attempting to improperly influence either directly or indirectly, an
employee or officer of the Executive Branch of the Federal Government to give consideration or to act
regarding a sponsored agreement or a regulatory matter are unallowable. Improper influence means any
influence that induces or tends to induce a Federal employee or officer to give consideration or to act regarding
a federally sponsored agreement or regulatory matter on any basis other than the merits of the matter.
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Thomas L. Fitzgerald, Attorney At Law
____________________________ _________________________
Signature Date
David Newell, Sr.
____________________________ _________________________
Chairman, County Commissioners Date
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ATTACHMENT H
PERSON COUNTY DEPARTMENT OF SOCIAL SERVICES
CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY
AND VOLUNTARY EXCLUSION-LOWER TIER COVERED TRANSACTIONS
Instructions for Certification
1. By signing and submitting this proposal, the prospective lower tier participant is providing the
certification set out below.
2. The certification in this clause is a material representation of the fact upon which reliance was
placed when this transaction was entered into. If it is later determined that the prospective lower
tier participant knowingly rendered an erroneous certification, in addition to other remedies
available to the Federal Government, the department or agency with which this transaction
originated may pursue available remedies, including suspension and/or debarment.
3. The prospective lower tier participant will provide immediate written notice to the person to
whom the proposal is submitted if at any time the prospective lower tier participant learns that its
certification was erroneous when submitted or has become erroneous by reason of changed
circumstances.
4. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered
transaction," "participant," "person," "primary covered transaction," "principal," "proposal," and
"voluntarily excluded," as used in this clause, have the meanings set out in the Definitions and
Coverage sections of rules implementing Executive Order 12549. You may contact the person to
which this proposal is submitted for assistance in obtaining a copy of those regulations.
5. The prospective lower tier participant agrees by submitting this proposal that, should the
proposed covered transaction be entered into, it shall not knowingly enter any lower tier covered
transaction with a person who is debarred, suspended, determined ineligible or voluntarily
excluded from participation in this covered transaction unless authorized by the department or
agency with which this transaction originated.
6. The prospective lower tier participant further agrees by submitting this proposal that it will
include this clause titled "Certification Regarding Debarment, Suspension, Ineligibility and
Voluntary Exclusion - Lower Tier Covered Transaction," without modification, in all lower tier
covered transactions and in all solicitations for lower tier covered transactions.
7. A participant in a covered transaction may rely upon a certification of a prospective
participant in a lower tier covered transaction that it is not debarred, suspended, ineligible, or
voluntarily excluded from covered transaction, unless it knows that the certification is erroneous.
A participant may decide the method and frequency of which it determines the eligibility of its
principals. Each participant may, but is not required to, check the Nonprocurement List.
8. Nothing contained in the foregoing shall be construed to require establishment of a system of
records in order to render in good faith the certification required by this clause. The knowledge
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and information of a participant is not required to exceed that which is normally possessed by a
prudent person in the ordinary course of business dealings.
9. Except for transactions authorized in paragraph 5 of these instructions, if a participant in a
covered transaction knowingly enters into a lower tier covered transaction with a person who is
suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in
addition to other remedies available to the Federal Government, the department or agency with
which this transaction originated may pursue available remedies, including suspension, and/or
debarment.
Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower
Tier Covered Transactions
(1) The prospective lower tier participant certifies, by submission of this proposal, that neither it
nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or
voluntarily excluded from participation in this transaction by any Federal department or agency.
(2) Where the prospective lower tier participant is unable to certify to any of the statements in this
certification, such prospective participant shall attach an explanation to this proposal.
Thomas L. Fitzgerald, Attorney At Law
____________________________ _________________________
Signature Date
David Newell, Sr.
____________________________ _________________________
Chairman, County Commissioners Date
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ATTACHMENT I
PERSON COUNTY
DEPARTMENT OF SOCIAL SERVICES
BUSINESS ASSOCIATE ADDENDUM
This Agreement is made effective the 1st day of July, 2016, by and between Person County
Department of Social Services (“Covered Entity”) and Thomas L. Fitzgerald, Attorney at Law
(“Business Associate”) (collectively the “Parties”).
1. BACKGROUND
a. Covered Entity and Business Associate are parties to a contract entitled Legal Services
Contract (the “Contract”), whereby Business Associate agrees to perform certain services for or
on behalf of Covered Entity.
b. Covered Entity is an organizational unit of Person County as the Person County Department
of Social Services (DSS) as a health care component for purposes of the HIPAA Privacy Rule.
c. The relationship between Covered Entity and Business Associate is such that the Parties
believe Business Associate is or may be a “business associate” within the meaning of the HIPAA
Privacy Rule.
d. The Parties enter into this Business Associate Addendum to the Contract with the intention of
complying with the HIPAA Privacy Rule provision that a covered entity may disclose protected
health information to a business associate, and may allow a business associate to create or
receive protected heath information on its behalf, if the covered entity obtains satisfactory
assurances that the business associate will appropriately safeguard the information.
2. DEFINITIONS
Unless some other meaning is clearly indicated by the context, the following terms shall have the
following meaning in this Agreement:
a. “HIPAA” means the Administrative Simplification Provisions, Sections 261 through 264, of
the federal Health Insurance Portability and Accountability Act of 1996, Public Law 104-191.
b. “Individual” shall have the same meaning as the term “individual” in 45 CFR160.103 and
shall include a person who qualifies as a personal representative in accordance with 45 CFR
164.502(g).
c. “Privacy Rule” shall mean the Standards for Privacy of Individually Identifiable Health
Information at 45 CFR part 160 and part 164, subparts A and E.
d. “Protected Health Information” shall have the same meaning as the term “protected health
information” in 45 CFR 160.103, limited to the information created or received by Business
Associate from or on behalf of Covered Entity.
e. “Required By Law” shall have the same meaning as the term “required by law” in 45 CFR
164.103.
f. “Secretary” shall mean the Secretary of the United States Department of Health and Human
Services or his designee.
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g. Unless otherwise defined in this Agreement, terms used herein shall have the same meaning
as those terms have in the Privacy Rule.
3. OBLIGATIONS OF BUSINESS ASSOCIATE
a. Business Associate agrees to not use or disclose Protected Health Information other than as
permitted or required by this Agreement or as Required By Law.
b. Business Associate agrees to use appropriate safeguards to prevent use or disclosure of the
Protected Health Information other than as provided for by this Agreement.
c. Business Associate agrees to mitigate, to the extent practicable, any harmful effect that is
known to Business Associate of a use or disclosure of Protected Health Information by Business
Associate in violation of the requirements of this Agreement.
d. Business Associate agrees to report to Covered Entity any use or disclosure of the Protected
Health Information not provided for by this Agreement of which it becomes aware.
e. Business Associate agrees to ensure that any agent, including a subcontractor, to whom it
provides Protected Health Information received from, or created or received by Business
Associate on behalf of Covered Entity agrees to the same restrictions and conditions that apply
through this Agreement to Business Associate with respect to such information.
f. Business Associate agrees to provide access, at the request of Covered Entity, to Protected
Health Information in a Designated Record Set to Covered Entity or, as directed by Covered
Entity, to an Individual in order to meet the requirements under 45 CFR 164.524.
g. Business Associate agrees, at the request of the Covered Entity, to make any amendment(s) to
Protected Health Information in a Designated Record Set that the Covered Entity directs or
agrees to pursuant to 45 CFR 164.526.
h. Unless otherwise prohibited by law, Business Associate agrees to make internal practices,
books, and records, including policies and procedures and Protected Health Information, relating
to the use and disclosure of Protected Health Information received from, or created or received
by Business Associate on behalf of Covered Entity, available to the Covered Entity, or to the
Person County Department of Social Services, in a time and manner designated by the
Secretary, for purposes of determining Covered Entity's compliance with the Privacy Rule.
i. Business Associate agrees to document such disclosures of Protected Health Information and
information related to such disclosures as would be required for Covered Entity to respond to a
request by an Individual for an accounting of disclosures of Protected Health Information in
accordance with 45 CFR 164.528, and to provide this information to Covered Entity or an
Individual to permit such a response.
4. PERMITTED USES AND DISCLOSURES
a. Except as otherwise limited in this Agreement or by other applicable law or agreement, if the
Contract permits, Business Associate may use or disclose Protected Health Information to
perform functions, activities, or services for, or on behalf of, Covered Entity as specified in the
Contract, provided that such use or disclosure:
1) would not violate the Privacy Rule if done by Covered Entity; or
2) would not violate the minimum necessary policies and procedures of the Covered
Entity.
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b. Except as otherwise limited in this Agreement or by other applicable law or agreements, if the
Contract permits, Business Associate may use Protected Health Information as necessary for the
proper management and administration of the Business Associate or to carry out the legal
responsibilities of the Business Associate.
c. Except as otherwise limited in this Agreement or by other applicable law or agreements, if the
Contract permits, Business Associate may disclose Protected Health Information for the proper
management and administration of the Business Associate, provided that:
1) disclosures are Required By Law; or
2) Business Associate obtains reasonable assurances from the person to whom the
information is disclosed that it will remain confidential and will be used or further
disclosed only as Required By Law or for the purpose for which it was disclosed to the
person, and the person notifies the Business Associate of any instances of which it is
aware in which the confidentiality of the information has been breached.
d. Except as otherwise limited in this Agreement or by other applicable law or agreements, if the
Contract permits, Business Associate may use Protected Health Information to provide data
aggregation services to Covered Entity as permitted by 45 CFR 164.504(e)(2)(i)(B).
e. Notwithstanding the foregoing provisions, Business Associate may not use or disclose
Protected Health Information if the use or disclosure would violate any term of the Contract or
other applicable law or agreements.
5. TERM AND TERMINATION
a. Term. This Agreement shall be effective as of the effective date stated above and shall
terminate when the Contract terminates.
b. Termination for Cause. Upon Covered Entity's knowledge of a material breach by Business
Associate, Covered Entity may, at its option:
1) Provide an opportunity for Business Associate to cure the breach or end the violation,
and terminate this Agreement and services provided by Business Associate, to the extent
permissible by law, if Business Associate does not cure the breach or end the violation
within the time specified by Covered Entity;
2) Immediately terminate this Agreement and services provided by Business Associate,
to the extent permissible by law; or
3) If neither termination nor cure is feasible, report the violation to the Secretary as
provided in the Privacy Rule.
c. Effect of Termination.
1) Except as provided in paragraph (2) of this section or in the Contract or by other
applicable law or agreements, upon termination of this Agreement and services provided
by Business Associate, for any reason, Business Associate shall return or destroy all
Protected Health Information received from Covered Entity, or created or received by
Business Associate on behalf of Covered Entity. This provision shall apply to Protected
Health Information that is in the possession of subcontractors or agents of Business
Associate. Business Associate shall retain no copies of the Protected Health Information.
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2) In the event that Business Associate determines that returning or destroying the
Protected Health Information is not feasible, Business Associate shall provide to Covered
Entity notification of the conditions that make return or destruction not feasible. Business
Associate shall extend the protections of this Agreement to such Protected Health
Information and limit further uses and disclosures of such Protected Health Information
to those purposes that make the return or destruction infeasible, for so long as Business
Associate maintains such Protected Health Information.
6. GENERAL TERMS AND CONDITIONS
a. This Agreement amends and is part of the Contract.
b. Except as provided in this Agreement, all terms and conditions of the Contract shall remain in
force and shall apply to this Agreement as if set forth fully herein.
c. In the event of a conflict in terms between this Agreement and the Contract, the interpretation
that is in accordance with the Privacy Rule shall prevail. In the event that a conflict then
remains, the Contract terms shall prevail so long as they are in accordance with the Privacy Rule.
d. A breach of this Agreement by Business Associate shall be considered sufficient basis for
Covered Entity to terminate the Contract for cause.
Thomas L. Fitzgerald, Attorney At Law
____________________________ _________________________
Signature Date
David Newell, Sr.
____________________________ _________________________
Chairman, County Commissioners Date
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Attachment M
State Certification
Contractor Certifications Required by North Carolina Law
Instructions
The person who signs this document should read the text of the statutes listed below and consult with
counsel and other knowledgeable persons before signing.
The text of Article 2 of Chapter 64 of the North Carolina General Statutes can be found online at:
http://www.ncga.state.nc.us/EnactedLegislation/Statutes/PDF/ByArticle/Chapter_64/Article_2.pdf
The text of G.S. 105-164.8(b) can be found online at:
http://www.ncga.state.nc.us/EnactedLegislation/Statutes/PDF/BySection/Chapter_105/GS_105-
164.8.pdf
The text of G.S. 143-48.5 (S.L. 2013-418, s. 2.(d)) can be found online at:
http://www.ncga.state.nc.us/Sessions/2013/Bills/House/PDF/H786v6.pdf
The text of G.S. 143-59.1 can be found online at:
http://www.ncga.state.nc.us/EnactedLegislation/Statutes/PDF/BySection/Chapter_143/GS_143-
59.1.pdf
The text of G.S. 143-59.2 can be found online at:
http://www.ncga.state.nc.us/EnactedLegislation/Statutes/PDF/BySection/Chapter_143/GS_143-
59.2.pdf
The text of G.S. 147-33.95(g) (S.L. 2013-418, s. 2.(e)) can be found online at:
http://www.ncga.state.nc.us/Sessions/2013/Bills/House/PDF/H786v6.pdf
Certifications
(1) Pursuant to G.S. 143-48.5 and G.S. 147-33.95(g), the undersigned hereby certifies that the
Contractor named below, and the Contractor’s subcontractors, complies with the requirements of
Article 2 of Chapter 64 of the NC General Statutes, including the requirement for each employer
with more than 25 employees in North Carolina to verify the work authorization of its employees
through the federal E-Verify system." E-Verify System Link: www.uscis.gov
Local government is specifically exempt from Article 2 of Chapter 64 of the North Carolina
General Statutes. However, local government is subject to and must comply with North Carolina
General Statute §153A-99.1., which states in part as follows:
Counties Must Use E-Verify. - Each county shall register and participate in E-Verify to verify the
work authorization of new employees hired to work in the United States.
(2) Pursuant to G.S. 143-59.1(b), the undersigned hereby certifies that the Contractor named below
is not an “ineligible Contractor” as set forth in G.S. 143-59.1(a) because:
(a) Neither the Contractor nor any of its affiliates has refused to collect the use tax levied
under Article 5 of Chapter 105 of the General Statutes on its sales delivered to North
Carolina when the sales met one or more of the conditions of G.S. 105-164.8(b); and
(b) [check one of the following boxes]
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Neither the Contractor nor any of its affiliates has incorporated or reincorporated
in a “tax haven country” as set forth in G.S. 143-59.1(c)(2) after December 31,
2001; or
The Contractor or one of its affiliates has incorporated or reincorporated in a “tax
haven country” as set forth in G.S. 143-59.1(c)(2) after December 31, 2001 but
the United States is not the principal market for the public trading of the stock of
the corporation incorporated in the tax haven country.
(3) Pursuant to G.S. 143-59.2(b), the undersigned hereby certifies that none of the Contractor’s
officers, directors, or owners (if the Contractor is an unincorporated business entity) has been
convicted of any violation of Chapter 78A of the General Statutes or the Securities Act of 1933 or
the Securities Exchange Act of 1934 within 10 years immediately prior to the date of the bid
solicitation.
(4) The undersigned hereby certifies further that:
(a) He or she is a duly authorized representative of the Contractor named below;
(b) He or she is authorized to make, and does hereby make, the foregoing certifications on
behalf of the Contractor; and
(c) He or she understands that any person who knowingly submits a false certification in
response to the requirements of G.S. 143-59.1 and -59.2 shall be guilty of a Class I
felony.
Contractor’s Name: Thomas L. Fitzgerald
Signature of Contractor’s Authorized Agent
Date
Printed Name of Contractor’s Authorized Agent
Thomas L. Fitzgerald
Title
Attorney at Law
Signature of Witness
Title
Printed Name of Witness
Date
The witness should be present when the Contractor’s Authorized Agent signs this certification and should
sign and date this document immediately thereafter.
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Attachment N
CERTIFICATION OF
ELIGIBILITY
Under the Iran
Divestment Act
Pursuant to G.S. 147-86.59, any person identified as engaging in investment activities in
Iran, determined by appearing on the Final Divestment List created by the State
Treasurer pursuant to G.S. 147-86.58, is ineligible to contract with the State of North
Carolina or any political subdivision of the State. The Iran Divestment Act of 2015, G.S.
147-86.55 et seq.* requires that each vendor, prior to contracting with the State certify,
and the undersigned on behalf of the Vendor does hereby certify, to the following:
1. that Thomas L. Fitzgerald, Attorney At Law, is not identified on the Final
Divestment List of entities that the State Treasurer has determined engages in
investment activities in Iran;
2. that Thomas L. Fitzgerald, Attorney At Law, shall not utilize on any contract with
the State agency any subcontractor that is identified on the Final Divestment List;
and
3. that Thomas L. Fitzgerald, Attorney At Law, is authorized to make this Certification.
Thomas L. Fitzgerald, Attorney At Law
____________________________ _________________________
Signature Date
* Note: Enacted by Session Law 2015‐118 as G.S. 143C‐55 et seq., but has been renumbered for
codification at the direction of the Revisor of Statutes.
The State Treasurer’s Final Divestment List can be found on the State Treasurer’s website at the address:
https://www.nctreasurer.com/inside‐the‐department/OpenGovernment/Pages/Iran‐Divestment‐Act‐Resources.aspx
and will be updated every 180 days. For questions about the Department of State Treasurer’s Iran Divestment
Policy, please contact Meryl Murtagh at Meryl.Murtagh@nctreasurer.com or (919) 814‐3852.
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Contract # 1009 Fiscal Year Begins July 1, 2016 Ends June 30, 2017
This contract is hereby entered into by and between the Person County Department of Social
Services (the "County") and Thomas L. Fitzgerald (the "Contractor") (referred to collectively as
the “Parties”). The Contractor’s federal tax identification number is 20-2272-781.
Contract Documents: This Contract consists of the following documents:
This contract
The General Terms and Conditions (Attachment A)
The Scope of Work, description of services, and rate (Attachment B)
Federal Certification Regarding Drug-Free Workplace & Certification Regarding Nondiscrimination (Attachment C)
Conflict of Interest (Attachment D)
No Overdue Taxes (Attachment E)
Federal Certification Regarding Lobbying (Attachment G)
Federal Certification Regarding Debarment (Attachment H)
HIPAA Business Associate Addendum (Attachment I)
State Certification (Attachment M)
Certification of Eligibility Under the Iran Divestment Act (Attachment N)
These documents constitute the entire agreement between the Parties and supersede all prior
oral or written statements or agreements.
Precedence among Contract Documents: In the event of a conflict between or among the
terms of the Contract Documents, the terms in the Contract Document with the highest relative
precedence shall prevail. The order of precedence shall be the order of documents as listed in
Paragraph 1, above, with the first-listed document having the highest precedence and the last-
listed document having the lowest precedence. If there are multiple Contract Amendments, the
most recent amendment shall have the highest precedence and the oldest amendment shall
have the lowest precedence.
Effective Period: This contract shall be effective on July 1, 2016 and shall terminate on
June 30, 2017. This contract must be twelve months or less.
Contractor’s Duties: The Contractor shall provide the services and in accordance with the
approved rate as described in Attachment B, Scope of Work.
County’s Duties: The County shall pay the Contractor in the manner and in the amounts
specified in the Contract Documents.
[ x ] a. There are no matching requirements from the Contractor.
[ ] b. The Contractor’s matching requirement is $__________, which shall consist of:
[ ] In-kind [ ] Cash [ ] Cash and In-kind [ ] Cash and/or In-kind
The contributions from the Contractor shall be sourced from non-federal funds.
The total contract amount including any Contractor match shall not exceed 1,000 hours
collectively for all attorneys under contract. Rate of compensation for Primary Attorney Thomas
L. Fitzgerald is $135 per hour.
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Reversion of Funds:
Any unexpended grant funds shall revert to the County Department of Social Services upon
termination of this contract.
Reporting Requirements:
Contractor shall comply with audit requirements as described in N.C.G.S. § 143C-6-22 & 23 and
OMB Circular- CFR Title 2 Grants and Agreements, Part 200, and shall disclose all information
required by 42 USC 455.104, or 42 USC 455.105, or 42 USC 455.106.
Payment Provisions:
Payment shall be made in accordance with the Contract Documents as described in the Scope
of Work, Attachment B.
Contract Administrators: All notices permitted or required to be given by one Party to the
other and all questions about the contract from one Party to the other shall be addressed and
delivered to the other Party’s Contract Administrator. The name, post office address, street
address, telephone number, fax number, and email address of the Parties’ respective initial
Contract Administrators are set out below. Either Party may change the name, post office
address, street address, telephone number, fax number, or email address of its Contract
Administrator by giving timely written notice to the other Party.
For the County: For the Contractor:
Wendy Bowman, Accounting Technician
Person County Department of Social Services Thomas L. Fitzgerald, Attorney
P.O. Box 770 P.O. Box 1519
355B South Madison Boulevard 22 Court Street
Roxboro, NC 27573 Roxboro, NC 27573
(336) 599-8361 (336) 599-2567
Supplementation of Expenditure of Public Funds: The Contractor assures that funds
received pursuant to this contract shall be used only to supplement, not to supplant, the total
amount of federal, state and local public funds that the Contractor otherwise expends for
contract services and related programs. Funds received under this contract shall be used to
provide additional public funding for such services; the funds shall not be used to reduce the
Contractor’s total expenditure of other public funds for such services.
Disbursements: As a condition of this contract, the Contractor acknowledges and agrees to
make disbursements in accordance with the following requirements:
(a) Implement adequate internal controls over disbursements;
(b) Pre-audit all vouchers presented for payment to determine:
Validity and accuracy of payment
Payment due date
Adequacy of documentation supporting payment
Legality of disbursement
(c) Assure adequate control of signature stamps/plates;
(d) Assure adequate control of negotiable instruments; and
(e) Implement procedures to insure that account balance is solvent and reconcile the
account monthly.
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Outsourcing to Other Countries: The Contractor certifies that it has identified to the County
all jobs related to the contract that have been outsourced to other countries, if any. The
Contractor further agrees that it will not outsource any such jobs during the term of this contract
without providing notice to the County.
Federal Certifications: Individuals and Organizations receiving federal funds must ensure
compliance with certain certifications required by federal laws and regulations. The contractor is
hereby complying with Certifications regarding Nondiscrimination, Drug-Free Workplace
Requirements, Environmental Tobacco Smoke, Debarment, Suspension, Ineligibility and
Voluntary Exclusion Lower Tier Covered Transactions, and Lobbying. These assurances and
certifications are to be signed by the contractor’s authorized representative.
Signature Warranty: The undersigned represent and warrant that they are authorized to bind
their principals to the terms of this agreement.
Signature Warranty:
The undersigned represent and warrant that they are authorized to bind their principals to the terms of this
agreement.
The Contractor and the County have executed this contract in duplicate originals, with one original being retained by
each party.
Thomas L. Fitzgerald, Attorney At Law
____________________________ _________________________
Signature Date
PERSON COUNTY
David Newell, Sr.
____________________________ _________________________
Chairman, County Commissioners Date
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
Act.
______________________________ ___________________________
Amy Wehrenberg, County Finance Director Date
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ATTACHMENT A
General Terms and Conditions
Relationships of the Parties
Independent Contractor: The Contractor is and shall be deemed to be an independent contractor in the performance of
this contract and as such shall be wholly responsible for the work to be performed and for the supervision of its employees.
The Contractor represents that it has, or shall secure at its own expense, all personnel required in performing the services
under this agreement. Such employees shall not be employees of, or have any individual contractual relationship with the
County.
Subcontracting: The Contractor shall not subcontract any of the work contemplated under this contract without prior written
approval from the County. Any approved subcontract shall be subject to all conditions of this contract. Only the
subcontractors specified in the contract documents are to be considered approved upon award of the contract. The County
shall not be obligated to pay for any work performed by any unapproved subcontractor. The Contractor shall be responsible
for the performance of all of its subcontractors.
Assignment: No assignment of the Contractor's obligations or the Contractor's right to receive payment hereunder shall be
permitted. However, upon written request approved by the issuing purchasing authority, the County may: Forward the
Contractor's payment check(s) directly to any person or entity designated by the Contractor, or Include any person or entity
designated by Contractor as a joint payee on the Contractor's payment check(s). In no event shall such approval and action
obligate the County to anyone other than the Contractor and the Contractor shall remain responsible for fulfillment of all
contract obligations.
Beneficiaries: Except as herein specifically provided otherwise, this contract shall inure to the benefit of and be binding
upon the parties hereto and their respective successors. It is expressly understood and agreed that the enforcement of the
terms and conditions of this contract, and all rights of action relating to such enforcement, shall be strictly reserved to the
County and the named Contractor. Nothing contained in this document shall give or allow any claim or right of action
whatsoever by any other third person. It is the express intention of the County and Contractor that any such person or entity,
other than the County or the Contractor, receiving services or benefits under this contract shall be deemed an incidental
beneficiary only.
Indemnity and Insurance
Indemnification: The Contractor agrees to indemnify and hold harmless the County and any of their officers, agents and
employees, from any claims of third parties arising out or any act or omission of the Contractor in connection with the
performance of this contract.
Insurance: During the term of the contract, the Contractor at its sole cost and expense shall provide commercial insurance
of such type and with such terms and limits as may be reasonably associated with the contract. As a minimum, the
Contractor shall provide and maintain the following coverage and limits:
Worker’s Compensation - The contractor shall provide and maintain Worker’s Compensation Insurance as required
by the laws of North Carolina, as well as employer’s liability coverage with minimum limits of $500,000.00, covering all
of Contractor’s employees who are engaged in any work under the contract. If any work is sublet, the Contractor shall
require the subcontractor to provide the same coverage for any of his employees engaged in any work under the
contract.
Commercial General Liability - General Liability Coverage on a Comprehensive Broad Form on an occurrence basis in
the minimum amount of $1,000,000.00 Combined Single Limit. (Defense cost shall be in excess of the limit of liability.)
Automobile Liability Insurance: The Contractor shall provide automobile liability insurance with a combined single
limit of $500,000.00 for bodily injury and property damage; a limit of $500,000.00 for uninsured/under insured
motorist coverage; and a limit of $2,000.00 for medical payment coverage. The Contractor shall provide this insurance
for all automobiles that are:
(a) owned by the Contractor and used in the performance of this contract;
(b) hired by the Contractor and used in the performance of this contract; and
(c) Owned by Contractor’s employees and used in performance of this contract (“non-owned vehicle insurance”).
Non-owned vehicle insurance protects employers when employees use their personal vehicles for work
purposes. Non-owned vehicle insurance supplements, but does not replace, the car-owner’s liability insurance.
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The Contractor is not required to provide and maintain automobile liability insurance on any vehicle – owned,
hired, or non-owned -- unless the vehicle is used in the performance of this contract.
(d) The insurance coverage minimums specified in subparagraph (a) are exclusive of defense costs.
(e) The Contractor understands and agrees that the insurance coverage minimums specified in subparagraph (a) are
not limits, or caps, on the Contractor’s liability or obligations under this contract.
(f) The Contractor may obtain a waiver of any one or more of the requirements in subparagraph (a) by
demonstrating that it has insurance that provides protection that is equal to or greater than the coverage and
limits specified in subparagraph (a). The County shall be the sole judge of whether such a waiver should be
granted.
(g) The Contractor may obtain a waiver of any one or more of the requirements in paragraph (a) by demonstrating
that it is self-insured and that its self-insurance provides protection that is equal to or greater than the coverage
and limits specified in subparagraph (a). The County shall be the sole judge of whether such a waiver should be
granted.
(h) Providing and maintaining the types and amounts of insurance or self-insurance specified in this paragraph is a
material obligation of the Contractor and is of the essence of this contract.
(i) The Contractor shall only obtain insurance from companies that are authorized to provide such coverage and
that are authorized by the Commissioner of Insurance to do business in the State of North Carolina. All such
insurance shall meet all laws of the State of North Carolina.
(j) The Contractor shall comply at all times with all lawful terms and conditions of its insurance policies and all
lawful requirements of its insurer.
(k) The Contractor shall require its subcontractors to comply with the requirements of this paragraph.
(l) The Contractor shall demonstrate its compliance with the requirements of this paragraph by submitting
certificates of insurance to the County before the Contractor begins work under this contract.
Transportation of Clients by Contractor:
The contractor will maintain Insurance requirements if required as noted under Article 7 Rule R2-36 of the North Carolina
Utilities Commission.
Default and Termination
Termination without Cause: The County may terminate this contract without cause by giving 30 days written notice to the
Contractor.
Termination for Cause: If, through any cause, the Contractor shall fail to fulfill its obligations under this contract in a timely
and proper manner, the County shall have the right to terminate this contract by giving written notice to the Contractor and
specifying the effective date thereof. In that event, all finished or unfinished deliverable items prepared by the Contractor
under this contract shall, at the option of the County, become its property and the Contractor shall be entitled to receive just
and equitable compensation for any satisfactory work completed on such materials, minus any payment or compensation
previously made. Notwithstanding the foregoing provision, the Contractor shall not be relieved of liability to the County for
damages sustained by the County by virtue of the Contractor’s breach of this agreement, and the County may withhold any
payment due the Contractor for the purpose of setoff until such time as the exact amount of damages due the County from
such breach can be determined. In case of default by the Contractor, without limiting any other remedies for breach
available to it, the County may procure the contract services from other sources and hold the Contractor responsible for any
excess cost occasioned thereby. The filing of a petition for bankruptcy by the Contractor shall be an act of default under this
contract.
Waiver of Default: Waiver by the County of any default or breach in compliance with the terms of this contract by the
Provider shall not be deemed a waiver of any subsequent default or breach and shall not be construed to be modification of
the terms of this contract unless stated to be such in writing, signed by an authorized representative of the County and the
Contractor and attached to the contract.
Availability of Funds: The parties to this contract agree and understand that the payment of the sums specified in this
contract is dependent and contingent upon and subject to the appropriation, allocation, and availability of funds for this
purpose to the County.
Force Majeure: Neither party shall be deemed to be in default of its obligations hereunder if and so long as it is prevented
from performing such obligations by any act of war, hostile foreign action, nuclear explosion, riot, strikes, civil insurrection,
earthquake, hurricane, tornado, or other catastrophic natural event or act of God.
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Survival of Promises: All promises, requirements, terms, conditions, provisions, representations, guarantees, and warranties
contained herein shall survive the contract expiration or termination date unless specifically provided otherwise herein, or
unless superseded by applicable Federal or State statutes of limitation.
Intellectual Property Rights
Copyrights and Ownership of Deliverables: All deliverable items produced pursuant to this contract are the exclusive
property of the County. The Contractor shall not assert a claim of copyright or other property interest in such deliverables.
Federal Intellectual Property Bankruptcy Protection Act: The Parties agree that the County shall be entitled to all rights and
benefits of the Federal Intellectual Property Bankruptcy Protection Act, Public Law 100-506, codified at 11 U.S.C. 365 (n)
and any amendments thereto.
Compliance with Applicable Laws
Compliance with Laws: The Contractor shall comply with all laws, ordinances, codes, rules, regulations, and licensing
requirements that are applicable to the conduct of its business, including those of federal, state, and local agencies having
jurisdiction and/or authority.
Title VI, Civil Rights Compliance: In accordance with Federal law and U.S. Department of Agriculture (USDA) and U.S.
Department of Health and Human Services (HHS) policy, this institution is prohibited from discriminating on the basis of
race, color, national origin, sex, age or disability. Under the Food Stamp Act and USDA policy, discrimination is prohibited
also on the basis of religion or political beliefs.
Equal Employment Opportunity: The Contractor shall comply with all federal and State laws relating to equal employment
opportunity.
Health Insurance Portability and Accountability Act (HIPAA): The Contractor agrees that, if the County determines that
some or all of the activities within the scope of this contract are subject to the Health Insurance Portability and Accountability
Act of 1996, P.L. 104-91, as amended (“HIPAA”), or its implementing regulations, it will comply with the HIPAA
requirements and will execute such agreements and practices as the County may require to ensure compliance.
(a) Data Security: The Contractor shall adopt and apply data security standards and procedures that comply with all
applicable federal, state, and local laws, regulations, and rules.
(b) Duty to Report: The Contractor shall report a suspected or confirmed security breach to the local Department of
Social Services/Human Services Contract Administrator within twenty-four (24) hours after the breach is first
discovered, provided that the Contractor shall report a breach involving Social Security Administration data or
Internal Revenue Service data within one (1) hour after the breach is first discovered.
(c) Cost Borne by Contractor: If any applicable federal, state, or local law, regulation, or rule requires the Contractor
to give written notice of a security breach to affected persons, the Contractor shall bear the cost of the notice.
Trafficking Victims Protection Act of 2000: The Contractor will comply with the requirements of Section 106(g) of the
Trafficking Victims Protection Act of 2000, as amended (22 U.S.C. 7104).
Executive Order # 24: It is unlawful for any vendor, contractor, subcontractor or supplier of the state to make gifts or to give
favors to any state employee. For additional information regarding the specific requirements and exemptions, contractors
are encouraged to review Executive Order 24 and G.S. Sec. 133-32.
Confidentiality
Confidentiality: Any information, data, instruments, documents, studies or reports given to or prepared or assembled by the
Contractor under this agreement shall be kept as confidential and not divulged or made available to any individual or
organization without the prior written approval of the County. The Contractor acknowledges that in receiving, storing,
processing or otherwise dealing with any confidential information it will safeguard and not further disclose the information
except as otherwise provided in this contract.
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Oversight
Access to Persons and Records: The State Auditor shall have access to persons and records as a result of all contracts or
grants entered into by State agencies or political subdivisions in accordance with General Statute 147-64.7. Additionally, as
the State funding authority, the Department of Health and Human Services shall have access to persons and records as a
result of all contracts or grants entered into by State agencies or political subdivisions.
Record Retention: Records shall not be destroyed, purged or disposed of without the express written consent of the
Division. State basic records retention policy requires all grant records to be retained for a minimum of five years or until all
audit exceptions have been resolved, whichever is longer. If the contract is subject to federal policy and regulations, record
retention may be longer than five years since records must be retained for a period of three years following submission of the
final Federal Financial Status Report, if applicable, or three years following the submission of a revised final Federal
Financial Status Report. Also, if any litigation, claim, negotiation, audit, disallowance action, or other action involving this
Contract has been started before expiration of the five-year retention period described above, the records must be retained
until completion of the action and resolution of all issues which arise from it, or until the end of the regular five-year period
described above, whichever is later. The record retention period for Temporary Assistance for Needy Families (TANF) and
MEDICAID and Medical Assistance grants and programs must be retained for a minimum of ten years.
Warranties and Certifications
Date and Time Warranty: The Contractor warrants that the product(s) and service(s) furnished pursuant to this contract
(“product” includes, without limitation, any piece of equipment, hardware, firmware, middleware, custom or commercial
software, or internal components, subroutines, and interfaces therein) that perform any date and/or time data recognition
function, calculation, or sequencing will support a four digit year format and will provide accurate date/time data and leap
year calculations. This warranty shall survive the termination or expiration of this contract.
Certification Regarding Collection of Taxes: G.S. 143-59.1 bars the Secretary of Administration from entering into contracts
with vendors that meet one of the conditions of G.S. 105-164.8(b) and yet refuse to collect use taxes on sales of tangible
personal property to purchasers in North Carolina. The conditions include: (a) maintenance of a retail establishment or
office; (b) presence of representatives in the State that solicit sales or transact business on behalf of the vendor; and (c)
systematic exploitation of the market by media-assisted, media-facilitated, or media-solicited means. The Contractor certifies
that it and all of its affiliates (if any) collect all required taxes.
E-Verify
Pursuant to G.S. 143-48.5 and G.S. 147-33.95(g), the undersigned hereby certifies that the Contractor named below, and the
Contractor’s subcontractors, complies with the requirements of Article 2 of Chapter 64 of the NC General Statutes, including
the requirement for each employer with more than 25 employees in North Carolina to verify the work authorization of its
employees through the federal E-Verify system." E-Verify System Link: www.uscis.gov
Miscellaneous
Choice of Law: The validity of this contract and any of its terms or provisions, as well as the rights and duties of the parties
to this contract, are governed by the laws of North Carolina. The Contractor, by signing this contract, agrees and submits,
solely for matters concerning this Contract, to the exclusive jurisdiction of the courts of North Carolina and agrees, solely for
such purpose, that the exclusive venue for any legal proceedings shall be the county is which the contract originated. The
place of this contract and all transactions and agreements relating to it, and their situs and forum, shall be the county where
the contract originated, where all matters, whether sounding in contract or tort, relating to the validity, construction,
interpretation, and enforcement shall be determined.
Amendment: This contract may not be amended orally or by performance. Any amendment must be made in written form
and executed by duly authorized representatives of the County and the Contractor.
Severability: In the event that a court of competent jurisdiction holds that a provision or requirement of this contract
violates any applicable law, each such provision or requirement shall continue to be enforced to the extent it is not in
violation of law or is not otherwise unenforceable and all other provisions and requirements of this contract shall remain in
full force and effect.
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Headings: The Section and Paragraph headings in these General Terms and Conditions are not material parts of the
agreement and should not be used to construe the meaning thereof.
Time of the Essence: Time is of the essence in the performance of this contract.
Key Personnel: The Contractor shall not replace any of the key personnel assigned to the performance of this contract
without the prior written approval of the County. The term “key personnel” includes any and all persons identified as such
in the contract documents and any other persons subsequently identified as key personnel by the written agreement of the
parties.
Care of Property: The Contractor agrees that it shall be responsible for the proper custody and care of any property
furnished to it for use in connection with the performance of this contract and will reimburse the County for loss of, or
damage to, such property. At the termination of this contract, the Contractor shall contact the County for instructions as to
the disposition of such property and shall comply with these instructions.
Travel Expenses: Reimbursement to the Contractor for travel mileage, meals, lodging and other travel expenses incurred in
the performance of this contract shall not exceed the rates established in County policy.
Sales/Use Tax Refunds: If eligible, the Contractor and all subcontractors shall: (a) ask the North Carolina Department of
Revenue for a refund of all sales and use taxes paid by them in the performance of this contract, pursuant to G.S. 105-
164.14; and (b) exclude all refundable sales and use taxes from all reportable expenditures before the expenses are entered
in their reimbursement reports.
Advertising: The Contractor shall not use the award of this contract as a part of any news release or commercial advertising.
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ATTACHMENT B – Scope of Work Federal Tax Id. 20-2272-781
STATE OF NORTH CAROLINA )
)
) CONTRACT FOR LEGAL SERVICES
)
COUNTY OF Person )
THIS CONTRACT made and entered into this the 1st day of July, 2016, by and
between the Person County Commissioners, party of the first part, and Thomas L.
Fitzgerald, Attorney, party of the second part;
W I T N E S S E T H
The parties hereby agree that the party of the second part shall provide legal
services to the party of the first part pursuant to the following mutual covenants:
1. This Contract shall begin July 1, 2016, and unless sooner terminated by 30
days’ notice of either party shall exist and continue through June 30, 2017.
2. Said party of the second part, upon reasonable notice, is to be available for
consultation, legal advice and for representation as requested by the Child Support
Enforcement Agency on all legal matters arising from the duties of the party of the first
part under Sections 128 through 140 of Chapter 110 of the North Carolina General
Statutes and Title 42 of the United States Code, Sections 651 through 660 and the
federal regulations lawfully promulgated pursuant thereto.
3. Said party of the second part agrees to comply with all the requirements of
Sections 128 through 140 of Chapter 110 of the North Carolina General Statutes, Title
42 of the United States Code, Sections 651 through 660, and the regulations
promulgated pursuant thereto relating to the performance of program legal services
including, but not limited to, maintaining such records as are required by the party of the
first part, to make said records available for federal or state audit if required, and to
make financial, statistical, and program progress reports as are required.
4. For their services under this contract, the party of the first part agrees to pay
the party of the second part one hundred thirty-five dollars ($135.00) per hour for out of
court time and one hundred thirty-five dollars ($135.00) per hour for in court time for
each hour spent by the party of the second part providing legal services under the Child
Support Enforcement Program. Such hourly rate shall encompass all expenses,
including, but not limited to, those for salary, supplies, office space, heating and
maintenance for office space, telephone service, long-distance telephone calls, and
travel (other than travel to attend the Child Support Enforcement Training). The party of
the second part is not to be reimbursed for any extraordinary expense incident to
performing the services included under this agreement; except, that the party of the first
part agrees to pay all court costs and filing fees which are required to be paid in
conjunction with services provided by the attorney under this agreement.
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5. The party of the second part shall notify the Agency when a conflict of interest
arises for the Attorney. In all such cases, referral shall be made to another attorney with
whom the Department has contracted for secondary employment for the provision of
legal services when conflicts arise.
6. The party of the second part further agrees to attend at least one training
session on Child Support Enforcement per year conducted by the Child Support
Enforcement Agency. Reimbursement shall be made in the amount of fifty-four cents
($0.54) per mile for travel and expenses not to exceed a total of three hundred twenty-
five dollars ($325.00) per year. In addition the party of the first part agrees to
compensate the party of the second part at the hourly rate of fifty-five dollars ($55.00)
for each hour that the party of the second part spends in training up to but not to exceed
the amount of four hundred forty dollars ($440.00) per day. Failure to attend one
approved workshop per year shall be construed as an indication that the party of the
second part does not wish to continue providing services under this agreement.
7. Person County Department of Social Services will pay standard costs for
ACTS training with consideration being given to Person County Department of Social
Services paying for Mr. Fitzgerald’s ACTS computer software should such acquisition
be necessary.
8. It is specifically agreed that the party of the second part is an independent
contractor and the party of the second part shall perform the services herein provided
according to his own judgment and method and shall not be subject to the control of the
party of the first part except as to the result of his work.
9. The party of the second part shall not under any circumstance be considered
an employee of the party of the first part. The party of the first part shall not withhold
federal or state taxes from sums to be paid to the party of the second part pursuant to
this agreement.
IN TESTIMONY WHEREOF, said parties have executed this contract in triplicate
originals, one of which is to be retained by the party of the first part, one of which is to
be retained by the party of the second part, and one of which is to be filed with Child
Support Enforcement Section, Division of Social Services of the Department of Human
Resources, Raleigh, North Carolina.
Thomas L. Fitzgerald, Attorney At Law
____________________________ _________________________
Signature Date
David Newell, Sr.
____________________________ _________________________
Chairman, County Commissioners Date
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ATTACHMENT C
CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS
AND CERTIFICATION REGARDING NONDISCRIMINATION
Person County Department of Social Services
I. By execution of this Agreement the Contractor certifies that it will provide a drug-free workplace by:
A. Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession or use of a controlled substance is prohibited in the Contractor’s workplace and specifying the actions that will be taken against employees for violation of
such prohibition;
B. Establishing a drug-free awareness program to inform employees about: (1) The dangers of drug abuse in the workplace; (2) The Contractor’s policy of maintaining a drug-free workplace; (3) Any available drug counseling, rehabilitation, and employee assistance programs; and
(4) The penalties that may be imposed upon employees for drug abuse violations
occurring in the workplace;
C. Making it a requirement that each employee be engaged in the performance of the agreement be given a copy of the statement required by paragraph (A); D. Notifying the employee in the statement required by paragraph (A) that, as a condition of employment under the agreement, the employee will:
(1) Abide by the terms of the statement; and
(2) Notify the employer of any criminal drug statute conviction for a violation occurring in the workplace no later than five days after such conviction;
E. Notifying the County within ten days after receiving notice under subparagraph (D)(2) from an employee or otherwise receiving actual notice of such conviction; F. Taking one of the following actions, within 30 days of receiving notice under
subparagraph (D)(2), with respect to any employee who is so convicted:
(1) Taking appropriate personnel action against such an employee, up to and including termination; or (2) Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State, or local health, law enforcement, or other appropriate agency; and
Making a good faith effort to continue to maintain a drug-free workplace through
implementation of paragraphs (A), (B), (C), (D), (E), and (F).
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The site(s) for the performance of work done in connection with the specific agreement are
listed below:
22 Court Street, Roxboro, NC 27573
Contractor will inform the County of any additional sites for performance of work under this agreement. False certification or violation of the certification shall be grounds for suspension of payment,
suspension or termination of grants, or government-wide Federal suspension or debarment
45 C.F.R. Section 82.510. Section 4 CFR Part 85, Section 85.615 and 86.620.
Certification Regarding Nondiscrimination
The Vendor certifies that it will comply with all Federal statutes relating to nondiscrimination.
These include but are not limited to: (a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352)
which prohibits discrimination on the basis of race, color or national origin; (b) Title IX of the
Education Amendments of 1972, as amended (20 U.S.C. §§1681-1683, and 1685-1686), which
prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as
amended (29 U.S.C. §794), which prohibits discrimination on the basis of handicaps; (d) the Age
Discrimination Act of 1975, as amended (42 U.S.C. §§6101-6107), which prohibits
discrimination on the basis of age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L.
92-255), as amended, relating to nondiscrimination on the basis of drug abuse; (f) the
Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of
1970 (P.L. 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or
alcoholism; (g) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. §§3601 et seq.), as
amended, relating to nondiscrimination in the sale, rental or financing of housing; (h) the Food
Stamp Act and USDA policy, which prohibit discrimination on the basis of religion and political
beliefs; and (i) the requirements of any other nondiscrimination statutes which may apply to this
Agreement.
Thomas L. Fitzgerald, Attorney At Law
____________________________ _________________________
Signature Date
David Newell, Sr.
____________________________ _________________________
Chairman, County Commissioners Date
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ATTACHMENT D:
CONFLICT OF INTEREST
The Board of Directors/Trustees or other governing persons, officers, employees or agents are to avoid
any conflict of interest, even the appearance of a conflict of interest. The Organization‘s Board of
Directors/Trustees or other governing body, officers, staff and agents are obligated to always act in the
best interest of the organization. This obligation requires that any Board member or other governing
person, officer, employee or agent, in the performance of Organization duties, seek only the furtherance
of the Organization mission. At all times, Board members or other governing persons, officers, employees
or agents, are prohibited from using their job title, the Organization's name or property, for private profit or
benefit.
A. The Board members or other governing persons, officers, employees, or agents of the Organization
should neither solicit nor accept gratuities, favors, or anything of monetary value from current or potential
contractors/vendors, persons receiving benefits from the Organization or persons who may benefit from
the actions of any Board member or other governing person, officer, employee or agent. This is not
intended to preclude bona-fide Organization fund raising-activities.
B. A Board or other governing body member may, with the approval of Board or other governing body,
receive honoraria for lectures and other such activities while not acting in any official capacity for the
Organization. Officers may, with the approval of the Board or other governing body, receive honoraria for
lectures and other such activities while on personal days, compensatory time, annual leave, or leave
without pay. Employees may, with the prior written approval of their supervisor, receive honoraria for
lectures and other such activities while on personal days, compensatory time, annual leave, or leave
without pay. If a Board or other governing body member, officer, employee or agent is acting in any
official capacity, honoraria received in connection with activities relating to the Organization are to be paid
to the Organization.
C. No Board member or other governing person, officer, employee, or agent of the Organization shall
participate in the selection, award, or administration of a purchase or contract with a vendor where, to his
knowledge, any of the following has a financial interest in that purchase or contract:
1. The Board member or other governing person, officer, employee, or agent;
2. Any member of their family by whole or half blood, step or personal relationship or relative-in-law;
3. An organization in which any of the above is an officer, director, or employee;
4. A person or organization with whom any of the above individuals is negotiating or has any
arrangement concerning prospective employment or contracts.
D. Duty to Disclosure -- Any conflict of interest, potential conflict of interest, or the appearance of a
conflict of interest is to be reported to the Board or other governing body or one’s supervisor immediately.
E. Board Action -- When a conflict of interest is relevant to a matter requiring action by the Board of
Directors/Trustees or other governing body, the Board member or other governing person, officer,
employee, or agent (person(s)) must disclose the existence of the conflict of interest and be given the
opportunity to disclose all material facts to the Board and members of committees with governing board
delegated powers considering the possible conflict of interest. After disclosure of all material facts, and
after any discussion with the person, he/she shall leave the governing board or committee meeting while
the determination of a conflict of interest is discussed and voted upon. The remaining board or committee
members shall decide if a conflict of interest exists. In addition, the person(s) shall not participate in the
final deliberation or decision regarding the matter under consideration and shall leave the meeting during
the discussion of and vote of the Board of Directors/Trustees or other governing body.
F. Violations of the Conflicts of Interest Policy -- If the Board of Directors/Trustees or other governing
body has reasonable cause to believe a member, officer, employee or agent has failed to disclose actual
or possible conflicts of interest, it shall inform the person of the basis for such belief and afford the person
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an opportunity to explain the alleged failure to disclose. If, after hearing the person's response and after
making further investigation as warranted by the circumstances, the Board of Directors/Trustees or other
governing body determines the member, officer, employee or agent has failed to disclose an actual or
possible conflict of interest, it shall take appropriate disciplinary and corrective action.
G. Record of Conflict -- The minutes of the governing board and all committees with board delegated
powers shall contain:
1. The names of the persons who disclosed or otherwise were found to have an actual or possible
conflict of interest, the nature of the conflict of interest, any action taken to determine whether a
conflict of interest was present, and the governing board's or committee's decision as to whether
a conflict of interest in fact existed.
2. The names of the persons who were present for discussions and votes relating to the transaction
or arrangement that presents a possible conflict of interest, the content of the discussion,
including any alternatives to the transaction or arrangement, and a record of any votes taken in
connection with the proceedings.
NOTARIZED CONFLICT OF INTEREST POLICY
Thomas L. Fitzgerald, Attorney At Law
_________________________________ _________________________
Signature Date
NORTH CAROLINA
PERSON COUNTY
I, __________________________, a Notary Public of said County and State do hereby certify that Thomas L. Fitzgerald,
Attorney at Law, personally appeared before me this date and acknowledged the due execution of the foregoing
agreement for the purposes therein expressed and by that authority duly given and as the act of the Organization,
affirmed that the foregoing Conflict of Interest Policy was adopted by the Board of Directors/Trustees or other
governing body in a meeting held on the __________ day of ___________, _________.
Sworn to and subscribed before me this _________ day of ______________________, 2016.
___________________________
Notary Public
My Commission expires: __________________
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ATTACHMENT E – OVERDUE TAXES
THOMAS L. FITZGERALD
ATTORNEY AT LAW
22 COURT STREET
P.O. BOX 1519
ROXBORO, NORTH CAROLINA 27573
(336) 599-2567
Fax (336) 599-5782
______________, 2016
To: Person County Department of Social Services
Certification:
I, Thomas L. Fitzgerald, certify that I do not have any overdue tax debts, as defined by N.C.G.S. 105-243.1, at
the federal, State, or local level. I further understand that any person who makes a false statement in violation
of N.C.G.S. 143C-6-23(c) is guilty of a criminal offense punishable as provided by N.C.G.S.) 143C-10-1b.
Sworn Statement:
I, Thomas L. Fitzgerald, being duly sworn, say that the foregoing certification is true, accurate and complete to
the best of my knowledge and was made and subscribed by me. I also acknowledge and understand that any
misuse of State funds will be reported to the appropriate authorities for further action.
Thomas L. Fitzgerald, Attorney At Law
____________________________ _________________________
Signature Date
NORTH CAROLINA
PERSON COUNTY
Sworn to and subscribed before me this _________ day of ______________________, 2016.
___________________________
Notary Public
My Commission expires: __________________
____________________
1 G.S. 105-243.1 defines: Overdue tax debt. – Any part of a tax debt that remains unpaid 90 days or more after the notice of final
assessment was mailed to the taxpayer. The term does not include a tax debt, however, if the taxpayer entered into an installment
agreement for the tax debt under G.S. 105-237 within 90 days after the notice of final assessment was mailed and has not failed to
make any payments due under the installment agreement.”
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ATTACHMENT G
Person County Department of Social Services
Certification Regarding Lobbying
Certification for Contracts, Grants, Loans and Cooperative Agreements
The undersigned certifies, to the best of his or her knowledge and belief, that:
(1) No Federal appropriated funds have been paid or will be paid by or on behalf of the undersigned, to any
person for influencing or attempting to influence an officer or employee of any Federal, state or local
government agency, a Member of Congress, a Member of the General Assembly, an officer or employee of
Congress, an officer or employee of the General Assembly, an employee of a Member of Congress, or an
employee of a Member of the General Assembly in connection with the awarding of any Federal or state
contract, the making of any Federal or state grant, the making of any Federal or state loan, the entering into
of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any
Federal or state contract, grant, loan, or cooperative agreement.
(2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for
influencing or attempting to influence an officer or employee of any Federal, state or local government
agency, a Member of Congress, a Member of the General Assembly, an officer or employee of Congress,
an officer or employee of the General Assembly, an employee of a Member of Congress, or an employee of
a Member of the General Assembly in connection with the awarding of any Federal or state contract, the
making of any Federal or state grant, the making of any Federal or state loan, the entering into of any
cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any
Federal or state contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit
Standard
Form LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions.
(3) The undersigned shall require that the language of this certification be included in the award documents for
all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and
cooperative agreements) and that all subrecipients shall certify and disclose accordingly.
(4) This certification is a material representation of fact upon which reliance was placed when this transaction
was made or entered into. Submission of this certification is a prerequisite for making or entering into this
transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required
certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each
such failure.
Notwithstanding other provisions of federal OMB Circulars-CFR Title 2, Grants and Agreements, Part 200, costs
associated with the following activities are unallowable:
Paragraph A.
(1) Attempts to influence the outcomes of any Federal, State, or local election, referendum, initiative, or
similar procedure, through in kind or cash contributions, endorsements, publicity, or similar activity;
(2) Establishing, administering, contributing to, or paying the expenses of a political party, campaign, political
action committee, or other organization established for the purpose of influencing the outcomes of
elections;
(3) Any attempt to influence: (i) The introduction of Federal or State legislation; or (ii) the enactment or
modification of any pending Federal or State legislation through communication with any member or
employee of the Congress or State legislature (including efforts to influence State or local officials to
engage in similar lobbying activity), or with any Government official or employee in connection with a
decision to sign or veto enrolled legislation;
(4) Any attempt to influence: (i) The introduction of Federal or State legislation; or (ii) the enactment or
modification of any pending Federal or State legislation by preparing, distributing or using publicity or
propaganda, or by urging members of the general public or any segment thereof to contribute to or
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participate in any mass demonstration, march, rally, fundraising drive, lobbying campaign or letter writing
or telephone campaign; or
(5) Legislative liaison activities, including attendance at legislative sessions or committee hearings, gathering
information regarding legislation, and analyzing the effect of legislation, when such activities are carried on
in support of or in knowing preparation for an effort to engage in unallowable lobbying.
The following activities as enumerated in Paragraph B are excepted from the coverage of Paragraph A:
Paragraph B.
(1) Providing a technical and factual presentation of information on a topic directly related to the performance
of a grant, contract or other agreement through hearing testimony, statements or letters to the Congress or a
State legislature, or subdivision, member, or cognizant staff member thereof, in response to a documented
request (including a Congressional Record notice requesting testimony or statements for the record at a
regularly scheduled hearing) made by the recipient member, legislative body or subdivision, or a cognizant
staff member thereof; provided such information is readily obtainable and can be readily put in deliverable
form; and further provided that costs under this section for travel, lodging or meals are unallowable unless
incurred to offer testimony at a regularly scheduled Congressional hearing pursuant to a written request for
such presentation made by the Chairman or Ranking Minority Member of the Committee or Subcommittee
conducting such hearing.
(2) Any lobbying made unallowable by subparagraph A (3) to influence State legislation in order to directly
reduce the cost, or to avoid material impairment of the organization's authority to perform the grant,
contract, or other agreement.
(3) Any activity specifically authorized by statute to be undertaken with funds from the grant, contract, or other
agreement.
Paragraph C.
(1) When an organization seeks reimbursement for indirect costs, total lobbying costs shall be separately
identified in the indirect cost rate proposal, and thereafter treated as other unallowable activity costs in
accordance with the procedures of subparagraph B.(3).
(2) Organizations shall submit, as part of the annual indirect cost rate proposal, a certification that the
requirements and standards of this paragraph have been complied with.
(3) Organizations shall maintain adequate records to demonstrate that the determination of costs as being
allowable or unallowable pursuant to this section complies with the requirements of this Circular.
(4) Time logs, calendars, or similar records shall not be required to be created for purposes of complying with
this paragraph during any particular calendar month when: (1) the employee engages in lobbying (as
defined in subparagraphs (a) and (b)) 25 percent or less of the employee's compensated hours of
employment during that calendar month, and (2) within the preceding five-year period, the organization has
not materially misstated allowable or unallowable costs of any nature, including legislative lobbying costs.
When conditions (1) and (2) are met, organizations are not required to establish records to support the
allowability of claimed costs in addition to records already required or maintained. Also, when conditions
(1) and (2) are met, the absence of time logs, calendars, or similar records will not serve as a basis for
disallowing costs by contesting estimates of lobbying time spent by employees during a calendar month.
(5) Agencies shall establish procedures for resolving in advance, in consultation with OMB, any significant
questions or disagreements concerning the interpretation or application of this section. Any such advance
resolution shall be binding in any subsequent settlements, audits or investigations with respect to that grant
or contract for purposes of interpretation of this Circular; provided, however, that this shall not be
construed to prevent a contractor or grantee from contesting the lawfulness of such a determination.
Paragraph D.
Executive lobbying costs. Costs incurred in attempting to improperly influence either directly or indirectly, an
employee or officer of the Executive Branch of the Federal Government to give consideration or to act
regarding a sponsored agreement or a regulatory matter are unallowable. Improper influence means any
influence that induces or tends to induce a Federal employee or officer to give consideration or to act regarding
a federally sponsored agreement or regulatory matter on any basis other than the merits of the matter.
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Thomas L. Fitzgerald, Attorney At Law
____________________________ _________________________
Signature Date
David Newell, Sr.
____________________________ _________________________
Chairman, County Commissioners Date
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ATTACHMENT H
PERSON COUNTY DEPARTMENT OF SOCIAL SERVICES
CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY
AND VOLUNTARY EXCLUSION-LOWER TIER COVERED TRANSACTIONS
Instructions for Certification
1. By signing and submitting this proposal, the prospective lower tier participant is providing the
certification set out below.
2. The certification in this clause is a material representation of the fact upon which reliance was
placed when this transaction was entered into. If it is later determined that the prospective lower
tier participant knowingly rendered an erroneous certification, in addition to other remedies
available to the Federal Government, the department or agency with which this transaction
originated may pursue available remedies, including suspension and/or debarment.
3. The prospective lower tier participant will provide immediate written notice to the person to
whom the proposal is submitted if at any time the prospective lower tier participant learns that its
certification was erroneous when submitted or has become erroneous by reason of changed
circumstances.
4. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered
transaction," "participant," "person," "primary covered transaction," "principal," "proposal," and
"voluntarily excluded," as used in this clause, have the meanings set out in the Definitions and
Coverage sections of rules implementing Executive Order 12549. You may contact the person to
which this proposal is submitted for assistance in obtaining a copy of those regulations.
5. The prospective lower tier participant agrees by submitting this proposal that, should the
proposed covered transaction be entered into, it shall not knowingly enter any lower tier covered
transaction with a person who is debarred, suspended, determined ineligible or voluntarily
excluded from participation in this covered transaction unless authorized by the department or
agency with which this transaction originated.
6. The prospective lower tier participant further agrees by submitting this proposal that it will
include this clause titled "Certification Regarding Debarment, Suspension, Ineligibility and
Voluntary Exclusion - Lower Tier Covered Transaction," without modification, in all lower tier
covered transactions and in all solicitations for lower tier covered transactions.
7. A participant in a covered transaction may rely upon a certification of a prospective
participant in a lower tier covered transaction that it is not debarred, suspended, ineligible, or
voluntarily excluded from covered transaction, unless it knows that the certification is erroneous.
A participant may decide the method and frequency of which it determines the eligibility of its
principals. Each participant may, but is not required to, check the Nonprocurement List.
8. Nothing contained in the foregoing shall be construed to require establishment of a system of
records in order to render in good faith the certification required by this clause. The knowledge
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and information of a participant is not required to exceed that which is normally possessed by a
prudent person in the ordinary course of business dealings.
9. Except for transactions authorized in paragraph 5 of these instructions, if a participant in a
covered transaction knowingly enters into a lower tier covered transaction with a person who is
suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in
addition to other remedies available to the Federal Government, the department or agency with
which this transaction originated may pursue available remedies, including suspension, and/or
debarment.
Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower
Tier Covered Transactions
(1) The prospective lower tier participant certifies, by submission of this proposal, that neither it
nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or
voluntarily excluded from participation in this transaction by any Federal department or agency.
(2) Where the prospective lower tier participant is unable to certify to any of the statements in this
certification, such prospective participant shall attach an explanation to this proposal.
Thomas L. Fitzgerald, Attorney At Law
____________________________ _________________________
Signature Date
David Newell, Sr.
____________________________ _________________________
Chairman, County Commissioners Date
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ATTACHMENT I
PERSON COUNTY
DEPARTMENT OF SOCIAL SERVICES
BUSINESS ASSOCIATE ADDENDUM
This Agreement is made effective the 1st day of July, 2016, by and between Person County
Department of Social Services (“Covered Entity”) and Thomas L. Fitzgerald, Attorney at Law
(“Business Associate”) (collectively the “Parties”).
1. BACKGROUND
a. Covered Entity and Business Associate are parties to a contract entitled Legal Services
Contract (the “Contract”), whereby Business Associate agrees to perform certain services for or
on behalf of Covered Entity.
b. Covered Entity is an organizational unit of Person County as the Person County Department
of Social Services (DSS) as a health care component for purposes of the HIPAA Privacy Rule.
c. The relationship between Covered Entity and Business Associate is such that the Parties
believe Business Associate is or may be a “business associate” within the meaning of the HIPAA
Privacy Rule.
d. The Parties enter into this Business Associate Addendum to the Contract with the intention of
complying with the HIPAA Privacy Rule provision that a covered entity may disclose protected
health information to a business associate, and may allow a business associate to create or
receive protected heath information on its behalf, if the covered entity obtains satisfactory
assurances that the business associate will appropriately safeguard the information.
2. DEFINITIONS
Unless some other meaning is clearly indicated by the context, the following terms shall have the
following meaning in this Agreement:
a. “HIPAA” means the Administrative Simplification Provisions, Sections 261 through 264, of
the federal Health Insurance Portability and Accountability Act of 1996, Public Law 104-191.
b. “Individual” shall have the same meaning as the term “individual” in 45 CFR160.103 and
shall include a person who qualifies as a personal representative in accordance with 45 CFR
164.502(g).
c. “Privacy Rule” shall mean the Standards for Privacy of Individually Identifiable Health
Information at 45 CFR part 160 and part 164, subparts A and E.
d. “Protected Health Information” shall have the same meaning as the term “protected health
information” in 45 CFR 160.103, limited to the information created or received by Business
Associate from or on behalf of Covered Entity.
e. “Required By Law” shall have the same meaning as the term “required by law” in 45 CFR
164.103.
f. “Secretary” shall mean the Secretary of the United States Department of Health and Human
Services or his designee.
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g. Unless otherwise defined in this Agreement, terms used herein shall have the same meaning
as those terms have in the Privacy Rule.
3. OBLIGATIONS OF BUSINESS ASSOCIATE
a. Business Associate agrees to not use or disclose Protected Health Information other than as
permitted or required by this Agreement or as Required By Law.
b. Business Associate agrees to use appropriate safeguards to prevent use or disclosure of the
Protected Health Information other than as provided for by this Agreement.
c. Business Associate agrees to mitigate, to the extent practicable, any harmful effect that is
known to Business Associate of a use or disclosure of Protected Health Information by Business
Associate in violation of the requirements of this Agreement.
d. Business Associate agrees to report to Covered Entity any use or disclosure of the Protected
Health Information not provided for by this Agreement of which it becomes aware.
e. Business Associate agrees to ensure that any agent, including a subcontractor, to whom it
provides Protected Health Information received from, or created or received by Business
Associate on behalf of Covered Entity agrees to the same restrictions and conditions that apply
through this Agreement to Business Associate with respect to such information.
f. Business Associate agrees to provide access, at the request of Covered Entity, to Protected
Health Information in a Designated Record Set to Covered Entity or, as directed by Covered
Entity, to an Individual in order to meet the requirements under 45 CFR 164.524.
g. Business Associate agrees, at the request of the Covered Entity, to make any amendment(s) to
Protected Health Information in a Designated Record Set that the Covered Entity directs or
agrees to pursuant to 45 CFR 164.526.
h. Unless otherwise prohibited by law, Business Associate agrees to make internal practices,
books, and records, including policies and procedures and Protected Health Information, relating
to the use and disclosure of Protected Health Information received from, or created or received
by Business Associate on behalf of Covered Entity, available to the Covered Entity, or to the
Person County Department of Social Services, in a time and manner designated by the
Secretary, for purposes of determining Covered Entity's compliance with the Privacy Rule.
i. Business Associate agrees to document such disclosures of Protected Health Information and
information related to such disclosures as would be required for Covered Entity to respond to a
request by an Individual for an accounting of disclosures of Protected Health Information in
accordance with 45 CFR 164.528, and to provide this information to Covered Entity or an
Individual to permit such a response.
4. PERMITTED USES AND DISCLOSURES
a. Except as otherwise limited in this Agreement or by other applicable law or agreement, if the
Contract permits, Business Associate may use or disclose Protected Health Information to
perform functions, activities, or services for, or on behalf of, Covered Entity as specified in the
Contract, provided that such use or disclosure:
1) would not violate the Privacy Rule if done by Covered Entity; or
2) would not violate the minimum necessary policies and procedures of the Covered
Entity.
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b. Except as otherwise limited in this Agreement or by other applicable law or agreements, if the
Contract permits, Business Associate may use Protected Health Information as necessary for the
proper management and administration of the Business Associate or to carry out the legal
responsibilities of the Business Associate.
c. Except as otherwise limited in this Agreement or by other applicable law or agreements, if the
Contract permits, Business Associate may disclose Protected Health Information for the proper
management and administration of the Business Associate, provided that:
1) disclosures are Required By Law; or
2) Business Associate obtains reasonable assurances from the person to whom the
information is disclosed that it will remain confidential and will be used or further
disclosed only as Required By Law or for the purpose for which it was disclosed to the
person, and the person notifies the Business Associate of any instances of which it is
aware in which the confidentiality of the information has been breached.
d. Except as otherwise limited in this Agreement or by other applicable law or agreements, if the
Contract permits, Business Associate may use Protected Health Information to provide data
aggregation services to Covered Entity as permitted by 45 CFR 164.504(e)(2)(i)(B).
e. Notwithstanding the foregoing provisions, Business Associate may not use or disclose
Protected Health Information if the use or disclosure would violate any term of the Contract or
other applicable law or agreements.
5. TERM AND TERMINATION
a. Term. This Agreement shall be effective as of the effective date stated above and shall
terminate when the Contract terminates.
b. Termination for Cause. Upon Covered Entity's knowledge of a material breach by Business
Associate, Covered Entity may, at its option:
1) Provide an opportunity for Business Associate to cure the breach or end the violation,
and terminate this Agreement and services provided by Business Associate, to the extent
permissible by law, if Business Associate does not cure the breach or end the violation
within the time specified by Covered Entity;
2) Immediately terminate this Agreement and services provided by Business Associate,
to the extent permissible by law; or
3) If neither termination nor cure is feasible, report the violation to the Secretary as
provided in the Privacy Rule.
c. Effect of Termination.
1) Except as provided in paragraph (2) of this section or in the Contract or by other
applicable law or agreements, upon termination of this Agreement and services provided
by Business Associate, for any reason, Business Associate shall return or destroy all
Protected Health Information received from Covered Entity, or created or received by
Business Associate on behalf of Covered Entity. This provision shall apply to Protected
Health Information that is in the possession of subcontractors or agents of Business
Associate. Business Associate shall retain no copies of the Protected Health Information.
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2) In the event that Business Associate determines that returning or destroying the
Protected Health Information is not feasible, Business Associate shall provide to Covered
Entity notification of the conditions that make return or destruction not feasible. Business
Associate shall extend the protections of this Agreement to such Protected Health
Information and limit further uses and disclosures of such Protected Health Information
to those purposes that make the return or destruction infeasible, for so long as Business
Associate maintains such Protected Health Information.
6. GENERAL TERMS AND CONDITIONS
a. This Agreement amends and is part of the Contract.
b. Except as provided in this Agreement, all terms and conditions of the Contract shall remain in
force and shall apply to this Agreement as if set forth fully herein.
c. In the event of a conflict in terms between this Agreement and the Contract, the interpretation
that is in accordance with the Privacy Rule shall prevail. In the event that a conflict then
remains, the Contract terms shall prevail so long as they are in accordance with the Privacy Rule.
d. A breach of this Agreement by Business Associate shall be considered sufficient basis for
Covered Entity to terminate the Contract for cause.
Thomas L. Fitzgerald, Attorney At Law
____________________________ _________________________
Signature Date
David Newell, Sr.
____________________________ _________________________
Chairman, County Commissioners Date
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Attachment M
State Certification
Contractor Certifications Required by North Carolina Law
Instructions
The person who signs this document should read the text of the statutes listed below and consult with
counsel and other knowledgeable persons before signing.
The text of Article 2 of Chapter 64 of the North Carolina General Statutes can be found online at:
http://www.ncga.state.nc.us/EnactedLegislation/Statutes/PDF/ByArticle/Chapter_64/Article_2.pdf
The text of G.S. 105-164.8(b) can be found online at:
http://www.ncga.state.nc.us/EnactedLegislation/Statutes/PDF/BySection/Chapter_105/GS_105-
164.8.pdf
The text of G.S. 143-48.5 (S.L. 2013-418, s. 2.(d)) can be found online at:
http://www.ncga.state.nc.us/Sessions/2013/Bills/House/PDF/H786v6.pdf
The text of G.S. 143-59.1 can be found online at:
http://www.ncga.state.nc.us/EnactedLegislation/Statutes/PDF/BySection/Chapter_143/GS_143-
59.1.pdf
The text of G.S. 143-59.2 can be found online at:
http://www.ncga.state.nc.us/EnactedLegislation/Statutes/PDF/BySection/Chapter_143/GS_143-
59.2.pdf
The text of G.S. 147-33.95(g) (S.L. 2013-418, s. 2.(e)) can be found online at:
http://www.ncga.state.nc.us/Sessions/2013/Bills/House/PDF/H786v6.pdf
Certifications
(1) Pursuant to G.S. 143-48.5 and G.S. 147-33.95(g), the undersigned hereby certifies that the
Contractor named below, and the Contractor’s subcontractors, complies with the requirements of
Article 2 of Chapter 64 of the NC General Statutes, including the requirement for each employer
with more than 25 employees in North Carolina to verify the work authorization of its employees
through the federal E-Verify system." E-Verify System Link: www.uscis.gov
Local government is specifically exempt from Article 2 of Chapter 64 of the North Carolina
General Statutes. However, local government is subject to and must comply with North Carolina
General Statute §153A-99.1., which states in part as follows:
Counties Must Use E-Verify. - Each county shall register and participate in E-Verify to verify the
work authorization of new employees hired to work in the United States.
(2) Pursuant to G.S. 143-59.1(b), the undersigned hereby certifies that the Contractor named below
is not an “ineligible Contractor” as set forth in G.S. 143-59.1(a) because:
(a) Neither the Contractor nor any of its affiliates has refused to collect the use tax levied
under Article 5 of Chapter 105 of the General Statutes on its sales delivered to North
Carolina when the sales met one or more of the conditions of G.S. 105-164.8(b); and
(b) [check one of the following boxes]
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Neither the Contractor nor any of its affiliates has incorporated or reincorporated
in a “tax haven country” as set forth in G.S. 143-59.1(c)(2) after December 31,
2001; or
The Contractor or one of its affiliates has incorporated or reincorporated in a “tax
haven country” as set forth in G.S. 143-59.1(c)(2) after December 31, 2001 but
the United States is not the principal market for the public trading of the stock of
the corporation incorporated in the tax haven country.
(3) Pursuant to G.S. 143-59.2(b), the undersigned hereby certifies that none of the Contractor’s
officers, directors, or owners (if the Contractor is an unincorporated business entity) has been
convicted of any violation of Chapter 78A of the General Statutes or the Securities Act of 1933 or
the Securities Exchange Act of 1934 within 10 years immediately prior to the date of the bid
solicitation.
(4) The undersigned hereby certifies further that:
(a) He or she is a duly authorized representative of the Contractor named below;
(b) He or she is authorized to make, and does hereby make, the foregoing certifications on
behalf of the Contractor; and
(c) He or she understands that any person who knowingly submits a false certification in
response to the requirements of G.S. 143-59.1 and -59.2 shall be guilty of a Class I
felony.
Contractor’s Name: Thomas L. Fitzgerald
Signature of Contractor’s Authorized Agent
Date
Printed Name of Contractor’s Authorized Agent
Thomas L. Fitzgerald
Title
Attorney at Law
Signature of Witness
Title
Printed Name of Witness
Date
The witness should be present when the Contractor’s Authorized Agent signs this certification and should
sign and date this document immediately thereafter.
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Attachment N
CERTIFICATION OF
ELIGIBILITY
Under the Iran
Divestment Act
Pursuant to G.S. 147-86.59, any person identified as engaging in investment activities in
Iran, determined by appearing on the Final Divestment List created by the State
Treasurer pursuant to G.S. 147-86.58, is ineligible to contract with the State of North
Carolina or any political subdivision of the State. The Iran Divestment Act of 2015, G.S.
147-86.55 et seq.* requires that each vendor, prior to contracting with the State certify,
and the undersigned on behalf of the Vendor does hereby certify, to the following:
1. that Thomas L. Fitzgerald, Attorney At Law, is not identified on the Final
Divestment List of entities that the State Treasurer has determined engages in
investment activities in Iran;
2. that Thomas L. Fitzgerald, Attorney At Law, shall not utilize on any contract with
the State agency any subcontractor that is identified on the Final Divestment List;
and
3. that Thomas L. Fitzgerald, Attorney At Law, is authorized to make this Certification.
Thomas L. Fitzgerald, Attorney At Law
____________________________ _________________________
Signature Date
* Note: Enacted by Session Law 2015‐118 as G.S. 143C‐55 et seq., but has been renumbered for
codification at the direction of the Revisor of Statutes.
The State Treasurer’s Final Divestment List can be found on the State Treasurer’s website at the address:
https://www.nctreasurer.com/inside‐the‐department/OpenGovernment/Pages/Iran‐Divestment‐Act‐Resources.aspx
and will be updated every 180 days. For questions about the Department of State Treasurer’s Iran Divestment
Policy, please contact Meryl Murtagh at Meryl.Murtagh@nctreasurer.com or (919) 814‐3852.
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Contract # 1010 Fiscal Year Begins July 1, 2016 Ends June 30, 2017
This contract is hereby entered into by and between the Person County Department of Social
Services (the "County") and Walter B. Cates (the "Contractor") (referred to collectively as the
“Parties”). The Contractor’s federal tax identification number is 56-135 0472.
Contract Documents: This Contract consists of the following documents:
This contract
The General Terms and Conditions (Attachment A)
The Scope of Work, description of services, and rate (Attachment B)
Federal Certification Regarding Drug-Free Workplace & Certification Regarding Nondiscrimination (Attachment C)
Conflict of Interest (Attachment D)
No Overdue Taxes (Attachment E)
Federal Certification Regarding Lobbying (Attachment G)
Federal Certification Regarding Debarment (Attachment H)
HIPAA Business Associate Addendum (Attachment I)
State Certification (Attachment M)
Certification of Eligibility Under the Iran Divestment Act (Attachment N)
These documents constitute the entire agreement between the Parties and supersede all prior
oral or written statements or agreements.
Precedence among Contract Documents: In the event of a conflict between or among the
terms of the Contract Documents, the terms in the Contract Document with the highest relative
precedence shall prevail. The order of precedence shall be the order of documents as listed in
Paragraph 1, above, with the first-listed document having the highest precedence and the last-
listed document having the lowest precedence. If there are multiple Contract Amendments, the
most recent amendment shall have the highest precedence and the oldest amendment shall
have the lowest precedence.
Effective Period: This contract shall be effective on July 1, 2016 and shall terminate on
June 30, 2017. This contract must be twelve months or less.
Contractor’s Duties: The Contractor shall provide the services and in accordance with the
approved rate as described in Attachment B, Scope of Work.
County’s Duties: The County shall pay the Contractor in the manner and in the amounts
specified in the Contract Documents.
[ x ] a. There are no matching requirements from the Contractor.
[ ] b. The Contractor’s matching requirement is $__________, which shall consist of:
[ ] In-kind [ ] Cash [ ] Cash and In-kind [ ] Cash and/or In-kind
The contributions from the Contractor shall be sourced from non-federal funds.
The total contract amount including any Contractor match shall not exceed 1,000 hours
collectively for all attorneys under contract. Rate of compensation for Secondary Attorney
Walter B. Cates is $75 per hour.
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Reversion of Funds:
Any unexpended grant funds shall revert to the County Department of Social Services upon
termination of this contract.
Reporting Requirements:
Contractor shall comply with audit requirements as described in N.C.G.S. § 143C-6-22 & 23 and
OMB Circular- CFR Title 2 Grants and Agreements, Part 200, and shall disclose all information
required by 42 USC 455.104, or 42 USC 455.105, or 42 USC 455.106.
Payment Provisions:
Payment shall be made in accordance with the Contract Documents as described in the Scope
of Work, Attachment B.
Contract Administrators: All notices permitted or required to be given by one Party to the
other and all questions about the contract from one Party to the other shall be addressed and
delivered to the other Party’s Contract Administrator. The name, post office address, street
address, telephone number, fax number, and email address of the Parties’ respective initial
Contract Administrators are set out below. Either Party may change the name, post office
address, street address, telephone number, fax number, or email address of its Contract
Administrator by giving timely written notice to the other Party.
For the County: For the Contractor:
Wendy Bowman, Accounting Technician
Person County Department of Social Services Walter B. Cates, Attorney
P.O. Box 770 P.O. Box 679
355B South Madison Boulevard 36 Court Street
Roxboro, NC 27573 Roxboro, NC 27573
(336) 599-8361 (336) 597-2251
Supplementation of Expenditure of Public Funds: The Contractor assures that funds
received pursuant to this contract shall be used only to supplement, not to supplant, the total
amount of federal, state and local public funds that the Contractor otherwise expends for
contract services and related programs. Funds received under this contract shall be used to
provide additional public funding for such services; the funds shall not be used to reduce the
Contractor’s total expenditure of other public funds for such services.
Disbursements: As a condition of this contract, the Contractor acknowledges and agrees to
make disbursements in accordance with the following requirements:
(a) Implement adequate internal controls over disbursements;
(b) Pre-audit all vouchers presented for payment to determine:
Validity and accuracy of payment
Payment due date
Adequacy of documentation supporting payment
Legality of disbursement
(c) Assure adequate control of signature stamps/plates;
(d) Assure adequate control of negotiable instruments; and
(e) Implement procedures to insure that account balance is solvent and reconcile the
account monthly.
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Outsourcing to Other Countries: The Contractor certifies that it has identified to the County
all jobs related to the contract that have been outsourced to other countries, if any. The
Contractor further agrees that it will not outsource any such jobs during the term of this contract
without providing notice to the County.
Federal Certifications: Individuals and Organizations receiving federal funds must ensure
compliance with certain certifications required by federal laws and regulations. The contractor is
hereby complying with Certifications regarding Nondiscrimination, Drug-Free Workplace
Requirements, Environmental Tobacco Smoke, Debarment, Suspension, Ineligibility and
Voluntary Exclusion Lower Tier Covered Transactions, and Lobbying. These assurances and
certifications are to be signed by the contractor’s authorized representative.
Signature Warranty: The undersigned represent and warrant that they are authorized to bind
their principals to the terms of this agreement.
Signature Warranty:
The undersigned represent and warrant that they are authorized to bind their principals to the terms of this
agreement.
The Contractor and the County have executed this contract in duplicate originals, with one original being retained by
each party.
Walter B. Cates, Attorney At Law
____________________________ _________________________
Signature Date
PERSON COUNTY
David Newell, Sr.
____________________________ _________________________
Chairman, County Commissioners Date
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
Act.
______________________________ ___________________________
Amy Wehrenberg, County Finance Director Date
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ATTACHMENT A
General Terms and Conditions
Relationships of the Parties
Independent Contractor: The Contractor is and shall be deemed to be an independent contractor in the performance of
this contract and as such shall be wholly responsible for the work to be performed and for the supervision of its employees.
The Contractor represents that it has, or shall secure at its own expense, all personnel required in performing the services
under this agreement. Such employees shall not be employees of, or have any individual contractual relationship with the
County.
Subcontracting: The Contractor shall not subcontract any of the work contemplated under this contract without prior written
approval from the County. Any approved subcontract shall be subject to all conditions of this contract. Only the
subcontractors specified in the contract documents are to be considered approved upon award of the contract. The County
shall not be obligated to pay for any work performed by any unapproved subcontractor. The Contractor shall be responsible
for the performance of all of its subcontractors.
Assignment: No assignment of the Contractor's obligations or the Contractor's right to receive payment hereunder shall be
permitted. However, upon written request approved by the issuing purchasing authority, the County may: Forward the
Contractor's payment check(s) directly to any person or entity designated by the Contractor, or Include any person or entity
designated by Contractor as a joint payee on the Contractor's payment check(s). In no event shall such approval and action
obligate the County to anyone other than the Contractor and the Contractor shall remain responsible for fulfillment of all
contract obligations.
Beneficiaries: Except as herein specifically provided otherwise, this contract shall inure to the benefit of and be binding
upon the parties hereto and their respective successors. It is expressly understood and agreed that the enforcement of the
terms and conditions of this contract, and all rights of action relating to such enforcement, shall be strictly reserved to the
County and the named Contractor. Nothing contained in this document shall give or allow any claim or right of action
whatsoever by any other third person. It is the express intention of the County and Contractor that any such person or entity,
other than the County or the Contractor, receiving services or benefits under this contract shall be deemed an incidental
beneficiary only.
Indemnity and Insurance
Indemnification: The Contractor agrees to indemnify and hold harmless the County and any of their officers, agents and
employees, from any claims of third parties arising out or any act or omission of the Contractor in connection with the
performance of this contract.
Insurance: During the term of the contract, the Contractor at its sole cost and expense shall provide commercial insurance
of such type and with such terms and limits as may be reasonably associated with the contract. As a minimum, the
Contractor shall provide and maintain the following coverage and limits:
Worker’s Compensation - The contractor shall provide and maintain Worker’s Compensation Insurance as required
by the laws of North Carolina, as well as employer’s liability coverage with minimum limits of $500,000.00, covering all
of Contractor’s employees who are engaged in any work under the contract. If any work is sublet, the Contractor shall
require the subcontractor to provide the same coverage for any of his employees engaged in any work under the
contract.
Commercial General Liability - General Liability Coverage on a Comprehensive Broad Form on an occurrence basis in
the minimum amount of $1,000,000.00 Combined Single Limit. (Defense cost shall be in excess of the limit of liability.)
Automobile Liability Insurance: The Contractor shall provide automobile liability insurance with a combined single
limit of $500,000.00 for bodily injury and property damage; a limit of $500,000.00 for uninsured/under insured
motorist coverage; and a limit of $2,000.00 for medical payment coverage. The Contractor shall provide this insurance
for all automobiles that are:
(a) owned by the Contractor and used in the performance of this contract;
(b) hired by the Contractor and used in the performance of this contract; and
(c) Owned by Contractor’s employees and used in performance of this contract (“non-owned vehicle insurance”).
Non-owned vehicle insurance protects employers when employees use their personal vehicles for work
purposes. Non-owned vehicle insurance supplements, but does not replace, the car-owner’s liability insurance.
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The Contractor is not required to provide and maintain automobile liability insurance on any vehicle – owned,
hired, or non-owned -- unless the vehicle is used in the performance of this contract.
(d) The insurance coverage minimums specified in subparagraph (a) are exclusive of defense costs.
(e) The Contractor understands and agrees that the insurance coverage minimums specified in subparagraph (a) are
not limits, or caps, on the Contractor’s liability or obligations under this contract.
(f) The Contractor may obtain a waiver of any one or more of the requirements in subparagraph (a) by
demonstrating that it has insurance that provides protection that is equal to or greater than the coverage and
limits specified in subparagraph (a). The County shall be the sole judge of whether such a waiver should be
granted.
(g) The Contractor may obtain a waiver of any one or more of the requirements in paragraph (a) by demonstrating
that it is self-insured and that its self-insurance provides protection that is equal to or greater than the coverage
and limits specified in subparagraph (a). The County shall be the sole judge of whether such a waiver should be
granted.
(h) Providing and maintaining the types and amounts of insurance or self-insurance specified in this paragraph is a
material obligation of the Contractor and is of the essence of this contract.
(i) The Contractor shall only obtain insurance from companies that are authorized to provide such coverage and
that are authorized by the Commissioner of Insurance to do business in the State of North Carolina. All such
insurance shall meet all laws of the State of North Carolina.
(j) The Contractor shall comply at all times with all lawful terms and conditions of its insurance policies and all
lawful requirements of its insurer.
(k) The Contractor shall require its subcontractors to comply with the requirements of this paragraph.
(l) The Contractor shall demonstrate its compliance with the requirements of this paragraph by submitting
certificates of insurance to the County before the Contractor begins work under this contract.
Transportation of Clients by Contractor:
The contractor will maintain Insurance requirements if required as noted under Article 7 Rule R2-36 of the North Carolina
Utilities Commission.
Default and Termination
Termination without Cause: The County may terminate this contract without cause by giving 30 days written notice to the
Contractor.
Termination for Cause: If, through any cause, the Contractor shall fail to fulfill its obligations under this contract in a timely
and proper manner, the County shall have the right to terminate this contract by giving written notice to the Contractor and
specifying the effective date thereof. In that event, all finished or unfinished deliverable items prepared by the Contractor
under this contract shall, at the option of the County, become its property and the Contractor shall be entitled to receive just
and equitable compensation for any satisfactory work completed on such materials, minus any payment or compensation
previously made. Notwithstanding the foregoing provision, the Contractor shall not be relieved of liability to the County for
damages sustained by the County by virtue of the Contractor’s breach of this agreement, and the County may withhold any
payment due the Contractor for the purpose of setoff until such time as the exact amount of damages due the County from
such breach can be determined. In case of default by the Contractor, without limiting any other remedies for breach
available to it, the County may procure the contract services from other sources and hold the Contractor responsible for any
excess cost occasioned thereby. The filing of a petition for bankruptcy by the Contractor shall be an act of default under this
contract.
Waiver of Default: Waiver by the County of any default or breach in compliance with the terms of this contract by the
Provider shall not be deemed a waiver of any subsequent default or breach and shall not be construed to be modification of
the terms of this contract unless stated to be such in writing, signed by an authorized representative of the County and the
Contractor and attached to the contract.
Availability of Funds: The parties to this contract agree and understand that the payment of the sums specified in this
contract is dependent and contingent upon and subject to the appropriation, allocation, and availability of funds for this
purpose to the County.
Force Majeure: Neither party shall be deemed to be in default of its obligations hereunder if and so long as it is prevented
from performing such obligations by any act of war, hostile foreign action, nuclear explosion, riot, strikes, civil insurrection,
earthquake, hurricane, tornado, or other catastrophic natural event or act of God.
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Survival of Promises: All promises, requirements, terms, conditions, provisions, representations, guarantees, and warranties
contained herein shall survive the contract expiration or termination date unless specifically provided otherwise herein, or
unless superseded by applicable Federal or State statutes of limitation.
Intellectual Property Rights
Copyrights and Ownership of Deliverables: All deliverable items produced pursuant to this contract are the exclusive
property of the County. The Contractor shall not assert a claim of copyright or other property interest in such deliverables.
Federal Intellectual Property Bankruptcy Protection Act: The Parties agree that the County shall be entitled to all rights and
benefits of the Federal Intellectual Property Bankruptcy Protection Act, Public Law 100-506, codified at 11 U.S.C. 365 (n)
and any amendments thereto.
Compliance with Applicable Laws
Compliance with Laws: The Contractor shall comply with all laws, ordinances, codes, rules, regulations, and licensing
requirements that are applicable to the conduct of its business, including those of federal, state, and local agencies having
jurisdiction and/or authority.
Title VI, Civil Rights Compliance: In accordance with Federal law and U.S. Department of Agriculture (USDA) and U.S.
Department of Health and Human Services (HHS) policy, this institution is prohibited from discriminating on the basis of
race, color, national origin, sex, age or disability. Under the Food Stamp Act and USDA policy, discrimination is prohibited
also on the basis of religion or political beliefs.
Equal Employment Opportunity: The Contractor shall comply with all federal and State laws relating to equal employment
opportunity.
Health Insurance Portability and Accountability Act (HIPAA): The Contractor agrees that, if the County determines that
some or all of the activities within the scope of this contract are subject to the Health Insurance Portability and Accountability
Act of 1996, P.L. 104-91, as amended (“HIPAA”), or its implementing regulations, it will comply with the HIPAA
requirements and will execute such agreements and practices as the County may require to ensure compliance.
(a) Data Security: The Contractor shall adopt and apply data security standards and procedures that comply with all
applicable federal, state, and local laws, regulations, and rules.
(b) Duty to Report: The Contractor shall report a suspected or confirmed security breach to the local Department of
Social Services/Human Services Contract Administrator within twenty-four (24) hours after the breach is first
discovered, provided that the Contractor shall report a breach involving Social Security Administration data or
Internal Revenue Service data within one (1) hour after the breach is first discovered.
(c) Cost Borne by Contractor: If any applicable federal, state, or local law, regulation, or rule requires the Contractor
to give written notice of a security breach to affected persons, the Contractor shall bear the cost of the notice.
Trafficking Victims Protection Act of 2000: The Contractor will comply with the requirements of Section 106(g) of the
Trafficking Victims Protection Act of 2000, as amended (22 U.S.C. 7104).
Executive Order # 24: It is unlawful for any vendor, contractor, subcontractor or supplier of the state to make gifts or to give
favors to any state employee. For additional information regarding the specific requirements and exemptions, contractors
are encouraged to review Executive Order 24 and G.S. Sec. 133-32.
Confidentiality
Confidentiality: Any information, data, instruments, documents, studies or reports given to or prepared or assembled by the
Contractor under this agreement shall be kept as confidential and not divulged or made available to any individual or
organization without the prior written approval of the County. The Contractor acknowledges that in receiving, storing,
processing or otherwise dealing with any confidential information it will safeguard and not further disclose the information
except as otherwise provided in this contract.
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Oversight
Access to Persons and Records: The State Auditor shall have access to persons and records as a result of all contracts or
grants entered into by State agencies or political subdivisions in accordance with General Statute 147-64.7. Additionally, as
the State funding authority, the Department of Health and Human Services shall have access to persons and records as a
result of all contracts or grants entered into by State agencies or political subdivisions.
Record Retention: Records shall not be destroyed, purged or disposed of without the express written consent of the
Division. State basic records retention policy requires all grant records to be retained for a minimum of five years or until all
audit exceptions have been resolved, whichever is longer. If the contract is subject to federal policy and regulations, record
retention may be longer than five years since records must be retained for a period of three years following submission of the
final Federal Financial Status Report, if applicable, or three years following the submission of a revised final Federal
Financial Status Report. Also, if any litigation, claim, negotiation, audit, disallowance action, or other action involving this
Contract has been started before expiration of the five-year retention period described above, the records must be retained
until completion of the action and resolution of all issues which arise from it, or until the end of the regular five-year period
described above, whichever is later. The record retention period for Temporary Assistance for Needy Families (TANF) and
MEDICAID and Medical Assistance grants and programs must be retained for a minimum of ten years.
Warranties and Certifications
Date and Time Warranty: The Contractor warrants that the product(s) and service(s) furnished pursuant to this contract
(“product” includes, without limitation, any piece of equipment, hardware, firmware, middleware, custom or commercial
software, or internal components, subroutines, and interfaces therein) that perform any date and/or time data recognition
function, calculation, or sequencing will support a four digit year format and will provide accurate date/time data and leap
year calculations. This warranty shall survive the termination or expiration of this contract.
Certification Regarding Collection of Taxes: G.S. 143-59.1 bars the Secretary of Administration from entering into contracts
with vendors that meet one of the conditions of G.S. 105-164.8(b) and yet refuse to collect use taxes on sales of tangible
personal property to purchasers in North Carolina. The conditions include: (a) maintenance of a retail establishment or
office; (b) presence of representatives in the State that solicit sales or transact business on behalf of the vendor; and (c)
systematic exploitation of the market by media-assisted, media-facilitated, or media-solicited means. The Contractor certifies
that it and all of its affiliates (if any) collect all required taxes.
E-Verify
Pursuant to G.S. 143-48.5 and G.S. 147-33.95(g), the undersigned hereby certifies that the Contractor named below, and the
Contractor’s subcontractors, complies with the requirements of Article 2 of Chapter 64 of the NC General Statutes, including
the requirement for each employer with more than 25 employees in North Carolina to verify the work authorization of its
employees through the federal E-Verify system." E-Verify System Link: www.uscis.gov
Miscellaneous
Choice of Law: The validity of this contract and any of its terms or provisions, as well as the rights and duties of the parties
to this contract, are governed by the laws of North Carolina. The Contractor, by signing this contract, agrees and submits,
solely for matters concerning this Contract, to the exclusive jurisdiction of the courts of North Carolina and agrees, solely for
such purpose, that the exclusive venue for any legal proceedings shall be the county is which the contract originated. The
place of this contract and all transactions and agreements relating to it, and their situs and forum, shall be the county where
the contract originated, where all matters, whether sounding in contract or tort, relating to the validity, construction,
interpretation, and enforcement shall be determined.
Amendment: This contract may not be amended orally or by performance. Any amendment must be made in written form
and executed by duly authorized representatives of the County and the Contractor.
Severability: In the event that a court of competent jurisdiction holds that a provision or requirement of this contract
violates any applicable law, each such provision or requirement shall continue to be enforced to the extent it is not in
violation of law or is not otherwise unenforceable and all other provisions and requirements of this contract shall remain in
full force and effect.
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Headings: The Section and Paragraph headings in these General Terms and Conditions are not material parts of the
agreement and should not be used to construe the meaning thereof.
Time of the Essence: Time is of the essence in the performance of this contract.
Key Personnel: The Contractor shall not replace any of the key personnel assigned to the performance of this contract
without the prior written approval of the County. The term “key personnel” includes any and all persons identified as such
in the contract documents and any other persons subsequently identified as key personnel by the written agreement of the
parties.
Care of Property: The Contractor agrees that it shall be responsible for the proper custody and care of any property
furnished to it for use in connection with the performance of this contract and will reimburse the County for loss of, or
damage to, such property. At the termination of this contract, the Contractor shall contact the County for instructions as to
the disposition of such property and shall comply with these instructions.
Travel Expenses: Reimbursement to the Contractor for travel mileage, meals, lodging and other travel expenses incurred in
the performance of this contract shall not exceed the rates established in County policy.
Sales/Use Tax Refunds: If eligible, the Contractor and all subcontractors shall: (a) ask the North Carolina Department of
Revenue for a refund of all sales and use taxes paid by them in the performance of this contract, pursuant to G.S. 105-
164.14; and (b) exclude all refundable sales and use taxes from all reportable expenditures before the expenses are entered
in their reimbursement reports.
Advertising: The Contractor shall not use the award of this contract as a part of any news release or commercial advertising.
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ATTACHMENT B – Scope of Work Federal Tax Id. 56-135 0472
NORTH CAROLINA
DUPLICATE ORIGINAL
PERSON COUNTY
LEGAL SERVICES AGREEMENT
THIS Agreement, made and entered into this the 1st day of July, 2016, by and between
the PERSON COUNTY DEPARTMENT OF SOCIAL SERVICES, hereinafter referred to as
Agency, and Walter B. Cates, Attorney at Law, hereinafter referred to as Attorney.
W I T N E S S E T H :
THAT WHEREAS, the Agency has determined that it has need for legal services and
consultation beyond those presently being provided by the county attorney;
AND WHEREAS, the Attorney is a member in a reputable law firm with an office in
Person County, North Carolina, and has expertise in the field of social services law, rules and
regulations, and the Agency is desirous of obtaining such legal services from said Attorney on a
continuing basis;
NOW, THEREFORE, it is hereby agreed that the Attorney shall provide legal services to
the Agency in the nature of consultations, interpretation of social services laws and regulations
and drafting of legal documents when necessary on the following terms and conditions:
1
The Attorney shall make himself available and on call to the Agency on a prompt basis
for the purposes herein above described until June 30, 2017. At the end of said period, the
arrangement herein described will be analyzed by the parties hereto to determine if same is
effective and fair to all parties concerned and revised or terminated accordingly as deemed
necessary.
2
The Agency shall pay for such legal services to the Attorney the sum of seventy-five
dollars ($75.00) per hour for out of court time and seventy-five dollars ($75.00) per hour for in
court time for each hour of legal services performed, same to be due and payable on or before the
10th of each month upon due submission by the Attorney of a statement of work detailing the
hours of work performed and the nature of such legal work.
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3
The Attorney will assist the Agency in maintaining records of the legal services provided
as same are necessary for the agency in filing its reports and funding statements.
4
It is understood and agreed that the legal services provided pursuant to this contract will
be in addition to those provided by the county attorney and not in substitution nor duplication of
such services by the county attorney.
5
It is specifically agreed that Attorney is an independent contractor and shall perform the
legal services herein provided according to his own judgment and method and shall not be
subject to control of the Agency except as to the result of his work.
6
The Attorney shall not under any circumstance be considered an employee of the
Agency. The Agency shall not withhold federal or state taxes from sums paid to the Attorney
pursuant to this agreement.
IN WITNESS WHEREOF, the parties have executed this agreement in duplicate
originals, one of which is retained by each of the parties hereto, on the day and year first above
written.
Walter B. Cates, Attorney At Law
____________________________ _________________________
Signature Date
David Newell, Sr.
____________________________ _________________________
Chairman, County Commissioners Date
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ATTACHMENT C
CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS
AND CERTIFICATION REGARDING NONDISCRIMINATION
Person County Department of Social Services
I. By execution of this Agreement the Contractor certifies that it will provide a drug-free workplace by:
A. Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession or use of a controlled substance is prohibited in the Contractor’s workplace and specifying the actions that will be taken against employees for violation of
such prohibition;
B. Establishing a drug-free awareness program to inform employees about: (1) The dangers of drug abuse in the workplace; (2) The Contractor’s policy of maintaining a drug-free workplace; (3) Any available drug counseling, rehabilitation, and employee assistance programs; and
(4) The penalties that may be imposed upon employees for drug abuse violations
occurring in the workplace;
C. Making it a requirement that each employee be engaged in the performance of the agreement be given a copy of the statement required by paragraph (A); D. Notifying the employee in the statement required by paragraph (A) that, as a condition of employment under the agreement, the employee will:
(1) Abide by the terms of the statement; and
(2) Notify the employer of any criminal drug statute conviction for a violation occurring in the workplace no later than five days after such conviction;
E. Notifying the County within ten days after receiving notice under subparagraph (D)(2) from an employee or otherwise receiving actual notice of such conviction; F. Taking one of the following actions, within 30 days of receiving notice under
subparagraph (D)(2), with respect to any employee who is so convicted:
(1) Taking appropriate personnel action against such an employee, up to and including termination; or (2) Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State, or local health, law enforcement, or other appropriate agency; and
Making a good faith effort to continue to maintain a drug-free workplace through
implementation of paragraphs (A), (B), (C), (D), (E), and (F).
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The site(s) for the performance of work done in connection with the specific agreement are
listed below:
36 Court Street, Roxboro, NC 27573
Contractor will inform the County of any additional sites for performance of work under this agreement. False certification or violation of the certification shall be grounds for suspension of payment,
suspension or termination of grants, or government-wide Federal suspension or debarment
45 C.F.R. Section 82.510. Section 4 CFR Part 85, Section 85.615 and 86.620.
Certification Regarding Nondiscrimination
The Vendor certifies that it will comply with all Federal statutes relating to nondiscrimination.
These include but are not limited to: (a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352)
which prohibits discrimination on the basis of race, color or national origin; (b) Title IX of the
Education Amendments of 1972, as amended (20 U.S.C. §§1681-1683, and 1685-1686), which
prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as
amended (29 U.S.C. §794), which prohibits discrimination on the basis of handicaps; (d) the Age
Discrimination Act of 1975, as amended (42 U.S.C. §§6101-6107), which prohibits
discrimination on the basis of age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L.
92-255), as amended, relating to nondiscrimination on the basis of drug abuse; (f) the
Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of
1970 (P.L. 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or
alcoholism; (g) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. §§3601 et seq.), as
amended, relating to nondiscrimination in the sale, rental or financing of housing; (h) the Food
Stamp Act and USDA policy, which prohibit discrimination on the basis of religion and political
beliefs; and (i) the requirements of any other nondiscrimination statutes which may apply to this
Agreement.
Walter B. Cates, Attorney At Law
____________________________ _________________________
Signature Date
David Newell, Sr.
____________________________ _________________________
Chairman, County Commissioners Date
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ATTACHMENT D:
CONFLICT OF INTEREST
The Board of Directors/Trustees or other governing persons, officers, employees or agents are to avoid
any conflict of interest, even the appearance of a conflict of interest. The Organization‘s Board of
Directors/Trustees or other governing body, officers, staff and agents are obligated to always act in the
best interest of the organization. This obligation requires that any Board member or other governing
person, officer, employee or agent, in the performance of Organization duties, seek only the furtherance
of the Organization mission. At all times, Board members or other governing persons, officers, employees
or agents, are prohibited from using their job title, the Organization's name or property, for private profit or
benefit.
A. The Board members or other governing persons, officers, employees, or agents of the Organization
should neither solicit nor accept gratuities, favors, or anything of monetary value from current or potential
contractors/vendors, persons receiving benefits from the Organization or persons who may benefit from
the actions of any Board member or other governing person, officer, employee or agent. This is not
intended to preclude bona-fide Organization fund raising-activities.
B. A Board or other governing body member may, with the approval of Board or other governing body,
receive honoraria for lectures and other such activities while not acting in any official capacity for the
Organization. Officers may, with the approval of the Board or other governing body, receive honoraria for
lectures and other such activities while on personal days, compensatory time, annual leave, or leave
without pay. Employees may, with the prior written approval of their supervisor, receive honoraria for
lectures and other such activities while on personal days, compensatory time, annual leave, or leave
without pay. If a Board or other governing body member, officer, employee or agent is acting in any
official capacity, honoraria received in connection with activities relating to the Organization are to be paid
to the Organization.
C. No Board member or other governing person, officer, employee, or agent of the Organization shall
participate in the selection, award, or administration of a purchase or contract with a vendor where, to his
knowledge, any of the following has a financial interest in that purchase or contract:
1. The Board member or other governing person, officer, employee, or agent;
2. Any member of their family by whole or half blood, step or personal relationship or relative-in-law;
3. An organization in which any of the above is an officer, director, or employee;
4. A person or organization with whom any of the above individuals is negotiating or has any
arrangement concerning prospective employment or contracts.
D. Duty to Disclosure -- Any conflict of interest, potential conflict of interest, or the appearance of a
conflict of interest is to be reported to the Board or other governing body or one’s supervisor immediately.
E. Board Action -- When a conflict of interest is relevant to a matter requiring action by the Board of
Directors/Trustees or other governing body, the Board member or other governing person, officer,
employee, or agent (person(s)) must disclose the existence of the conflict of interest and be given the
opportunity to disclose all material facts to the Board and members of committees with governing board
delegated powers considering the possible conflict of interest. After disclosure of all material facts, and
after any discussion with the person, he/she shall leave the governing board or committee meeting while
the determination of a conflict of interest is discussed and voted upon. The remaining board or committee
members shall decide if a conflict of interest exists. In addition, the person(s) shall not participate in the
final deliberation or decision regarding the matter under consideration and shall leave the meeting during
the discussion of and vote of the Board of Directors/Trustees or other governing body.
F. Violations of the Conflicts of Interest Policy -- If the Board of Directors/Trustees or other governing
body has reasonable cause to believe a member, officer, employee or agent has failed to disclose actual
or possible conflicts of interest, it shall inform the person of the basis for such belief and afford the person
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an opportunity to explain the alleged failure to disclose. If, after hearing the person's response and after
making further investigation as warranted by the circumstances, the Board of Directors/Trustees or other
governing body determines the member, officer, employee or agent has failed to disclose an actual or
possible conflict of interest, it shall take appropriate disciplinary and corrective action.
G. Record of Conflict -- The minutes of the governing board and all committees with board delegated
powers shall contain:
1. The names of the persons who disclosed or otherwise were found to have an actual or possible
conflict of interest, the nature of the conflict of interest, any action taken to determine whether a
conflict of interest was present, and the governing board's or committee's decision as to whether
a conflict of interest in fact existed.
2. The names of the persons who were present for discussions and votes relating to the transaction
or arrangement that presents a possible conflict of interest, the content of the discussion,
including any alternatives to the transaction or arrangement, and a record of any votes taken in
connection with the proceedings.
NOTARIZED CONFLICT OF INTEREST POLICY
Walter B. Cates
_________________________________ _________________________
Signature Date
NORTH CAROLINA
PERSON COUNTY
I, __________________________, a Notary Public of said County and State do hereby certify that Walter B. Cates,
Attorney at Law, personally appeared before me this date and acknowledged the due execution of the foregoing
agreement for the purposes therein expressed and by that authority duly given and as the act of the Organization,
affirmed that the foregoing Conflict of Interest Policy was adopted by the Board of Directors/Trustees or other
governing body in a meeting held on the __________ day of ___________, _________.
Sworn to and subscribed before me this _________ day of ______________________, 2016.
___________________________
Notary Public
My Commission expires: __________________
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ATTACHMENT E – OVERDUE TAXES
______________, 2016
To: Person County Department of Social Services
Certification:
I, Walter B. Cates, certify that I do not have any overdue tax debts, as defined by N.C.G.S. 105-243.1, at the
federal, State, or local level. I further understand that any person who makes a false statement in violation of
N.C.G.S. 143C-6-23(c) is guilty of a criminal offense punishable as provided by N.C.G.S.) 143C-10-1b.
Sworn Statement:
I, Walter B. Cates, being duly sworn, say that the foregoing certification is true, accurate and complete to the
best of my knowledge and was made and subscribed by me. I also acknowledge and understand that any
misuse of State funds will be reported to the appropriate authorities for further action.
Walter B. Cates, Attorney At Law
____________________________ _________________________
Signature Date
NORTH CAROLINA
PERSON COUNTY
Sworn to and subscribed before me this _________ day of ______________________, 2016.
___________________________
Notary Public
My Commission expires: __________________
____________________
1 G.S. 105-243.1 defines: Overdue tax debt. – Any part of a tax debt that remains unpaid 90 days or more after the notice of final
assessment was mailed to the taxpayer. The term does not include a tax debt, however, if the taxpayer entered into an installment
agreement for the tax debt under G.S. 105-237 within 90 days after the notice of final assessment was mailed and has not failed to
make any payments due under the installment agreement.”
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ATTACHMENT G
Person County Department of Social Services
Certification Regarding Lobbying
Certification for Contracts, Grants, Loans and Cooperative Agreements
The undersigned certifies, to the best of his or her knowledge and belief, that:
(1) No Federal appropriated funds have been paid or will be paid by or on behalf of the undersigned, to any
person for influencing or attempting to influence an officer or employee of any Federal, state or local
government agency, a Member of Congress, a Member of the General Assembly, an officer or employee of
Congress, an officer or employee of the General Assembly, an employee of a Member of Congress, or an
employee of a Member of the General Assembly in connection with the awarding of any Federal or state
contract, the making of any Federal or state grant, the making of any Federal or state loan, the entering into
of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any
Federal or state contract, grant, loan, or cooperative agreement.
(2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for
influencing or attempting to influence an officer or employee of any Federal, state or local government
agency, a Member of Congress, a Member of the General Assembly, an officer or employee of Congress,
an officer or employee of the General Assembly, an employee of a Member of Congress, or an employee of
a Member of the General Assembly in connection with the awarding of any Federal or state contract, the
making of any Federal or state grant, the making of any Federal or state loan, the entering into of any
cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any
Federal or state contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit
Standard
Form LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions.
(3) The undersigned shall require that the language of this certification be included in the award documents for
all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and
cooperative agreements) and that all subrecipients shall certify and disclose accordingly.
(4) This certification is a material representation of fact upon which reliance was placed when this transaction
was made or entered into. Submission of this certification is a prerequisite for making or entering into this
transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required
certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each
such failure.
Notwithstanding other provisions of federal OMB Circulars-CFR Title 2, Grants and Agreements, Part 200, costs
associated with the following activities are unallowable:
Paragraph A.
(1) Attempts to influence the outcomes of any Federal, State, or local election, referendum, initiative, or
similar procedure, through in kind or cash contributions, endorsements, publicity, or similar activity;
(2) Establishing, administering, contributing to, or paying the expenses of a political party, campaign, political
action committee, or other organization established for the purpose of influencing the outcomes of
elections;
(3) Any attempt to influence: (i) The introduction of Federal or State legislation; or (ii) the enactment or
modification of any pending Federal or State legislation through communication with any member or
employee of the Congress or State legislature (including efforts to influence State or local officials to
engage in similar lobbying activity), or with any Government official or employee in connection with a
decision to sign or veto enrolled legislation;
(4) Any attempt to influence: (i) The introduction of Federal or State legislation; or (ii) the enactment or
modification of any pending Federal or State legislation by preparing, distributing or using publicity or
propaganda, or by urging members of the general public or any segment thereof to contribute to or
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participate in any mass demonstration, march, rally, fundraising drive, lobbying campaign or letter writing
or telephone campaign; or
(5) Legislative liaison activities, including attendance at legislative sessions or committee hearings, gathering
information regarding legislation, and analyzing the effect of legislation, when such activities are carried on
in support of or in knowing preparation for an effort to engage in unallowable lobbying.
The following activities as enumerated in Paragraph B are excepted from the coverage of Paragraph A:
Paragraph B.
(1) Providing a technical and factual presentation of information on a topic directly related to the performance
of a grant, contract or other agreement through hearing testimony, statements or letters to the Congress or a
State legislature, or subdivision, member, or cognizant staff member thereof, in response to a documented
request (including a Congressional Record notice requesting testimony or statements for the record at a
regularly scheduled hearing) made by the recipient member, legislative body or subdivision, or a cognizant
staff member thereof; provided such information is readily obtainable and can be readily put in deliverable
form; and further provided that costs under this section for travel, lodging or meals are unallowable unless
incurred to offer testimony at a regularly scheduled Congressional hearing pursuant to a written request for
such presentation made by the Chairman or Ranking Minority Member of the Committee or Subcommittee
conducting such hearing.
(2) Any lobbying made unallowable by subparagraph A (3) to influence State legislation in order to directly
reduce the cost, or to avoid material impairment of the organization's authority to perform the grant,
contract, or other agreement.
(3) Any activity specifically authorized by statute to be undertaken with funds from the grant, contract, or other
agreement.
Paragraph C.
(1) When an organization seeks reimbursement for indirect costs, total lobbying costs shall be separately
identified in the indirect cost rate proposal, and thereafter treated as other unallowable activity costs in
accordance with the procedures of subparagraph B.(3).
(2) Organizations shall submit, as part of the annual indirect cost rate proposal, a certification that the
requirements and standards of this paragraph have been complied with.
(3) Organizations shall maintain adequate records to demonstrate that the determination of costs as being
allowable or unallowable pursuant to this section complies with the requirements of this Circular.
(4) Time logs, calendars, or similar records shall not be required to be created for purposes of complying with
this paragraph during any particular calendar month when: (1) the employee engages in lobbying (as
defined in subparagraphs (a) and (b)) 25 percent or less of the employee's compensated hours of
employment during that calendar month, and (2) within the preceding five-year period, the organization has
not materially misstated allowable or unallowable costs of any nature, including legislative lobbying costs.
When conditions (1) and (2) are met, organizations are not required to establish records to support the
allowability of claimed costs in addition to records already required or maintained. Also, when conditions
(1) and (2) are met, the absence of time logs, calendars, or similar records will not serve as a basis for
disallowing costs by contesting estimates of lobbying time spent by employees during a calendar month.
(5) Agencies shall establish procedures for resolving in advance, in consultation with OMB, any significant
questions or disagreements concerning the interpretation or application of this section. Any such advance
resolution shall be binding in any subsequent settlements, audits or investigations with respect to that grant
or contract for purposes of interpretation of this Circular; provided, however, that this shall not be
construed to prevent a contractor or grantee from contesting the lawfulness of such a determination.
Paragraph D.
Executive lobbying costs. Costs incurred in attempting to improperly influence either directly or indirectly, an
employee or officer of the Executive Branch of the Federal Government to give consideration or to act
regarding a sponsored agreement or a regulatory matter are unallowable. Improper influence means any
influence that induces or tends to induce a Federal employee or officer to give consideration or to act regarding
a federally sponsored agreement or regulatory matter on any basis other than the merits of the matter.
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Walter B. Cates, Attorney At Law
____________________________ _________________________
Signature Date
David Newell, Sr.
____________________________ _________________________
Chairman, County Commissioners Date
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ATTACHMENT H
PERSON COUNTY DEPARTMENT OF SOCIAL SERVICES
CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY
AND VOLUNTARY EXCLUSION-LOWER TIER COVERED TRANSACTIONS
Instructions for Certification
1. By signing and submitting this proposal, the prospective lower tier participant is providing the
certification set out below.
2. The certification in this clause is a material representation of the fact upon which reliance was
placed when this transaction was entered into. If it is later determined that the prospective lower
tier participant knowingly rendered an erroneous certification, in addition to other remedies
available to the Federal Government, the department or agency with which this transaction
originated may pursue available remedies, including suspension and/or debarment.
3. The prospective lower tier participant will provide immediate written notice to the person to
whom the proposal is submitted if at any time the prospective lower tier participant learns that its
certification was erroneous when submitted or has become erroneous by reason of changed
circumstances.
4. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered
transaction," "participant," "person," "primary covered transaction," "principal," "proposal," and
"voluntarily excluded," as used in this clause, have the meanings set out in the Definitions and
Coverage sections of rules implementing Executive Order 12549. You may contact the person to
which this proposal is submitted for assistance in obtaining a copy of those regulations.
5. The prospective lower tier participant agrees by submitting this proposal that, should the
proposed covered transaction be entered into, it shall not knowingly enter any lower tier covered
transaction with a person who is debarred, suspended, determined ineligible or voluntarily
excluded from participation in this covered transaction unless authorized by the department or
agency with which this transaction originated.
6. The prospective lower tier participant further agrees by submitting this proposal that it will
include this clause titled "Certification Regarding Debarment, Suspension, Ineligibility and
Voluntary Exclusion - Lower Tier Covered Transaction," without modification, in all lower tier
covered transactions and in all solicitations for lower tier covered transactions.
7. A participant in a covered transaction may rely upon a certification of a prospective
participant in a lower tier covered transaction that it is not debarred, suspended, ineligible, or
voluntarily excluded from covered transaction, unless it knows that the certification is erroneous.
A participant may decide the method and frequency of which it determines the eligibility of its
principals. Each participant may, but is not required to, check the Nonprocurement List.
8. Nothing contained in the foregoing shall be construed to require establishment of a system of
records in order to render in good faith the certification required by this clause. The knowledge
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and information of a participant is not required to exceed that which is normally possessed by a
prudent person in the ordinary course of business dealings.
9. Except for transactions authorized in paragraph 5 of these instructions, if a participant in a
covered transaction knowingly enters into a lower tier covered transaction with a person who is
suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in
addition to other remedies available to the Federal Government, the department or agency with
which this transaction originated may pursue available remedies, including suspension, and/or
debarment.
Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower
Tier Covered Transactions
(1) The prospective lower tier participant certifies, by submission of this proposal, that neither it
nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or
voluntarily excluded from participation in this transaction by any Federal department or agency.
(2) Where the prospective lower tier participant is unable to certify to any of the statements in this
certification, such prospective participant shall attach an explanation to this proposal.
Walter B. Cates, Attorney At Law
____________________________ _________________________
Signature Date
David Newell, Sr.
____________________________ _________________________
Chairman, County Commissioners Date
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ATTACHMENT I
PERSON COUNTY
DEPARTMENT OF SOCIAL SERVICES
BUSINESS ASSOCIATE ADDENDUM
This Agreement is made effective the 1st day of July, 2016, by and between Person County
Department of Social Services (“Covered Entity”) and Walter B. Cates, Attorney at Law
(“Business Associate”) (collectively the “Parties”).
1. BACKGROUND
a. Covered Entity and Business Associate are parties to a contract entitled Legal Services
Contract (the “Contract”), whereby Business Associate agrees to perform certain services for or
on behalf of Covered Entity.
b. Covered Entity is an organizational unit of Person County as the Person County Department
of Social Services (DSS) as a health care component for purposes of the HIPAA Privacy Rule.
c. The relationship between Covered Entity and Business Associate is such that the Parties
believe Business Associate is or may be a “business associate” within the meaning of the HIPAA
Privacy Rule.
d. The Parties enter into this Business Associate Addendum to the Contract with the intention of
complying with the HIPAA Privacy Rule provision that a covered entity may disclose protected
health information to a business associate, and may allow a business associate to create or
receive protected heath information on its behalf, if the covered entity obtains satisfactory
assurances that the business associate will appropriately safeguard the information.
2. DEFINITIONS
Unless some other meaning is clearly indicated by the context, the following terms shall have the
following meaning in this Agreement:
a. “HIPAA” means the Administrative Simplification Provisions, Sections 261 through 264, of
the federal Health Insurance Portability and Accountability Act of 1996, Public Law 104-191.
b. “Individual” shall have the same meaning as the term “individual” in 45 CFR160.103 and
shall include a person who qualifies as a personal representative in accordance with 45 CFR
164.502(g).
c. “Privacy Rule” shall mean the Standards for Privacy of Individually Identifiable Health
Information at 45 CFR part 160 and part 164, subparts A and E.
d. “Protected Health Information” shall have the same meaning as the term “protected health
information” in 45 CFR 160.103, limited to the information created or received by Business
Associate from or on behalf of Covered Entity.
e. “Required By Law” shall have the same meaning as the term “required by law” in 45 CFR
164.103.
f. “Secretary” shall mean the Secretary of the United States Department of Health and Human
Services or his designee.
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g. Unless otherwise defined in this Agreement, terms used herein shall have the same meaning
as those terms have in the Privacy Rule.
3. OBLIGATIONS OF BUSINESS ASSOCIATE
a. Business Associate agrees to not use or disclose Protected Health Information other than as
permitted or required by this Agreement or as Required By Law.
b. Business Associate agrees to use appropriate safeguards to prevent use or disclosure of the
Protected Health Information other than as provided for by this Agreement.
c. Business Associate agrees to mitigate, to the extent practicable, any harmful effect that is
known to Business Associate of a use or disclosure of Protected Health Information by Business
Associate in violation of the requirements of this Agreement.
d. Business Associate agrees to report to Covered Entity any use or disclosure of the Protected
Health Information not provided for by this Agreement of which it becomes aware.
e. Business Associate agrees to ensure that any agent, including a subcontractor, to whom it
provides Protected Health Information received from, or created or received by Business
Associate on behalf of Covered Entity agrees to the same restrictions and conditions that apply
through this Agreement to Business Associate with respect to such information.
f. Business Associate agrees to provide access, at the request of Covered Entity, to Protected
Health Information in a Designated Record Set to Covered Entity or, as directed by Covered
Entity, to an Individual in order to meet the requirements under 45 CFR 164.524.
g. Business Associate agrees, at the request of the Covered Entity, to make any amendment(s) to
Protected Health Information in a Designated Record Set that the Covered Entity directs or
agrees to pursuant to 45 CFR 164.526.
h. Unless otherwise prohibited by law, Business Associate agrees to make internal practices,
books, and records, including policies and procedures and Protected Health Information, relating
to the use and disclosure of Protected Health Information received from, or created or received
by Business Associate on behalf of Covered Entity, available to the Covered Entity, or to the
Person County Department of Social Services, in a time and manner designated by the
Secretary, for purposes of determining Covered Entity's compliance with the Privacy Rule.
i. Business Associate agrees to document such disclosures of Protected Health Information and
information related to such disclosures as would be required for Covered Entity to respond to a
request by an Individual for an accounting of disclosures of Protected Health Information in
accordance with 45 CFR 164.528, and to provide this information to Covered Entity or an
Individual to permit such a response.
4. PERMITTED USES AND DISCLOSURES
a. Except as otherwise limited in this Agreement or by other applicable law or agreement, if the
Contract permits, Business Associate may use or disclose Protected Health Information to
perform functions, activities, or services for, or on behalf of, Covered Entity as specified in the
Contract, provided that such use or disclosure:
1) would not violate the Privacy Rule if done by Covered Entity; or
2) would not violate the minimum necessary policies and procedures of the Covered
Entity.
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b. Except as otherwise limited in this Agreement or by other applicable law or agreements, if the
Contract permits, Business Associate may use Protected Health Information as necessary for the
proper management and administration of the Business Associate or to carry out the legal
responsibilities of the Business Associate.
c. Except as otherwise limited in this Agreement or by other applicable law or agreements, if the
Contract permits, Business Associate may disclose Protected Health Information for the proper
management and administration of the Business Associate, provided that:
1) disclosures are Required By Law; or
2) Business Associate obtains reasonable assurances from the person to whom the
information is disclosed that it will remain confidential and will be used or further
disclosed only as Required By Law or for the purpose for which it was disclosed to the
person, and the person notifies the Business Associate of any instances of which it is
aware in which the confidentiality of the information has been breached.
d. Except as otherwise limited in this Agreement or by other applicable law or agreements, if the
Contract permits, Business Associate may use Protected Health Information to provide data
aggregation services to Covered Entity as permitted by 45 CFR 164.504(e)(2)(i)(B).
e. Notwithstanding the foregoing provisions, Business Associate may not use or disclose
Protected Health Information if the use or disclosure would violate any term of the Contract or
other applicable law or agreements.
5. TERM AND TERMINATION
a. Term. This Agreement shall be effective as of the effective date stated above and shall
terminate when the Contract terminates.
b. Termination for Cause. Upon Covered Entity's knowledge of a material breach by Business
Associate, Covered Entity may, at its option:
1) Provide an opportunity for Business Associate to cure the breach or end the violation,
and terminate this Agreement and services provided by Business Associate, to the extent
permissible by law, if Business Associate does not cure the breach or end the violation
within the time specified by Covered Entity;
2) Immediately terminate this Agreement and services provided by Business Associate,
to the extent permissible by law; or
3) If neither termination nor cure is feasible, report the violation to the Secretary as
provided in the Privacy Rule.
c. Effect of Termination.
1) Except as provided in paragraph (2) of this section or in the Contract or by other
applicable law or agreements, upon termination of this Agreement and services provided
by Business Associate, for any reason, Business Associate shall return or destroy all
Protected Health Information received from Covered Entity, or created or received by
Business Associate on behalf of Covered Entity. This provision shall apply to Protected
Health Information that is in the possession of subcontractors or agents of Business
Associate. Business Associate shall retain no copies of the Protected Health Information.
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2) In the event that Business Associate determines that returning or destroying the
Protected Health Information is not feasible, Business Associate shall provide to Covered
Entity notification of the conditions that make return or destruction not feasible. Business
Associate shall extend the protections of this Agreement to such Protected Health
Information and limit further uses and disclosures of such Protected Health Information
to those purposes that make the return or destruction infeasible, for so long as Business
Associate maintains such Protected Health Information.
6. GENERAL TERMS AND CONDITIONS
a. This Agreement amends and is part of the Contract.
b. Except as provided in this Agreement, all terms and conditions of the Contract shall remain in
force and shall apply to this Agreement as if set forth fully herein.
c. In the event of a conflict in terms between this Agreement and the Contract, the interpretation
that is in accordance with the Privacy Rule shall prevail. In the event that a conflict then
remains, the Contract terms shall prevail so long as they are in accordance with the Privacy Rule.
d. A breach of this Agreement by Business Associate shall be considered sufficient basis for
Covered Entity to terminate the Contract for cause.
Walter B. Cates, Attorney At Law
____________________________ _________________________
Signature Date
David Newell, Sr.
____________________________ _________________________
Chairman, County Commissioners Date
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Attachment M
State Certification
Contractor Certifications Required by North Carolina Law
Instructions
The person who signs this document should read the text of the statutes listed below and consult with
counsel and other knowledgeable persons before signing.
The text of Article 2 of Chapter 64 of the North Carolina General Statutes can be found online at:
http://www.ncga.state.nc.us/EnactedLegislation/Statutes/PDF/ByArticle/Chapter_64/Article_2.pdf
The text of G.S. 105-164.8(b) can be found online at:
http://www.ncga.state.nc.us/EnactedLegislation/Statutes/PDF/BySection/Chapter_105/GS_105-
164.8.pdf
The text of G.S. 143-48.5 (S.L. 2013-418, s. 2.(d)) can be found online at:
http://www.ncga.state.nc.us/Sessions/2013/Bills/House/PDF/H786v6.pdf
The text of G.S. 143-59.1 can be found online at:
http://www.ncga.state.nc.us/EnactedLegislation/Statutes/PDF/BySection/Chapter_143/GS_143-
59.1.pdf
The text of G.S. 143-59.2 can be found online at:
http://www.ncga.state.nc.us/EnactedLegislation/Statutes/PDF/BySection/Chapter_143/GS_143-
59.2.pdf
The text of G.S. 147-33.95(g) (S.L. 2013-418, s. 2.(e)) can be found online at:
http://www.ncga.state.nc.us/Sessions/2013/Bills/House/PDF/H786v6.pdf
Certifications
(1) Pursuant to G.S. 143-48.5 and G.S. 147-33.95(g), the undersigned hereby certifies that the
Contractor named below, and the Contractor’s subcontractors, complies with the requirements of
Article 2 of Chapter 64 of the NC General Statutes, including the requirement for each employer
with more than 25 employees in North Carolina to verify the work authorization of its employees
through the federal E-Verify system." E-Verify System Link: www.uscis.gov
Local government is specifically exempt from Article 2 of Chapter 64 of the North Carolina
General Statutes. However, local government is subject to and must comply with North Carolina
General Statute §153A-99.1., which states in part as follows:
Counties Must Use E-Verify. - Each county shall register and participate in E-Verify to verify the
work authorization of new employees hired to work in the United States.
(2) Pursuant to G.S. 143-59.1(b), the undersigned hereby certifies that the Contractor named below
is not an “ineligible Contractor” as set forth in G.S. 143-59.1(a) because:
(a) Neither the Contractor nor any of its affiliates has refused to collect the use tax levied
under Article 5 of Chapter 105 of the General Statutes on its sales delivered to North
Carolina when the sales met one or more of the conditions of G.S. 105-164.8(b); and
(b) [check one of the following boxes]
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Neither the Contractor nor any of its affiliates has incorporated or reincorporated
in a “tax haven country” as set forth in G.S. 143-59.1(c)(2) after December 31,
2001; or
The Contractor or one of its affiliates has incorporated or reincorporated in a “tax
haven country” as set forth in G.S. 143-59.1(c)(2) after December 31, 2001 but
the United States is not the principal market for the public trading of the stock of
the corporation incorporated in the tax haven country.
(3) Pursuant to G.S. 143-59.2(b), the undersigned hereby certifies that none of the Contractor’s
officers, directors, or owners (if the Contractor is an unincorporated business entity) has been
convicted of any violation of Chapter 78A of the General Statutes or the Securities Act of 1933 or
the Securities Exchange Act of 1934 within 10 years immediately prior to the date of the bid
solicitation.
(4) The undersigned hereby certifies further that:
(a) He or she is a duly authorized representative of the Contractor named below;
(b) He or she is authorized to make, and does hereby make, the foregoing certifications on
behalf of the Contractor; and
(c) He or she understands that any person who knowingly submits a false certification in
response to the requirements of G.S. 143-59.1 and -59.2 shall be guilty of a Class I
felony.
Contractor’s Name: Walter B. Cates
Signature of Contractor’s Authorized Agent
Date
Printed Name of Contractor’s Authorized Agent
Walter B. Cates
Title
Attorney at Law
Signature of Witness
Title
Printed Name of Witness
Date
The witness should be present when the Contractor’s Authorized Agent signs this certification and should
sign and date this document immediately thereafter.
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Attachment N
CERTIFICATION OF ELIGIBILITY
Under the Iran
Divestment Act
Pursuant to G.S. 147-86.59, any person identified as engaging in investment activities in
Iran, determined by appearing on the Final Divestment List created by the State
Treasurer pursuant to G.S. 147-86.58, is ineligible to contract with the State of North
Carolina or any political subdivision of the State. The Iran Divestment Act of 2015, G.S.
147-86.55 et seq.* requires that each vendor, prior to contracting with the State certify,
and the undersigned on behalf of the Vendor does hereby certify, to the following:
1. that Walter B. Cates, Attorney At Law, is not identified on the Final
Divestment List of entities that the State Treasurer has determined engages in
investment activities in Iran;
2. that Walter B. Cates, Attorney At Law, shall not utilize on any contract with the
State agency any subcontractor that is identified on the Final Divestment List; and
3. that Walter B. Cates, Attorney At Law, is authorized to make this Certification.
Walter B. Cates, Attorney At Law
____________________________ _________________________
Signature Date
* Note: Enacted by Session Law 2015‐118 as G.S. 143C‐55 et seq., but has been renumbered for
codification at the direction of the Revisor of Statutes.
The State Treasurer’s Final Divestment List can be found on the State Treasurer’s website at the address:
https://www.nctreasurer.com/inside‐the‐department/OpenGovernment/Pages/Iran‐Divestment‐Act‐Resources.aspx
and will be updated every 180 days. For questions about the Department of State Treasurer’s Iran Divestment
Policy, please contact Meryl Murtagh at Meryl.Murtagh@nctreasurer.com or (919) 814‐3852.
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Contract # 1011 Fiscal Year Begins July 1, 2016 Ends June 30, 2017
This contract is hereby entered into by and between the Person County Department of Social
Services (the "County") and Walter B. Cates (the "Contractor") (referred to collectively as the
“Parties”). The Contractor’s federal tax identification number is 56-135 0472.
Contract Documents: This Contract consists of the following documents:
This contract
The General Terms and Conditions (Attachment A)
The Scope of Work, description of services, and rate (Attachment B)
Federal Certification Regarding Drug-Free Workplace & Certification Regarding Nondiscrimination (Attachment C)
Conflict of Interest (Attachment D)
No Overdue Taxes (Attachment E)
Federal Certification Regarding Lobbying (Attachment G)
Federal Certification Regarding Debarment (Attachment H)
HIPAA Business Associate Addendum (Attachment I)
State Certification (Attachment M)
Certification of Eligibility Under the Iran Divestment Act (Attachment N)
These documents constitute the entire agreement between the Parties and supersede all prior
oral or written statements or agreements.
Precedence among Contract Documents: In the event of a conflict between or among the
terms of the Contract Documents, the terms in the Contract Document with the highest relative
precedence shall prevail. The order of precedence shall be the order of documents as listed in
Paragraph 1, above, with the first-listed document having the highest precedence and the last-
listed document having the lowest precedence. If there are multiple Contract Amendments, the
most recent amendment shall have the highest precedence and the oldest amendment shall
have the lowest precedence.
Effective Period: This contract shall be effective on July 1, 2016 and shall terminate on
June 30, 2017. This contract must be twelve months or less.
Contractor’s Duties: The Contractor shall provide the services and in accordance with the
approved rate as described in Attachment B, Scope of Work.
County’s Duties: The County shall pay the Contractor in the manner and in the amounts
specified in the Contract Documents.
[ x ] a. There are no matching requirements from the Contractor.
[ ] b. The Contractor’s matching requirement is $__________, which shall consist of:
[ ] In-kind [ ] Cash [ ] Cash and In-kind [ ] Cash and/or In-kind
The contributions from the Contractor shall be sourced from non-federal funds.
The total contract amount including any Contractor match shall not exceed 1,000 hours
collectively for all attorneys under contract. Rate of compensation for Secondary Attorney
Walter B. Cates is $75 per hour.
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Reversion of Funds:
Any unexpended grant funds shall revert to the County Department of Social Services upon
termination of this contract.
Reporting Requirements:
Contractor shall comply with audit requirements as described in N.C.G.S. § 143C-6-22 & 23 and
OMB Circular- CFR Title 2 Grants and Agreements, Part 200, and shall disclose all information
required by 42 USC 455.104, or 42 USC 455.105, or 42 USC 455.106.
Payment Provisions:
Payment shall be made in accordance with the Contract Documents as described in the Scope
of Work, Attachment B.
Contract Administrators: All notices permitted or required to be given by one Party to the
other and all questions about the contract from one Party to the other shall be addressed and
delivered to the other Party’s Contract Administrator. The name, post office address, street
address, telephone number, fax number, and email address of the Parties’ respective initial
Contract Administrators are set out below. Either Party may change the name, post office
address, street address, telephone number, fax number, or email address of its Contract
Administrator by giving timely written notice to the other Party.
For the County: For the Contractor:
Wendy Bowman, Accounting Technician
Person County Department of Social Services Walter B. Cates, Attorney
P.O. Box 770 P.O. Box 679
355B South Madison Boulevard 36 Court Street
Roxboro, NC 27573 Roxboro, NC 27573
(336) 599-8361 (336) 597-2251
Supplementation of Expenditure of Public Funds: The Contractor assures that funds
received pursuant to this contract shall be used only to supplement, not to supplant, the total
amount of federal, state and local public funds that the Contractor otherwise expends for
contract services and related programs. Funds received under this contract shall be used to
provide additional public funding for such services; the funds shall not be used to reduce the
Contractor’s total expenditure of other public funds for such services.
Disbursements: As a condition of this contract, the Contractor acknowledges and agrees to
make disbursements in accordance with the following requirements:
(a) Implement adequate internal controls over disbursements;
(b) Pre-audit all vouchers presented for payment to determine:
Validity and accuracy of payment
Payment due date
Adequacy of documentation supporting payment
Legality of disbursement
(c) Assure adequate control of signature stamps/plates;
(d) Assure adequate control of negotiable instruments; and
(e) Implement procedures to insure that account balance is solvent and reconcile the
account monthly.
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Outsourcing to Other Countries: The Contractor certifies that it has identified to the County
all jobs related to the contract that have been outsourced to other countries, if any. The
Contractor further agrees that it will not outsource any such jobs during the term of this contract
without providing notice to the County.
Federal Certifications: Individuals and Organizations receiving federal funds must ensure
compliance with certain certifications required by federal laws and regulations. The contractor is
hereby complying with Certifications regarding Nondiscrimination, Drug-Free Workplace
Requirements, Environmental Tobacco Smoke, Debarment, Suspension, Ineligibility and
Voluntary Exclusion Lower Tier Covered Transactions, and Lobbying. These assurances and
certifications are to be signed by the contractor’s authorized representative.
Signature Warranty: The undersigned represent and warrant that they are authorized to bind
their principals to the terms of this agreement.
Signature Warranty:
The undersigned represent and warrant that they are authorized to bind their principals to the terms of this
agreement.
The Contractor and the County have executed this contract in duplicate originals, with one original being retained by
each party.
Walter B. Cates, Attorney At Law
____________________________ _________________________
Signature Date
PERSON COUNTY
David Newell, Sr.
____________________________ _________________________
Chairman, County Commissioners Date
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
Act.
______________________________ ___________________________
Amy Wehrenberg, County Finance Director Date
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ATTACHMENT A
General Terms and Conditions
Relationships of the Parties
Independent Contractor: The Contractor is and shall be deemed to be an independent contractor in the performance of
this contract and as such shall be wholly responsible for the work to be performed and for the supervision of its employees.
The Contractor represents that it has, or shall secure at its own expense, all personnel required in performing the services
under this agreement. Such employees shall not be employees of, or have any individual contractual relationship with the
County.
Subcontracting: The Contractor shall not subcontract any of the work contemplated under this contract without prior written
approval from the County. Any approved subcontract shall be subject to all conditions of this contract. Only the
subcontractors specified in the contract documents are to be considered approved upon award of the contract. The County
shall not be obligated to pay for any work performed by any unapproved subcontractor. The Contractor shall be responsible
for the performance of all of its subcontractors.
Assignment: No assignment of the Contractor's obligations or the Contractor's right to receive payment hereunder shall be
permitted. However, upon written request approved by the issuing purchasing authority, the County may: Forward the
Contractor's payment check(s) directly to any person or entity designated by the Contractor, or Include any person or entity
designated by Contractor as a joint payee on the Contractor's payment check(s). In no event shall such approval and action
obligate the County to anyone other than the Contractor and the Contractor shall remain responsible for fulfillment of all
contract obligations.
Beneficiaries: Except as herein specifically provided otherwise, this contract shall inure to the benefit of and be binding
upon the parties hereto and their respective successors. It is expressly understood and agreed that the enforcement of the
terms and conditions of this contract, and all rights of action relating to such enforcement, shall be strictly reserved to the
County and the named Contractor. Nothing contained in this document shall give or allow any claim or right of action
whatsoever by any other third person. It is the express intention of the County and Contractor that any such person or entity,
other than the County or the Contractor, receiving services or benefits under this contract shall be deemed an incidental
beneficiary only.
Indemnity and Insurance
Indemnification: The Contractor agrees to indemnify and hold harmless the County and any of their officers, agents and
employees, from any claims of third parties arising out or any act or omission of the Contractor in connection with the
performance of this contract.
Insurance: During the term of the contract, the Contractor at its sole cost and expense shall provide commercial insurance
of such type and with such terms and limits as may be reasonably associated with the contract. As a minimum, the
Contractor shall provide and maintain the following coverage and limits:
Worker’s Compensation - The contractor shall provide and maintain Worker’s Compensation Insurance as required
by the laws of North Carolina, as well as employer’s liability coverage with minimum limits of $500,000.00, covering all
of Contractor’s employees who are engaged in any work under the contract. If any work is sublet, the Contractor shall
require the subcontractor to provide the same coverage for any of his employees engaged in any work under the
contract.
Commercial General Liability - General Liability Coverage on a Comprehensive Broad Form on an occurrence basis in
the minimum amount of $1,000,000.00 Combined Single Limit. (Defense cost shall be in excess of the limit of liability.)
Automobile Liability Insurance: The Contractor shall provide automobile liability insurance with a combined single
limit of $500,000.00 for bodily injury and property damage; a limit of $500,000.00 for uninsured/under insured
motorist coverage; and a limit of $2,000.00 for medical payment coverage. The Contractor shall provide this insurance
for all automobiles that are:
(a) owned by the Contractor and used in the performance of this contract;
(b) hired by the Contractor and used in the performance of this contract; and
(c) Owned by Contractor’s employees and used in performance of this contract (“non-owned vehicle insurance”).
Non-owned vehicle insurance protects employers when employees use their personal vehicles for work
purposes. Non-owned vehicle insurance supplements, but does not replace, the car-owner’s liability insurance.
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The Contractor is not required to provide and maintain automobile liability insurance on any vehicle – owned,
hired, or non-owned -- unless the vehicle is used in the performance of this contract.
(d) The insurance coverage minimums specified in subparagraph (a) are exclusive of defense costs.
(e) The Contractor understands and agrees that the insurance coverage minimums specified in subparagraph (a) are
not limits, or caps, on the Contractor’s liability or obligations under this contract.
(f) The Contractor may obtain a waiver of any one or more of the requirements in subparagraph (a) by
demonstrating that it has insurance that provides protection that is equal to or greater than the coverage and
limits specified in subparagraph (a). The County shall be the sole judge of whether such a waiver should be
granted.
(g) The Contractor may obtain a waiver of any one or more of the requirements in paragraph (a) by demonstrating
that it is self-insured and that its self-insurance provides protection that is equal to or greater than the coverage
and limits specified in subparagraph (a). The County shall be the sole judge of whether such a waiver should be
granted.
(h) Providing and maintaining the types and amounts of insurance or self-insurance specified in this paragraph is a
material obligation of the Contractor and is of the essence of this contract.
(i) The Contractor shall only obtain insurance from companies that are authorized to provide such coverage and
that are authorized by the Commissioner of Insurance to do business in the State of North Carolina. All such
insurance shall meet all laws of the State of North Carolina.
(j) The Contractor shall comply at all times with all lawful terms and conditions of its insurance policies and all
lawful requirements of its insurer.
(k) The Contractor shall require its subcontractors to comply with the requirements of this paragraph.
(l) The Contractor shall demonstrate its compliance with the requirements of this paragraph by submitting
certificates of insurance to the County before the Contractor begins work under this contract.
Transportation of Clients by Contractor:
The contractor will maintain Insurance requirements if required as noted under Article 7 Rule R2-36 of the North Carolina
Utilities Commission.
Default and Termination
Termination without Cause: The County may terminate this contract without cause by giving 30 days written notice to the
Contractor.
Termination for Cause: If, through any cause, the Contractor shall fail to fulfill its obligations under this contract in a timely
and proper manner, the County shall have the right to terminate this contract by giving written notice to the Contractor and
specifying the effective date thereof. In that event, all finished or unfinished deliverable items prepared by the Contractor
under this contract shall, at the option of the County, become its property and the Contractor shall be entitled to receive just
and equitable compensation for any satisfactory work completed on such materials, minus any payment or compensation
previously made. Notwithstanding the foregoing provision, the Contractor shall not be relieved of liability to the County for
damages sustained by the County by virtue of the Contractor’s breach of this agreement, and the County may withhold any
payment due the Contractor for the purpose of setoff until such time as the exact amount of damages due the County from
such breach can be determined. In case of default by the Contractor, without limiting any other remedies for breach
available to it, the County may procure the contract services from other sources and hold the Contractor responsible for any
excess cost occasioned thereby. The filing of a petition for bankruptcy by the Contractor shall be an act of default under this
contract.
Waiver of Default: Waiver by the County of any default or breach in compliance with the terms of this contract by the
Provider shall not be deemed a waiver of any subsequent default or breach and shall not be construed to be modification of
the terms of this contract unless stated to be such in writing, signed by an authorized representative of the County and the
Contractor and attached to the contract.
Availability of Funds: The parties to this contract agree and understand that the payment of the sums specified in this
contract is dependent and contingent upon and subject to the appropriation, allocation, and availability of funds for this
purpose to the County.
Force Majeure: Neither party shall be deemed to be in default of its obligations hereunder if and so long as it is prevented
from performing such obligations by any act of war, hostile foreign action, nuclear explosion, riot, strikes, civil insurrection,
earthquake, hurricane, tornado, or other catastrophic natural event or act of God.
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Survival of Promises: All promises, requirements, terms, conditions, provisions, representations, guarantees, and warranties
contained herein shall survive the contract expiration or termination date unless specifically provided otherwise herein, or
unless superseded by applicable Federal or State statutes of limitation.
Intellectual Property Rights
Copyrights and Ownership of Deliverables: All deliverable items produced pursuant to this contract are the exclusive
property of the County. The Contractor shall not assert a claim of copyright or other property interest in such deliverables.
Federal Intellectual Property Bankruptcy Protection Act: The Parties agree that the County shall be entitled to all rights and
benefits of the Federal Intellectual Property Bankruptcy Protection Act, Public Law 100-506, codified at 11 U.S.C. 365 (n)
and any amendments thereto.
Compliance with Applicable Laws
Compliance with Laws: The Contractor shall comply with all laws, ordinances, codes, rules, regulations, and licensing
requirements that are applicable to the conduct of its business, including those of federal, state, and local agencies having
jurisdiction and/or authority.
Title VI, Civil Rights Compliance: In accordance with Federal law and U.S. Department of Agriculture (USDA) and U.S.
Department of Health and Human Services (HHS) policy, this institution is prohibited from discriminating on the basis of
race, color, national origin, sex, age or disability. Under the Food Stamp Act and USDA policy, discrimination is prohibited
also on the basis of religion or political beliefs.
Equal Employment Opportunity: The Contractor shall comply with all federal and State laws relating to equal employment
opportunity.
Health Insurance Portability and Accountability Act (HIPAA): The Contractor agrees that, if the County determines that
some or all of the activities within the scope of this contract are subject to the Health Insurance Portability and Accountability
Act of 1996, P.L. 104-91, as amended (“HIPAA”), or its implementing regulations, it will comply with the HIPAA
requirements and will execute such agreements and practices as the County may require to ensure compliance.
(a) Data Security: The Contractor shall adopt and apply data security standards and procedures that comply with all
applicable federal, state, and local laws, regulations, and rules.
(b) Duty to Report: The Contractor shall report a suspected or confirmed security breach to the local Department of
Social Services/Human Services Contract Administrator within twenty-four (24) hours after the breach is first
discovered, provided that the Contractor shall report a breach involving Social Security Administration data or
Internal Revenue Service data within one (1) hour after the breach is first discovered.
(c) Cost Borne by Contractor: If any applicable federal, state, or local law, regulation, or rule requires the Contractor
to give written notice of a security breach to affected persons, the Contractor shall bear the cost of the notice.
Trafficking Victims Protection Act of 2000: The Contractor will comply with the requirements of Section 106(g) of the
Trafficking Victims Protection Act of 2000, as amended (22 U.S.C. 7104).
Executive Order # 24: It is unlawful for any vendor, contractor, subcontractor or supplier of the state to make gifts or to give
favors to any state employee. For additional information regarding the specific requirements and exemptions, contractors
are encouraged to review Executive Order 24 and G.S. Sec. 133-32.
Confidentiality
Confidentiality: Any information, data, instruments, documents, studies or reports given to or prepared or assembled by the
Contractor under this agreement shall be kept as confidential and not divulged or made available to any individual or
organization without the prior written approval of the County. The Contractor acknowledges that in receiving, storing,
processing or otherwise dealing with any confidential information it will safeguard and not further disclose the information
except as otherwise provided in this contract.
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Oversight
Access to Persons and Records: The State Auditor shall have access to persons and records as a result of all contracts or
grants entered into by State agencies or political subdivisions in accordance with General Statute 147-64.7. Additionally, as
the State funding authority, the Department of Health and Human Services shall have access to persons and records as a
result of all contracts or grants entered into by State agencies or political subdivisions.
Record Retention: Records shall not be destroyed, purged or disposed of without the express written consent of the
Division. State basic records retention policy requires all grant records to be retained for a minimum of five years or until all
audit exceptions have been resolved, whichever is longer. If the contract is subject to federal policy and regulations, record
retention may be longer than five years since records must be retained for a period of three years following submission of the
final Federal Financial Status Report, if applicable, or three years following the submission of a revised final Federal
Financial Status Report. Also, if any litigation, claim, negotiation, audit, disallowance action, or other action involving this
Contract has been started before expiration of the five-year retention period described above, the records must be retained
until completion of the action and resolution of all issues which arise from it, or until the end of the regular five-year period
described above, whichever is later. The record retention period for Temporary Assistance for Needy Families (TANF) and
MEDICAID and Medical Assistance grants and programs must be retained for a minimum of ten years.
Warranties and Certifications
Date and Time Warranty: The Contractor warrants that the product(s) and service(s) furnished pursuant to this contract
(“product” includes, without limitation, any piece of equipment, hardware, firmware, middleware, custom or commercial
software, or internal components, subroutines, and interfaces therein) that perform any date and/or time data recognition
function, calculation, or sequencing will support a four digit year format and will provide accurate date/time data and leap
year calculations. This warranty shall survive the termination or expiration of this contract.
Certification Regarding Collection of Taxes: G.S. 143-59.1 bars the Secretary of Administration from entering into contracts
with vendors that meet one of the conditions of G.S. 105-164.8(b) and yet refuse to collect use taxes on sales of tangible
personal property to purchasers in North Carolina. The conditions include: (a) maintenance of a retail establishment or
office; (b) presence of representatives in the State that solicit sales or transact business on behalf of the vendor; and (c)
systematic exploitation of the market by media-assisted, media-facilitated, or media-solicited means. The Contractor certifies
that it and all of its affiliates (if any) collect all required taxes.
E-Verify
Pursuant to G.S. 143-48.5 and G.S. 147-33.95(g), the undersigned hereby certifies that the Contractor named below, and the
Contractor’s subcontractors, complies with the requirements of Article 2 of Chapter 64 of the NC General Statutes, including
the requirement for each employer with more than 25 employees in North Carolina to verify the work authorization of its
employees through the federal E-Verify system." E-Verify System Link: www.uscis.gov
Miscellaneous
Choice of Law: The validity of this contract and any of its terms or provisions, as well as the rights and duties of the parties
to this contract, are governed by the laws of North Carolina. The Contractor, by signing this contract, agrees and submits,
solely for matters concerning this Contract, to the exclusive jurisdiction of the courts of North Carolina and agrees, solely for
such purpose, that the exclusive venue for any legal proceedings shall be the county is which the contract originated. The
place of this contract and all transactions and agreements relating to it, and their situs and forum, shall be the county where
the contract originated, where all matters, whether sounding in contract or tort, relating to the validity, construction,
interpretation, and enforcement shall be determined.
Amendment: This contract may not be amended orally or by performance. Any amendment must be made in written form
and executed by duly authorized representatives of the County and the Contractor.
Severability: In the event that a court of competent jurisdiction holds that a provision or requirement of this contract
violates any applicable law, each such provision or requirement shall continue to be enforced to the extent it is not in
violation of law or is not otherwise unenforceable and all other provisions and requirements of this contract shall remain in
full force and effect.
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Headings: The Section and Paragraph headings in these General Terms and Conditions are not material parts of the
agreement and should not be used to construe the meaning thereof.
Time of the Essence: Time is of the essence in the performance of this contract.
Key Personnel: The Contractor shall not replace any of the key personnel assigned to the performance of this contract
without the prior written approval of the County. The term “key personnel” includes any and all persons identified as such
in the contract documents and any other persons subsequently identified as key personnel by the written agreement of the
parties.
Care of Property: The Contractor agrees that it shall be responsible for the proper custody and care of any property
furnished to it for use in connection with the performance of this contract and will reimburse the County for loss of, or
damage to, such property. At the termination of this contract, the Contractor shall contact the County for instructions as to
the disposition of such property and shall comply with these instructions.
Travel Expenses: Reimbursement to the Contractor for travel mileage, meals, lodging and other travel expenses incurred in
the performance of this contract shall not exceed the rates established in County policy.
Sales/Use Tax Refunds: If eligible, the Contractor and all subcontractors shall: (a) ask the North Carolina Department of
Revenue for a refund of all sales and use taxes paid by them in the performance of this contract, pursuant to G.S. 105-
164.14; and (b) exclude all refundable sales and use taxes from all reportable expenditures before the expenses are entered
in their reimbursement reports.
Advertising: The Contractor shall not use the award of this contract as a part of any news release or commercial advertising.
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ATTACHMENT B – Scope of Work Federal Tax Id. 56-135 0472
STATE OF NORTH CAROLINA )
)
) CONTRACT FOR LEGAL SERVICES
)
COUNTY OF Person )
THIS CONTRACT made and entered into this the 1st day of July, 2016, by and
between the Person County Commissioners, party of the first part, and Walter B. Cates,
Attorney, party of the second part;
W I T N E S S E T H :
The parties hereby agree that the party of the second part shall provide legal
services to the party of the first part pursuant to the following mutual covenants:
1. This Contract shall begin July 1, 2016, and unless sooner terminated by 30
days’ notice of either party shall exist and continue through June 30, 2017.
2. Said party of the second part, upon reasonable notice, is to be available for
consultation, legal advice and for representation as requested by the Child Support
Enforcement Agency on all legal matters arising from the duties of the party of the first
part under Sections 128 through 140 of Chapter 110 of the North Carolina General
Statutes and Title 42 of the United States Code, Sections 651 through 660 and the
federal regulations lawfully promulgated pursuant thereto.
3. Said party of the second part, agrees to comply with all the requirements of
Sections 128 through 140 of Chapter 110 of the North Carolina General Statutes, Title
42 of the United States Code, Sections 651 through 660, and the regulations
promulgated pursuant thereto relating to the performance of program legal services
including, but not limited to, maintaining such records as are required by the party of the
first part, to make said records available for federal or state audit if required, and to
make financial, statistical, and program progress reports as are required.
4. For his services under this contract, the party of the first part agrees to pay
the party of the second part seventy-five dollars ($75.00) per hour for out of court time
and seventy-five dollars ($75.00) per hour for in court time for each hour spent by the
party of the second part providing legal services under the Child Support Enforcement
Program. Such hourly rate shall encompass all expenses, including, but not limited to,
those for salary, supplies, office space, heating and maintenance for office space,
telephone service, long-distance telephone calls, and travel. The party of the second
part is not to be reimbursed for any extraordinary expense incident to performing the
services included under this agreement; except, that the party of the first part agrees to
pay all court costs and filing fees which are required to be paid in conjunction with
services provided by the attorney under this agreement.
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5. It is specifically agreed that the party of the second part is an independent
contractor and the party of the second part shall perform the services herein provided
according to his own judgment and method and shall not be subject to the control of the
party of the first part except as to the result of his work.
6. The party of the second part shall not under any circumstance be considered
an employee of the party of the first part. The party of the first part shall not withhold
federal or state taxes from sums to be paid to the party of the second part pursuant to
this agreement.
IN TESTIMONY WHEREOF, said parties have executed this contract in triplicate
originals, one of which is to be retained by the party of the first part, one of which is to
be retained by the parties of the second part, and one of which is to be filed with Child
Support Enforcement Section, Division of Social Services of the Department of Human
Resources, Raleigh, North Carolina.
Walter B. Cates, Attorney At Law
____________________________ _________________________
Signature Date
David Newell, Sr.
____________________________ _________________________
Chairman, County Commissioners Date
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ATTACHMENT C
CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS
AND CERTIFICATION REGARDING NONDISCRIMINATION
Person County Department of Social Services
I. By execution of this Agreement the Contractor certifies that it will provide a drug-free workplace by:
A. Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession or use of a controlled substance is prohibited in the Contractor’s workplace and specifying the actions that will be taken against employees for violation of
such prohibition;
B. Establishing a drug-free awareness program to inform employees about: (1) The dangers of drug abuse in the workplace; (2) The Contractor’s policy of maintaining a drug-free workplace; (3) Any available drug counseling, rehabilitation, and employee assistance programs; and
(4) The penalties that may be imposed upon employees for drug abuse violations
occurring in the workplace;
C. Making it a requirement that each employee be engaged in the performance of the agreement be given a copy of the statement required by paragraph (A); D. Notifying the employee in the statement required by paragraph (A) that, as a condition of employment under the agreement, the employee will:
(1) Abide by the terms of the statement; and
(2) Notify the employer of any criminal drug statute conviction for a violation occurring in the workplace no later than five days after such conviction;
E. Notifying the County within ten days after receiving notice under subparagraph (D)(2) from an employee or otherwise receiving actual notice of such conviction; F. Taking one of the following actions, within 30 days of receiving notice under
subparagraph (D)(2), with respect to any employee who is so convicted:
(1) Taking appropriate personnel action against such an employee, up to and including termination; or (2) Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State, or local health, law enforcement, or other appropriate agency; and
Making a good faith effort to continue to maintain a drug-free workplace through
implementation of paragraphs (A), (B), (C), (D), (E), and (F).
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The site(s) for the performance of work done in connection with the specific agreement are
listed below:
36 Court Street, Roxboro, NC 27573
Contractor will inform the County of any additional sites for performance of work under this agreement. False certification or violation of the certification shall be grounds for suspension of payment,
suspension or termination of grants, or government-wide Federal suspension or debarment
45 C.F.R. Section 82.510. Section 4 CFR Part 85, Section 85.615 and 86.620.
Certification Regarding Nondiscrimination
The Vendor certifies that it will comply with all Federal statutes relating to nondiscrimination.
These include but are not limited to: (a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352)
which prohibits discrimination on the basis of race, color or national origin; (b) Title IX of the
Education Amendments of 1972, as amended (20 U.S.C. §§1681-1683, and 1685-1686), which
prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as
amended (29 U.S.C. §794), which prohibits discrimination on the basis of handicaps; (d) the Age
Discrimination Act of 1975, as amended (42 U.S.C. §§6101-6107), which prohibits
discrimination on the basis of age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L.
92-255), as amended, relating to nondiscrimination on the basis of drug abuse; (f) the
Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of
1970 (P.L. 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or
alcoholism; (g) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. §§3601 et seq.), as
amended, relating to nondiscrimination in the sale, rental or financing of housing; (h) the Food
Stamp Act and USDA policy, which prohibit discrimination on the basis of religion and political
beliefs; and (i) the requirements of any other nondiscrimination statutes which may apply to this
Agreement.
Walter B. Cates, Attorney At Law
____________________________ _________________________
Signature Date
David Newell, Sr.
____________________________ _________________________
Chairman, County Commissioners Date
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ATTACHMENT D:
CONFLICT OF INTEREST
The Board of Directors/Trustees or other governing persons, officers, employees or agents are to avoid
any conflict of interest, even the appearance of a conflict of interest. The Organization‘s Board of
Directors/Trustees or other governing body, officers, staff and agents are obligated to always act in the
best interest of the organization. This obligation requires that any Board member or other governing
person, officer, employee or agent, in the performance of Organization duties, seek only the furtherance
of the Organization mission. At all times, Board members or other governing persons, officers, employees
or agents, are prohibited from using their job title, the Organization's name or property, for private profit or
benefit.
A. The Board members or other governing persons, officers, employees, or agents of the Organization
should neither solicit nor accept gratuities, favors, or anything of monetary value from current or potential
contractors/vendors, persons receiving benefits from the Organization or persons who may benefit from
the actions of any Board member or other governing person, officer, employee or agent. This is not
intended to preclude bona-fide Organization fund raising-activities.
B. A Board or other governing body member may, with the approval of Board or other governing body,
receive honoraria for lectures and other such activities while not acting in any official capacity for the
Organization. Officers may, with the approval of the Board or other governing body, receive honoraria for
lectures and other such activities while on personal days, compensatory time, annual leave, or leave
without pay. Employees may, with the prior written approval of their supervisor, receive honoraria for
lectures and other such activities while on personal days, compensatory time, annual leave, or leave
without pay. If a Board or other governing body member, officer, employee or agent is acting in any
official capacity, honoraria received in connection with activities relating to the Organization are to be paid
to the Organization.
C. No Board member or other governing person, officer, employee, or agent of the Organization shall
participate in the selection, award, or administration of a purchase or contract with a vendor where, to his
knowledge, any of the following has a financial interest in that purchase or contract:
1. The Board member or other governing person, officer, employee, or agent;
2. Any member of their family by whole or half blood, step or personal relationship or relative-in-law;
3. An organization in which any of the above is an officer, director, or employee;
4. A person or organization with whom any of the above individuals is negotiating or has any
arrangement concerning prospective employment or contracts.
D. Duty to Disclosure -- Any conflict of interest, potential conflict of interest, or the appearance of a
conflict of interest is to be reported to the Board or other governing body or one’s supervisor immediately.
E. Board Action -- When a conflict of interest is relevant to a matter requiring action by the Board of
Directors/Trustees or other governing body, the Board member or other governing person, officer,
employee, or agent (person(s)) must disclose the existence of the conflict of interest and be given the
opportunity to disclose all material facts to the Board and members of committees with governing board
delegated powers considering the possible conflict of interest. After disclosure of all material facts, and
after any discussion with the person, he/she shall leave the governing board or committee meeting while
the determination of a conflict of interest is discussed and voted upon. The remaining board or committee
members shall decide if a conflict of interest exists. In addition, the person(s) shall not participate in the
final deliberation or decision regarding the matter under consideration and shall leave the meeting during
the discussion of and vote of the Board of Directors/Trustees or other governing body.
F. Violations of the Conflicts of Interest Policy -- If the Board of Directors/Trustees or other governing
body has reasonable cause to believe a member, officer, employee or agent has failed to disclose actual
or possible conflicts of interest, it shall inform the person of the basis for such belief and afford the person
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an opportunity to explain the alleged failure to disclose. If, after hearing the person's response and after
making further investigation as warranted by the circumstances, the Board of Directors/Trustees or other
governing body determines the member, officer, employee or agent has failed to disclose an actual or
possible conflict of interest, it shall take appropriate disciplinary and corrective action.
G. Record of Conflict -- The minutes of the governing board and all committees with board delegated
powers shall contain:
1. The names of the persons who disclosed or otherwise were found to have an actual or possible
conflict of interest, the nature of the conflict of interest, any action taken to determine whether a
conflict of interest was present, and the governing board's or committee's decision as to whether
a conflict of interest in fact existed.
2. The names of the persons who were present for discussions and votes relating to the transaction
or arrangement that presents a possible conflict of interest, the content of the discussion,
including any alternatives to the transaction or arrangement, and a record of any votes taken in
connection with the proceedings.
NOTARIZED CONFLICT OF INTEREST POLICY
Walter B. Cates
_________________________________ _________________________
Signature Date
NORTH CAROLINA
PERSON COUNTY
I, __________________________, a Notary Public of said County and State do hereby certify that Walter B. Cates,
Attorney at Law, personally appeared before me this date and acknowledged the due execution of the foregoing
agreement for the purposes therein expressed and by that authority duly given and as the act of the Organization,
affirmed that the foregoing Conflict of Interest Policy was adopted by the Board of Directors/Trustees or other
governing body in a meeting held on the __________ day of ___________, _________.
Sworn to and subscribed before me this _________ day of ______________________, 2016.
___________________________
Notary Public
My Commission expires: __________________
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ATTACHMENT E – OVERDUE TAXES
______________, 2016
To: Person County Department of Social Services
Certification:
I, Walter B. Cates, certify that I do not have any overdue tax debts, as defined by N.C.G.S. 105-243.1, at the
federal, State, or local level. I further understand that any person who makes a false statement in violation of
N.C.G.S. 143C-6-23(c) is guilty of a criminal offense punishable as provided by N.C.G.S.) 143C-10-1b.
Sworn Statement:
I, Walter B. Cates, being duly sworn, say that the foregoing certification is true, accurate and complete to the
best of my knowledge and was made and subscribed by me. I also acknowledge and understand that any
misuse of State funds will be reported to the appropriate authorities for further action.
Walter B. Cates, Attorney At Law
____________________________ _________________________
Signature Date
NORTH CAROLINA
PERSON COUNTY
Sworn to and subscribed before me this _________ day of ______________________, 2016.
___________________________
Notary Public
My Commission expires: __________________
____________________
1 G.S. 105-243.1 defines: Overdue tax debt. – Any part of a tax debt that remains unpaid 90 days or more after the notice of final
assessment was mailed to the taxpayer. The term does not include a tax debt, however, if the taxpayer entered into an installment
agreement for the tax debt under G.S. 105-237 within 90 days after the notice of final assessment was mailed and has not failed to
make any payments due under the installment agreement.”
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ATTACHMENT G
Person County Department of Social Services
Certification Regarding Lobbying
Certification for Contracts, Grants, Loans and Cooperative Agreements
The undersigned certifies, to the best of his or her knowledge and belief, that:
(1) No Federal appropriated funds have been paid or will be paid by or on behalf of the undersigned, to any
person for influencing or attempting to influence an officer or employee of any Federal, state or local
government agency, a Member of Congress, a Member of the General Assembly, an officer or employee of
Congress, an officer or employee of the General Assembly, an employee of a Member of Congress, or an
employee of a Member of the General Assembly in connection with the awarding of any Federal or state
contract, the making of any Federal or state grant, the making of any Federal or state loan, the entering into
of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any
Federal or state contract, grant, loan, or cooperative agreement.
(2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for
influencing or attempting to influence an officer or employee of any Federal, state or local government
agency, a Member of Congress, a Member of the General Assembly, an officer or employee of Congress,
an officer or employee of the General Assembly, an employee of a Member of Congress, or an employee of
a Member of the General Assembly in connection with the awarding of any Federal or state contract, the
making of any Federal or state grant, the making of any Federal or state loan, the entering into of any
cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any
Federal or state contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit
Standard
Form LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions.
(3) The undersigned shall require that the language of this certification be included in the award documents for
all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and
cooperative agreements) and that all subrecipients shall certify and disclose accordingly.
(4) This certification is a material representation of fact upon which reliance was placed when this transaction
was made or entered into. Submission of this certification is a prerequisite for making or entering into this
transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required
certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each
such failure.
Notwithstanding other provisions of federal OMB Circulars-CFR Title 2, Grants and Agreements, Part 200, costs
associated with the following activities are unallowable:
Paragraph A.
(1) Attempts to influence the outcomes of any Federal, State, or local election, referendum, initiative, or
similar procedure, through in kind or cash contributions, endorsements, publicity, or similar activity;
(2) Establishing, administering, contributing to, or paying the expenses of a political party, campaign, political
action committee, or other organization established for the purpose of influencing the outcomes of
elections;
(3) Any attempt to influence: (i) The introduction of Federal or State legislation; or (ii) the enactment or
modification of any pending Federal or State legislation through communication with any member or
employee of the Congress or State legislature (including efforts to influence State or local officials to
engage in similar lobbying activity), or with any Government official or employee in connection with a
decision to sign or veto enrolled legislation;
(4) Any attempt to influence: (i) The introduction of Federal or State legislation; or (ii) the enactment or
modification of any pending Federal or State legislation by preparing, distributing or using publicity or
propaganda, or by urging members of the general public or any segment thereof to contribute to or
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participate in any mass demonstration, march, rally, fundraising drive, lobbying campaign or letter writing
or telephone campaign; or
(5) Legislative liaison activities, including attendance at legislative sessions or committee hearings, gathering
information regarding legislation, and analyzing the effect of legislation, when such activities are carried on
in support of or in knowing preparation for an effort to engage in unallowable lobbying.
The following activities as enumerated in Paragraph B are excepted from the coverage of Paragraph A:
Paragraph B.
(1) Providing a technical and factual presentation of information on a topic directly related to the performance
of a grant, contract or other agreement through hearing testimony, statements or letters to the Congress or a
State legislature, or subdivision, member, or cognizant staff member thereof, in response to a documented
request (including a Congressional Record notice requesting testimony or statements for the record at a
regularly scheduled hearing) made by the recipient member, legislative body or subdivision, or a cognizant
staff member thereof; provided such information is readily obtainable and can be readily put in deliverable
form; and further provided that costs under this section for travel, lodging or meals are unallowable unless
incurred to offer testimony at a regularly scheduled Congressional hearing pursuant to a written request for
such presentation made by the Chairman or Ranking Minority Member of the Committee or Subcommittee
conducting such hearing.
(2) Any lobbying made unallowable by subparagraph A (3) to influence State legislation in order to directly
reduce the cost, or to avoid material impairment of the organization's authority to perform the grant,
contract, or other agreement.
(3) Any activity specifically authorized by statute to be undertaken with funds from the grant, contract, or other
agreement.
Paragraph C.
(1) When an organization seeks reimbursement for indirect costs, total lobbying costs shall be separately
identified in the indirect cost rate proposal, and thereafter treated as other unallowable activity costs in
accordance with the procedures of subparagraph B.(3).
(2) Organizations shall submit, as part of the annual indirect cost rate proposal, a certification that the
requirements and standards of this paragraph have been complied with.
(3) Organizations shall maintain adequate records to demonstrate that the determination of costs as being
allowable or unallowable pursuant to this section complies with the requirements of this Circular.
(4) Time logs, calendars, or similar records shall not be required to be created for purposes of complying with
this paragraph during any particular calendar month when: (1) the employee engages in lobbying (as
defined in subparagraphs (a) and (b)) 25 percent or less of the employee's compensated hours of
employment during that calendar month, and (2) within the preceding five-year period, the organization has
not materially misstated allowable or unallowable costs of any nature, including legislative lobbying costs.
When conditions (1) and (2) are met, organizations are not required to establish records to support the
allowability of claimed costs in addition to records already required or maintained. Also, when conditions
(1) and (2) are met, the absence of time logs, calendars, or similar records will not serve as a basis for
disallowing costs by contesting estimates of lobbying time spent by employees during a calendar month.
(5) Agencies shall establish procedures for resolving in advance, in consultation with OMB, any significant
questions or disagreements concerning the interpretation or application of this section. Any such advance
resolution shall be binding in any subsequent settlements, audits or investigations with respect to that grant
or contract for purposes of interpretation of this Circular; provided, however, that this shall not be
construed to prevent a contractor or grantee from contesting the lawfulness of such a determination.
Paragraph D.
Executive lobbying costs. Costs incurred in attempting to improperly influence either directly or indirectly, an
employee or officer of the Executive Branch of the Federal Government to give consideration or to act
regarding a sponsored agreement or a regulatory matter are unallowable. Improper influence means any
influence that induces or tends to induce a Federal employee or officer to give consideration or to act regarding
a federally sponsored agreement or regulatory matter on any basis other than the merits of the matter.
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Walter B. Cates, Attorney At Law
____________________________ _________________________
Signature Date
David Newell, Sr.
____________________________ _________________________
Chairman, County Commissioners Date
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ATTACHMENT H
PERSON COUNTY DEPARTMENT OF SOCIAL SERVICES
CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY
AND VOLUNTARY EXCLUSION-LOWER TIER COVERED TRANSACTIONS
Instructions for Certification
1. By signing and submitting this proposal, the prospective lower tier participant is providing the
certification set out below.
2. The certification in this clause is a material representation of the fact upon which reliance was
placed when this transaction was entered into. If it is later determined that the prospective lower
tier participant knowingly rendered an erroneous certification, in addition to other remedies
available to the Federal Government, the department or agency with which this transaction
originated may pursue available remedies, including suspension and/or debarment.
3. The prospective lower tier participant will provide immediate written notice to the person to
whom the proposal is submitted if at any time the prospective lower tier participant learns that its
certification was erroneous when submitted or has become erroneous by reason of changed
circumstances.
4. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered
transaction," "participant," "person," "primary covered transaction," "principal," "proposal," and
"voluntarily excluded," as used in this clause, have the meanings set out in the Definitions and
Coverage sections of rules implementing Executive Order 12549. You may contact the person to
which this proposal is submitted for assistance in obtaining a copy of those regulations.
5. The prospective lower tier participant agrees by submitting this proposal that, should the
proposed covered transaction be entered into, it shall not knowingly enter any lower tier covered
transaction with a person who is debarred, suspended, determined ineligible or voluntarily
excluded from participation in this covered transaction unless authorized by the department or
agency with which this transaction originated.
6. The prospective lower tier participant further agrees by submitting this proposal that it will
include this clause titled "Certification Regarding Debarment, Suspension, Ineligibility and
Voluntary Exclusion - Lower Tier Covered Transaction," without modification, in all lower tier
covered transactions and in all solicitations for lower tier covered transactions.
7. A participant in a covered transaction may rely upon a certification of a prospective
participant in a lower tier covered transaction that it is not debarred, suspended, ineligible, or
voluntarily excluded from covered transaction, unless it knows that the certification is erroneous.
A participant may decide the method and frequency of which it determines the eligibility of its
principals. Each participant may, but is not required to, check the Nonprocurement List.
8. Nothing contained in the foregoing shall be construed to require establishment of a system of
records in order to render in good faith the certification required by this clause. The knowledge
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and information of a participant is not required to exceed that which is normally possessed by a
prudent person in the ordinary course of business dealings.
9. Except for transactions authorized in paragraph 5 of these instructions, if a participant in a
covered transaction knowingly enters into a lower tier covered transaction with a person who is
suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in
addition to other remedies available to the Federal Government, the department or agency with
which this transaction originated may pursue available remedies, including suspension, and/or
debarment.
Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower
Tier Covered Transactions
(1) The prospective lower tier participant certifies, by submission of this proposal, that neither it
nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or
voluntarily excluded from participation in this transaction by any Federal department or agency.
(2) Where the prospective lower tier participant is unable to certify to any of the statements in this
certification, such prospective participant shall attach an explanation to this proposal.
Walter B. Cates, Attorney At Law
____________________________ _________________________
Signature Date
David Newell, Sr.
____________________________ _________________________
Chairman, County Commissioners Date
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ATTACHMENT I
PERSON COUNTY
DEPARTMENT OF SOCIAL SERVICES
BUSINESS ASSOCIATE ADDENDUM
This Agreement is made effective the 1st day of July, 2016, by and between Person County
Department of Social Services (“Covered Entity”) and Walter B. Cates, Attorney at Law
(“Business Associate”) (collectively the “Parties”).
1. BACKGROUND
a. Covered Entity and Business Associate are parties to a contract entitled Legal Services
Contract (the “Contract”), whereby Business Associate agrees to perform certain services for or
on behalf of Covered Entity.
b. Covered Entity is an organizational unit of Person County as the Person County Department
of Social Services (DSS) as a health care component for purposes of the HIPAA Privacy Rule.
c. The relationship between Covered Entity and Business Associate is such that the Parties
believe Business Associate is or may be a “business associate” within the meaning of the HIPAA
Privacy Rule.
d. The Parties enter into this Business Associate Addendum to the Contract with the intention of
complying with the HIPAA Privacy Rule provision that a covered entity may disclose protected
health information to a business associate, and may allow a business associate to create or
receive protected heath information on its behalf, if the covered entity obtains satisfactory
assurances that the business associate will appropriately safeguard the information.
2. DEFINITIONS
Unless some other meaning is clearly indicated by the context, the following terms shall have the
following meaning in this Agreement:
a. “HIPAA” means the Administrative Simplification Provisions, Sections 261 through 264, of
the federal Health Insurance Portability and Accountability Act of 1996, Public Law 104-191.
b. “Individual” shall have the same meaning as the term “individual” in 45 CFR160.103 and
shall include a person who qualifies as a personal representative in accordance with 45 CFR
164.502(g).
c. “Privacy Rule” shall mean the Standards for Privacy of Individually Identifiable Health
Information at 45 CFR part 160 and part 164, subparts A and E.
d. “Protected Health Information” shall have the same meaning as the term “protected health
information” in 45 CFR 160.103, limited to the information created or received by Business
Associate from or on behalf of Covered Entity.
e. “Required By Law” shall have the same meaning as the term “required by law” in 45 CFR
164.103.
f. “Secretary” shall mean the Secretary of the United States Department of Health and Human
Services or his designee.
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g. Unless otherwise defined in this Agreement, terms used herein shall have the same meaning
as those terms have in the Privacy Rule.
3. OBLIGATIONS OF BUSINESS ASSOCIATE
a. Business Associate agrees to not use or disclose Protected Health Information other than as
permitted or required by this Agreement or as Required By Law.
b. Business Associate agrees to use appropriate safeguards to prevent use or disclosure of the
Protected Health Information other than as provided for by this Agreement.
c. Business Associate agrees to mitigate, to the extent practicable, any harmful effect that is
known to Business Associate of a use or disclosure of Protected Health Information by Business
Associate in violation of the requirements of this Agreement.
d. Business Associate agrees to report to Covered Entity any use or disclosure of the Protected
Health Information not provided for by this Agreement of which it becomes aware.
e. Business Associate agrees to ensure that any agent, including a subcontractor, to whom it
provides Protected Health Information received from, or created or received by Business
Associate on behalf of Covered Entity agrees to the same restrictions and conditions that apply
through this Agreement to Business Associate with respect to such information.
f. Business Associate agrees to provide access, at the request of Covered Entity, to Protected
Health Information in a Designated Record Set to Covered Entity or, as directed by Covered
Entity, to an Individual in order to meet the requirements under 45 CFR 164.524.
g. Business Associate agrees, at the request of the Covered Entity, to make any amendment(s) to
Protected Health Information in a Designated Record Set that the Covered Entity directs or
agrees to pursuant to 45 CFR 164.526.
h. Unless otherwise prohibited by law, Business Associate agrees to make internal practices,
books, and records, including policies and procedures and Protected Health Information, relating
to the use and disclosure of Protected Health Information received from, or created or received
by Business Associate on behalf of Covered Entity, available to the Covered Entity, or to the
Person County Department of Social Services, in a time and manner designated by the
Secretary, for purposes of determining Covered Entity's compliance with the Privacy Rule.
i. Business Associate agrees to document such disclosures of Protected Health Information and
information related to such disclosures as would be required for Covered Entity to respond to a
request by an Individual for an accounting of disclosures of Protected Health Information in
accordance with 45 CFR 164.528, and to provide this information to Covered Entity or an
Individual to permit such a response.
4. PERMITTED USES AND DISCLOSURES
a. Except as otherwise limited in this Agreement or by other applicable law or agreement, if the
Contract permits, Business Associate may use or disclose Protected Health Information to
perform functions, activities, or services for, or on behalf of, Covered Entity as specified in the
Contract, provided that such use or disclosure:
1) would not violate the Privacy Rule if done by Covered Entity; or
2) would not violate the minimum necessary policies and procedures of the Covered
Entity.
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b. Except as otherwise limited in this Agreement or by other applicable law or agreements, if the
Contract permits, Business Associate may use Protected Health Information as necessary for the
proper management and administration of the Business Associate or to carry out the legal
responsibilities of the Business Associate.
c. Except as otherwise limited in this Agreement or by other applicable law or agreements, if the
Contract permits, Business Associate may disclose Protected Health Information for the proper
management and administration of the Business Associate, provided that:
1) disclosures are Required By Law; or
2) Business Associate obtains reasonable assurances from the person to whom the
information is disclosed that it will remain confidential and will be used or further
disclosed only as Required By Law or for the purpose for which it was disclosed to the
person, and the person notifies the Business Associate of any instances of which it is
aware in which the confidentiality of the information has been breached.
d. Except as otherwise limited in this Agreement or by other applicable law or agreements, if the
Contract permits, Business Associate may use Protected Health Information to provide data
aggregation services to Covered Entity as permitted by 45 CFR 164.504(e)(2)(i)(B).
e. Notwithstanding the foregoing provisions, Business Associate may not use or disclose
Protected Health Information if the use or disclosure would violate any term of the Contract or
other applicable law or agreements.
5. TERM AND TERMINATION
a. Term. This Agreement shall be effective as of the effective date stated above and shall
terminate when the Contract terminates.
b. Termination for Cause. Upon Covered Entity's knowledge of a material breach by Business
Associate, Covered Entity may, at its option:
1) Provide an opportunity for Business Associate to cure the breach or end the violation,
and terminate this Agreement and services provided by Business Associate, to the extent
permissible by law, if Business Associate does not cure the breach or end the violation
within the time specified by Covered Entity;
2) Immediately terminate this Agreement and services provided by Business Associate,
to the extent permissible by law; or
3) If neither termination nor cure is feasible, report the violation to the Secretary as
provided in the Privacy Rule.
c. Effect of Termination.
1) Except as provided in paragraph (2) of this section or in the Contract or by other
applicable law or agreements, upon termination of this Agreement and services provided
by Business Associate, for any reason, Business Associate shall return or destroy all
Protected Health Information received from Covered Entity, or created or received by
Business Associate on behalf of Covered Entity. This provision shall apply to Protected
Health Information that is in the possession of subcontractors or agents of Business
Associate. Business Associate shall retain no copies of the Protected Health Information.
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2) In the event that Business Associate determines that returning or destroying the
Protected Health Information is not feasible, Business Associate shall provide to Covered
Entity notification of the conditions that make return or destruction not feasible. Business
Associate shall extend the protections of this Agreement to such Protected Health
Information and limit further uses and disclosures of such Protected Health Information
to those purposes that make the return or destruction infeasible, for so long as Business
Associate maintains such Protected Health Information.
6. GENERAL TERMS AND CONDITIONS
a. This Agreement amends and is part of the Contract.
b. Except as provided in this Agreement, all terms and conditions of the Contract shall remain in
force and shall apply to this Agreement as if set forth fully herein.
c. In the event of a conflict in terms between this Agreement and the Contract, the interpretation
that is in accordance with the Privacy Rule shall prevail. In the event that a conflict then
remains, the Contract terms shall prevail so long as they are in accordance with the Privacy Rule.
d. A breach of this Agreement by Business Associate shall be considered sufficient basis for
Covered Entity to terminate the Contract for cause.
Walter B. Cates, Attorney At Law
____________________________ _________________________
Signature Date
David Newell, Sr.
____________________________ _________________________
Chairman, County Commissioners Date
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Attachment M
State Certification
Contractor Certifications Required by North Carolina Law
Instructions
The person who signs this document should read the text of the statutes listed below and consult with
counsel and other knowledgeable persons before signing.
The text of Article 2 of Chapter 64 of the North Carolina General Statutes can be found online at:
http://www.ncga.state.nc.us/EnactedLegislation/Statutes/PDF/ByArticle/Chapter_64/Article_2.pdf
The text of G.S. 105-164.8(b) can be found online at:
http://www.ncga.state.nc.us/EnactedLegislation/Statutes/PDF/BySection/Chapter_105/GS_105-
164.8.pdf
The text of G.S. 143-48.5 (S.L. 2013-418, s. 2.(d)) can be found online at:
http://www.ncga.state.nc.us/Sessions/2013/Bills/House/PDF/H786v6.pdf
The text of G.S. 143-59.1 can be found online at:
http://www.ncga.state.nc.us/EnactedLegislation/Statutes/PDF/BySection/Chapter_143/GS_143-
59.1.pdf
The text of G.S. 143-59.2 can be found online at:
http://www.ncga.state.nc.us/EnactedLegislation/Statutes/PDF/BySection/Chapter_143/GS_143-
59.2.pdf
The text of G.S. 147-33.95(g) (S.L. 2013-418, s. 2.(e)) can be found online at:
http://www.ncga.state.nc.us/Sessions/2013/Bills/House/PDF/H786v6.pdf
Certifications
(1) Pursuant to G.S. 143-48.5 and G.S. 147-33.95(g), the undersigned hereby certifies that the
Contractor named below, and the Contractor’s subcontractors, complies with the requirements of
Article 2 of Chapter 64 of the NC General Statutes, including the requirement for each employer
with more than 25 employees in North Carolina to verify the work authorization of its employees
through the federal E-Verify system." E-Verify System Link: www.uscis.gov
Local government is specifically exempt from Article 2 of Chapter 64 of the North Carolina
General Statutes. However, local government is subject to and must comply with North Carolina
General Statute §153A-99.1., which states in part as follows:
Counties Must Use E-Verify. - Each county shall register and participate in E-Verify to verify the
work authorization of new employees hired to work in the United States.
(2) Pursuant to G.S. 143-59.1(b), the undersigned hereby certifies that the Contractor named below
is not an “ineligible Contractor” as set forth in G.S. 143-59.1(a) because:
(a) Neither the Contractor nor any of its affiliates has refused to collect the use tax levied
under Article 5 of Chapter 105 of the General Statutes on its sales delivered to North
Carolina when the sales met one or more of the conditions of G.S. 105-164.8(b); and
(b) [check one of the following boxes]
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Neither the Contractor nor any of its affiliates has incorporated or reincorporated
in a “tax haven country” as set forth in G.S. 143-59.1(c)(2) after December 31,
2001; or
The Contractor or one of its affiliates has incorporated or reincorporated in a “tax
haven country” as set forth in G.S. 143-59.1(c)(2) after December 31, 2001 but
the United States is not the principal market for the public trading of the stock of
the corporation incorporated in the tax haven country.
(3) Pursuant to G.S. 143-59.2(b), the undersigned hereby certifies that none of the Contractor’s
officers, directors, or owners (if the Contractor is an unincorporated business entity) has been
convicted of any violation of Chapter 78A of the General Statutes or the Securities Act of 1933 or
the Securities Exchange Act of 1934 within 10 years immediately prior to the date of the bid
solicitation.
(4) The undersigned hereby certifies further that:
(a) He or she is a duly authorized representative of the Contractor named below;
(b) He or she is authorized to make, and does hereby make, the foregoing certifications on
behalf of the Contractor; and
(c) He or she understands that any person who knowingly submits a false certification in
response to the requirements of G.S. 143-59.1 and -59.2 shall be guilty of a Class I
felony.
Contractor’s Name: Walter B. Cates
Signature of Contractor’s Authorized Agent
Date
Printed Name of Contractor’s Authorized Agent
Walter B. Cates
Title
Attorney at Law
Signature of Witness
Title
Printed Name of Witness
Date
The witness should be present when the Contractor’s Authorized Agent signs this certification and should
sign and date this document immediately thereafter.
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Attachment N
CERTIFICATION OF
ELIGIBILITY
Under the Iran
Divestment Act
Pursuant to G.S. 147-86.59, any person identified as engaging in investment activities in
Iran, determined by appearing on the Final Divestment List created by the State
Treasurer pursuant to G.S. 147-86.58, is ineligible to contract with the State of North
Carolina or any political subdivision of the State. The Iran Divestment Act of 2015, G.S.
147-86.55 et seq.* requires that each vendor, prior to contracting with the State certify,
and the undersigned on behalf of the Vendor does hereby certify, to the following:
1. that Walter B. Cates, Attorney At Law, is not identified on the Final
Divestment List of entities that the State Treasurer has determined engages in
investment activities in Iran;
2. that Walter B. Cates, Attorney At Law, shall not utilize on any contract with the
State agency any subcontractor that is identified on the Final Divestment List; and
3. that Walter B. Cates, Attorney At Law, is authorized to make this Certification.
Walter B. Cates, Attorney At Law
____________________________ _________________________
Signature Date
* Note: Enacted by Session Law 2015‐118 as G.S. 143C‐55 et seq., but has been renumbered for
codification at the direction of the Revisor of Statutes.
The State Treasurer’s Final Divestment List can be found on the State Treasurer’s website at the address:
https://www.nctreasurer.com/inside‐the‐department/OpenGovernment/Pages/Iran‐Divestment‐Act‐Resources.aspx
and will be updated every 180 days. For questions about the Department of State Treasurer’s Iran Divestment
Policy, please contact Meryl Murtagh at Meryl.Murtagh@nctreasurer.com or (919) 814‐3852.
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Contract # 1012 Fiscal Year Begins July 1, 2016 Ends June 30, 2017
This contract is hereby entered into by and between the Person County Department of Social
Services (the "County") and Julie A. Ramsey (the "Contractor") (referred to collectively as the
“Parties”). The Contractor’s federal tax identification number is 56-199 9585.
Contract Documents: This Contract consists of the following documents:
This contract
The General Terms and Conditions (Attachment A)
The Scope of Work, description of services, and rate (Attachment B)
Federal Certification Regarding Drug-Free Workplace & Certification Regarding Nondiscrimination (Attachment C)
Conflict of Interest (Attachment D)
No Overdue Taxes (Attachment E)
Federal Certification Regarding Lobbying (Attachment G)
Federal Certification Regarding Debarment (Attachment H)
HIPAA Business Associate Addendum (Attachment I)
State Certification (Attachment M)
Certification of Eligibility Under the Iran Divestment Act (Attachment N)
These documents constitute the entire agreement between the Parties and supersede all prior
oral or written statements or agreements.
Precedence among Contract Documents: In the event of a conflict between or among the
terms of the Contract Documents, the terms in the Contract Document with the highest relative
precedence shall prevail. The order of precedence shall be the order of documents as listed in
Paragraph 1, above, with the first-listed document having the highest precedence and the last-
listed document having the lowest precedence. If there are multiple Contract Amendments, the
most recent amendment shall have the highest precedence and the oldest amendment shall
have the lowest precedence.
Effective Period: This contract shall be effective on July 1, 2016 and shall terminate on
June 30, 2017. This contract must be twelve months or less.
Contractor’s Duties: The Contractor shall provide the services and in accordance with the
approved rate as described in Attachment B, Scope of Work.
County’s Duties: The County shall pay the Contractor in the manner and in the amounts
specified in the Contract Documents.
[ x ] a. There are no matching requirements from the Contractor.
[ ] b. The Contractor’s matching requirement is $__________, which shall consist of:
[ ] In-kind [ ] Cash [ ] Cash and In-kind [ ] Cash and/or In-kind
The contributions from the Contractor shall be sourced from non-federal funds.
The total contract amount including any Contractor match shall not exceed 1,000 hours
collectively for all attorneys under contract. Rate of compensation for Secondary Attorney
Julie A. Ramsey is $75 per hour.
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Reversion of Funds:
Any unexpended grant funds shall revert to the County Department of Social Services upon
termination of this contract.
Reporting Requirements:
Contractor shall comply with audit requirements as described in N.C.G.S. § 143C-6-22 & 23 and
OMB Circular- CFR Title 2 Grants and Agreements, Part 200, and shall disclose all information
required by 42 USC 455.104, or 42 USC 455.105, or 42 USC 455.106.
Payment Provisions:
Payment shall be made in accordance with the Contract Documents as described in the Scope
of Work, Attachment B.
Contract Administrators: All notices permitted or required to be given by one Party to the
other and all questions about the contract from one Party to the other shall be addressed and
delivered to the other Party’s Contract Administrator. The name, post office address, street
address, telephone number, fax number, and email address of the Parties’ respective initial
Contract Administrators are set out below. Either Party may change the name, post office
address, street address, telephone number, fax number, or email address of its Contract
Administrator by giving timely written notice to the other Party.
For the County: For the Contractor:
Wendy Bowman, Accounting Technician
Person County Department of Social Services Julie A. Ramsey, Attorney
P.O. Box 770 P.O. Box 3130
355B South Madison Boulevard 22 Court Street, Suite 200
Roxboro, NC 27573 Roxboro, NC 27573
(336) 599-8361 (336) 599-5004
Supplementation of Expenditure of Public Funds: The Contractor assures that funds
received pursuant to this contract shall be used only to supplement, not to supplant, the total
amount of federal, state and local public funds that the Contractor otherwise expends for
contract services and related programs. Funds received under this contract shall be used to
provide additional public funding for such services; the funds shall not be used to reduce the
Contractor’s total expenditure of other public funds for such services.
Disbursements: As a condition of this contract, the Contractor acknowledges and agrees to
make disbursements in accordance with the following requirements:
(a) Implement adequate internal controls over disbursements;
(b) Pre-audit all vouchers presented for payment to determine:
Validity and accuracy of payment
Payment due date
Adequacy of documentation supporting payment
Legality of disbursement
(c) Assure adequate control of signature stamps/plates;
(d) Assure adequate control of negotiable instruments; and
(e) Implement procedures to insure that account balance is solvent and reconcile the
account monthly.
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Outsourcing to Other Countries: The Contractor certifies that it has identified to the County
all jobs related to the contract that have been outsourced to other countries, if any. The
Contractor further agrees that it will not outsource any such jobs during the term of this contract
without providing notice to the County.
Federal Certifications: Individuals and Organizations receiving federal funds must ensure
compliance with certain certifications required by federal laws and regulations. The contractor is
hereby complying with Certifications regarding Nondiscrimination, Drug-Free Workplace
Requirements, Environmental Tobacco Smoke, Debarment, Suspension, Ineligibility and
Voluntary Exclusion Lower Tier Covered Transactions, and Lobbying. These assurances and
certifications are to be signed by the contractor’s authorized representative.
Signature Warranty: The undersigned represent and warrant that they are authorized to bind
their principals to the terms of this agreement.
Signature Warranty:
The undersigned represent and warrant that they are authorized to bind their principals to the terms of this
agreement.
The Contractor and the County have executed this contract in duplicate originals, with one original being retained by
each party.
Julie A. Ramsey, Attorney At Law
____________________________ _________________________
Signature Date
PERSON COUNTY
David Newell, Sr.
____________________________ _________________________
Chairman, County Commissioners Date
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
Act.
______________________________ ___________________________
Amy Wehrenberg, County Finance Director Date
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ATTACHMENT A
General Terms and Conditions
Relationships of the Parties
Independent Contractor: The Contractor is and shall be deemed to be an independent contractor in the performance of
this contract and as such shall be wholly responsible for the work to be performed and for the supervision of its employees.
The Contractor represents that it has, or shall secure at its own expense, all personnel required in performing the services
under this agreement. Such employees shall not be employees of, or have any individual contractual relationship with the
County.
Subcontracting: The Contractor shall not subcontract any of the work contemplated under this contract without prior written
approval from the County. Any approved subcontract shall be subject to all conditions of this contract. Only the
subcontractors specified in the contract documents are to be considered approved upon award of the contract. The County
shall not be obligated to pay for any work performed by any unapproved subcontractor. The Contractor shall be responsible
for the performance of all of its subcontractors.
Assignment: No assignment of the Contractor's obligations or the Contractor's right to receive payment hereunder shall be
permitted. However, upon written request approved by the issuing purchasing authority, the County may: Forward the
Contractor's payment check(s) directly to any person or entity designated by the Contractor, or Include any person or entity
designated by Contractor as a joint payee on the Contractor's payment check(s). In no event shall such approval and action
obligate the County to anyone other than the Contractor and the Contractor shall remain responsible for fulfillment of all
contract obligations.
Beneficiaries: Except as herein specifically provided otherwise, this contract shall inure to the benefit of and be binding
upon the parties hereto and their respective successors. It is expressly understood and agreed that the enforcement of the
terms and conditions of this contract, and all rights of action relating to such enforcement, shall be strictly reserved to the
County and the named Contractor. Nothing contained in this document shall give or allow any claim or right of action
whatsoever by any other third person. It is the express intention of the County and Contractor that any such person or entity,
other than the County or the Contractor, receiving services or benefits under this contract shall be deemed an incidental
beneficiary only.
Indemnity and Insurance
Indemnification: The Contractor agrees to indemnify and hold harmless the County and any of their officers, agents and
employees, from any claims of third parties arising out or any act or omission of the Contractor in connection with the
performance of this contract.
Insurance: During the term of the contract, the Contractor at its sole cost and expense shall provide commercial insurance
of such type and with such terms and limits as may be reasonably associated with the contract. As a minimum, the
Contractor shall provide and maintain the following coverage and limits:
Worker’s Compensation - The contractor shall provide and maintain Worker’s Compensation Insurance as required
by the laws of North Carolina, as well as employer’s liability coverage with minimum limits of $500,000.00, covering all
of Contractor’s employees who are engaged in any work under the contract. If any work is sublet, the Contractor shall
require the subcontractor to provide the same coverage for any of his employees engaged in any work under the
contract.
Commercial General Liability - General Liability Coverage on a Comprehensive Broad Form on an occurrence basis in
the minimum amount of $1,000,000.00 Combined Single Limit. (Defense cost shall be in excess of the limit of liability.)
Automobile Liability Insurance: The Contractor shall provide automobile liability insurance with a combined single
limit of $500,000.00 for bodily injury and property damage; a limit of $500,000.00 for uninsured/under insured
motorist coverage; and a limit of $2,000.00 for medical payment coverage. The Contractor shall provide this insurance
for all automobiles that are:
(a) owned by the Contractor and used in the performance of this contract;
(b) hired by the Contractor and used in the performance of this contract; and
(c) Owned by Contractor’s employees and used in performance of this contract (“non-owned vehicle insurance”).
Non-owned vehicle insurance protects employers when employees use their personal vehicles for work
purposes. Non-owned vehicle insurance supplements, but does not replace, the car-owner’s liability insurance.
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The Contractor is not required to provide and maintain automobile liability insurance on any vehicle – owned,
hired, or non-owned -- unless the vehicle is used in the performance of this contract.
(d) The insurance coverage minimums specified in subparagraph (a) are exclusive of defense costs.
(e) The Contractor understands and agrees that the insurance coverage minimums specified in subparagraph (a) are
not limits, or caps, on the Contractor’s liability or obligations under this contract.
(f) The Contractor may obtain a waiver of any one or more of the requirements in subparagraph (a) by
demonstrating that it has insurance that provides protection that is equal to or greater than the coverage and
limits specified in subparagraph (a). The County shall be the sole judge of whether such a waiver should be
granted.
(g) The Contractor may obtain a waiver of any one or more of the requirements in paragraph (a) by demonstrating
that it is self-insured and that its self-insurance provides protection that is equal to or greater than the coverage
and limits specified in subparagraph (a). The County shall be the sole judge of whether such a waiver should be
granted.
(h) Providing and maintaining the types and amounts of insurance or self-insurance specified in this paragraph is a
material obligation of the Contractor and is of the essence of this contract.
(i) The Contractor shall only obtain insurance from companies that are authorized to provide such coverage and
that are authorized by the Commissioner of Insurance to do business in the State of North Carolina. All such
insurance shall meet all laws of the State of North Carolina.
(j) The Contractor shall comply at all times with all lawful terms and conditions of its insurance policies and all
lawful requirements of its insurer.
(k) The Contractor shall require its subcontractors to comply with the requirements of this paragraph.
(l) The Contractor shall demonstrate its compliance with the requirements of this paragraph by submitting
certificates of insurance to the County before the Contractor begins work under this contract.
Transportation of Clients by Contractor:
The contractor will maintain Insurance requirements if required as noted under Article 7 Rule R2-36 of the North Carolina
Utilities Commission.
Default and Termination
Termination without Cause: The County may terminate this contract without cause by giving 30 days written notice to the
Contractor.
Termination for Cause: If, through any cause, the Contractor shall fail to fulfill its obligations under this contract in a timely
and proper manner, the County shall have the right to terminate this contract by giving written notice to the Contractor and
specifying the effective date thereof. In that event, all finished or unfinished deliverable items prepared by the Contractor
under this contract shall, at the option of the County, become its property and the Contractor shall be entitled to receive just
and equitable compensation for any satisfactory work completed on such materials, minus any payment or compensation
previously made. Notwithstanding the foregoing provision, the Contractor shall not be relieved of liability to the County for
damages sustained by the County by virtue of the Contractor’s breach of this agreement, and the County may withhold any
payment due the Contractor for the purpose of setoff until such time as the exact amount of damages due the County from
such breach can be determined. In case of default by the Contractor, without limiting any other remedies for breach
available to it, the County may procure the contract services from other sources and hold the Contractor responsible for any
excess cost occasioned thereby. The filing of a petition for bankruptcy by the Contractor shall be an act of default under this
contract.
Waiver of Default: Waiver by the County of any default or breach in compliance with the terms of this contract by the
Provider shall not be deemed a waiver of any subsequent default or breach and shall not be construed to be modification of
the terms of this contract unless stated to be such in writing, signed by an authorized representative of the County and the
Contractor and attached to the contract.
Availability of Funds: The parties to this contract agree and understand that the payment of the sums specified in this
contract is dependent and contingent upon and subject to the appropriation, allocation, and availability of funds for this
purpose to the County.
Force Majeure: Neither party shall be deemed to be in default of its obligations hereunder if and so long as it is prevented
from performing such obligations by any act of war, hostile foreign action, nuclear explosion, riot, strikes, civil insurrection,
earthquake, hurricane, tornado, or other catastrophic natural event or act of God.
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Survival of Promises: All promises, requirements, terms, conditions, provisions, representations, guarantees, and warranties
contained herein shall survive the contract expiration or termination date unless specifically provided otherwise herein, or
unless superseded by applicable Federal or State statutes of limitation.
Intellectual Property Rights
Copyrights and Ownership of Deliverables: All deliverable items produced pursuant to this contract are the exclusive
property of the County. The Contractor shall not assert a claim of copyright or other property interest in such deliverables.
Federal Intellectual Property Bankruptcy Protection Act: The Parties agree that the County shall be entitled to all rights and
benefits of the Federal Intellectual Property Bankruptcy Protection Act, Public Law 100-506, codified at 11 U.S.C. 365 (n)
and any amendments thereto.
Compliance with Applicable Laws
Compliance with Laws: The Contractor shall comply with all laws, ordinances, codes, rules, regulations, and licensing
requirements that are applicable to the conduct of its business, including those of federal, state, and local agencies having
jurisdiction and/or authority.
Title VI, Civil Rights Compliance: In accordance with Federal law and U.S. Department of Agriculture (USDA) and U.S.
Department of Health and Human Services (HHS) policy, this institution is prohibited from discriminating on the basis of
race, color, national origin, sex, age or disability. Under the Food Stamp Act and USDA policy, discrimination is prohibited
also on the basis of religion or political beliefs.
Equal Employment Opportunity: The Contractor shall comply with all federal and State laws relating to equal employment
opportunity.
Health Insurance Portability and Accountability Act (HIPAA): The Contractor agrees that, if the County determines that
some or all of the activities within the scope of this contract are subject to the Health Insurance Portability and Accountability
Act of 1996, P.L. 104-91, as amended (“HIPAA”), or its implementing regulations, it will comply with the HIPAA
requirements and will execute such agreements and practices as the County may require to ensure compliance.
(a) Data Security: The Contractor shall adopt and apply data security standards and procedures that comply with all
applicable federal, state, and local laws, regulations, and rules.
(b) Duty to Report: The Contractor shall report a suspected or confirmed security breach to the local Department of
Social Services/Human Services Contract Administrator within twenty-four (24) hours after the breach is first
discovered, provided that the Contractor shall report a breach involving Social Security Administration data or
Internal Revenue Service data within one (1) hour after the breach is first discovered.
(c) Cost Borne by Contractor: If any applicable federal, state, or local law, regulation, or rule requires the Contractor
to give written notice of a security breach to affected persons, the Contractor shall bear the cost of the notice.
Trafficking Victims Protection Act of 2000: The Contractor will comply with the requirements of Section 106(g) of the
Trafficking Victims Protection Act of 2000, as amended (22 U.S.C. 7104).
Executive Order # 24: It is unlawful for any vendor, contractor, subcontractor or supplier of the state to make gifts or to give
favors to any state employee. For additional information regarding the specific requirements and exemptions, contractors
are encouraged to review Executive Order 24 and G.S. Sec. 133-32.
Confidentiality
Confidentiality: Any information, data, instruments, documents, studies or reports given to or prepared or assembled by the
Contractor under this agreement shall be kept as confidential and not divulged or made available to any individual or
organization without the prior written approval of the County. The Contractor acknowledges that in receiving, storing,
processing or otherwise dealing with any confidential information it will safeguard and not further disclose the information
except as otherwise provided in this contract.
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Oversight
Access to Persons and Records: The State Auditor shall have access to persons and records as a result of all contracts or
grants entered into by State agencies or political subdivisions in accordance with General Statute 147-64.7. Additionally, as
the State funding authority, the Department of Health and Human Services shall have access to persons and records as a
result of all contracts or grants entered into by State agencies or political subdivisions.
Record Retention: Records shall not be destroyed, purged or disposed of without the express written consent of the
Division. State basic records retention policy requires all grant records to be retained for a minimum of five years or until all
audit exceptions have been resolved, whichever is longer. If the contract is subject to federal policy and regulations, record
retention may be longer than five years since records must be retained for a period of three years following submission of the
final Federal Financial Status Report, if applicable, or three years following the submission of a revised final Federal
Financial Status Report. Also, if any litigation, claim, negotiation, audit, disallowance action, or other action involving this
Contract has been started before expiration of the five-year retention period described above, the records must be retained
until completion of the action and resolution of all issues which arise from it, or until the end of the regular five-year period
described above, whichever is later. The record retention period for Temporary Assistance for Needy Families (TANF) and
MEDICAID and Medical Assistance grants and programs must be retained for a minimum of ten years.
Warranties and Certifications
Date and Time Warranty: The Contractor warrants that the product(s) and service(s) furnished pursuant to this contract
(“product” includes, without limitation, any piece of equipment, hardware, firmware, middleware, custom or commercial
software, or internal components, subroutines, and interfaces therein) that perform any date and/or time data recognition
function, calculation, or sequencing will support a four digit year format and will provide accurate date/time data and leap
year calculations. This warranty shall survive the termination or expiration of this contract.
Certification Regarding Collection of Taxes: G.S. 143-59.1 bars the Secretary of Administration from entering into contracts
with vendors that meet one of the conditions of G.S. 105-164.8(b) and yet refuse to collect use taxes on sales of tangible
personal property to purchasers in North Carolina. The conditions include: (a) maintenance of a retail establishment or
office; (b) presence of representatives in the State that solicit sales or transact business on behalf of the vendor; and (c)
systematic exploitation of the market by media-assisted, media-facilitated, or media-solicited means. The Contractor certifies
that it and all of its affiliates (if any) collect all required taxes.
E-Verify
Pursuant to G.S. 143-48.5 and G.S. 147-33.95(g), the undersigned hereby certifies that the Contractor named below, and the
Contractor’s subcontractors, complies with the requirements of Article 2 of Chapter 64 of the NC General Statutes, including
the requirement for each employer with more than 25 employees in North Carolina to verify the work authorization of its
employees through the federal E-Verify system." E-Verify System Link: www.uscis.gov
Miscellaneous
Choice of Law: The validity of this contract and any of its terms or provisions, as well as the rights and duties of the parties
to this contract, are governed by the laws of North Carolina. The Contractor, by signing this contract, agrees and submits,
solely for matters concerning this Contract, to the exclusive jurisdiction of the courts of North Carolina and agrees, solely for
such purpose, that the exclusive venue for any legal proceedings shall be the county is which the contract originated. The
place of this contract and all transactions and agreements relating to it, and their situs and forum, shall be the county where
the contract originated, where all matters, whether sounding in contract or tort, relating to the validity, construction,
interpretation, and enforcement shall be determined.
Amendment: This contract may not be amended orally or by performance. Any amendment must be made in written form
and executed by duly authorized representatives of the County and the Contractor.
Severability: In the event that a court of competent jurisdiction holds that a provision or requirement of this contract
violates any applicable law, each such provision or requirement shall continue to be enforced to the extent it is not in
violation of law or is not otherwise unenforceable and all other provisions and requirements of this contract shall remain in
full force and effect.
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Headings: The Section and Paragraph headings in these General Terms and Conditions are not material parts of the
agreement and should not be used to construe the meaning thereof.
Time of the Essence: Time is of the essence in the performance of this contract.
Key Personnel: The Contractor shall not replace any of the key personnel assigned to the performance of this contract
without the prior written approval of the County. The term “key personnel” includes any and all persons identified as such
in the contract documents and any other persons subsequently identified as key personnel by the written agreement of the
parties.
Care of Property: The Contractor agrees that it shall be responsible for the proper custody and care of any property
furnished to it for use in connection with the performance of this contract and will reimburse the County for loss of, or
damage to, such property. At the termination of this contract, the Contractor shall contact the County for instructions as to
the disposition of such property and shall comply with these instructions.
Travel Expenses: Reimbursement to the Contractor for travel mileage, meals, lodging and other travel expenses incurred in
the performance of this contract shall not exceed the rates established in County policy.
Sales/Use Tax Refunds: If eligible, the Contractor and all subcontractors shall: (a) ask the North Carolina Department of
Revenue for a refund of all sales and use taxes paid by them in the performance of this contract, pursuant to G.S. 105-
164.14; and (b) exclude all refundable sales and use taxes from all reportable expenditures before the expenses are entered
in their reimbursement reports.
Advertising: The Contractor shall not use the award of this contract as a part of any news release or commercial advertising.
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ATTACHMENT B – Scope of Work Federal Tax Id. 56-199 9585
NORTH CAROLINA
DUPLICATE ORIGINAL
PERSON COUNTY
LEGAL SERVICES AGREEMENT
THIS Agreement, made and entered into this the 1st day of July, 2016, by and between
the PERSON COUNTY DEPARTMENT OF SOCIAL SERVICES, hereinafter referred to as
Agency, and Julie A. Ramsey, Attorney at Law, hereinafter referred to as Attorney.
W I T N E S S E T H :
THAT WHEREAS, the Agency has determined that it has need for legal services and
consultation beyond those presently being provided by the county attorney;
AND WHEREAS, the Attorney is a member in a reputable law firm with an office in
Person County, North Carolina, and has expertise in the field of social services law, rules and
regulations, and the Agency is desirous of obtaining such legal services from said Attorney on a
continuing basis;
NOW, THEREFORE, it is hereby agreed that the Attorney shall provide legal services to
the Agency in the nature of consultations, interpretation of social services laws and regulations
and drafting of legal documents when necessary on the following terms and conditions:
1
The Attorney shall make herself available and on call to the Agency on a prompt basis for
the purposes herein above described until June 30, 2017. At the end of said period, the
arrangement herein described will be analyzed by the parties hereto to determine if same is
effective and fair to all parties concerned and revised or terminated accordingly as deemed
necessary.
2
The Agency shall pay for such legal services to the Attorney the sum of seventy-five
dollars ($75.00) per hour for out of court time and seventy-five dollars ($75.00) per hour for in
court time for each hour of legal services performed, same to be due and payable on or before the
10th of each month upon due submission by the Attorney of a statement of work detailing the
hours of work performed and the nature of such legal work.
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3
The Attorney will assist the Agency in maintaining records of the legal services provided
as same are necessary for the agency in filing its reports and funding statements.
4
It is understood and agreed that the legal services provided pursuant to this contract will
be in addition to those provided by the county attorney and not in substitution nor duplication of
such services by the county attorney.
5
It is specifically agreed that Attorney is an independent contractor and shall perform the
legal services herein provided according to her own judgment and method and shall not be
subject to control of the Agency except as to the result of her work.
6
The Attorney shall not under any circumstance be considered an employee of the
Agency. The Agency shall not withhold federal or state taxes from sums paid to the Attorney
pursuant to this agreement.
IN WITNESS WHEREOF, the parties have executed this agreement in duplicate
originals, one of which is retained by each of the parties hereto, on the day and year first above
written.
Julie A. Ramsey, Attorney At Law
____________________________ _________________________
Signature Date
David Newell, Sr.
____________________________ _________________________
Chairman, County Commissioners Date
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ATTACHMENT C
CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS
AND CERTIFICATION REGARDING NONDISCRIMINATION
Person County Department of Social Services
I. By execution of this Agreement the Contractor certifies that it will provide a drug-free workplace by:
A. Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession or use of a controlled substance is prohibited in the Contractor’s workplace and specifying the actions that will be taken against employees for violation of
such prohibition;
B. Establishing a drug-free awareness program to inform employees about: (1) The dangers of drug abuse in the workplace; (2) The Contractor’s policy of maintaining a drug-free workplace; (3) Any available drug counseling, rehabilitation, and employee assistance programs; and
(4) The penalties that may be imposed upon employees for drug abuse violations
occurring in the workplace;
C. Making it a requirement that each employee be engaged in the performance of the agreement be given a copy of the statement required by paragraph (A); D. Notifying the employee in the statement required by paragraph (A) that, as a condition of employment under the agreement, the employee will:
(1) Abide by the terms of the statement; and
(2) Notify the employer of any criminal drug statute conviction for a violation occurring in the workplace no later than five days after such conviction;
E. Notifying the County within ten days after receiving notice under subparagraph (D)(2) from an employee or otherwise receiving actual notice of such conviction; F. Taking one of the following actions, within 30 days of receiving notice under
subparagraph (D)(2), with respect to any employee who is so convicted:
(1) Taking appropriate personnel action against such an employee, up to and including termination; or (2) Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State, or local health, law enforcement, or other appropriate agency; and
Making a good faith effort to continue to maintain a drug-free workplace through
implementation of paragraphs (A), (B), (C), (D), (E), and (F).
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The site(s) for the performance of work done in connection with the specific agreement are
listed below:
22 Court Street, Suite 200, Roxboro, NC 27573
Contractor will inform the County of any additional sites for performance of work under this agreement. False certification or violation of the certification shall be grounds for suspension of payment,
suspension or termination of grants, or government-wide Federal suspension or debarment
45 C.F.R. Section 82.510. Section 4 CFR Part 85, Section 85.615 and 86.620.
Certification Regarding Nondiscrimination
The Vendor certifies that it will comply with all Federal statutes relating to nondiscrimination.
These include but are not limited to: (a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352)
which prohibits discrimination on the basis of race, color or national origin; (b) Title IX of the
Education Amendments of 1972, as amended (20 U.S.C. §§1681-1683, and 1685-1686), which
prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as
amended (29 U.S.C. §794), which prohibits discrimination on the basis of handicaps; (d) the Age
Discrimination Act of 1975, as amended (42 U.S.C. §§6101-6107), which prohibits
discrimination on the basis of age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L.
92-255), as amended, relating to nondiscrimination on the basis of drug abuse; (f) the
Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of
1970 (P.L. 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or
alcoholism; (g) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. §§3601 et seq.), as
amended, relating to nondiscrimination in the sale, rental or financing of housing; (h) the Food
Stamp Act and USDA policy, which prohibit discrimination on the basis of religion and political
beliefs; and (i) the requirements of any other nondiscrimination statutes which may apply to this
Agreement.
Julie A. Ramsey, Attorney At Law
____________________________ _________________________
Signature Date
David Newell, Sr.
____________________________ _________________________
Chairman, County Commissioners Date
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ATTACHMENT D:
CONFLICT OF INTEREST
The Board of Directors/Trustees or other governing persons, officers, employees or agents are to avoid
any conflict of interest, even the appearance of a conflict of interest. The Organization‘s Board of
Directors/Trustees or other governing body, officers, staff and agents are obligated to always act in the
best interest of the organization. This obligation requires that any Board member or other governing
person, officer, employee or agent, in the performance of Organization duties, seek only the furtherance
of the Organization mission. At all times, Board members or other governing persons, officers, employees
or agents, are prohibited from using their job title, the Organization's name or property, for private profit or
benefit.
A. The Board members or other governing persons, officers, employees, or agents of the Organization
should neither solicit nor accept gratuities, favors, or anything of monetary value from current or potential
contractors/vendors, persons receiving benefits from the Organization or persons who may benefit from
the actions of any Board member or other governing person, officer, employee or agent. This is not
intended to preclude bona-fide Organization fund raising-activities.
B. A Board or other governing body member may, with the approval of Board or other governing body,
receive honoraria for lectures and other such activities while not acting in any official capacity for the
Organization. Officers may, with the approval of the Board or other governing body, receive honoraria for
lectures and other such activities while on personal days, compensatory time, annual leave, or leave
without pay. Employees may, with the prior written approval of their supervisor, receive honoraria for
lectures and other such activities while on personal days, compensatory time, annual leave, or leave
without pay. If a Board or other governing body member, officer, employee or agent is acting in any
official capacity, honoraria received in connection with activities relating to the Organization are to be paid
to the Organization.
C. No Board member or other governing person, officer, employee, or agent of the Organization shall
participate in the selection, award, or administration of a purchase or contract with a vendor where, to his
knowledge, any of the following has a financial interest in that purchase or contract:
1. The Board member or other governing person, officer, employee, or agent;
2. Any member of their family by whole or half blood, step or personal relationship or relative-in-law;
3. An organization in which any of the above is an officer, director, or employee;
4. A person or organization with whom any of the above individuals is negotiating or has any
arrangement concerning prospective employment or contracts.
D. Duty to Disclosure -- Any conflict of interest, potential conflict of interest, or the appearance of a
conflict of interest is to be reported to the Board or other governing body or one’s supervisor immediately.
E. Board Action -- When a conflict of interest is relevant to a matter requiring action by the Board of
Directors/Trustees or other governing body, the Board member or other governing person, officer,
employee, or agent (person(s)) must disclose the existence of the conflict of interest and be given the
opportunity to disclose all material facts to the Board and members of committees with governing board
delegated powers considering the possible conflict of interest. After disclosure of all material facts, and
after any discussion with the person, he/she shall leave the governing board or committee meeting while
the determination of a conflict of interest is discussed and voted upon. The remaining board or committee
members shall decide if a conflict of interest exists. In addition, the person(s) shall not participate in the
final deliberation or decision regarding the matter under consideration and shall leave the meeting during
the discussion of and vote of the Board of Directors/Trustees or other governing body.
F. Violations of the Conflicts of Interest Policy -- If the Board of Directors/Trustees or other governing
body has reasonable cause to believe a member, officer, employee or agent has failed to disclose actual
or possible conflicts of interest, it shall inform the person of the basis for such belief and afford the person
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an opportunity to explain the alleged failure to disclose. If, after hearing the person's response and after
making further investigation as warranted by the circumstances, the Board of Directors/Trustees or other
governing body determines the member, officer, employee or agent has failed to disclose an actual or
possible conflict of interest, it shall take appropriate disciplinary and corrective action.
G. Record of Conflict -- The minutes of the governing board and all committees with board delegated
powers shall contain:
1. The names of the persons who disclosed or otherwise were found to have an actual or possible
conflict of interest, the nature of the conflict of interest, any action taken to determine whether a
conflict of interest was present, and the governing board's or committee's decision as to whether
a conflict of interest in fact existed.
2. The names of the persons who were present for discussions and votes relating to the transaction
or arrangement that presents a possible conflict of interest, the content of the discussion,
including any alternatives to the transaction or arrangement, and a record of any votes taken in
connection with the proceedings.
NOTARIZED CONFLICT OF INTEREST POLICY
Julie A. Ramsey, Attorney At Law
_________________________________ _________________________
Signature Date
NORTH CAROLINA
PERSON COUNTY
I, __________________________, a Notary Public of said County and State do hereby certify that Julie A. Ramsey,
Attorney at Law, personally appeared before me this date and acknowledged the due execution of the foregoing
agreement for the purposes therein expressed and by that authority duly given and as the act of the Organization,
affirmed that the foregoing Conflict of Interest Policy was adopted by the Board of Directors/Trustees or other
governing body in a meeting held on the __________ day of ___________, _________.
Sworn to and subscribed before me this _________ day of ______________________, 2016.
___________________________
Notary Public
My Commission expires: __________________
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ATTACHMENT E – OVERDUE TAXES
JULIE A. RAMSEY
--------------------------------------ATTORNEY AT LAW------------------------------------
22 Court Street, Suite 200 336-599-5004 – Telephone
P.O. Box 3130 336-599-5007 – Fax
Roxboro, NC 27573 julie.ramsey@esinc.net
______________, 2016
To: Person County Department of Social Services
Certification:
I, Julie A. Ramsey, certify that I do not have any overdue tax debts, as defined by N.C.G.S. 105-243.1, at the
federal, State, or local level. I further understand that any person who makes a false statement in violation of
N.C.G.S. 143C-6-23(c) is guilty of a criminal offense punishable as provided by N.C.G.S.) 143C-10-1b.
Sworn Statement:
I, Julie A. Ramsey, being duly sworn, say that the foregoing certification is true, accurate and complete to the
best of my knowledge and was made and subscribed by me. I also acknowledge and understand that any
misuse of State funds will be reported to the appropriate authorities for further action.
Julie A. Ramsey, Attorney At Law
____________________________ _________________________
Signature Date
NORTH CAROLINA
PERSON COUNTY
Sworn to and subscribed before me this _________ day of ______________________, 2016.
___________________________
Notary Public
My Commission expires: __________________
____________________
1 G.S. 105-243.1 defines: Overdue tax debt. – Any part of a tax debt that remains unpaid 90 days or more after the notice of final
assessment was mailed to the taxpayer. The term does not include a tax debt, however, if the taxpayer entered into an installment agreement for the tax debt under G.S. 105-237 within 90 days after the notice of final assessment was mailed and has not failed to
make any payments due under the installment agreement.”
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ATTACHMENT G
Person County Department of Social Services
Certification Regarding Lobbying
Certification for Contracts, Grants, Loans and Cooperative Agreements
The undersigned certifies, to the best of his or her knowledge and belief, that:
(1) No Federal appropriated funds have been paid or will be paid by or on behalf of the undersigned, to any
person for influencing or attempting to influence an officer or employee of any Federal, state or local
government agency, a Member of Congress, a Member of the General Assembly, an officer or employee of
Congress, an officer or employee of the General Assembly, an employee of a Member of Congress, or an
employee of a Member of the General Assembly in connection with the awarding of any Federal or state
contract, the making of any Federal or state grant, the making of any Federal or state loan, the entering into
of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any
Federal or state contract, grant, loan, or cooperative agreement.
(2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for
influencing or attempting to influence an officer or employee of any Federal, state or local government
agency, a Member of Congress, a Member of the General Assembly, an officer or employee of Congress,
an officer or employee of the General Assembly, an employee of a Member of Congress, or an employee of
a Member of the General Assembly in connection with the awarding of any Federal or state contract, the
making of any Federal or state grant, the making of any Federal or state loan, the entering into of any
cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any
Federal or state contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit
Standard
Form LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions.
(3) The undersigned shall require that the language of this certification be included in the award documents for
all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and
cooperative agreements) and that all subrecipients shall certify and disclose accordingly.
(4) This certification is a material representation of fact upon which reliance was placed when this transaction
was made or entered into. Submission of this certification is a prerequisite for making or entering into this
transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required
certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each
such failure.
Notwithstanding other provisions of federal OMB Circulars-CFR Title 2, Grants and Agreements, Part 200, costs
associated with the following activities are unallowable:
Paragraph A.
(1) Attempts to influence the outcomes of any Federal, State, or local election, referendum, initiative, or
similar procedure, through in kind or cash contributions, endorsements, publicity, or similar activity;
(2) Establishing, administering, contributing to, or paying the expenses of a political party, campaign, political
action committee, or other organization established for the purpose of influencing the outcomes of
elections;
(3) Any attempt to influence: (i) The introduction of Federal or State legislation; or (ii) the enactment or
modification of any pending Federal or State legislation through communication with any member or
employee of the Congress or State legislature (including efforts to influence State or local officials to
engage in similar lobbying activity), or with any Government official or employee in connection with a
decision to sign or veto enrolled legislation;
(4) Any attempt to influence: (i) The introduction of Federal or State legislation; or (ii) the enactment or
modification of any pending Federal or State legislation by preparing, distributing or using publicity or
propaganda, or by urging members of the general public or any segment thereof to contribute to or
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participate in any mass demonstration, march, rally, fundraising drive, lobbying campaign or letter writing
or telephone campaign; or
(5) Legislative liaison activities, including attendance at legislative sessions or committee hearings, gathering
information regarding legislation, and analyzing the effect of legislation, when such activities are carried on
in support of or in knowing preparation for an effort to engage in unallowable lobbying.
The following activities as enumerated in Paragraph B are excepted from the coverage of Paragraph A:
Paragraph B.
(1) Providing a technical and factual presentation of information on a topic directly related to the performance
of a grant, contract or other agreement through hearing testimony, statements or letters to the Congress or a
State legislature, or subdivision, member, or cognizant staff member thereof, in response to a documented
request (including a Congressional Record notice requesting testimony or statements for the record at a
regularly scheduled hearing) made by the recipient member, legislative body or subdivision, or a cognizant
staff member thereof; provided such information is readily obtainable and can be readily put in deliverable
form; and further provided that costs under this section for travel, lodging or meals are unallowable unless
incurred to offer testimony at a regularly scheduled Congressional hearing pursuant to a written request for
such presentation made by the Chairman or Ranking Minority Member of the Committee or Subcommittee
conducting such hearing.
(2) Any lobbying made unallowable by subparagraph A (3) to influence State legislation in order to directly
reduce the cost, or to avoid material impairment of the organization's authority to perform the grant,
contract, or other agreement.
(3) Any activity specifically authorized by statute to be undertaken with funds from the grant, contract, or other
agreement.
Paragraph C.
(1) When an organization seeks reimbursement for indirect costs, total lobbying costs shall be separately
identified in the indirect cost rate proposal, and thereafter treated as other unallowable activity costs in
accordance with the procedures of subparagraph B.(3).
(2) Organizations shall submit, as part of the annual indirect cost rate proposal, a certification that the
requirements and standards of this paragraph have been complied with.
(3) Organizations shall maintain adequate records to demonstrate that the determination of costs as being
allowable or unallowable pursuant to this section complies with the requirements of this Circular.
(4) Time logs, calendars, or similar records shall not be required to be created for purposes of complying with
this paragraph during any particular calendar month when: (1) the employee engages in lobbying (as
defined in subparagraphs (a) and (b)) 25 percent or less of the employee's compensated hours of
employment during that calendar month, and (2) within the preceding five-year period, the organization has
not materially misstated allowable or unallowable costs of any nature, including legislative lobbying costs.
When conditions (1) and (2) are met, organizations are not required to establish records to support the
allowability of claimed costs in addition to records already required or maintained. Also, when conditions
(1) and (2) are met, the absence of time logs, calendars, or similar records will not serve as a basis for
disallowing costs by contesting estimates of lobbying time spent by employees during a calendar month.
(5) Agencies shall establish procedures for resolving in advance, in consultation with OMB, any significant
questions or disagreements concerning the interpretation or application of this section. Any such advance
resolution shall be binding in any subsequent settlements, audits or investigations with respect to that grant
or contract for purposes of interpretation of this Circular; provided, however, that this shall not be
construed to prevent a contractor or grantee from contesting the lawfulness of such a determination.
Paragraph D.
Executive lobbying costs. Costs incurred in attempting to improperly influence either directly or indirectly, an
employee or officer of the Executive Branch of the Federal Government to give consideration or to act
regarding a sponsored agreement or a regulatory matter are unallowable. Improper influence means any
influence that induces or tends to induce a Federal employee or officer to give consideration or to act regarding
a federally sponsored agreement or regulatory matter on any basis other than the merits of the matter.
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Julie A. Ramsey, Attorney At Law
____________________________ _________________________
Signature Date
David Newell, Sr.
____________________________ _________________________
Chairman, County Commissioners Date
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ATTACHMENT H
PERSON COUNTY DEPARTMENT OF SOCIAL SERVICES
CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY
AND VOLUNTARY EXCLUSION-LOWER TIER COVERED TRANSACTIONS
Instructions for Certification
1. By signing and submitting this proposal, the prospective lower tier participant is providing the
certification set out below.
2. The certification in this clause is a material representation of the fact upon which reliance was
placed when this transaction was entered into. If it is later determined that the prospective lower
tier participant knowingly rendered an erroneous certification, in addition to other remedies
available to the Federal Government, the department or agency with which this transaction
originated may pursue available remedies, including suspension and/or debarment.
3. The prospective lower tier participant will provide immediate written notice to the person to
whom the proposal is submitted if at any time the prospective lower tier participant learns that its
certification was erroneous when submitted or has become erroneous by reason of changed
circumstances.
4. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered
transaction," "participant," "person," "primary covered transaction," "principal," "proposal," and
"voluntarily excluded," as used in this clause, have the meanings set out in the Definitions and
Coverage sections of rules implementing Executive Order 12549. You may contact the person to
which this proposal is submitted for assistance in obtaining a copy of those regulations.
5. The prospective lower tier participant agrees by submitting this proposal that, should the
proposed covered transaction be entered into, it shall not knowingly enter any lower tier covered
transaction with a person who is debarred, suspended, determined ineligible or voluntarily
excluded from participation in this covered transaction unless authorized by the department or
agency with which this transaction originated.
6. The prospective lower tier participant further agrees by submitting this proposal that it will
include this clause titled "Certification Regarding Debarment, Suspension, Ineligibility and
Voluntary Exclusion - Lower Tier Covered Transaction," without modification, in all lower tier
covered transactions and in all solicitations for lower tier covered transactions.
7. A participant in a covered transaction may rely upon a certification of a prospective
participant in a lower tier covered transaction that it is not debarred, suspended, ineligible, or
voluntarily excluded from covered transaction, unless it knows that the certification is erroneous.
A participant may decide the method and frequency of which it determines the eligibility of its
principals. Each participant may, but is not required to, check the Nonprocurement List.
8. Nothing contained in the foregoing shall be construed to require establishment of a system of
records in order to render in good faith the certification required by this clause. The knowledge
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and information of a participant is not required to exceed that which is normally possessed by a
prudent person in the ordinary course of business dealings.
9. Except for transactions authorized in paragraph 5 of these instructions, if a participant in a
covered transaction knowingly enters into a lower tier covered transaction with a person who is
suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in
addition to other remedies available to the Federal Government, the department or agency with
which this transaction originated may pursue available remedies, including suspension, and/or
debarment.
Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower
Tier Covered Transactions
(1) The prospective lower tier participant certifies, by submission of this proposal, that neither it
nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or
voluntarily excluded from participation in this transaction by any Federal department or agency.
(2) Where the prospective lower tier participant is unable to certify to any of the statements in this
certification, such prospective participant shall attach an explanation to this proposal.
Julie A. Ramsey, Attorney At Law
____________________________ _________________________
Signature Date
David Newell, Sr.
____________________________ _________________________
Chairman, County Commissioners Date
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ATTACHMENT I
PERSON COUNTY
DEPARTMENT OF SOCIAL SERVICES
BUSINESS ASSOCIATE ADDENDUM
This Agreement is made effective the 1st day of July, 2016, by and between Person County
Department of Social Services (“Covered Entity”) and Julie A. Ramsey, Attorney at Law
(“Business Associate”) (collectively the “Parties”).
1. BACKGROUND
a. Covered Entity and Business Associate are parties to a contract entitled Legal Services
Contract (the “Contract”), whereby Business Associate agrees to perform certain services for or
on behalf of Covered Entity.
b. Covered Entity is an organizational unit of Person County as the Person County Department
of Social Services (DSS) as a health care component for purposes of the HIPAA Privacy Rule.
c. The relationship between Covered Entity and Business Associate is such that the Parties
believe Business Associate is or may be a “business associate” within the meaning of the HIPAA
Privacy Rule.
d. The Parties enter into this Business Associate Addendum to the Contract with the intention of
complying with the HIPAA Privacy Rule provision that a covered entity may disclose protected
health information to a business associate, and may allow a business associate to create or
receive protected heath information on its behalf, if the covered entity obtains satisfactory
assurances that the business associate will appropriately safeguard the information.
2. DEFINITIONS
Unless some other meaning is clearly indicated by the context, the following terms shall have the
following meaning in this Agreement:
a. “HIPAA” means the Administrative Simplification Provisions, Sections 261 through 264, of
the federal Health Insurance Portability and Accountability Act of 1996, Public Law 104-191.
b. “Individual” shall have the same meaning as the term “individual” in 45 CFR160.103 and
shall include a person who qualifies as a personal representative in accordance with 45 CFR
164.502(g).
c. “Privacy Rule” shall mean the Standards for Privacy of Individually Identifiable Health
Information at 45 CFR part 160 and part 164, subparts A and E.
d. “Protected Health Information” shall have the same meaning as the term “protected health
information” in 45 CFR 160.103, limited to the information created or received by Business
Associate from or on behalf of Covered Entity.
e. “Required By Law” shall have the same meaning as the term “required by law” in 45 CFR
164.103.
f. “Secretary” shall mean the Secretary of the United States Department of Health and Human
Services or his designee.
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g. Unless otherwise defined in this Agreement, terms used herein shall have the same meaning
as those terms have in the Privacy Rule.
3. OBLIGATIONS OF BUSINESS ASSOCIATE
a. Business Associate agrees to not use or disclose Protected Health Information other than as
permitted or required by this Agreement or as Required By Law.
b. Business Associate agrees to use appropriate safeguards to prevent use or disclosure of the
Protected Health Information other than as provided for by this Agreement.
c. Business Associate agrees to mitigate, to the extent practicable, any harmful effect that is
known to Business Associate of a use or disclosure of Protected Health Information by Business
Associate in violation of the requirements of this Agreement.
d. Business Associate agrees to report to Covered Entity any use or disclosure of the Protected
Health Information not provided for by this Agreement of which it becomes aware.
e. Business Associate agrees to ensure that any agent, including a subcontractor, to whom it
provides Protected Health Information received from, or created or received by Business
Associate on behalf of Covered Entity agrees to the same restrictions and conditions that apply
through this Agreement to Business Associate with respect to such information.
f. Business Associate agrees to provide access, at the request of Covered Entity, to Protected
Health Information in a Designated Record Set to Covered Entity or, as directed by Covered
Entity, to an Individual in order to meet the requirements under 45 CFR 164.524.
g. Business Associate agrees, at the request of the Covered Entity, to make any amendment(s) to
Protected Health Information in a Designated Record Set that the Covered Entity directs or
agrees to pursuant to 45 CFR 164.526.
h. Unless otherwise prohibited by law, Business Associate agrees to make internal practices,
books, and records, including policies and procedures and Protected Health Information, relating
to the use and disclosure of Protected Health Information received from, or created or received
by Business Associate on behalf of Covered Entity, available to the Covered Entity, or to the
Person County Department of Social Services, in a time and manner designated by the
Secretary, for purposes of determining Covered Entity's compliance with the Privacy Rule.
i. Business Associate agrees to document such disclosures of Protected Health Information and
information related to such disclosures as would be required for Covered Entity to respond to a
request by an Individual for an accounting of disclosures of Protected Health Information in
accordance with 45 CFR 164.528, and to provide this information to Covered Entity or an
Individual to permit such a response.
4. PERMITTED USES AND DISCLOSURES
a. Except as otherwise limited in this Agreement or by other applicable law or agreement, if the
Contract permits, Business Associate may use or disclose Protected Health Information to
perform functions, activities, or services for, or on behalf of, Covered Entity as specified in the
Contract, provided that such use or disclosure:
1) would not violate the Privacy Rule if done by Covered Entity; or
2) would not violate the minimum necessary policies and procedures of the Covered
Entity.
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b. Except as otherwise limited in this Agreement or by other applicable law or agreements, if the
Contract permits, Business Associate may use Protected Health Information as necessary for the
proper management and administration of the Business Associate or to carry out the legal
responsibilities of the Business Associate.
c. Except as otherwise limited in this Agreement or by other applicable law or agreements, if the
Contract permits, Business Associate may disclose Protected Health Information for the proper
management and administration of the Business Associate, provided that:
1) disclosures are Required By Law; or
2) Business Associate obtains reasonable assurances from the person to whom the
information is disclosed that it will remain confidential and will be used or further
disclosed only as Required By Law or for the purpose for which it was disclosed to the
person, and the person notifies the Business Associate of any instances of which it is
aware in which the confidentiality of the information has been breached.
d. Except as otherwise limited in this Agreement or by other applicable law or agreements, if the
Contract permits, Business Associate may use Protected Health Information to provide data
aggregation services to Covered Entity as permitted by 45 CFR 164.504(e)(2)(i)(B).
e. Notwithstanding the foregoing provisions, Business Associate may not use or disclose
Protected Health Information if the use or disclosure would violate any term of the Contract or
other applicable law or agreements.
5. TERM AND TERMINATION
a. Term. This Agreement shall be effective as of the effective date stated above and shall
terminate when the Contract terminates.
b. Termination for Cause. Upon Covered Entity's knowledge of a material breach by Business
Associate, Covered Entity may, at its option:
1) Provide an opportunity for Business Associate to cure the breach or end the violation,
and terminate this Agreement and services provided by Business Associate, to the extent
permissible by law, if Business Associate does not cure the breach or end the violation
within the time specified by Covered Entity;
2) Immediately terminate this Agreement and services provided by Business Associate,
to the extent permissible by law; or
3) If neither termination nor cure is feasible, report the violation to the Secretary as
provided in the Privacy Rule.
c. Effect of Termination.
1) Except as provided in paragraph (2) of this section or in the Contract or by other
applicable law or agreements, upon termination of this Agreement and services provided
by Business Associate, for any reason, Business Associate shall return or destroy all
Protected Health Information received from Covered Entity, or created or received by
Business Associate on behalf of Covered Entity. This provision shall apply to Protected
Health Information that is in the possession of subcontractors or agents of Business
Associate. Business Associate shall retain no copies of the Protected Health Information.
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2) In the event that Business Associate determines that returning or destroying the
Protected Health Information is not feasible, Business Associate shall provide to Covered
Entity notification of the conditions that make return or destruction not feasible. Business
Associate shall extend the protections of this Agreement to such Protected Health
Information and limit further uses and disclosures of such Protected Health Information
to those purposes that make the return or destruction infeasible, for so long as Business
Associate maintains such Protected Health Information.
6. GENERAL TERMS AND CONDITIONS
a. This Agreement amends and is part of the Contract.
b. Except as provided in this Agreement, all terms and conditions of the Contract shall remain in
force and shall apply to this Agreement as if set forth fully herein.
c. In the event of a conflict in terms between this Agreement and the Contract, the interpretation
that is in accordance with the Privacy Rule shall prevail. In the event that a conflict then
remains, the Contract terms shall prevail so long as they are in accordance with the Privacy Rule.
d. A breach of this Agreement by Business Associate shall be considered sufficient basis for
Covered Entity to terminate the Contract for cause.
Julie A. Ramsey, Attorney At Law
____________________________ _________________________
Signature Date
David Newell, Sr.
____________________________ _________________________
Chairman, County Commissioners Date
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Attachment M
State Certification
Contractor Certifications Required by North Carolina Law
Instructions
The person who signs this document should read the text of the statutes listed below and consult with
counsel and other knowledgeable persons before signing.
The text of Article 2 of Chapter 64 of the North Carolina General Statutes can be found online at:
http://www.ncga.state.nc.us/EnactedLegislation/Statutes/PDF/ByArticle/Chapter_64/Article_2.pdf
The text of G.S. 105-164.8(b) can be found online at:
http://www.ncga.state.nc.us/EnactedLegislation/Statutes/PDF/BySection/Chapter_105/GS_105-
164.8.pdf
The text of G.S. 143-48.5 (S.L. 2013-418, s. 2.(d)) can be found online at:
http://www.ncga.state.nc.us/Sessions/2013/Bills/House/PDF/H786v6.pdf
The text of G.S. 143-59.1 can be found online at:
http://www.ncga.state.nc.us/EnactedLegislation/Statutes/PDF/BySection/Chapter_143/GS_143-
59.1.pdf
The text of G.S. 143-59.2 can be found online at:
http://www.ncga.state.nc.us/EnactedLegislation/Statutes/PDF/BySection/Chapter_143/GS_143-
59.2.pdf
The text of G.S. 147-33.95(g) (S.L. 2013-418, s. 2.(e)) can be found online at:
http://www.ncga.state.nc.us/Sessions/2013/Bills/House/PDF/H786v6.pdf
Certifications
(1) Pursuant to G.S. 143-48.5 and G.S. 147-33.95(g), the undersigned hereby certifies that the
Contractor named below, and the Contractor’s subcontractors, complies with the requirements of
Article 2 of Chapter 64 of the NC General Statutes, including the requirement for each employer
with more than 25 employees in North Carolina to verify the work authorization of its employees
through the federal E-Verify system." E-Verify System Link: www.uscis.gov
Local government is specifically exempt from Article 2 of Chapter 64 of the North Carolina
General Statutes. However, local government is subject to and must comply with North Carolina
General Statute §153A-99.1., which states in part as follows:
Counties Must Use E-Verify. - Each county shall register and participate in E-Verify to verify the
work authorization of new employees hired to work in the United States.
(2) Pursuant to G.S. 143-59.1(b), the undersigned hereby certifies that the Contractor named below
is not an “ineligible Contractor” as set forth in G.S. 143-59.1(a) because:
(a) Neither the Contractor nor any of its affiliates has refused to collect the use tax levied
under Article 5 of Chapter 105 of the General Statutes on its sales delivered to North
Carolina when the sales met one or more of the conditions of G.S. 105-164.8(b); and
(b) [check one of the following boxes]
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Neither the Contractor nor any of its affiliates has incorporated or reincorporated
in a “tax haven country” as set forth in G.S. 143-59.1(c)(2) after December 31,
2001; or
The Contractor or one of its affiliates has incorporated or reincorporated in a “tax
haven country” as set forth in G.S. 143-59.1(c)(2) after December 31, 2001 but
the United States is not the principal market for the public trading of the stock of
the corporation incorporated in the tax haven country.
(3) Pursuant to G.S. 143-59.2(b), the undersigned hereby certifies that none of the Contractor’s
officers, directors, or owners (if the Contractor is an unincorporated business entity) has been
convicted of any violation of Chapter 78A of the General Statutes or the Securities Act of 1933 or
the Securities Exchange Act of 1934 within 10 years immediately prior to the date of the bid
solicitation.
(4) The undersigned hereby certifies further that:
(a) He or she is a duly authorized representative of the Contractor named below;
(b) He or she is authorized to make, and does hereby make, the foregoing certifications on
behalf of the Contractor; and
(c) He or she understands that any person who knowingly submits a false certification in
response to the requirements of G.S. 143-59.1 and -59.2 shall be guilty of a Class I
felony.
Contractor’s Name: Julie A. Ramsey
Signature of Contractor’s Authorized Agent
Date
Printed Name of Contractor’s Authorized Agent
Julie A. Ramsey
Title
Attorney at Law
Signature of Witness
Title
Printed Name of Witness
Date
The witness should be present when the Contractor’s Authorized Agent signs this certification and should
sign and date this document immediately thereafter.
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Attachment N
CERTIFICATION OF
ELIGIBILITY
Under the Iran
Divestment Act
Pursuant to G.S. 147-86.59, any person identified as engaging in investment activities in
Iran, determined by appearing on the Final Divestment List created by the State
Treasurer pursuant to G.S. 147-86.58, is ineligible to contract with the State of North
Carolina or any political subdivision of the State. The Iran Divestment Act of 2015, G.S.
147-86.55 et seq.* requires that each vendor, prior to contracting with the State certify,
and the undersigned on behalf of the Vendor does hereby certify, to the following:
1. that Julie A. Ramsey, Attorney At Law, is not identified on the Final
Divestment List of entities that the State Treasurer has determined engages in
investment activities in Iran;
2. that Julie A. Ramsey, Attorney At Law, shall not utilize on any contract with the
State agency any subcontractor that is identified on the Final Divestment List; and
3. that Julie A. Ramsey, Attorney At Law, is authorized to make this Certification.
Julie A. Ramsey, Attorney At Law
____________________________ _________________________
Signature Date
* Note: Enacted by Session Law 2015‐118 as G.S. 143C‐55 et seq., but has been renumbered for
codification at the direction of the Revisor of Statutes.
The State Treasurer’s Final Divestment List can be found on the State Treasurer’s website at the address:
https://www.nctreasurer.com/inside‐the‐department/OpenGovernment/Pages/Iran‐Divestment‐Act‐Resources.aspx
and will be updated every 180 days. For questions about the Department of State Treasurer’s Iran Divestment
Policy, please contact Meryl Murtagh at Meryl.Murtagh@nctreasurer.com or (919) 814‐3852.
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Contract # 1013 Fiscal Year Begins July 1, 2016 Ends June 30, 2017
This contract is hereby entered into by and between the Person County Department of Social
Services (the "County") and Julie A. Ramsey (the "Contractor") (referred to collectively as the
“Parties”). The Contractor’s federal tax identification number is 56-199 9585.
Contract Documents: This Contract consists of the following documents:
This contract
The General Terms and Conditions (Attachment A)
The Scope of Work, description of services, and rate (Attachment B)
Federal Certification Regarding Drug-Free Workplace & Certification Regarding Nondiscrimination (Attachment C)
Conflict of Interest (Attachment D)
No Overdue Taxes (Attachment E)
Federal Certification Regarding Lobbying (Attachment G)
Federal Certification Regarding Debarment (Attachment H)
HIPAA Business Associate Addendum (Attachment I)
State Certification (Attachment M)
Certification of Eligibility Under the Iran Divestment Act (Attachment N)
These documents constitute the entire agreement between the Parties and supersede all prior
oral or written statements or agreements.
Precedence among Contract Documents: In the event of a conflict between or among the
terms of the Contract Documents, the terms in the Contract Document with the highest relative
precedence shall prevail. The order of precedence shall be the order of documents as listed in
Paragraph 1, above, with the first-listed document having the highest precedence and the last-
listed document having the lowest precedence. If there are multiple Contract Amendments, the
most recent amendment shall have the highest precedence and the oldest amendment shall
have the lowest precedence.
Effective Period: This contract shall be effective on July 1, 2016 and shall terminate on
June 30, 2017. This contract must be twelve months or less.
Contractor’s Duties: The Contractor shall provide the services and in accordance with the
approved rate as described in Attachment B, Scope of Work.
County’s Duties: The County shall pay the Contractor in the manner and in the amounts
specified in the Contract Documents.
[ x ] a. There are no matching requirements from the Contractor.
[ ] b. The Contractor’s matching requirement is $__________, which shall consist of:
[ ] In-kind [ ] Cash [ ] Cash and In-kind [ ] Cash and/or In-kind
The contributions from the Contractor shall be sourced from non-federal funds.
The total contract amount including any Contractor match shall not exceed 1,000 hours
collectively for all attorneys under contract. Rate of compensation for Secondary Attorney
Julie A. Ramsey is $75 per hour.
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Reversion of Funds:
Any unexpended grant funds shall revert to the County Department of Social Services upon
termination of this contract.
Reporting Requirements:
Contractor shall comply with audit requirements as described in N.C.G.S. § 143C-6-22 & 23 and
OMB Circular- CFR Title 2 Grants and Agreements, Part 200, and shall disclose all information
required by 42 USC 455.104, or 42 USC 455.105, or 42 USC 455.106.
Payment Provisions:
Payment shall be made in accordance with the Contract Documents as described in the Scope
of Work, Attachment B.
Contract Administrators: All notices permitted or required to be given by one Party to the
other and all questions about the contract from one Party to the other shall be addressed and
delivered to the other Party’s Contract Administrator. The name, post office address, street
address, telephone number, fax number, and email address of the Parties’ respective initial
Contract Administrators are set out below. Either Party may change the name, post office
address, street address, telephone number, fax number, or email address of its Contract
Administrator by giving timely written notice to the other Party.
For the County: For the Contractor:
Wendy Bowman, Accounting Technician
Person County Department of Social Services Julie A. Ramsey, Attorney
P.O. Box 770 P.O. Box 3130
355B South Madison Boulevard 22 Court Street, Suite 200
Roxboro, NC 27573 Roxboro, NC 27573
(336) 599-8361 (336) 599-5004
Supplementation of Expenditure of Public Funds: The Contractor assures that funds
received pursuant to this contract shall be used only to supplement, not to supplant, the total
amount of federal, state and local public funds that the Contractor otherwise expends for
contract services and related programs. Funds received under this contract shall be used to
provide additional public funding for such services; the funds shall not be used to reduce the
Contractor’s total expenditure of other public funds for such services.
Disbursements: As a condition of this contract, the Contractor acknowledges and agrees to
make disbursements in accordance with the following requirements:
(a) Implement adequate internal controls over disbursements;
(b) Pre-audit all vouchers presented for payment to determine:
Validity and accuracy of payment
Payment due date
Adequacy of documentation supporting payment
Legality of disbursement
(c) Assure adequate control of signature stamps/plates;
(d) Assure adequate control of negotiable instruments; and
(e) Implement procedures to insure that account balance is solvent and reconcile the
account monthly.
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Outsourcing to Other Countries: The Contractor certifies that it has identified to the County
all jobs related to the contract that have been outsourced to other countries, if any. The
Contractor further agrees that it will not outsource any such jobs during the term of this contract
without providing notice to the County.
Federal Certifications: Individuals and Organizations receiving federal funds must ensure
compliance with certain certifications required by federal laws and regulations. The contractor is
hereby complying with Certifications regarding Nondiscrimination, Drug-Free Workplace
Requirements, Environmental Tobacco Smoke, Debarment, Suspension, Ineligibility and
Voluntary Exclusion Lower Tier Covered Transactions, and Lobbying. These assurances and
certifications are to be signed by the contractor’s authorized representative.
Signature Warranty: The undersigned represent and warrant that they are authorized to bind
their principals to the terms of this agreement.
Signature Warranty:
The undersigned represent and warrant that they are authorized to bind their principals to the terms of this
agreement.
The Contractor and the County have executed this contract in duplicate originals, with one original being retained by
each party.
Julie A. Ramsey, Attorney At Law
____________________________ _________________________
Signature Date
PERSON COUNTY
David Newell, Sr.
____________________________ _________________________
Chairman, County Commissioners Date
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
Act.
______________________________ ___________________________
Amy Wehrenberg, County Finance Director Date
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ATTACHMENT A
General Terms and Conditions
Relationships of the Parties
Independent Contractor: The Contractor is and shall be deemed to be an independent contractor in the performance of
this contract and as such shall be wholly responsible for the work to be performed and for the supervision of its employees.
The Contractor represents that it has, or shall secure at its own expense, all personnel required in performing the services
under this agreement. Such employees shall not be employees of, or have any individual contractual relationship with the
County.
Subcontracting: The Contractor shall not subcontract any of the work contemplated under this contract without prior written
approval from the County. Any approved subcontract shall be subject to all conditions of this contract. Only the
subcontractors specified in the contract documents are to be considered approved upon award of the contract. The County
shall not be obligated to pay for any work performed by any unapproved subcontractor. The Contractor shall be responsible
for the performance of all of its subcontractors.
Assignment: No assignment of the Contractor's obligations or the Contractor's right to receive payment hereunder shall be
permitted. However, upon written request approved by the issuing purchasing authority, the County may: Forward the
Contractor's payment check(s) directly to any person or entity designated by the Contractor, or Include any person or entity
designated by Contractor as a joint payee on the Contractor's payment check(s). In no event shall such approval and action
obligate the County to anyone other than the Contractor and the Contractor shall remain responsible for fulfillment of all
contract obligations.
Beneficiaries: Except as herein specifically provided otherwise, this contract shall inure to the benefit of and be binding
upon the parties hereto and their respective successors. It is expressly understood and agreed that the enforcement of the
terms and conditions of this contract, and all rights of action relating to such enforcement, shall be strictly reserved to the
County and the named Contractor. Nothing contained in this document shall give or allow any claim or right of action
whatsoever by any other third person. It is the express intention of the County and Contractor that any such person or entity,
other than the County or the Contractor, receiving services or benefits under this contract shall be deemed an incidental
beneficiary only.
Indemnity and Insurance
Indemnification: The Contractor agrees to indemnify and hold harmless the County and any of their officers, agents and
employees, from any claims of third parties arising out or any act or omission of the Contractor in connection with the
performance of this contract.
Insurance: During the term of the contract, the Contractor at its sole cost and expense shall provide commercial insurance
of such type and with such terms and limits as may be reasonably associated with the contract. As a minimum, the
Contractor shall provide and maintain the following coverage and limits:
Worker’s Compensation - The contractor shall provide and maintain Worker’s Compensation Insurance as required
by the laws of North Carolina, as well as employer’s liability coverage with minimum limits of $500,000.00, covering all
of Contractor’s employees who are engaged in any work under the contract. If any work is sublet, the Contractor shall
require the subcontractor to provide the same coverage for any of his employees engaged in any work under the
contract.
Commercial General Liability - General Liability Coverage on a Comprehensive Broad Form on an occurrence basis in
the minimum amount of $1,000,000.00 Combined Single Limit. (Defense cost shall be in excess of the limit of liability.)
Automobile Liability Insurance: The Contractor shall provide automobile liability insurance with a combined single
limit of $500,000.00 for bodily injury and property damage; a limit of $500,000.00 for uninsured/under insured
motorist coverage; and a limit of $2,000.00 for medical payment coverage. The Contractor shall provide this insurance
for all automobiles that are:
(a) owned by the Contractor and used in the performance of this contract;
(b) hired by the Contractor and used in the performance of this contract; and
(c) Owned by Contractor’s employees and used in performance of this contract (“non-owned vehicle insurance”).
Non-owned vehicle insurance protects employers when employees use their personal vehicles for work
purposes. Non-owned vehicle insurance supplements, but does not replace, the car-owner’s liability insurance.
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The Contractor is not required to provide and maintain automobile liability insurance on any vehicle – owned,
hired, or non-owned -- unless the vehicle is used in the performance of this contract.
(d) The insurance coverage minimums specified in subparagraph (a) are exclusive of defense costs.
(e) The Contractor understands and agrees that the insurance coverage minimums specified in subparagraph (a) are
not limits, or caps, on the Contractor’s liability or obligations under this contract.
(f) The Contractor may obtain a waiver of any one or more of the requirements in subparagraph (a) by
demonstrating that it has insurance that provides protection that is equal to or greater than the coverage and
limits specified in subparagraph (a). The County shall be the sole judge of whether such a waiver should be
granted.
(g) The Contractor may obtain a waiver of any one or more of the requirements in paragraph (a) by demonstrating
that it is self-insured and that its self-insurance provides protection that is equal to or greater than the coverage
and limits specified in subparagraph (a). The County shall be the sole judge of whether such a waiver should be
granted.
(h) Providing and maintaining the types and amounts of insurance or self-insurance specified in this paragraph is a
material obligation of the Contractor and is of the essence of this contract.
(i) The Contractor shall only obtain insurance from companies that are authorized to provide such coverage and
that are authorized by the Commissioner of Insurance to do business in the State of North Carolina. All such
insurance shall meet all laws of the State of North Carolina.
(j) The Contractor shall comply at all times with all lawful terms and conditions of its insurance policies and all
lawful requirements of its insurer.
(k) The Contractor shall require its subcontractors to comply with the requirements of this paragraph.
(l) The Contractor shall demonstrate its compliance with the requirements of this paragraph by submitting
certificates of insurance to the County before the Contractor begins work under this contract.
Transportation of Clients by Contractor:
The contractor will maintain Insurance requirements if required as noted under Article 7 Rule R2-36 of the North Carolina
Utilities Commission.
Default and Termination
Termination without Cause: The County may terminate this contract without cause by giving 30 days written notice to the
Contractor.
Termination for Cause: If, through any cause, the Contractor shall fail to fulfill its obligations under this contract in a timely
and proper manner, the County shall have the right to terminate this contract by giving written notice to the Contractor and
specifying the effective date thereof. In that event, all finished or unfinished deliverable items prepared by the Contractor
under this contract shall, at the option of the County, become its property and the Contractor shall be entitled to receive just
and equitable compensation for any satisfactory work completed on such materials, minus any payment or compensation
previously made. Notwithstanding the foregoing provision, the Contractor shall not be relieved of liability to the County for
damages sustained by the County by virtue of the Contractor’s breach of this agreement, and the County may withhold any
payment due the Contractor for the purpose of setoff until such time as the exact amount of damages due the County from
such breach can be determined. In case of default by the Contractor, without limiting any other remedies for breach
available to it, the County may procure the contract services from other sources and hold the Contractor responsible for any
excess cost occasioned thereby. The filing of a petition for bankruptcy by the Contractor shall be an act of default under this
contract.
Waiver of Default: Waiver by the County of any default or breach in compliance with the terms of this contract by the
Provider shall not be deemed a waiver of any subsequent default or breach and shall not be construed to be modification of
the terms of this contract unless stated to be such in writing, signed by an authorized representative of the County and the
Contractor and attached to the contract.
Availability of Funds: The parties to this contract agree and understand that the payment of the sums specified in this
contract is dependent and contingent upon and subject to the appropriation, allocation, and availability of funds for this
purpose to the County.
Force Majeure: Neither party shall be deemed to be in default of its obligations hereunder if and so long as it is prevented
from performing such obligations by any act of war, hostile foreign action, nuclear explosion, riot, strikes, civil insurrection,
earthquake, hurricane, tornado, or other catastrophic natural event or act of God.
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Survival of Promises: All promises, requirements, terms, conditions, provisions, representations, guarantees, and warranties
contained herein shall survive the contract expiration or termination date unless specifically provided otherwise herein, or
unless superseded by applicable Federal or State statutes of limitation.
Intellectual Property Rights
Copyrights and Ownership of Deliverables: All deliverable items produced pursuant to this contract are the exclusive
property of the County. The Contractor shall not assert a claim of copyright or other property interest in such deliverables.
Federal Intellectual Property Bankruptcy Protection Act: The Parties agree that the County shall be entitled to all rights and
benefits of the Federal Intellectual Property Bankruptcy Protection Act, Public Law 100-506, codified at 11 U.S.C. 365 (n)
and any amendments thereto.
Compliance with Applicable Laws
Compliance with Laws: The Contractor shall comply with all laws, ordinances, codes, rules, regulations, and licensing
requirements that are applicable to the conduct of its business, including those of federal, state, and local agencies having
jurisdiction and/or authority.
Title VI, Civil Rights Compliance: In accordance with Federal law and U.S. Department of Agriculture (USDA) and U.S.
Department of Health and Human Services (HHS) policy, this institution is prohibited from discriminating on the basis of
race, color, national origin, sex, age or disability. Under the Food Stamp Act and USDA policy, discrimination is prohibited
also on the basis of religion or political beliefs.
Equal Employment Opportunity: The Contractor shall comply with all federal and State laws relating to equal employment
opportunity.
Health Insurance Portability and Accountability Act (HIPAA): The Contractor agrees that, if the County determines that
some or all of the activities within the scope of this contract are subject to the Health Insurance Portability and Accountability
Act of 1996, P.L. 104-91, as amended (“HIPAA”), or its implementing regulations, it will comply with the HIPAA
requirements and will execute such agreements and practices as the County may require to ensure compliance.
(a) Data Security: The Contractor shall adopt and apply data security standards and procedures that comply with all
applicable federal, state, and local laws, regulations, and rules.
(b) Duty to Report: The Contractor shall report a suspected or confirmed security breach to the local Department of
Social Services/Human Services Contract Administrator within twenty-four (24) hours after the breach is first
discovered, provided that the Contractor shall report a breach involving Social Security Administration data or
Internal Revenue Service data within one (1) hour after the breach is first discovered.
(c) Cost Borne by Contractor: If any applicable federal, state, or local law, regulation, or rule requires the Contractor
to give written notice of a security breach to affected persons, the Contractor shall bear the cost of the notice.
Trafficking Victims Protection Act of 2000: The Contractor will comply with the requirements of Section 106(g) of the
Trafficking Victims Protection Act of 2000, as amended (22 U.S.C. 7104).
Executive Order # 24: It is unlawful for any vendor, contractor, subcontractor or supplier of the state to make gifts or to give
favors to any state employee. For additional information regarding the specific requirements and exemptions, contractors
are encouraged to review Executive Order 24 and G.S. Sec. 133-32.
Confidentiality
Confidentiality: Any information, data, instruments, documents, studies or reports given to or prepared or assembled by the
Contractor under this agreement shall be kept as confidential and not divulged or made available to any individual or
organization without the prior written approval of the County. The Contractor acknowledges that in receiving, storing,
processing or otherwise dealing with any confidential information it will safeguard and not further disclose the information
except as otherwise provided in this contract.
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Oversight
Access to Persons and Records: The State Auditor shall have access to persons and records as a result of all contracts or
grants entered into by State agencies or political subdivisions in accordance with General Statute 147-64.7. Additionally, as
the State funding authority, the Department of Health and Human Services shall have access to persons and records as a
result of all contracts or grants entered into by State agencies or political subdivisions.
Record Retention: Records shall not be destroyed, purged or disposed of without the express written consent of the
Division. State basic records retention policy requires all grant records to be retained for a minimum of five years or until all
audit exceptions have been resolved, whichever is longer. If the contract is subject to federal policy and regulations, record
retention may be longer than five years since records must be retained for a period of three years following submission of the
final Federal Financial Status Report, if applicable, or three years following the submission of a revised final Federal
Financial Status Report. Also, if any litigation, claim, negotiation, audit, disallowance action, or other action involving this
Contract has been started before expiration of the five-year retention period described above, the records must be retained
until completion of the action and resolution of all issues which arise from it, or until the end of the regular five-year period
described above, whichever is later. The record retention period for Temporary Assistance for Needy Families (TANF) and
MEDICAID and Medical Assistance grants and programs must be retained for a minimum of ten years.
Warranties and Certifications
Date and Time Warranty: The Contractor warrants that the product(s) and service(s) furnished pursuant to this contract
(“product” includes, without limitation, any piece of equipment, hardware, firmware, middleware, custom or commercial
software, or internal components, subroutines, and interfaces therein) that perform any date and/or time data recognition
function, calculation, or sequencing will support a four digit year format and will provide accurate date/time data and leap
year calculations. This warranty shall survive the termination or expiration of this contract.
Certification Regarding Collection of Taxes: G.S. 143-59.1 bars the Secretary of Administration from entering into contracts
with vendors that meet one of the conditions of G.S. 105-164.8(b) and yet refuse to collect use taxes on sales of tangible
personal property to purchasers in North Carolina. The conditions include: (a) maintenance of a retail establishment or
office; (b) presence of representatives in the State that solicit sales or transact business on behalf of the vendor; and (c)
systematic exploitation of the market by media-assisted, media-facilitated, or media-solicited means. The Contractor certifies
that it and all of its affiliates (if any) collect all required taxes.
E-Verify
Pursuant to G.S. 143-48.5 and G.S. 147-33.95(g), the undersigned hereby certifies that the Contractor named below, and the
Contractor’s subcontractors, complies with the requirements of Article 2 of Chapter 64 of the NC General Statutes, including
the requirement for each employer with more than 25 employees in North Carolina to verify the work authorization of its
employees through the federal E-Verify system." E-Verify System Link: www.uscis.gov
Miscellaneous
Choice of Law: The validity of this contract and any of its terms or provisions, as well as the rights and duties of the parties
to this contract, are governed by the laws of North Carolina. The Contractor, by signing this contract, agrees and submits,
solely for matters concerning this Contract, to the exclusive jurisdiction of the courts of North Carolina and agrees, solely for
such purpose, that the exclusive venue for any legal proceedings shall be the county is which the contract originated. The
place of this contract and all transactions and agreements relating to it, and their situs and forum, shall be the county where
the contract originated, where all matters, whether sounding in contract or tort, relating to the validity, construction,
interpretation, and enforcement shall be determined.
Amendment: This contract may not be amended orally or by performance. Any amendment must be made in written form
and executed by duly authorized representatives of the County and the Contractor.
Severability: In the event that a court of competent jurisdiction holds that a provision or requirement of this contract
violates any applicable law, each such provision or requirement shall continue to be enforced to the extent it is not in
violation of law or is not otherwise unenforceable and all other provisions and requirements of this contract shall remain in
full force and effect.
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Headings: The Section and Paragraph headings in these General Terms and Conditions are not material parts of the
agreement and should not be used to construe the meaning thereof.
Time of the Essence: Time is of the essence in the performance of this contract.
Key Personnel: The Contractor shall not replace any of the key personnel assigned to the performance of this contract
without the prior written approval of the County. The term “key personnel” includes any and all persons identified as such
in the contract documents and any other persons subsequently identified as key personnel by the written agreement of the
parties.
Care of Property: The Contractor agrees that it shall be responsible for the proper custody and care of any property
furnished to it for use in connection with the performance of this contract and will reimburse the County for loss of, or
damage to, such property. At the termination of this contract, the Contractor shall contact the County for instructions as to
the disposition of such property and shall comply with these instructions.
Travel Expenses: Reimbursement to the Contractor for travel mileage, meals, lodging and other travel expenses incurred in
the performance of this contract shall not exceed the rates established in County policy.
Sales/Use Tax Refunds: If eligible, the Contractor and all subcontractors shall: (a) ask the North Carolina Department of
Revenue for a refund of all sales and use taxes paid by them in the performance of this contract, pursuant to G.S. 105-
164.14; and (b) exclude all refundable sales and use taxes from all reportable expenditures before the expenses are entered
in their reimbursement reports.
Advertising: The Contractor shall not use the award of this contract as a part of any news release or commercial advertising.
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ATTACHMENT B – Scope of Work Federal Tax Id. 56-199 9585
STATE OF NORTH CAROLINA )
)
) CONTRACT FOR LEGAL SERVICES
)
COUNTY OF Person )
THIS CONTRACT made and entered into this the 1st day of July, 2016, by and
between the Person County Commissioners, party of the first part, and Julie A. Ramsey,
Attorney, party of the second part;
W I T N E S S E T H :
The parties hereby agree that the party of the second part shall provide legal
services to the party of the first part pursuant to the following mutual covenants:
1. This Contract shall begin July 1, 2016, and unless sooner terminated by 30
days’ notice of either party shall exist and continue through June 30, 2017.
2. Said party of the second part, upon reasonable notice, is to be available for
consultation, legal advice and for representation as requested by the Child Support
Enforcement Agency on all legal matters arising from the duties of the party of the first
part under Sections 128 through 140 of Chapter 110 of the North Carolina General
Statutes and Title 42 of the United States Code, Sections 651 through 660 and the
federal regulations lawfully promulgated pursuant thereto.
3. Said party of the second part, agrees to comply with all the requirements of
Sections 128 through 140 of Chapter 110 of the North Carolina General Statutes, Title
42 of the United States Code, Sections 651 through 660, and the regulations
promulgated pursuant thereto relating to the performance of program legal services
including, but not limited to, maintaining such records as are required by the party of the
first part, to make said records available for federal or state audit if required, and to
make financial, statistical, and program progress reports as are required.
4. For her services under this contract, the party of the first part agrees to pay
the party of the second part seventy-five dollars ($75.00) per hour for out of court time
and seventy-five dollars ($75.00) per hour for in court time for each hour spent by the
party of the second part providing legal services under the Child Support Enforcement
Program. Such hourly rate shall encompass all expenses, including, but not limited to,
those for salary, supplies, office space, heating and maintenance for office space,
telephone service, long-distance telephone calls, and travel. The party of the second
part is not to be reimbursed for any extraordinary expense incident to performing the
services included under this agreement; except, that the party of the first part agrees to
pay all court costs and filing fees which are required to be paid in conjunction with
services provided by the attorney under this agreement.
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5. It is specifically agreed that the party of the second part is an independent
contractor and the party of the second part shall perform the services herein provided
according to his own judgment and method and shall not be subject to the control of the
party of the first part except as to the result of his work.
6. The party of the second part shall not under any circumstance be considered
an employee of the party of the first part. The party of the first part shall not withhold
federal or state taxes from sums to be paid to the party of the second part pursuant to
this agreement.
IN TESTIMONY WHEREOF, said parties have executed this contract in triplicate
originals, one of which is to be retained by the party of the first part, one of which is to
be retained by the parties of the second part, and one of which is to be filed with Child
Support Enforcement Section, Division of Social Services of the Department of Human
Resources, Raleigh, North Carolina.
Julie A. Ramsey, Attorney At Law
____________________________ _________________________
Signature Date
David Newell, Sr.
____________________________ _________________________
Chairman, County Commissioners Date
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ATTACHMENT C
CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS
AND CERTIFICATION REGARDING NONDISCRIMINATION
Person County Department of Social Services
I. By execution of this Agreement the Contractor certifies that it will provide a drug-free workplace by:
A. Publishing a statement notifying employees that the unlawful manufacture, distribution, dispensing, possession or use of a controlled substance is prohibited in the Contractor’s workplace and specifying the actions that will be taken against employees for violation of
such prohibition;
B. Establishing a drug-free awareness program to inform employees about: (1) The dangers of drug abuse in the workplace; (2) The Contractor’s policy of maintaining a drug-free workplace; (3) Any available drug counseling, rehabilitation, and employee assistance programs; and
(4) The penalties that may be imposed upon employees for drug abuse violations
occurring in the workplace;
C. Making it a requirement that each employee be engaged in the performance of the agreement be given a copy of the statement required by paragraph (A); D. Notifying the employee in the statement required by paragraph (A) that, as a condition of employment under the agreement, the employee will:
(1) Abide by the terms of the statement; and
(2) Notify the employer of any criminal drug statute conviction for a violation occurring in the workplace no later than five days after such conviction;
E. Notifying the County within ten days after receiving notice under subparagraph (D)(2) from an employee or otherwise receiving actual notice of such conviction; F. Taking one of the following actions, within 30 days of receiving notice under
subparagraph (D)(2), with respect to any employee who is so convicted:
(1) Taking appropriate personnel action against such an employee, up to and including termination; or (2) Requiring such employee to participate satisfactorily in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State, or local health, law enforcement, or other appropriate agency; and
Making a good faith effort to continue to maintain a drug-free workplace through
implementation of paragraphs (A), (B), (C), (D), (E), and (F).
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The site(s) for the performance of work done in connection with the specific agreement are
listed below:
22 Court Street, Suite 200, Roxboro, NC 27573
Contractor will inform the County of any additional sites for performance of work under this agreement. False certification or violation of the certification shall be grounds for suspension of payment,
suspension or termination of grants, or government-wide Federal suspension or debarment
45 C.F.R. Section 82.510. Section 4 CFR Part 85, Section 85.615 and 86.620.
Certification Regarding Nondiscrimination
The Vendor certifies that it will comply with all Federal statutes relating to nondiscrimination.
These include but are not limited to: (a) Title VI of the Civil Rights Act of 1964 (P.L. 88-352)
which prohibits discrimination on the basis of race, color or national origin; (b) Title IX of the
Education Amendments of 1972, as amended (20 U.S.C. §§1681-1683, and 1685-1686), which
prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as
amended (29 U.S.C. §794), which prohibits discrimination on the basis of handicaps; (d) the Age
Discrimination Act of 1975, as amended (42 U.S.C. §§6101-6107), which prohibits
discrimination on the basis of age; (e) the Drug Abuse Office and Treatment Act of 1972 (P.L.
92-255), as amended, relating to nondiscrimination on the basis of drug abuse; (f) the
Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of
1970 (P.L. 91-616), as amended, relating to nondiscrimination on the basis of alcohol abuse or
alcoholism; (g) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. §§3601 et seq.), as
amended, relating to nondiscrimination in the sale, rental or financing of housing; (h) the Food
Stamp Act and USDA policy, which prohibit discrimination on the basis of religion and political
beliefs; and (i) the requirements of any other nondiscrimination statutes which may apply to this
Agreement.
Julie A. Ramsey, Attorney At Law
____________________________ _________________________
Signature Date
David Newell, Sr.
____________________________ _________________________
Chairman, County Commissioners Date
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ATTACHMENT D:
CONFLICT OF INTEREST
The Board of Directors/Trustees or other governing persons, officers, employees or agents are to avoid
any conflict of interest, even the appearance of a conflict of interest. The Organization‘s Board of
Directors/Trustees or other governing body, officers, staff and agents are obligated to always act in the
best interest of the organization. This obligation requires that any Board member or other governing
person, officer, employee or agent, in the performance of Organization duties, seek only the furtherance
of the Organization mission. At all times, Board members or other governing persons, officers, employees
or agents, are prohibited from using their job title, the Organization's name or property, for private profit or
benefit.
A. The Board members or other governing persons, officers, employees, or agents of the Organization
should neither solicit nor accept gratuities, favors, or anything of monetary value from current or potential
contractors/vendors, persons receiving benefits from the Organization or persons who may benefit from
the actions of any Board member or other governing person, officer, employee or agent. This is not
intended to preclude bona-fide Organization fund raising-activities.
B. A Board or other governing body member may, with the approval of Board or other governing body,
receive honoraria for lectures and other such activities while not acting in any official capacity for the
Organization. Officers may, with the approval of the Board or other governing body, receive honoraria for
lectures and other such activities while on personal days, compensatory time, annual leave, or leave
without pay. Employees may, with the prior written approval of their supervisor, receive honoraria for
lectures and other such activities while on personal days, compensatory time, annual leave, or leave
without pay. If a Board or other governing body member, officer, employee or agent is acting in any
official capacity, honoraria received in connection with activities relating to the Organization are to be paid
to the Organization.
C. No Board member or other governing person, officer, employee, or agent of the Organization shall
participate in the selection, award, or administration of a purchase or contract with a vendor where, to his
knowledge, any of the following has a financial interest in that purchase or contract:
1. The Board member or other governing person, officer, employee, or agent;
2. Any member of their family by whole or half blood, step or personal relationship or relative-in-law;
3. An organization in which any of the above is an officer, director, or employee;
4. A person or organization with whom any of the above individuals is negotiating or has any
arrangement concerning prospective employment or contracts.
D. Duty to Disclosure -- Any conflict of interest, potential conflict of interest, or the appearance of a
conflict of interest is to be reported to the Board or other governing body or one’s supervisor immediately.
E. Board Action -- When a conflict of interest is relevant to a matter requiring action by the Board of
Directors/Trustees or other governing body, the Board member or other governing person, officer,
employee, or agent (person(s)) must disclose the existence of the conflict of interest and be given the
opportunity to disclose all material facts to the Board and members of committees with governing board
delegated powers considering the possible conflict of interest. After disclosure of all material facts, and
after any discussion with the person, he/she shall leave the governing board or committee meeting while
the determination of a conflict of interest is discussed and voted upon. The remaining board or committee
members shall decide if a conflict of interest exists. In addition, the person(s) shall not participate in the
final deliberation or decision regarding the matter under consideration and shall leave the meeting during
the discussion of and vote of the Board of Directors/Trustees or other governing body.
F. Violations of the Conflicts of Interest Policy -- If the Board of Directors/Trustees or other governing
body has reasonable cause to believe a member, officer, employee or agent has failed to disclose actual
or possible conflicts of interest, it shall inform the person of the basis for such belief and afford the person
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an opportunity to explain the alleged failure to disclose. If, after hearing the person's response and after
making further investigation as warranted by the circumstances, the Board of Directors/Trustees or other
governing body determines the member, officer, employee or agent has failed to disclose an actual or
possible conflict of interest, it shall take appropriate disciplinary and corrective action.
G. Record of Conflict -- The minutes of the governing board and all committees with board delegated
powers shall contain:
1. The names of the persons who disclosed or otherwise were found to have an actual or possible
conflict of interest, the nature of the conflict of interest, any action taken to determine whether a
conflict of interest was present, and the governing board's or committee's decision as to whether
a conflict of interest in fact existed.
2. The names of the persons who were present for discussions and votes relating to the transaction
or arrangement that presents a possible conflict of interest, the content of the discussion,
including any alternatives to the transaction or arrangement, and a record of any votes taken in
connection with the proceedings.
NOTARIZED CONFLICT OF INTEREST POLICY
Julie A. Ramsey, Attorney At Law
_________________________________ _________________________
Signature Date
NORTH CAROLINA
PERSON COUNTY
I, __________________________, a Notary Public of said County and State do hereby certify that Julie A. Ramsey,
Attorney at Law, personally appeared before me this date and acknowledged the due execution of the foregoing
agreement for the purposes therein expressed and by that authority duly given and as the act of the Organization,
affirmed that the foregoing Conflict of Interest Policy was adopted by the Board of Directors/Trustees or other
governing body in a meeting held on the __________ day of ___________, _________.
Sworn to and subscribed before me this _________ day of ______________________, 2016.
___________________________
Notary Public
My Commission expires: __________________
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ATTACHMENT E – OVERDUE TAXES
JULIE A. RAMSEY
--------------------------------------ATTORNEY AT LAW------------------------------------
22 Court Street, Suite 200 336-599-5004 – Telephone
P.O. Box 3130 336-599-5007 – Fax
Roxboro, NC 27573 julie.ramsey@esinc.net
______________, 2016
To: Person County Department of Social Services
Certification:
I, Julie A. Ramsey, certify that I do not have any overdue tax debts, as defined by N.C.G.S. 105-243.1, at the
federal, State, or local level. I further understand that any person who makes a false statement in violation of
N.C.G.S. 143C-6-23(c) is guilty of a criminal offense punishable as provided by N.C.G.S.) 143C-10-1b.
Sworn Statement:
I, Julie A. Ramsey, being duly sworn, say that the foregoing certification is true, accurate and complete to the
best of my knowledge and was made and subscribed by me. I also acknowledge and understand that any
misuse of State funds will be reported to the appropriate authorities for further action.
Julie A. Ramsey, Attorney At Law
____________________________ _________________________
Signature Date
NORTH CAROLINA
PERSON COUNTY
Sworn to and subscribed before me this _________ day of ______________________, 2016.
___________________________
Notary Public
My Commission expires: __________________
____________________
1 G.S. 105-243.1 defines: Overdue tax debt. – Any part of a tax debt that remains unpaid 90 days or more after the notice of final
assessment was mailed to the taxpayer. The term does not include a tax debt, however, if the taxpayer entered into an installment agreement for the tax debt under G.S. 105-237 within 90 days after the notice of final assessment was mailed and has not failed to
make any payments due under the installment agreement.”
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ATTACHMENT G
Person County Department of Social Services
Certification Regarding Lobbying
Certification for Contracts, Grants, Loans and Cooperative Agreements
The undersigned certifies, to the best of his or her knowledge and belief, that:
(1) No Federal appropriated funds have been paid or will be paid by or on behalf of the undersigned, to any
person for influencing or attempting to influence an officer or employee of any Federal, state or local
government agency, a Member of Congress, a Member of the General Assembly, an officer or employee of
Congress, an officer or employee of the General Assembly, an employee of a Member of Congress, or an
employee of a Member of the General Assembly in connection with the awarding of any Federal or state
contract, the making of any Federal or state grant, the making of any Federal or state loan, the entering into
of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any
Federal or state contract, grant, loan, or cooperative agreement.
(2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for
influencing or attempting to influence an officer or employee of any Federal, state or local government
agency, a Member of Congress, a Member of the General Assembly, an officer or employee of Congress,
an officer or employee of the General Assembly, an employee of a Member of Congress, or an employee of
a Member of the General Assembly in connection with the awarding of any Federal or state contract, the
making of any Federal or state grant, the making of any Federal or state loan, the entering into of any
cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any
Federal or state contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit
Standard
Form LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions.
(3) The undersigned shall require that the language of this certification be included in the award documents for
all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and
cooperative agreements) and that all subrecipients shall certify and disclose accordingly.
(4) This certification is a material representation of fact upon which reliance was placed when this transaction
was made or entered into. Submission of this certification is a prerequisite for making or entering into this
transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required
certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each
such failure.
Notwithstanding other provisions of federal OMB Circulars-CFR Title 2, Grants and Agreements, Part 200, costs
associated with the following activities are unallowable:
Paragraph A.
(1) Attempts to influence the outcomes of any Federal, State, or local election, referendum, initiative, or
similar procedure, through in kind or cash contributions, endorsements, publicity, or similar activity;
(2) Establishing, administering, contributing to, or paying the expenses of a political party, campaign, political
action committee, or other organization established for the purpose of influencing the outcomes of
elections;
(3) Any attempt to influence: (i) The introduction of Federal or State legislation; or (ii) the enactment or
modification of any pending Federal or State legislation through communication with any member or
employee of the Congress or State legislature (including efforts to influence State or local officials to
engage in similar lobbying activity), or with any Government official or employee in connection with a
decision to sign or veto enrolled legislation;
(4) Any attempt to influence: (i) The introduction of Federal or State legislation; or (ii) the enactment or
modification of any pending Federal or State legislation by preparing, distributing or using publicity or
propaganda, or by urging members of the general public or any segment thereof to contribute to or
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participate in any mass demonstration, march, rally, fundraising drive, lobbying campaign or letter writing
or telephone campaign; or
(5) Legislative liaison activities, including attendance at legislative sessions or committee hearings, gathering
information regarding legislation, and analyzing the effect of legislation, when such activities are carried on
in support of or in knowing preparation for an effort to engage in unallowable lobbying.
The following activities as enumerated in Paragraph B are excepted from the coverage of Paragraph A:
Paragraph B.
(1) Providing a technical and factual presentation of information on a topic directly related to the performance
of a grant, contract or other agreement through hearing testimony, statements or letters to the Congress or a
State legislature, or subdivision, member, or cognizant staff member thereof, in response to a documented
request (including a Congressional Record notice requesting testimony or statements for the record at a
regularly scheduled hearing) made by the recipient member, legislative body or subdivision, or a cognizant
staff member thereof; provided such information is readily obtainable and can be readily put in deliverable
form; and further provided that costs under this section for travel, lodging or meals are unallowable unless
incurred to offer testimony at a regularly scheduled Congressional hearing pursuant to a written request for
such presentation made by the Chairman or Ranking Minority Member of the Committee or Subcommittee
conducting such hearing.
(2) Any lobbying made unallowable by subparagraph A (3) to influence State legislation in order to directly
reduce the cost, or to avoid material impairment of the organization's authority to perform the grant,
contract, or other agreement.
(3) Any activity specifically authorized by statute to be undertaken with funds from the grant, contract, or other
agreement.
Paragraph C.
(1) When an organization seeks reimbursement for indirect costs, total lobbying costs shall be separately
identified in the indirect cost rate proposal, and thereafter treated as other unallowable activity costs in
accordance with the procedures of subparagraph B.(3).
(2) Organizations shall submit, as part of the annual indirect cost rate proposal, a certification that the
requirements and standards of this paragraph have been complied with.
(3) Organizations shall maintain adequate records to demonstrate that the determination of costs as being
allowable or unallowable pursuant to this section complies with the requirements of this Circular.
(4) Time logs, calendars, or similar records shall not be required to be created for purposes of complying with
this paragraph during any particular calendar month when: (1) the employee engages in lobbying (as
defined in subparagraphs (a) and (b)) 25 percent or less of the employee's compensated hours of
employment during that calendar month, and (2) within the preceding five-year period, the organization has
not materially misstated allowable or unallowable costs of any nature, including legislative lobbying costs.
When conditions (1) and (2) are met, organizations are not required to establish records to support the
allowability of claimed costs in addition to records already required or maintained. Also, when conditions
(1) and (2) are met, the absence of time logs, calendars, or similar records will not serve as a basis for
disallowing costs by contesting estimates of lobbying time spent by employees during a calendar month.
(5) Agencies shall establish procedures for resolving in advance, in consultation with OMB, any significant
questions or disagreements concerning the interpretation or application of this section. Any such advance
resolution shall be binding in any subsequent settlements, audits or investigations with respect to that grant
or contract for purposes of interpretation of this Circular; provided, however, that this shall not be
construed to prevent a contractor or grantee from contesting the lawfulness of such a determination.
Paragraph D.
Executive lobbying costs. Costs incurred in attempting to improperly influence either directly or indirectly, an
employee or officer of the Executive Branch of the Federal Government to give consideration or to act
regarding a sponsored agreement or a regulatory matter are unallowable. Improper influence means any
influence that induces or tends to induce a Federal employee or officer to give consideration or to act regarding
a federally sponsored agreement or regulatory matter on any basis other than the merits of the matter.
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Julie A. Ramsey, Attorney At Law
____________________________ _________________________
Signature Date
David Newell, Sr.
____________________________ _________________________
Chairman, County Commissioners Date
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ATTACHMENT H
PERSON COUNTY DEPARTMENT OF SOCIAL SERVICES
CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY
AND VOLUNTARY EXCLUSION-LOWER TIER COVERED TRANSACTIONS
Instructions for Certification
1. By signing and submitting this proposal, the prospective lower tier participant is providing the
certification set out below.
2. The certification in this clause is a material representation of the fact upon which reliance was
placed when this transaction was entered into. If it is later determined that the prospective lower
tier participant knowingly rendered an erroneous certification, in addition to other remedies
available to the Federal Government, the department or agency with which this transaction
originated may pursue available remedies, including suspension and/or debarment.
3. The prospective lower tier participant will provide immediate written notice to the person to
whom the proposal is submitted if at any time the prospective lower tier participant learns that its
certification was erroneous when submitted or has become erroneous by reason of changed
circumstances.
4. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered
transaction," "participant," "person," "primary covered transaction," "principal," "proposal," and
"voluntarily excluded," as used in this clause, have the meanings set out in the Definitions and
Coverage sections of rules implementing Executive Order 12549. You may contact the person to
which this proposal is submitted for assistance in obtaining a copy of those regulations.
5. The prospective lower tier participant agrees by submitting this proposal that, should the
proposed covered transaction be entered into, it shall not knowingly enter any lower tier covered
transaction with a person who is debarred, suspended, determined ineligible or voluntarily
excluded from participation in this covered transaction unless authorized by the department or
agency with which this transaction originated.
6. The prospective lower tier participant further agrees by submitting this proposal that it will
include this clause titled "Certification Regarding Debarment, Suspension, Ineligibility and
Voluntary Exclusion - Lower Tier Covered Transaction," without modification, in all lower tier
covered transactions and in all solicitations for lower tier covered transactions.
7. A participant in a covered transaction may rely upon a certification of a prospective
participant in a lower tier covered transaction that it is not debarred, suspended, ineligible, or
voluntarily excluded from covered transaction, unless it knows that the certification is erroneous.
A participant may decide the method and frequency of which it determines the eligibility of its
principals. Each participant may, but is not required to, check the Nonprocurement List.
8. Nothing contained in the foregoing shall be construed to require establishment of a system of
records in order to render in good faith the certification required by this clause. The knowledge
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and information of a participant is not required to exceed that which is normally possessed by a
prudent person in the ordinary course of business dealings.
9. Except for transactions authorized in paragraph 5 of these instructions, if a participant in a
covered transaction knowingly enters into a lower tier covered transaction with a person who is
suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in
addition to other remedies available to the Federal Government, the department or agency with
which this transaction originated may pursue available remedies, including suspension, and/or
debarment.
Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion - Lower
Tier Covered Transactions
(1) The prospective lower tier participant certifies, by submission of this proposal, that neither it
nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or
voluntarily excluded from participation in this transaction by any Federal department or agency.
(2) Where the prospective lower tier participant is unable to certify to any of the statements in this
certification, such prospective participant shall attach an explanation to this proposal.
Julie A. Ramsey, Attorney At Law
____________________________ _________________________
Signature Date
David Newell, Sr.
____________________________ _________________________
Chairman, County Commissioners Date
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ATTACHMENT I
PERSON COUNTY
DEPARTMENT OF SOCIAL SERVICES
BUSINESS ASSOCIATE ADDENDUM
This Agreement is made effective the 1st day of July, 2016, by and between Person County
Department of Social Services (“Covered Entity”) and Julie A. Ramsey, Attorney at Law
(“Business Associate”) (collectively the “Parties”).
1. BACKGROUND
a. Covered Entity and Business Associate are parties to a contract entitled Legal Services
Contract (the “Contract”), whereby Business Associate agrees to perform certain services for or
on behalf of Covered Entity.
b. Covered Entity is an organizational unit of Person County as the Person County Department
of Social Services (DSS) as a health care component for purposes of the HIPAA Privacy Rule.
c. The relationship between Covered Entity and Business Associate is such that the Parties
believe Business Associate is or may be a “business associate” within the meaning of the HIPAA
Privacy Rule.
d. The Parties enter into this Business Associate Addendum to the Contract with the intention of
complying with the HIPAA Privacy Rule provision that a covered entity may disclose protected
health information to a business associate, and may allow a business associate to create or
receive protected heath information on its behalf, if the covered entity obtains satisfactory
assurances that the business associate will appropriately safeguard the information.
2. DEFINITIONS
Unless some other meaning is clearly indicated by the context, the following terms shall have the
following meaning in this Agreement:
a. “HIPAA” means the Administrative Simplification Provisions, Sections 261 through 264, of
the federal Health Insurance Portability and Accountability Act of 1996, Public Law 104-191.
b. “Individual” shall have the same meaning as the term “individual” in 45 CFR160.103 and
shall include a person who qualifies as a personal representative in accordance with 45 CFR
164.502(g).
c. “Privacy Rule” shall mean the Standards for Privacy of Individually Identifiable Health
Information at 45 CFR part 160 and part 164, subparts A and E.
d. “Protected Health Information” shall have the same meaning as the term “protected health
information” in 45 CFR 160.103, limited to the information created or received by Business
Associate from or on behalf of Covered Entity.
e. “Required By Law” shall have the same meaning as the term “required by law” in 45 CFR
164.103.
f. “Secretary” shall mean the Secretary of the United States Department of Health and Human
Services or his designee.
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g. Unless otherwise defined in this Agreement, terms used herein shall have the same meaning
as those terms have in the Privacy Rule.
3. OBLIGATIONS OF BUSINESS ASSOCIATE
a. Business Associate agrees to not use or disclose Protected Health Information other than as
permitted or required by this Agreement or as Required By Law.
b. Business Associate agrees to use appropriate safeguards to prevent use or disclosure of the
Protected Health Information other than as provided for by this Agreement.
c. Business Associate agrees to mitigate, to the extent practicable, any harmful effect that is
known to Business Associate of a use or disclosure of Protected Health Information by Business
Associate in violation of the requirements of this Agreement.
d. Business Associate agrees to report to Covered Entity any use or disclosure of the Protected
Health Information not provided for by this Agreement of which it becomes aware.
e. Business Associate agrees to ensure that any agent, including a subcontractor, to whom it
provides Protected Health Information received from, or created or received by Business
Associate on behalf of Covered Entity agrees to the same restrictions and conditions that apply
through this Agreement to Business Associate with respect to such information.
f. Business Associate agrees to provide access, at the request of Covered Entity, to Protected
Health Information in a Designated Record Set to Covered Entity or, as directed by Covered
Entity, to an Individual in order to meet the requirements under 45 CFR 164.524.
g. Business Associate agrees, at the request of the Covered Entity, to make any amendment(s) to
Protected Health Information in a Designated Record Set that the Covered Entity directs or
agrees to pursuant to 45 CFR 164.526.
h. Unless otherwise prohibited by law, Business Associate agrees to make internal practices,
books, and records, including policies and procedures and Protected Health Information, relating
to the use and disclosure of Protected Health Information received from, or created or received
by Business Associate on behalf of Covered Entity, available to the Covered Entity, or to the
Person County Department of Social Services, in a time and manner designated by the
Secretary, for purposes of determining Covered Entity's compliance with the Privacy Rule.
i. Business Associate agrees to document such disclosures of Protected Health Information and
information related to such disclosures as would be required for Covered Entity to respond to a
request by an Individual for an accounting of disclosures of Protected Health Information in
accordance with 45 CFR 164.528, and to provide this information to Covered Entity or an
Individual to permit such a response.
4. PERMITTED USES AND DISCLOSURES
a. Except as otherwise limited in this Agreement or by other applicable law or agreement, if the
Contract permits, Business Associate may use or disclose Protected Health Information to
perform functions, activities, or services for, or on behalf of, Covered Entity as specified in the
Contract, provided that such use or disclosure:
1) would not violate the Privacy Rule if done by Covered Entity; or
2) would not violate the minimum necessary policies and procedures of the Covered
Entity.
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b. Except as otherwise limited in this Agreement or by other applicable law or agreements, if the
Contract permits, Business Associate may use Protected Health Information as necessary for the
proper management and administration of the Business Associate or to carry out the legal
responsibilities of the Business Associate.
c. Except as otherwise limited in this Agreement or by other applicable law or agreements, if the
Contract permits, Business Associate may disclose Protected Health Information for the proper
management and administration of the Business Associate, provided that:
1) disclosures are Required By Law; or
2) Business Associate obtains reasonable assurances from the person to whom the
information is disclosed that it will remain confidential and will be used or further
disclosed only as Required By Law or for the purpose for which it was disclosed to the
person, and the person notifies the Business Associate of any instances of which it is
aware in which the confidentiality of the information has been breached.
d. Except as otherwise limited in this Agreement or by other applicable law or agreements, if the
Contract permits, Business Associate may use Protected Health Information to provide data
aggregation services to Covered Entity as permitted by 45 CFR 164.504(e)(2)(i)(B).
e. Notwithstanding the foregoing provisions, Business Associate may not use or disclose
Protected Health Information if the use or disclosure would violate any term of the Contract or
other applicable law or agreements.
5. TERM AND TERMINATION
a. Term. This Agreement shall be effective as of the effective date stated above and shall
terminate when the Contract terminates.
b. Termination for Cause. Upon Covered Entity's knowledge of a material breach by Business
Associate, Covered Entity may, at its option:
1) Provide an opportunity for Business Associate to cure the breach or end the violation,
and terminate this Agreement and services provided by Business Associate, to the extent
permissible by law, if Business Associate does not cure the breach or end the violation
within the time specified by Covered Entity;
2) Immediately terminate this Agreement and services provided by Business Associate,
to the extent permissible by law; or
3) If neither termination nor cure is feasible, report the violation to the Secretary as
provided in the Privacy Rule.
c. Effect of Termination.
1) Except as provided in paragraph (2) of this section or in the Contract or by other
applicable law or agreements, upon termination of this Agreement and services provided
by Business Associate, for any reason, Business Associate shall return or destroy all
Protected Health Information received from Covered Entity, or created or received by
Business Associate on behalf of Covered Entity. This provision shall apply to Protected
Health Information that is in the possession of subcontractors or agents of Business
Associate. Business Associate shall retain no copies of the Protected Health Information.
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2) In the event that Business Associate determines that returning or destroying the
Protected Health Information is not feasible, Business Associate shall provide to Covered
Entity notification of the conditions that make return or destruction not feasible. Business
Associate shall extend the protections of this Agreement to such Protected Health
Information and limit further uses and disclosures of such Protected Health Information
to those purposes that make the return or destruction infeasible, for so long as Business
Associate maintains such Protected Health Information.
6. GENERAL TERMS AND CONDITIONS
a. This Agreement amends and is part of the Contract.
b. Except as provided in this Agreement, all terms and conditions of the Contract shall remain in
force and shall apply to this Agreement as if set forth fully herein.
c. In the event of a conflict in terms between this Agreement and the Contract, the interpretation
that is in accordance with the Privacy Rule shall prevail. In the event that a conflict then
remains, the Contract terms shall prevail so long as they are in accordance with the Privacy Rule.
d. A breach of this Agreement by Business Associate shall be considered sufficient basis for
Covered Entity to terminate the Contract for cause.
Julie A. Ramsey, Attorney At Law
____________________________ _________________________
Signature Date
David Newell, Sr.
____________________________ _________________________
Chairman, County Commissioners Date
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Attachment M
State Certification
Contractor Certifications Required by North Carolina Law
Instructions
The person who signs this document should read the text of the statutes listed below and consult with
counsel and other knowledgeable persons before signing.
The text of Article 2 of Chapter 64 of the North Carolina General Statutes can be found online at:
http://www.ncga.state.nc.us/EnactedLegislation/Statutes/PDF/ByArticle/Chapter_64/Article_2.pdf
The text of G.S. 105-164.8(b) can be found online at:
http://www.ncga.state.nc.us/EnactedLegislation/Statutes/PDF/BySection/Chapter_105/GS_105-
164.8.pdf
The text of G.S. 143-48.5 (S.L. 2013-418, s. 2.(d)) can be found online at:
http://www.ncga.state.nc.us/Sessions/2013/Bills/House/PDF/H786v6.pdf
The text of G.S. 143-59.1 can be found online at:
http://www.ncga.state.nc.us/EnactedLegislation/Statutes/PDF/BySection/Chapter_143/GS_143-
59.1.pdf
The text of G.S. 143-59.2 can be found online at:
http://www.ncga.state.nc.us/EnactedLegislation/Statutes/PDF/BySection/Chapter_143/GS_143-
59.2.pdf
The text of G.S. 147-33.95(g) (S.L. 2013-418, s. 2.(e)) can be found online at:
http://www.ncga.state.nc.us/Sessions/2013/Bills/House/PDF/H786v6.pdf
Certifications
(1) Pursuant to G.S. 143-48.5 and G.S. 147-33.95(g), the undersigned hereby certifies that the
Contractor named below, and the Contractor’s subcontractors, complies with the requirements of
Article 2 of Chapter 64 of the NC General Statutes, including the requirement for each employer
with more than 25 employees in North Carolina to verify the work authorization of its employees
through the federal E-Verify system." E-Verify System Link: www.uscis.gov
Local government is specifically exempt from Article 2 of Chapter 64 of the North Carolina
General Statutes. However, local government is subject to and must comply with North Carolina
General Statute §153A-99.1., which states in part as follows:
Counties Must Use E-Verify. - Each county shall register and participate in E-Verify to verify the
work authorization of new employees hired to work in the United States.
(2) Pursuant to G.S. 143-59.1(b), the undersigned hereby certifies that the Contractor named below
is not an “ineligible Contractor” as set forth in G.S. 143-59.1(a) because:
(a) Neither the Contractor nor any of its affiliates has refused to collect the use tax levied
under Article 5 of Chapter 105 of the General Statutes on its sales delivered to North
Carolina when the sales met one or more of the conditions of G.S. 105-164.8(b); and
(b) [check one of the following boxes]
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Neither the Contractor nor any of its affiliates has incorporated or reincorporated
in a “tax haven country” as set forth in G.S. 143-59.1(c)(2) after December 31,
2001; or
The Contractor or one of its affiliates has incorporated or reincorporated in a “tax
haven country” as set forth in G.S. 143-59.1(c)(2) after December 31, 2001 but
the United States is not the principal market for the public trading of the stock of
the corporation incorporated in the tax haven country.
(3) Pursuant to G.S. 143-59.2(b), the undersigned hereby certifies that none of the Contractor’s
officers, directors, or owners (if the Contractor is an unincorporated business entity) has been
convicted of any violation of Chapter 78A of the General Statutes or the Securities Act of 1933 or
the Securities Exchange Act of 1934 within 10 years immediately prior to the date of the bid
solicitation.
(4) The undersigned hereby certifies further that:
(a) He or she is a duly authorized representative of the Contractor named below;
(b) He or she is authorized to make, and does hereby make, the foregoing certifications on
behalf of the Contractor; and
(c) He or she understands that any person who knowingly submits a false certification in
response to the requirements of G.S. 143-59.1 and -59.2 shall be guilty of a Class I
felony.
Contractor’s Name: Julie A. Ramsey
Signature of Contractor’s Authorized Agent
Date
Printed Name of Contractor’s Authorized Agent
Julie A. Ramsey
Title
Attorney at Law
Signature of Witness
Title
Printed Name of Witness
Date
The witness should be present when the Contractor’s Authorized Agent signs this certification and should
sign and date this document immediately thereafter.
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Attachment N
CERTIFICATION OF
ELIGIBILITY
Under the Iran
Divestment Act
Pursuant to G.S. 147-86.59, any person identified as engaging in investment activities in
Iran, determined by appearing on the Final Divestment List created by the State
Treasurer pursuant to G.S. 147-86.58, is ineligible to contract with the State of North
Carolina or any political subdivision of the State. The Iran Divestment Act of 2015, G.S.
147-86.55 et seq.* requires that each vendor, prior to contracting with the State certify,
and the undersigned on behalf of the Vendor does hereby certify, to the following:
1. that Julie A. Ramsey, Attorney At Law, is not identified on the Final
Divestment List of entities that the State Treasurer has determined engages in
investment activities in Iran;
2. that Julie A. Ramsey, Attorney At Law, shall not utilize on any contract with the
State agency any subcontractor that is identified on the Final Divestment List; and
3. that Julie A. Ramsey, Attorney At Law, is authorized to make this Certification.
Julie A. Ramsey, Attorney At Law
____________________________ _________________________
Signature Date
* Note: Enacted by Session Law 2015‐118 as G.S. 143C‐55 et seq., but has been renumbered for
codification at the direction of the Revisor of Statutes.
The State Treasurer’s Final Divestment List can be found on the State Treasurer’s website at the address:
https://www.nctreasurer.com/inside‐the‐department/OpenGovernment/Pages/Iran‐Divestment‐Act‐Resources.aspx
and will be updated every 180 days. For questions about the Department of State Treasurer’s Iran Divestment
Policy, please contact Meryl Murtagh at Meryl.Murtagh@nctreasurer.com or (919) 814‐3852.
325
AGENDA ABSTRACT
Meeting Date: July 18, 2016
Agenda Title: Tax Adjustments for July 2016
Summary of Information: Attached please find the tax releases and motor vehicle pending
refunds:
1. July 2016 tax releases.
2. July 2016 North Carolina Vehicle Tax System (NCVTS) pending refunds.
Recommended Action: Motion to accept reports and authorize refunds.
Submitted By: Russell Jones, Tax Administrator
326
COSSYS PERSON COUNTY TAX OFFICE COLLECTION SCROLL-12:LEVY ADJUSTMENTS ALL TAX YEARS 07072016 PAGE: 1
ACCOUNT # COLREC COUNTY-TAX DISTRICT DISTRICT DOG PENALTY INT/DISC LIEN-COST TOTAL NUMBER TRNREC CLRK DATE
DISTRICT-"
3973 1132013 WARREN LAWRENCE & FRANCES LEASEHOLD
3973 113 52001 -14.00 0.00- 0 0.00- 0 0.00 0.00 -4.02 0.00 -18.02 15530R 1991 MP 06222016
REASON:SHOP TORN DOWN 2010
3973 1142014 WARREN LAWRENCE & FRANCES LEASEHOLD 3973 114 55247 -14.00 0.00- 0 0.00- 0 0.00 0.00 -2.43 0.00 -16.43 15531R 1992 MP 06222016
REASON:SHOP TORN DOWN 2010
3973 3012015 WARREN LAWRENCE & FRANCES LEASEHOLD 3973 301 14574 -14.00 0.00- 0 0.00- 0 0.00 0.00 -0.87 0.00 -14.87 15532R 1993 MP 06222016 REASON:SHOP TORN DOWN 2010
62355 1132013 CAMARILLO JOSE PERS/SW/LT2/37 MARGIES 62355 113 51499 -30.03 0.00- 0 0.00- 0 0.00 -3.00 0.00 0.00 -33.03 15533R 1994 RH 06272016 -27.02-50 -2.70 0.00 -29.72__________ -62.75
REASON:CORRECT YR OF SW
62355 1142014 CAMARILLO JOSE PERS/SW/LT2/37 MARGIES 62355 114 54327 -30.03 0.00- 0 0.00- 0 0.00 -3.01 0.00 0.00 -33.04 15534R 1995 RH 06272016 -28.31-50 -2.83 0.00 -31.14__________
-64.18
REASON:CORRECT YEAR OF SW
62355 2012015 CAMARILLO JOSE PERS/SW/LT2/37 MARGIES 62355 201 33839 -30.03 0.00- 0 0.00- 0 0.00 -3.00 0.00 0.00 -33.03 15535R 1996 RH 06272016
-28.31-50 -2.83 0.00 -31.14__________
-64.17 REASON:CORRECT YEAR OF SW
40092 1062006 NEWMAN DALE LAMONT GS300 4S
40092 106 42490 -0.30 0.00- 0 0.00- 0 0.00 0.00 0.00 0.00 -0.30 2006R 1997 SRJ 06302016
-0.37-50 0.00 0.00 -0.37__________ -0.67 REASON:UNDER ONE DOLLAR
50687 1092009 LAZENBY BETTY RENEE LANCER ES 4S
50687 109 44342 -0.30 0.00- 0 0.00- 0 0.00 0.00 0.00 0.00 -0.30 2009R 1998 SRJ 06302016 -0.34-50 0.00 0.00 -0.34__________ -0.64 REASON:UNDER ONE DOLLAR
46504 1122012 CASH CHARLENE ANNETTA ACCORD LX 4S 46504 112 48463 -0.28 0.00- 0 0.00- 0 0.00 0.00 0.00 0.00 -0.28 2012R 1999 SRJ 06302016 -0.64-50 0.00 0.00 -0.64__________ -0.92
REASON:UNDER ONE DOLLAR
57413 1122012 GRAY MICHAEL LINN SUNFIRE GT CP 57413 112 48344 -0.18 0.00- 0 0.00- 0 0.00 0.00 0.00 0.00 -0.18 2012R 2000 SRJ 06302016 -0.31-50 0.00 0.00 -0.31__________
-0.49
REASON:UNDER ONE DOLLAR
41983 1132013 HOLDER BARBARA NICOLE EXPLORER XLT 4X2 4D MP 41983 113 51173 -0.43 0.00- 0 0.00- 0 0.00 0.00 0.00 0.00 -0.43 2013R 2001 SRJ 06302016
-0.52-50 0.00 0.00 -0.52__________
-0.95 REASON:UNDER ONE DOLLAR
4520 1132013 POOLE CLYDE SAMUEL 735I 4S
4520 113 51302 -0.06 0.00- 0 0.00- 0 0.00 0.00 0.00 0.00 -0.06 2013R 2002 SRJ 06302016
-0.16-50 0.00 0.00 -0.16__________ -0.22 REASON:UNDER ONE DOLLAR
99330 9022015 ALLENS CHAPEL BAPTIST CHURCH CHURCH/A RELIGIOUS
99330 902 16413 0.00 0.00- 0 -0.60-30 0.00 0.00 0.00 0.00 -0.60 2015R 2003 SRJ 06302016
REASON:UNDER ONE DOLLAR
62568 3162015 BAGLEY R BLAIR NORTHWOOD/LT18/VL
62568 316 27334 -0.56 0.00- 0 -0.02-30 0.00 0.00 0.00 0.00 -0.58 2015R 2004 SRJ 06302016
REASON:UNDER ONE DOLLAR
35193 3022015 CRUTCHFIELD JESSE A JR & PAULI 3 ACRES & HOUSE 35193 302 21304 -0.41 0.00- 0 -0.01-30 0.00 0.00 0.00 0.00 -0.42 2015R 2005 SRJ 06302016
REASON:UNDER ONE DOLLAR
327
COSSYS PERSON COUNTY TAX OFFICE COLLECTION SCROLL-12:LEVY ADJUSTMENTS ALL TAX YEARS 07072016 PAGE: 2
ACCOUNT # COLREC COUNTY-TAX DISTRICT DISTRICT DOG PENALTY INT/DISC LIEN-COST TOTAL NUMBER TRNREC CLRK DATE
DISTRICT-"
60131 3012015 EMORY PAMELA SATTERFIELD 1 & 11/100 ACRES
60131 301 58265 -0.27 0.00- 0 0.00- 0 0.00 0.00 0.00 0.00 -0.27 2015R 2006 SRJ 06302016
REASON:UNDER ONE DOLLAR
65454 3012015 HUNT JANET ANN 2 & 51/100 ACRES 65454 301 4403 -0.03 0.00- 0 -0.01-30 0.00 0.00 0.00 0.00 -0.04 2015R 2007 SRJ 06302016
REASON:UNDER ONE DOLLAR
12479 3032015 JOHNSON WILLIAM I & LOISTEEN WINCO POINTE/LT27/VL 12479 303 22597 -0.58 0.00- 0 -0.02-30 0.00 0.00 0.00 0.00 -0.60 2015R 2008 SRJ 06302016 REASON:UNDER ONE DOLLAR
6034 3012015 STEWART IRENE MCCOY 1 ACRE & HOUSE 6034 301 1557 -0.01 0.00- 0 -0.01-30 0.00 0.00 0.00 0.00 -0.02 2015R 2009 SRJ 06302016 REASON:UNDER ONE DOLLAR
7156 3012015 STEWART MARVIN & HERFORD EST 69 & 14/100 ACRE FARM
7156 301 2962 -0.02 0.00- 0 -0.01-30 0.00 0.00 0.00 0.00 -0.03 2015R 2010 SRJ 06302016 REASON:UNDER ONE DOLLAR
3583 3012015 TROTTER EVELYN S FOREST HILLS/H&L
3583 301 8598 -0.01 0.00- 0 -0.01-30 0.00 0.00 0.00 0.00 -0.02 2015R 2011 SRJ 06302016
REASON:UNDER ONE DOLLAR
56204 3012015 WILLIFORD RORY D & PATRICIA R HOLEMAN PLNTN/P1/L1/H&L 56204 301 25115 -0.22 0.00- 0 -0.01-30 0.00 0.00 0.00 0.00 -0.23 2015R 2012 SRJ 06302016
REASON:UNDER ONE DOLLAR
6820 3012015 WILSON STACY P HOUSE & LOT 6820 301 14903 -0.02 0.00- 0 -0.01-30 0.00 0.00 0.00 0.00 -0.03 2015R 2013 SRJ 06302016 REASON:UNDER ONE DOLLAR
5872 3022015 WINSTEAD MARTHA & OTHERS 16 & 70/100 AC/TRACT 4 5872 302 23411 -0.48 0.00- 0 -0.02-30 0.00 0.00 0.00 0.00 -0.50 2015R 2014 SRJ 06302016 REASON:UNDER ONE DOLLAR
328
COSSYS PERSON COUNTY TAX OFFICE COLLECTION SCROLL-12:LEVY ADJUSTMENTS ALL TAX YEARS 07072016 PAGE: 3
TRANSACTION TOTALS PAGE
TRANSACTIONS FROM 1 THROUGH 3695 IN SY0:TAX .MOD AMOUNTS FROM -999999999.99 THROUGH 999999999.99TRANSACTION TYPES:R
TRANSACTIONS 06012016->99992027 0 PAYMENTS 0 DISC/CORR 24 RELEASES TOTAL CREDIT NET CREDIT (PAYMENT+RELEASE) (TOTAL-DISC/CORR)PERSON COUNTY TAX OFFICE 0.00 0.00 -136.25 136.25 136.25LATE LISTING 0.00 0.00 -9.01 9.01 9.01
DOG 0.00 0.00 0.00 0.00 0.00
CODE DISTRICT NAME 30 STORMWATER FEE 0.00 0.00 -0.73 0.73 0.73 --------------- --------------- --------------- --------------- --------------- SUB-TOTAL 0.00 0.00 -145.99 145.99 145.99
STATE 3PCT INTEREST 0.00 0.00 0.00 0.00 0.00
DISCOUNT 0.00 0.00 0.00 0.00 0.00INTEREST 0.00 0.00 -7.32 7.32 7.32LIEN SALE COST 0.00 0.00 0.00 0.00 0.00 --------------- --------------- --------------- --------------- ---------------
TOTAL 0.00 0.00 -153.31 153.31 153.31
50 CITY OF ROXBORO 0.00 0.00 -85.98 85.98 85.98LATE LISTING 0.00 0.00 -8.36 8.36 8.36 --------------- --------------- --------------- --------------- ---------------
SUB-TOTAL 0.00 0.00 -94.34 94.34 94.34
DISCOUNT 0.00 0.00 0.00 0.00 0.00INTEREST 0.00 0.00 0.00 0.00 0.00 --------------- --------------- --------------- --------------- --------------- TOTAL 0.00 0.00 -94.34 94.34 94.34
TOTAL TAXES 0.00 0.00 -240.33 240.33 240.33TOTAL LIEN COST 0.00 0.00 0.00 0.00 0.00TOTAL DISCOUNT 0.00 0.00 0.00 0.00 0.00
TOTAL INTEREST 0.00 0.00 -7.32 7.32 7.32
TOTAL STATE 3PCT INTEREST 0.00 0.00 0.00 0.00 0.00 =============== =============== =============== =============== =============== GRAND TOTAL 0.00 0.00 -247.65 247.65 247.65
329
Payee NameAddress 3Refund Type Refund Reason Create DateTax JurisdictionLevy Type Change Total Change01 Tax ($6.75) ($6.75)$6.7501 Tax ($17.32) ($17.32)$17.3201 Tax ($11.20) ($11.20)$11.2001 Tax ($30.97) ($30.97)$30.9701 Tax ($13.30) ($13.30)$13.3001 Tax ($32.23) ($32.23)$32.2301 Tax ($8.63) ($8.63)50 Tax ($8.13) ($8.13)50 Vehicle Fee $0.00$0.00$16.7601 Tax ($25.25) ($25.25)50 Tax ($23.81) ($23.81)50 Vehicle Fee $0.00$0.00$49.0601 Tax ($171.73) ($171.73)$171.7301 Tax ($8.06) ($8.06)$8.0601 Tax ($114.32) ($114.32)$114.3201 Tax ($59.45) ($59.45)$59.4501 Tax ($82.95) ($82.95)50 Tax ($78.21) ($78.21)50 Vehicle Fee $0.00$0.00$161.1601 Tax ($18.69) ($19.76)50 Tax ($17.62) ($18.63)$38.3901 Tax ($22.87) ($22.87)$22.87GENTRY, BRUCE ROGERS ROXBORO, NC 27574 Proration Vehicle Sold 06/14/2016GENTRY, AB KEITH ROXBORO, NC 27573 Adjustment < $100 Over Assessment 06/27/2016FULLER, TARQUISE NICOLE ROXBORO, NC 27573 Proration Vehicle Sold 06/16/2016FERGUSON, AARON GUY TIMBERLAKE, NC 27583 Proration Vehicle Sold 06/24/2016EDWARDS, JESSE JR ROUGEMONT, NC 27572 Proration Vehicle Totalled 06/23/2016EDWARDS, JESSE JR ROUGEMONT, NC 27572 Proration Vehicle Totalled 06/23/2016DIXON, GERALD EVAN TIMBERLAKE, NC 27583 Proration Vehicle Sold 06/20/2016DAY, AMY MARTIN ROXBORO, NC 27573 Proration Vehicle Sold 06/24/2016DAVENPORT, DAVID ANTHONY ROXBORO, NC 27573 Proration Vehicle Sold 06/14/2016COONEY, PATRICK RUSSELL ROXBORO, NC 27574 Proration Vehicle Sold 06/16/2016CHRISTIAN, AISHA KAI ROXBORO, NC 27574 Proration Vehicle Sold 06/24/2016CADDELL, BOBBY LAWRENCE TIMBERLAKE, NC 27583 Proration Vehicle Sold 06/24/2016CADDELL, BOBBY LAWRENCE TIMBERLAKE, NC 27583 Proration Vehicle Sold 06/24/2016BYRD, CURTIS DEAN ROXBORO, NC 27574 Proration Tag Surrender 06/28/2016Vehicle Sold 06/20/2016 ROXBORO, NC 27573 ProrationAVERY, ERNEST LEROY JR330
Payee NameAddress 3Refund Type Refund Reason Create DateTax JurisdictionLevy Type Change Total Change01 Tax ($2.43) ($2.43)$2.4301 Tax ($7.38) ($7.38)$7.3801 Tax ($112.10) ($112.10)$112.1001 Tax ($31.64) ($31.64)$31.6401 Tax ($45.99) ($45.99)$45.9901 Tax ($10.39) ($10.39)50 Tax ($9.80) ($9.80)50 Vehicle Fee $0.00 $0.00$20.1901 Tax ($24.43) ($24.43)$24.4301 Tax ($64.68) ($64.68)$64.6801 Tax ($42.42) ($42.42)$42.4201 Tax ($30.08) ($30.08)$30.0801 Tax ($16.57) ($17.39)$17.3901 Tax ($1.42) ($1.42)$1.4201 Tax ($10.10) ($10.61)$10.61WOZNICKI-BYRD, JENNIFER ANN ROXBORO, NC 27574 Proration Vehicle Sold 06/28/2016WOODS, CONSTANCE RAMSEY ROXBORO, NC 27573 Proration Vehicle Sold 06/13/2016WILBORN, TRAVIS DEAN ROXBORO, NC 27574 Proration Vehicle Sold 06/20/2016WALKER, OPHELIA STEPHEN ROXBORO, NC 27574 Proration Vehicle Sold 06/15/2016WADE, ROBERT EDWARD ROXBORO, NC 27573 Proration Vehicle Sold 06/21/2016MCGHEE, AMY RENEE ROXBORO, NC 27574 Adjustment < $100 Over Assessment 06/17/2016MATHERLY, PAUL EUGENE HURDLE MILLS, NC 27541 Proration Vehicle Sold 06/24/2016MARTINEZ, ANNIE LEA ROXBORO, NC 27573 Proration Vehicle Sold 06/20/2016LUXTON, BLAKE ALAN ROXBORO, NC 27573 Proration Vehicle Sold 06/24/2016HARTIGAN, JEREMY DAVID ROUGEMONT, NC 27572 Proration Vehicle Sold 06/21/2016GRAY, JODY CLARENCE ROXBORO, NC 27574 Proration Vehicle Sold 06/24/2016GENTRY, PAMELA WINEBRENNER ROXBORO, NC 27573 Proration Vehicle Sold 06/15/2016GENTRY, DEBRA CLACK ROXBORO, NC 27574 Proration Vehicle Totalled 06/23/2016331
AGENDA ABSTRACT
Meeting Date: July 18, 2016
Agenda Title: A Resolution to Grant an Advance Life Support Service Ambulance
Franchise to North State Medical Transports, Inc., and a
Resolution to Grant a Basic Life Support Service Ambulance Franchise to
Regional One, Inc.
Summary of Information:
The Department of Emergency Services received two applications to be considered for an
ambulance service franchise. The Emergency Services Director and EMS Staff reviewed the
applications presented and each applicant was requested to provide a presentation of services
offered. Each applicant demonstrated that they were qualified to provide the needed services as
deemed necessary by the Emergency Services Department in which we hereby recommend the
Board of Commissioners to grant an Advance Life Support Service Ambulance Franchise to North
State Medical Transports, Inc., and to grant a Basic Life Support Service Ambulance Franchise to
Regional One, Inc.
Recommended Action:
Adopt the two resolutions granting an ambulance franchise to each North State Medical Transport
and Regional One ambulance services.
Submitted By: Douglas Young, Emergency Services Director
332
A RESOLUTION TO GRANT
AN ADVANCE LIFE SUPPORT SERVICE
AMBULANCE FRANCHISE TO NORTH STATE MEDICAL TRANSPORT, INC.
WHEREAS, NORTH STATE MEDICAL TRANSPORT, INC., has applied
for an ambulance franchise, in accordance with the provisions of the Person County’s
Ambulance Franchise Ordinance; and
WHEREAS, the Department of Emergency Services staff and the Medical
Director reviewed the application for An advanced life support service ambulance franchise
filed by North State Medical Transport, Inc., made an investigation and analysis, as required
by the Person County’s Ambulance Franchise Ordinance, and recommended that a franchise
be issued to North State Medical Transport, Inc.; and
WHEREAS, the Board of Commissioners finds that the public convenience
and necessity would be served by the issuance of a advanced life support service ambulance
franchise to North State Medical Transport, Inc.; and
WHEREAS, the Board of Commissioners, therefore concludes that a
advanced life support service ambulance franchise should be issued to North State Medical
Transport, Inc.
NOW THEREFORE, BE IT RESOLVED by the Board of Commissioners of
the County of Person, North Carolina, that the request by North State Medical Transport, Inc.
for an advanced life support service ambulance franchise be, and is hereby, approved and that
an advanced life support service ambulance franchise with a term of five (5) years, expiring
on June 30, 2021, be granted, subject to the following conditions:
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1. Compliance with all of the applicable provisions of the Person
County’s Ambulance Franchise Ordinance and other applicable federal, state, and local laws,
and the conditions set forth.
2. The ambulance franchise holder will keep such records and make such
reports to the Director of Emergency Services or her/his designee with respect to furnishing
ambulance service under this ambulance franchise as shall be required and requested by the
Director of Emergency Services or her/his designee. The Director of Emergency Services or
her/his designee may prescribe the form of such records and reports and shall have the right
to inspect the records, facilities, and equipment of the ambulance franchise holder at any
time.
3. The ambulance franchise holder will indemnify, keep and hold the
County free and harmless from any and all liability for injury or damage to any and all
persons, firms and corporations and property arising out of or directly or indirectly resulting
from the performance of this permit; and in the event any suit or proceeding shall be brought
against the County, at law or in equity, either independently or jointly with the franchise
holder, on account of, founded upon or arising out of the performance of this franchise, the
franchise holder will defend the County therein at the cost of the franchise holder, and in the
event of a final judgement or decree being obtained or entered in any such action of suit
against the County, either independently or jointly with the franchise holder, then the
franchise holder will pay such judgement, together will all costs and expenses of whatever
nature, or comply with such decree, and hold the County harmless therefrom.
4. Should the ambulance franchise holder breach any term, condition or
provision of this permit and fail to correct, remedy or remove the condition that constitutes
334
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such breach within thirty (30) days after written notice thereof has been received by the
franchise holder from the County Manager or her/his designee, or should the franchise holder
become insolvent or a receiver or receivers be appointed for it, or should the franchise holder
make assignment for the benefit of its creditors and such insolvency is not remedied or such
receivership or assignment is not vacated within thirty (30) days, the County Manager or
her/his designee may immediately terminate this permit.
5. Neither the franchise nor the rights, privileges and obligations inuring
to or assumed by the ambulance franchise holder thereunder shall be assigned or transferred,
directly or indirectly, and every such assignment or transfer shall be void and shall
automatically and immediately terminate this franchise.
6. The terms of the ambulance franchise shall be for five (5) years,
beginning July 1, 2016 and ending June 30, 2021, subject to annual review and, for good
cause, revision with respect to services provided and rates charged thereunder, and thereafter
automatically renewable for a term of one (1) year unless either party should notify the other
in writing no less than sixty (60) days prior to the termination of such renewal period of its
election not to renew the same.
7. The ambulance service required will serve the hospital, nursing homes,
general public, and doctors’ offices.
8. Ambulance service must conform to the Person County’s Ambulance
Franchise Ordinance as amended.
9. North State Medical Transport, Inc. shall provide a performance bond
or letter of credit (in a form acceptable to the County Attorney) to secure performance under
this franchise.
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10. North State Medical Transport, Inc. shall provide an audited financial
statement and profit and loss statement for 2015 within ninety (90) days after this date.
11. The ambulance franchise holder shall immediately notify the Director
of Emergency Services of any citation and/or suspension issued against North State Medical
Transport, Inc. state EMS agency certificate, and/or any employee’s state EMS certification,
issued by the North Carolina Office of Emergency Medical Services.
12. The ambulance operator permit holder shall have a two-way radio
communication system between the County of Person Emergency Communications Center,
North State Medical Transport, Inc. dispatch office, and each ambulance as defined in the
County’s Ambulance Franchise Ordinance.
All communication equipment will be maintained so that it will operate effectively and
efficiently.
13. The ambulance franchise holder will have available at all times, 24
consecutive hours each day of the year, at a minimum for service at least the following
vehicles and equipment:
a. Two (2) ambulances, which meet the state minimum certification
requirements, to answer advanced life support calls;
b. Proper staff that meets the North Carolina EMS personnel regulations
with additional current certification for Emergency Medical
Technicians-Basic (EMT-B) in the following:
1. Emergency Vehicle Operating Course (EVOC)or Emergency
Vehicle Driver (EVD);
2. CPR
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c. Additional current certifications for Paramedics, or in the following:
1. Advanced Cardiac Life Support (ACLS)
2. Pediatric Advance Life Support (PALS) or Pediatric Education
for Pre-Hospital Professionals (PEPP)
3. CPR
4. Emergency Vehicle Operations Course (EVOC) or Emergency
Vehicle Driver.
14. North State Medical Transport, Inc. Shall operate a central business
and response office within a reasonable distance of Person County within 90 days of the
franchise issued date, said location must be approved by the County Manager or her/his
designee.
15. North State Medical Transport, Inc. shall have at least one single-party
telephone service for receipt and dispatch of ambulance as set forth by the Person County’s
Ambulance Franchise Ordinance. The telephone shall be manned 24 hours a day to take calls
from the public. The telephone number assigned to these services shall be listed and made
available through publication for use of the general public.
16. Qualified personnel must be provided to efficiently operate telephone
and radio communications systems and services for the immediate rendition of ambulance
services.
17. Insurance shall be carried against loss and liability in connection with the
performance of the ambulance service. (Minimum required – One-million ($1,000,000) for
bodily to any one person in any one accident and not less than five-hundred thousand
($500,000) for all bodily injuries resulting from any one accident, and one-hundred thousand
337
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($100,000) for property damage.) A copy of the insurance carried must be provided to the
County Manager or her/his designee.
18. The County reserves the right to request a financial statement from the
bidder or proof of financial stability.
APPROVED:
Person County Board of Commissioners
________________________________
David Newell, Sr.
Chairman of the Board
ATTEST:
______________________________
Brenda B. Reaves, Clerk to the Board
338
A RESOLUTION TO GRANT
A BASIC LIFE SUPPORT SERVICE
AMBULANCE FRANCHISE TO REGIONAL ONE, INC.
WHEREAS, Regional One, Inc., trading as Regional One EMS, (Regional
One) has applied for an ambulance franchise, in accordance with the provisions of the
Person County’s Ambulance Franchise Ordinance; and
WHEREAS, the Department of Emergency Services staff and the Medical
Director reviewed the application for a basic life support service ambulance franchise filed
by Regional One, made an investigation and analysis, as required by the Person County’s
Ambulance Franchise Ordinance, and recommended that a franchise be issued to Regional
One; and
WHEREAS, the Board of Commissioners finds that the public convenience
and necessity would be served by the issuance of a basic life support service ambulance
franchise to Regional One; and
WHEREAS, the Board of Commissioners, therefore concludes that a basic
life support service ambulance franchise should be issued to Regional One.
NOW THEREFORE, BE IT RESOLVED by the Board of Commissioners
of the County of Person, North Carolina, that the request by Regional One, Inc., trading as
Regional One EMS, for a basic life support service ambulance franchise be, and is hereby,
approved and that a basic life support service ambulance franchise with a term of five (5)
years, expiring on June 30, 2021, be granted, subject to the following conditions:
1. Compliance with all of the applicable provisions of the Person
County’s Ambulance Franchise Ordinance and other applicable federal, state, and local
laws, and the conditions set forth.
339
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2. The ambulance franchise holder will keep such records and make
such reports to the Director of Emergency Services or her/his designee with respect to
furnishing ambulance service under this ambulance franchise as shall be required and
requested by the Director of Emergency Services or her/his designee. The Director of
Emergency Services or her/his designee may prescribe the form of such records and
reports and shall have the right to inspect the records, facilities, and equipment of the
ambulance franchise holder at any time.
3. The ambulance franchise holder will indemnify, keep and hold the
County free and harmless from any and all liability for injury or damage to any and all
persons, firms and corporations and property arising out of or directly or indirectly
resulting from the performance of this permit; and in the event any suit or proceeding shall
be brought against the County, at law or in equity, either independently or jointly with the
franchise holder, on account of, founded upon or arising out of the performance of this
franchise, the franchise holder will defend the County therein at the cost of the franchise
holder, and in the event of a final judgement or decree being obtained or entered in any
such action of suit against the County, either independently or jointly with the franchise
holder, then the franchise holder will pay such judgement, together will all costs and
expenses of whatever nature, or comply with such decree, and hold the County harmless
therefrom.
4. Should the ambulance franchise holder breach any term, condition
or provision of this permit and fail to correct, remedy or remove the condition that
constitutes such breach within thirty (30) days after written notice thereof has been
received by the franchise holder from the County Manager or her/his designee, or should
340
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the franchise holder become insolvent or a receiver or receivers be appointed for it, or
should the franchise holder make assignment for the benefit of its creditors and such
insolvency is not remedied or such receivership or assignment is not vacated within thirty
(30) days, the County Manager or her/his designee may immediately terminate this permit.
5. Neither the franchise nor the rights, privileges and obligations
inuring to or assumed by the ambulance franchise holder thereunder shall be assigned or
transferred, directly or indirectly, and every such assignment or transfer shall be void and
shall automatically and immediately terminate this franchise.
6. The terms of the ambulance franchise shall be for five (5) years,
beginning July 1, 2016 and ending June 30, 2021, subject to annual review and, for good
cause, revision with respect to services provided and rates charged thereunder, and
thereafter automatically renewable for a term of one (1) year unless either party should
notify the other in writing no less than sixty (60) days prior to the termination of such
renewal period of its election not to renew the same.
7. The ambulance service required will serve the hospital, nursing
homes, general public, and doctors’ offices.
8. Ambulance service must conform to the Person County’s
Ambulance Franchise Ordinance as amended.
9. Regional One shall provide a performance bond or letter of credit
(in a form acceptable to the County Attorney) to secure performance under this franchise.
10. Regional One shall provide an audited financial statement and profit
and loss statement for 2015 within ninety (90) days after this date.
341
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11. The ambulance franchise holder shall immediately notify the
Director of Emergency Services of any citation and/or suspension issued against Regional
One’s state EMS agency certificate, and/or any employee’s state EMS certification, issued
by the North Carolina and Virginia Office of Emergency Medical Services.
12. The ambulance operator permit holder shall have a two-way radio
communication system between the County of Person Emergency Communications
Center, Regional One EMS (ROEMS) dispatch office, and each ambulance as defined in
the County’s Ambulance Franchise Ordinance. All communication equipment will be
maintained so that it will operate effectively and efficiently.
13. The ambulance franchise holder will have available at all times, 24
consecutive hours each day of the year, at a minimum for service at least the following
vehicles and equipment:
a. Two (2) ambulances, which meet the state minimum certification
requirements, to answer basic life support calls;
b. Proper staff that meets the North Carolina EMS personnel
regulations with additional current certification for Emergency
Medical Technicians-Basic (EMT-B) in the following:
1. Emergency Vehicle Operating Course (EVOC)or Emergency
Vehicle Driver (EVD);
2. CPR
c. Additional current certifications for Paramedics, or Intermediate
Technicians in the following:
1. Advanced Cardiac Life Support (ACLS)
342
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2. Pediatric Advance Life Support (PALS) or Pediatric
Education for Pre-Hospital Professionals (PEPP)
3. CPR
4. Emergency Vehicle Operations Course (EVOC) or
Emergency Vehicle Driver.
14. Regional One shall operate a central business and response office
within a reasonable distance of Person County within 90 days of the franchise issued date,
said location must be approved by the County Manager or her/his designee.
15. Regional One shall have at least one single-party telephone
service for receipt and dispatch of ambulance as set forth by the Person County’s
Ambulance Franchise Ordinance. The telephone shall be manned 24 hours a day to take
calls from the public. The telephone number assigned to these services shall be listed and
made available through publication for use of the general public.
16. Qualified personnel must be provided to efficiently operate
telephone and radio communications systems and services for the immediate rendition of
ambulance services.
17. Insurance shall be carried against loss and liability in connection
with the performance of the ambulance service. (Minimum required – One-million
($1,000,000) for bodily to any one person in any one accident and not less than five-
hundred thousand ($500,000) for all bodily injuries resulting from any one accident, and
one-hundred thousand ($100,000) for property damage.) A copy of the insurance carried
must be provided to the County Manager or his designee.
343
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18. The County reserves the right to request a financial statement from
the bidder or proof of financial stability.
APPROVED:
Person County Board of Commissioners
_________________________________
David Newell, Sr.
Chairman of the Board
ATTEST:
_______________________________
Brenda B. Reaves, Clerk to the Board
344
AGENDA ABSTRACT
Meeting Date: July 18, 2016
Agenda Title: Person County Environmental Issues Advisory Committee
Recommendations and Request for the Board of Commissioners to adopt a
Resolution for Improving Roadside Cleanup in Person County, a
Resolution for Education and Action on Recycle Materials, a Resolution
to Re-stimulate the Adopt a Highway Program and a Resolution for
County-wide Mandatory Recycling
Summary of Information:
Increase Person County Solid Waste user fees by $5 per year to fund litter pick-up and
removal. Alternatively, obtain grant funding from a foundation. Modest fee increase or
grant funding covers operational expenses of hiring part time employees to pick up litter -
bagging trash and recyclables separately.
Greater enforcement of existing litter and recycling laws.
Continue with prison crews picking up litter.
Assign citizens who have been court ordered to perform community service to pick up
litter. Community Service Supervisor to coordinate with county for assignments.
Increase awareness and encourage citizen groups to participate in the Adopt-A-Highway
program.
Place high resolution portable roadside cameras in areas frequently littered to identify and
prosecute offenders throughout Person County.
Education campaign: Encourage schools to set up and participate in recycling. Increase
awareness of the harmful effects of litter. EIAC to be a resource to support the creation of
environmental clubs and work with Parent-Teacher Associations in each school for
implementation and fund-raising.
Recommended Action:
1. List of recommendations concerning roadside litter
2. Request three resolutions to be sent to the NC General Assembly regarding roadside liter
3. A resolution request concerning recycling in Person County
Submitted By: Ken Hill, Committee Chairman
345
Resolution for Improving Roadside Cleanup in Person County
Whereas the NC DOT budgets approximately $16 million a year for litter removal according to
DOT Representatives;
Whereas Person County is eager to reinstate a cleanup program for County roadsides; and
Whereas Person County requests equal consideration in the state-wide litter removal process.
Now, therefore, be it Resolved, that NC DOT:
1. Supply details to each county regarding how funds are allocated by county; and
2. Give an accounting as to how those funds are used.
Adopted this 18th day of July, 2016.
_________________________________________
David Newell, Sr., Chairman
Person County Board of Commissioners
Attest:
_________________________________________
Brenda B. Reaves. CMC, NCCCC
Clerk to the Board of Commissioners
346
Resolution for Education and Action on Recycle Materials
Whereas many recyclable materials are being trashed throughout every county;
Whereas these materials can provide more revenue when recycled than when buried;
Whereas many of these items are on the list that are required to be recycled; and
Whereas action is required at the state level;
Now, therefore, be it Resolved, that the NC General Assembly:
1. Increase the recycling of these items by imposing a deposit on bottles and cans; and
2. Impose a deposit on recyclable packaging materials.
Adopted this 18th day of July, 2016.
_________________________________________
David Newell, Sr., Chairman
Person County Board of Commissioners
Attest:
_________________________________________
Brenda B. Reaves. CMC, NCCCC
Clerk to the Board of Commissioners
347
A Resolution to Re-stimulate the Adopt A Highway Program
Whereas the state has an Adopt A Highway program that is not doing the job of keeping the
roadsides clean;
Whereas many of the roads have not been adopted; and
Whereas many of those that have been adopted are not being cleaned on a regular basis.
Now, therefore, be it Resolved, that the Adopt a Highway Coordinator:
1. Request regular reporting from those who have adopted a highway;
2. Inform and educate the county on what is being done; and
3. Make a plan with a county coordinator to expand and improve the local program.
Adopted this 18th day of July, 2016.
_________________________________________
David Newell, Sr., Chairman
Person County Board of Commissioners
Attest:
_________________________________________
Brenda B. Reaves. CMC, NCCCC
Clerk to the Board of Commissioners
348
Resolution for County-wide Mandatory Recycling
Whereas landfill space use can be minimized through the use of our recycling center;
Whereas the statewide waste reduction goal is 40 %, and Person County is about 5%;
Whereas it costs county citizens approximately $40 a ton to bury a ton of recyclables;
Whereas Person County is losing a revenue stream when people fail to recycle; and
Whereas Person County is violating state recycling laws by wasting these valuable resources.
Now, therefore, be it Resolved, that the Person County Board of Commissioners:
1. Take a position on recycling that shows they are examples for citizens to follow.
2. Initiate programs to maximize the use of our recycle center.
3. Require citizens to abide by the state laws and either bring their recyclables to the Person
County Recycling Center or pay a collector to dispose of them in the proper manner.
Adopted this 18th day of July, 2016.
_________________________________________
David Newell, Sr., Chairman
Person County Board of Commissioners
Attest:
_________________________________________
Brenda B. Reaves. CMC, NCCCC
Clerk to the Board of Commissioners
349
AGENDA ABSTRACT
Meeting Date: July 18, 2016
Agenda Title: Request by the U.S. Motto Action Committee for the Board of
Commissioners to adopt a Resolution Supporting the display of the national motto
“In God We Trust” in prominent locations
Summary of Information: A Request to join 44 other NC Counties and 34 NC City Halls that
have adopted a resolution to display our Nation’s Motto, “In God We Trust”
Recommended Action: Adopt a resolution to display “In God We Trust” on the Old Courthouse,
County Office Building, and/or Commissioners Chambers
Submitted By: Rick Lanier/Vice Chairman of the U.S. Motto Action Committee
350
RESOLUTION BY THE BOARD OF COMMISSIONERS OF THE COUNTY OF PERSON,
IN THE STATE OF NORTH CAROLINA,
SUPPORTING THE DISPLAY OF THE NATIONAL MOTTO
“IN GOD WE TRUST” IN PROMINENT LOCATIONS
WHEREAS, “In God We Trust” became the United States national motto on July 30, 1956, shortly
after our nation led the world through the trauma of World War II and
WHEREAS, the words have been used on United States currency since 1864: and
WHEREAS, the same inspiring slogan is engraved above the entrance to the Senate Chamber as
well as above the Speaker’s dais in the House of Representatives: and
WHEREAS, in both war and peace, these words have been a profound source of strength and
guidance to many generations of Americans; and
WHEREAS, the County desires to display this patriotic motto in a way to solemnize public
occasions and express confidence in our society.
NOW, THEREFORE, BE IT RESOLVED the Board of Commissioners of Person County does
hereby resolve as follows:
Section 1. That the Board of Commissioners of the County of Person, North Carolina, does hereby
determine that the historic and patriotic words of our national motto, “In God We Trust” shall be
permanently and prominently displayed over the front entrance door at the Courthouse, on the
exterior Morgan Street entrance of the County Office Building and inside the Board of
Commissioners’ usual meeting room 215 of the County Office Building, and to remain there in
perpetuity.
Section 2. The County Clerk shall certify to the passage and adoption of this resolution and enter it
into the book of resolutions.
PASSED, APPROVED AND ADOPTED at a regular meeting of the Board of Commissioners of
the County of Person, North Carolina, held on the 18th day of July, 2016
_________________________________________
David Newell, Sr., Chairman
Person County Board of Commissioners
Attest:
_________________________________________
Brenda B. Reaves. CMC, NCCCC
Clerk to the Board of Commissioners
351
Dear Honorable Elected Officials,
This is an invitation to join the growing list of cities and counties that are "Voting Yes" to
proudly and prominently display our national motto, IN GOD WE TRUST, in and on their
governmental buildings.
My name is Rick Lanier and I am the Co-Founder and Vice Chairman of the US MOTTO
ACTION COMMITTEE. I served as a County Commissioner of Davidson County in
Lexington, NC from 1998 to 2002. In 2002, I led my board of Commissioners to
“Vote Yes”, to display IN GOD WE TRUST, on the exterior our Governmental Center. Soon
after that several other surrounding cities and counties joined us in doing the same.
To encourage this we formed the US MOTTO ACTION COMMITTEE. Its sole purpose is to
promote patriotism by encouraging elected officials to "Vote Yes" to display IN GOD WE
TRUST in and on their governmental Buildings.
Displaying the Motto gives ceremonial honor to public occasions and expresses
confidence in our society. These words have been used on US Currency since 1864. This
inspiring slogan is engraved above the entrance of the US Senate Chamber as well as
above the Speaker’s Seat in the US House of Representatives. On July 30, 1956, during
the Dwight D. Eisenhower administration, the U.S. Congress adopted IN GOD WE
TRUST as the official National Motto of the United States of America. Thus, displaying
our Motto is a legal right, protected by the first amendment.
On November 1, 2011 the U.S. House of Representatives voted overwhelmingly, 396 - 9,
to reaffirm IN GOD WE TRUST as our nation's motto. Congressman Randy Forbes, of
Virginia, sponsored the resolution, in part, because some have mistakenly stated that
"E Pluribus Unum" is our national motto. Most importantly, the resolution specifically
encourages the placement of the motto in and on all government buildings from
courthouses to school classrooms. A recent survey shows that 87% of all Americans still
support the display of our National Motto.
In times of both war and peace, these words have been a profound source of strength and
guidance to many generations of Americans.
As a grassroots patriotic movement, the US MOTTO ACTION COMMITTEE stands on solid
legal ground. Since Davidson County paved the way, not one legal challenge has been
raised against any city or county that has "Voted Yes." This effort is legal and there is
nothing to challenge!
We are very pleased to announce that we are having an overwhelming success with the
counties and cities that are readily voting "Yes” to display IN GOD WE TRUST, in or on
their Government Building.
Elected officials like you, are showing a commitment to the values that our country was
founded upon.
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The purpose of this letter is to urge you to place us on your next possible meeting
agenda. It would be our pleasure to incur the full cost of this display.
Finally, we welcome you to call or contact us personally with any
questions or encouragement we can provide.
Thank you, Rick Lanier
Please distribute this "Letter of Invitation"
to your Elected Officials and other appropriate staff members via their in box or e‐mail
Thank You.
US MOTTO ACTION COMMITTEE
MISSION STATEMENT
TO DEFEND, PROMOTE,
AND ASSIST
IN THE AWARENESS
AND FURTHERANCE OF OUR
US MOTTO,
“IN GOD WE TRUST,”
ON PUBLIC BUILDINGS,
STRUCTURES, MONUMENTS,
THE PRINTED PAGE,
AND TO ENCOURAGE
OUR GODLY HERITAGE
IN VARIOUS OTHER ASPECTS.
USMAC
PO Box 1351
Lexington, NC 27293
E‐mail usmotto02@gmail.com
DAVID WHITE- Chairman 336-239-0473 davidmwhite7@aol.com
RICK LANIER- Vice Chairman 336-798-7700 7thheaven@windstream.net
FRED MCCLURE- Treasurer 336-249-9269 fred@fredmcclure.com
PASTOR RON BAITY- Chaplain 336-785-0529 rbaity4520@aol.com
MARK SMITH- Secretary 336-306-6476 MSDKSmith@icloud.com
THE US MOTTO ACTION COMMITTEE
Established
DECEMBER 30, 2002
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MOTTO ALL LOCATIONS APPROVEDSTATELOCATION COUNTY APPROVAL INSTALLATIONPATROLDATEPROGRESSDECALS1 North Carolina Alamance County Alamance 4/6/2015Complete2 North Carolina Alexander County Alexander 4/13/2015Complete323 North Carolina Alleghany County Alleghany 8/17/2015Complete244 North Carolina Ashe CountyAshe 1/20/2015Complete5 North Carolina Avery County Avery 7/6/2015Complete206 North Carolina Brunswick County Brunswick 1/13/2015Complete7 North Carolina Burke County Burke 3/7/2015Complete8 North Carolina Caldwell County Caldwell 6/15/2015Complete9 North Carolina Caswell County Caswell 3/16/2015Complete10 North Carolina Chatham County Chatham 5/16/2016 Confirm Size/Location11 North Carolina Cherokee County Cherokee 2/1/2015 Ordered1612 North Carolina Clay CountyClay 9/3/2015Complete2213 North Carolina Cleveland County Cleveland 2/11/2015Complete5514 North Carolina Davidson County Davidson 11/26/2002Complete13015 North Carolina Davie County Davie 8/7/2006Complete16 North Carolina Gaston County Gaston 2/10/2015Complete17 North Carolina Graham County Graham 8/4/2015Complete1518 North Carolina Haywood County Haywood 6/1/1932Complete6019 North Carolina Henderson County Henderson 9/16/2015Phase 1 Complete10020 North Carolina Iredell County Iredell 4/19/2006Complete21 North Carolina Lee County Lee 11/17/2014Complete22 North Carolina Lincoln County Lincoln 3/16/2015Complete14023 North Carolina Macon County Macon 10/13/2015Complete5024 North Carolina McDowell County McDowell 4/13/2015Complete3525 North Carolina Mitchell County Mitchell 7/13/2015Complete1726 North Carolina Moore County Moore 3/17/2015Complete27 North Carolina Montgomery County Montgomery 5/19/2015 Confirm Size/Location28 North Carolina Pender County Pender 1/5/2015Complete29 North Carolina Polk County Polk 7/20/2015Complete3230 North Carolina Randolph County Randolph 4/6/2015Complete354
31 North Carolina Robeson County Robeson 1/21/2015Complete32 North Carolina Rockingham County Rockingham 5/4/2015Complete33 North Carolina Rowan County Rowan 4/3/2006Complete34 North Carolina Rutherford County Rutherford 7/6/2015Complete5235 North Carolina Scotland County Scotland 5/2/2016 Confirm Size/Location5036 North Carolina Stanly County Stanly 2/19/2015Complete37 North Carolina Stokes County Stokes 4/13/2015Complete4838 North Carolina Surry CountySurry 5/18/2015Complete8039 North Carolina Swain County Swain 8/27/2015Complete2540 North Carolina Watauga County Watauga 5/5/2015Complete4241 North Carolina Wilkes County Wilkes 5/5/2015Complete42 North Carolina Union County Union 2/16/2015Complete43 North Carolina Yadkin County Yadkin 3/2/2006Complete44 North Carolina Yancey County Yancey 8/10/2015Complete45 North Carolina Badin Town Hall Stanly 9/8/2015Complete46 North Carolina Belville Town Hall Brunswick 1/26/2015Complete47 North Carolina Cajah's Mtn Town Hall Caldwell 4/5/2016 Ready To Order48 North Carolina China Grove Town Hall Rowan 5/5/2015Complete3049 North Carolina Crossnore Town Hall Avery 9/8/2015Complete50 North Carolina Denton Town Hall Davidson 2/2/2015Complete51 North Carolina Dillsboro Town Hall Gaston 10/12/2015Complete52 North Carolina Elkin City Hall Surry 8/10/2015Complete53 North Carolina Elk Park Town Hall Avery 8/3/2015Complete54 North Carolina Granite Falls Town Hall Caldwell 9/21/2015Complete55 North Carolina Harmony Town Hall Iredell 3/2/2015Complete56 North Carolina Hildebran Town Hall Burke 8/24/2015Complete57 North Carolina King City Hall Stokes 6/6/2016Complete2858 North Carolina King's Mountain City Hall Cleveland 4/28/2015Complete59 North Carolina Lake Lure Town Hall Rutherford 2/9/2016Complete60 North Carolina Lattimore Town Hall Cleveland 3/10/2015Complete61 North Carolina Madison Town Hall Rockingham 4/9/2015 Confirm Size/Location62 North Carolina Mayodan Town Hall Rockingham 5/11/2015 Confirm Size/Location63 North Carolina Midway Town Hall Davidson 4/6/2015Complete355
64 North Carolina Murphy City Hall Cherokee 4/4/2016Ordered65 North Carolina Newland Town Hall Avery 9/1/2015Complete266 North Carolina Randleman City Hall Randolph 1/5/2016 Confirm Size/Location67 North Carolina Rhodhiss Town Hall Burke 7/1/2015Complete68 North Carolina Robbins Town Hall Moore 3/12/2015Complete69 North Carolina Shelby City Hall Cleveland 6/6/2016 Confirm Size/Location70 North Carolina Sawmills Town Hall Caldwell 2/16/2016Complete71 North Carolina Stokesdale Town Hall Guilford 4/14/2016 Confirm Size/Location72 North Carolina Stoneville Town Hall Rockingham 4/7/2015Complete73 North Carolina Thomasville City Hall Davidson 7/17/2004Complete74 North Carolina Trinity City Hall Randolph 2/28/2015Complete75 North Carolina Troutman City Hall Iredell 5/14/2015Complete76 North Carolina Wallace Town Hall Duplin 1/7/2015Complete77 North Carolina Wallburg Town Hall Davidson 12/9/2014Complete78 North Carolina Walnut Cove Town Hall Stokes 1/12/2016Complete356
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The U. S. Motto Action Committee
Promoting the public display of
the national motto of the United States
Hear me, O LORD, hear me, that this people
may know that thou art the LORD God, and
that thou hast turned their heart back again.
I Kings 18:37
USMAC Board
David White, Chair (336) 239-0473
davidmwhite7@aol.com
Rick Lanier, Vice Chair (336) 798-7700
7thheaven@windstream.net
Pastor Mark Smith, Secretary (336) 306-6476
MSDKSmith@icloud.com
Fred McClure, Treasurer (336) 249-9269
fred@fredmcclure.com
Dr. Ron Baity, Chaplain (336) 785-0529
rbaity4520@aol.com
Dr. Richard Callahan (336) 259-9113
richardd.callahan@gmail.com
To defend, promote and assist
in the awareness and
furtherance of our U. S. Motto,
“In God We Trust,”
on public buildings, structures,
monuments, the printed page,
and to encourage our Godly Heritage
in various other aspects.
USMAC Mission
What you can do!
Pray
* For municipalities to vote “Yes” to display
our National Motto -In God We Trust.
* For pastors to catch our vision and motivate
their members in our mission.
* For patriotic individuals to get involved in
their local community.
Promote
* Contact your city or county commissioners
to request the U.S. Motto be displayed.
* Ask your pastor or civic organization to
invite a member of the USMAC
to share our mission.
* Get involved! One active, energetic voice can
make a tremendous difference.
Provide
* USMAC incurs ALL costs to display the U.S.
Motto on government buildings.
* We depend on churches and patriotic
individuals to meet these needs.
* Costs range up to $2,500 per location
* Become a USMAC Partner with a One Time
Gift to promote a permanent and public
reminder of America’s Godly Heritage.
Donations may be mailed to:
USMACP.O. Box 1351 Lexington, NC 27293
(336) 798-7700 usmotto02@gmail.com
In God
we Trust
If the foundations be destroyed,
what can the righteous do?
Psalm 11:3
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The U.S. Motto Action Committee
actively encourages local elected officials
across NC and our nation to display the National Motto.
Our purpose is to promote America’s Christian heritage with the hope
that hearts would turn back to Him.
II Chronicles 7:14
We believe God gave birth to the
U.S. Motto Action Committee.
A Brief History
August 2002
With a desire to promote patriotism, David White petitioned
Commissioner Rick Lanier to place the national motto,
In God We Trust, on the Davidson County Governmental Center.
November 26, 2002
Commissioner Lanier led the Davidson County Commissioners
to approve the display of our National Motto.
December 29, 2002
The US Motto was publicly displayed on the
Davidson County Governmental Center.
December 30, 2002
In an effort to promote America’s Godly Heritage,
David White, Rick Lanier, Todd Clark, and
Fred McClure formed the US Motto Action Committee. Shortly
thereafter, Pastor Ron Baity was added as Committee Chaplain.
June 24, 2003
Two ACLU-funded attorneys sued Davidson County
citing the public display of the Motto violated
the “separation of church and state.”
August 12, 2003
Due to the proactive efforts of the USMAC, the Commissioners
unanimously decided to fight the lawsuit
May 2004
U. S. District Court Judge William Osteen, Sr.
dismissed the lawsuit, citing no church/state conflict
May 13, 2005
The U. S. Fourth Circuit Court of Appeals
affirmed Judge Osteen’s opinion.
November 14, 2005
The U. S. Supreme Court refused to hear the case. The decision of
the Fourth Circuit Court of Appeals became case law.
Ref: Lambeth and Lea vs. Davidson County, NC # 04-1753 To join our effort to publicly display the U.S. Motto on your city or county building,
contact us at (336) 798-7700 or usmotto02@gmail.com.
Wallburg
Town Hall
Approved on 2/10/2015 Approved on 3/02/2015
Approved on 3/02/2006
“If we ever forget that we are One Nation Under God,
then we will be one nation gone under.” Ronald Reagan
Approved on 12/09/2014
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Piggyback Publication Notice
The Person County Board of Commissioners will consider a waiver of competitive
bidding under G.S. 143-129(g) at its regular meeting on July 18, 2016 for the purchase
of a 911 Computer Aided Dispatch (CAD) system from SunGard Public Sector, LLC,
the seller having agreed to extend to Person County the same or more favorable prices
and terms set forth in its contract with Johnson County, Missouri entered into on July
25, 2015. For additional information, contact Douglas Young, Emergency Services
Director at 336-599-3136 or in person at 216 Barden Street, Roxboro, North Carolina,
27573 or via email at dyoung@personcounty.net.
Brenda B. Reaves
Clerk to the Board
363
AGENDA ABSTRACT
Meeting Date: July 18, 2016
Agenda Title: Resolution approving a purchase of 911 CAD System pursuant to General
Statute 143-129(g) Piggyback Exception
Summary of Information:
The current 911 Computer Aided Dispatch (CAD) system has been in place since 1996. During
this time and most recently there have been several improvements to technology within the 911
Center and additional feature functionalities are needed. These needs include Text to 911 CAD
integration, CAD2CAD interoperability with bordering counties, and mobile CAD deployment.
During the past 12 months the Department’s 911 Communications Division Manager and staff
has reviewed different CAD equipment that would meet our needs for the future.
The North Carolina 911 Board approved funding for this project.
Recommended Action:
Approval from the Board of Commissioners that a piggyback procurement method be allowed to
purchase the SunGard CAD product for Department’s 911 center which is fully NC 911 Board
funded.
Submitted By: Douglas Young, Emergency Services Director
364
Person County Board of County Commissioners
Resolution approving a purchase pursuant to
General Statute 143-129(g) PIGGYBACK EXCEPTION
WHEREAS, North Carolina General Statute 143-129(g) authorizes counties to utilize an
alternative method for purchase of apparatus, equipment and supplies; and
WHEREAS, the Person County Emergency Services Department has a need to purchase a 911
Computer Aided Dispatch (CAD) system from SunGard Public Sector, LLC; and
WHEREAS, Johnson County, Missouri, for its Emergency Services Department, entered into a
contract on July 25, 2015 with SunGard Public Sector, LLC for such a system; and
WHEREAS, SunGard Public Sector, LLC has agreed to offer the same or better cost and
conditions to Person County as it did to Johnson County, Missouri.
NOW THEREFORE BE IT RESOLVED by the Person County Board of County
Commissioners that it hereby waives competitive bidding requirements pursuant to General
Statute 143-129(g) for this contract and hereby awards the attached contract to SunGard Public
Sector, LLC.
Adopted this 18th day of July, 2016.
_________________________________________
David Newell, Sr., Chairman
Person County Board of Commissioners
Attest:
_________________________________________
Brenda B. Reaves. CMC, NCCCC
Clerk to the Board of Commissioners
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AGENDA ABSTRACT
Meeting Date: July 18, 2016
Agenda Title: Tax Collector Settlement
Summary of Information: As required by G.S. 105-373(a)(3), an annual settlement for taxes
for the current fiscal year and all previous years must be made with the governing body of the
taxing unit. The settlement is included in the Attachment I items.
Recommended Action: Motion to accept report.
Submitted By: Russell Jones, Tax Administrator
393
2015 Tax Collector Settlement394
2015 Tax Base•Budget tax base for 2015-$ 4.040 billion•Actual tax base for 2015- $ 4.093 billion•Tax base was higher than budget by 1.3 %•Actual base for 2015 was over by $53 million•Actual base for 2015 was over by $53 million•These numbers do not include NCVTS395
2015 tax year collections•Budgeted collection rate for 2015– 97.25%•Actual collection rate for 2015–98.82%•Collection rate was over by 1.57%•Collections was $ 882,197 more than •Collections was $ 882,197 more than anticipated on current year collections•Average collection rate for Person County for last 10 years is 97.95%396
2015 Tax YearUncollected Balances•County 2015 uncollected taxes-all –$ 341,536•County 2015 uncollected real only-–$ 324,123–$ 324,123•County 2015 uncollected other-–$ 17,233397
Collection activities•Total payments for all years, including City of Roxboro-–$33,845,399•Total payments for all years, Person County-•Total payments for all years, Person County-–$ 29,251,233•Processed payments- 37,441•2016 Prepayments were $ 80,985 398
Prior year tax collections•This includes 2005-2014 tax years•County Unpaid balances on July 1, 2015-–$ 1,013,700•County Unpaid balances on June 30, 2016-•County Unpaid balances on June 30, 2016-–$ 607,345•County Collections on Prior Years-–$ 406,355399
Forced Collections•Attachments- 302 payments–$ 163,760 County–$ 70,410 City–$ 234,170 Total•Garnishments-2,285 payments•Garnishments-2,285 payments–$ 208,654 County–$ 27,948 City–$ 236,602 Total400
Forced CollectionsCounty and City•Escheats- Also known as NC Cash–$ 5,126•Debt Setoff- 414 accounts collected–$ 50,419 for Tax Office–$ 50,419 for Tax Office–$ 31,036 for EMS–$ 4,593 for Health Department–$ 451 for Library–$ 86,499 Total Collected401
Uncollected County Balances•All years uncollected- $ 938,646•Total bills left uncollected- 7,797•Uncollected vehicle bills- 3,636–$ 92,634–$ 92,634•Uncollected real estate bills- 2,960–$ 786,310•Uncollected other tax bills-–$ 59,702402
2005-11thYear Taxes •2005 Original Levy- $23,257,057•Total bills uncollected- 366- $12,558•Uncollected Real Estate bills-42- $ 5,013•Uncollected Vehicle bills-295-$ 6,342•Uncollected Vehicle bills-295-$ 6,342•Uncollected Other bills- 29- $ 1,203•.05% Uncollected after 10 years •or 5/100 of 1%403
2015-NCVTS (MOTOR VEHICLES) •2015 TOTAL ASSESSED VALUE- $ 337,154,947•2015 Billed- $ 2,364,411•Collected- $ 2,360,505 •2015-Uncollected-$ 3,906•2015-Uncollected-$ 3,906•2015 Collection Rate on Vehicles= 99.83%404
2015-Stormwater •2015 Billed- $ 273,881•Collected- $ 266,186 •2015-Uncollected- $ 7,695•2015 Collection Rate on Stormwater= 97.20%•2015 Collection Rate on Stormwater= 97.20%405
AGENDA ABSTRACT
Meeting Date: July 18, 2016
Agenda Title: Order to Collect Taxes
Summary of Information: As required by G.S. 105-321, the governing board of the taxing
unit must issue an order of collection to tax collectors. This gives the tax collector legal
authority to collect taxes. The order is included in Attachment II.
Recommended Action: Motion to direct Tax Collector to collect taxes for 2006 through
2016.
Submitted By: Russell Jones, Tax Administrator
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PERSON COUNTY
OFFICE OF THE TAX
ADMINISTRATOR
Person County Tax Office
P.O. Box 1116
13 Abbitt St
Roxboro, North Carolina 27573-1116
(336) 597-1721 Fax No. (336) 322-8619
ATTACHMENT II
County of Person
To the Tax Collector of the County of Person:
You are hereby authorized, empowered, and commanded to collect the
taxes set forth in the tax records filed in the office of Person County
Tax Office and in the tax receipts herewith delivered to you, in the
amounts and from the taxpayers likewise therein set forth, for the tax
years 2006 through 2016. Such taxes are hereby declared to be a first
lien upon all real property of the respective taxpayers in the County
of Person, and this order shall be a full and sufficient authority to
direct, require, and enable you to levy on and sell any real or
personal property of such taxpayers, for and on account thereof, in
accordance with law.
Witness my hand and official seal, this 18th day of July, 2016.
_________________________________________
David Newell, Sr., Chairman,
Board of Commissioners of Person County
Attest:
_________________________________________________
Brenda B. Reaves, Clerk to the Board
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AGENDA ABSTRACT
Meeting Date: July 18, 2016
Agenda Title: Rock Athletic Complex Outfield Renovation and Irrigation Options
Summary of Information:
The Rock Athletic Complex is now closed for summer/fall renovations and turf maintenance. The original
plan is to plant common Bermuda and let it germinate and then grow throughout the months of July
through October. This process would require temporary irrigation to the outfield portions of each ball
field. Temporary irrigation is currently in place.
Option #1: Continue original plan with additional water reel irrigation. This option will cost
approximately $7,700. This is already included in the current year budget.
Option #2: Install a fully automatic irrigations system to all ball fields and sprig plant Bermuda 419 to all
outfields. Currently all ball fields have been sodded and are established with Bermuda 419. This option
will cost $115,800.
Option #3: Purchase portable water reels and plant sprig Bermuda 419 on all outfield. This option will
cost approximately $29,100.
This project would dramatically help the Rock Athletic Complex become a great complex that will assure
quality sport opportunities for our families, citizens, and visitors to Person County. The 2016 spring
season at the Rock Athletic Complex was a great success for the citizens of Person County with
approximately 800-1,000 people in attendance each night for two months. We are in preparation for and
excited about the upcoming 2016 fall season. The project has a number of different possible opportunities
for funding which include: remaining project funds from Person County CIP projects, PARTF grant
award, and sponsorships.
Director’s Recommendation/Timeline:
Current time- Late September: continue to improve ball field turf and renovations to supporting facilities.
Early September: Plant hybrid rye grass on the outfields.
Late September- Late October: Play fall baseball season.
November: Install irrigation and replant trenched areas with hybrid rye grass. Or, continue to use current
irrigation process and plant hybrid rye grass.
April 1, 2017: Opening Day for Spring Little League.
Early June: Plant Sprig Bermuda 419 on the outfields or go with original plan and plan seeded common
Bermuda.
June- Mid September: Growing Season
Late September 2017: Little League Fall Season and possible travel tournament host By Person County
Please see attached quote information.
Recommended Action:
Discuss renovation options and possibly using remaining 2016 CIP project funds; Prospective 2016 Parks
and Recreation Trust Fund Grant award; or sponsorships to install irrigation options and grass options.
Submitted By: John Hill, Director of Recreation, Arts, and Parks Department
408
Nolan Thomas and Company, Inc. Confidential Page 1
QUOTATION
Client: Person County
Address:
Attn: John Hill, Jennifer Dunkley
Email:
Nolan Thomas & Company, Inc.
Sports Turf Contractors
PO Box 625
Oxford, NC 27565
Ph: 919-693-6478
Fax: 772-365-6129
Web: www.ntandcoinc.com
This Quotation, when properly executed, becomes a purchase order, subject to the terms, conditions, and
limitations appearing herewith. This quotation is subject to availability of necessary labor, materials, and supplies
to produce the items quoted.
Date: 2/15316
Project: Person County Ball Fields
Scope of Work:
Provide approximately 72,000 square feet of big rolled Bermuda sod.
Install sod on the infields of the 4 largest field. The smallest infield will be seeded.
Roll sod.
Provide and install a ¼ topdressing sand on the sod.
Total Cost: $44,038
Exclusions/Exceptions:
Permits and/or engineering fees.
Tap or impact fees of any kind.
Export of any infield clay. Owner will load and remove offsite.
Any watering or grow in of seed.
NT and Co will not warranty grass that has not been properly maintained, watered,
and cared for.
Any irrigation.
NT and Co is not responsible for water that washes across infields from outside
playing areas.
Locating, relocation, removal, and/or repair of any utilities.
Rock excavation or rock trenching.
Haul off of excess sub-grade material.
409
Nolan Thomas and Company, Inc. Confidential Page 2
Temporary power, water, and/or washroom facilities.
Construction and removal of any access road.
Replacement of suitable soils/ABC stone on sub-grade.
Repair or replacement of existing drives damaged by truck or construction
equipment.
Anything not specifically included in the above scope of work.
Our prevailing prices are subject to change without notice except when protected
by your unfilled purchase order.
Terms of Payment: Net 15
A service charge of 1 ½% per month (effective annual rate of 18%) will be charged on all accounts not
paid within thirty (30) days.
Expiration of Acceptance:
The prices quoted herein expire thirty (30) days from date of quote unless made effective as a purchase
order prior to expiration, by proper approval and signature.
Please print, sign, fax to (772) 365-6129
Accepted By: _____________________________ Nolan Thomas and Company, Inc.
Date: ___________________________________
Company: _______________________________
Submitted By:
Tim Grein
Nolan Thomas & Company, Inc.
Mobile: 336-803-1108
Fax: 772-365-6129
Email: tim.grein@ntandcoinc.com
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Nolan Thomas and Company, Inc. Confidential Page 1
QUOTATION
Client: Person County
Address:
Attn: John Hill
Email:
Nolan Thomas & Company, Inc.
Sports Turf Contractors
PO Box 625
Oxford, NC 27565
Ph: 919-693-6478
Fax: 772-365-6129
Web: www.ntandcoinc.com
This Quotation, when properly executed, becomes a purchase order, subject to the terms, conditions, and
limitations appearing herewith. This quotation is subject to availability of necessary labor, materials, and supplies
to produce the items quoted.
Date: 6/7/2016
Project: Irrigation and Sprigging
Scope of Work:
Irrigation:
Provide and install 2” backflow preventer and booster pump.
Provide and install irrigation controller for fields 1-4.
Supply and install irrigation on fields 1-5.
Supply and install controller for field 5.
Supply and install quick coupler valve on each field for hand watering.
Total Cost: $94,400
Sprigging:
Aerovate outfields prior to installing pre plant amendments.
Supply and install pre plant fertilizer on outfields.
Supply and install pre-emergent herbicide on outfields.
Supply and install certified Bermuda 419 sprigs on outfields.
Total Cost: $21,400
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Nolan Thomas and Company, Inc. Confidential Page 2
Exclusions/Exceptions:
Permits and/or engineering fees.
Tap or impact fees of any kind.
Electrical for booster pump and controllers not included in price.
Price assumes that the pvc line running to each field is in good condition.
Replacement of main line is not included in price.
Locating, relocation, removal, and/or repair of any utilities.
Rock excavation or rock trenching.
Haul off of excess sub-grade material.
Temporary power, water, and/or washroom facilities.
Construction and removal of any access road.
Supply and installation of electrical conduit.
Replacement of suitable soils/ABC stone on sub-grade.
Repair or replacement of existing drives damaged by truck or construction
equipment.
Anything not specifically included in the above scope of work.
Our prevailing prices are subject to change without notice except when protected
by your unfilled purchase order.
Terms of Payment: Net 15
A service charge of 1 ½% per month (effective annual rate of 18%) will be charged on all accounts not
paid within thirty (30) days.
Expiration of Acceptance:
The prices quoted herein expire thirty (30) days from date of quote unless made effective as a purchase
order prior to expiration, by proper approval and signature.
Please print, sign, fax to (772) 365-6129
Accepted By: _____________________________ Nolan Thomas and Company, Inc.
Date: ___________________________________
Company: _______________________________
Submitted By:
Tim Grein
Nolan Thomas & Company, Inc.
Mobile: 336-803-1108
Fax: 772-365-6129
Email: tim.grein@ntandcoinc.com
Web: www.ntandcoinc.com
413
AGENDA ABSTRACT
Meeting Date: July 18, 2016
Agenda Title: Review the Request for Proposals for County Employee Benefits Brokers
Summary of Information: The Board of Commissioners directed the County Manager to
develop a Request for Proposals (RFP) for the administration of the County’s self-funded health
insurance plan which renews every year on July 1. This RFP does not indicate any
dissatisfaction with our current services, plans, brokers, or providers. Rather, this process will
ensure that our employees are continually offered the best benefit services and products available
while maintaining fiscal responsibility through a transparent process.
While developing this RFP, staff studied the processes that other counties have used to secure
their benefit providers. This RFP combines the elements that are needed for Person County
Government and takes into account best practices across the State.
Staff has also evaluated the possibility of bringing the benefit administration service in-house,
but due to the comprehensive needs of a self-funded health insurance system, this would not be
cost effective.
The Board is requested to provide feedback on this process. A selection committee can be
formed to evaluate the proposals received with a recommendation brought back to the Board of
Commissioners. The RFP will remain active for the month of August with a recommendation
for a contract to be brought back to the Board by October.
Recommended Action: Review the Request for Proposals and provide feedback to staff.
Submitted By: Heidi York, County Manager
414
REQUEST FOR PROPOSALS (RFP)
EMPLOYEE BENEFITS BROKER / CONSULTING SERVICES
TITLE: Employee Benefits Broker Services
ISSUE DATE: August 1, 2016
DUE DATE: August 31, 2016
DELIVER TO: Angie Warren, HR & Risk Management Director
Person County Government
304 S. Morgan St., Rm 204
Roxboro, NC 27573
*Electronically submitted (email/fax) proposals will not be accepted
Sealed proposals must be received by 5:00 PM on August 31, 2016. Indicate the firm and/or
company name and the primary contact person on the front of each sealed proposal envelope or
package. Any proposals received after 5:00 PM on August 31, 2016 will not be considered.
Each vendor will need to provide six (6) copies of the proposal.
Finalists will be interviewed on a date to be determined.
I. PURPOSE
Person County Government is soliciting Request for Proposals (RFP) for employee benefits
broker/consulting services. Currently, we are not requesting specific rates for our benefits. We are
in search of a broker/consultant with evidence that they are able to provide the needed benefit
administration for Person County and its employees. It is our intention not to release census data
or claims history until after the benefit consultant has been chosen. The broker/consultant must
have a proven track record of successfully providing the outlined “Scope of Services” for
employers of comparable size and complexity.
This Request for Proposal does not indicate in any way that we are dissatisfied with the services,
plans and/or products of our current provider, instead we are ensuring that our employees are
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continually offered the best benefit services and products available while maintaining fiscal
responsibility.
Person County’s health insurance is a self-funded plan with an effective date of July 1. There are
currently 396 benefit eligible employees and 29 retirees on the medical plan.
II. SCOPE OF SERVICE
Broker selected must be qualified to:
Assist with annual benefits renewals, including negotiation of changes in contracts.
Provide ACA compliance consulting and reporting services.
Prepare bid specifications, identify appropriate markets, analyze proposals submitted, make
recommendations, and assist in negotiation of (preferably multi-year) contracts not less than
90 days prior to renewal.
Annual reviews of selected employee benefit package for quality of benefits provided, cost
effectiveness, competitiveness and plan administration.
Monitor ongoing contracts, including provider plan administration, provider compliance with
contract, and incurred claims.
Provide information on employee benefit issues, trends and proposed or new legislation.
Be available to meet with the Benefits staff and Management as needed.
Assist in the design of employee benefits communications. Participate in Benefit Fairs and
annual enrollment process.
Create health care consumerism and wellness initiatives.
Provide a key contact person to be available to answer questions and resolve issues that arise
during the year regarding employee benefits, contract administration, and service provisions.
Prepare benefit booklets each year prior to open enrollment. (provide samples)
Provide online access for employees during open enrollment.
Perform other related consultation services as needed or requested.
III. TYPE OF PLAN
Person County desires to have one vendor provide and service all benefits offered to our
employees. Proposals should include the following benefits. Verify that your firm has the
experience and expertise to “shop the market” for and administer each of the following benefits:
Benefits Yes / No
Health Coverage ______
Dental Coverage ______
Vision Care ______
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Section 125 Flexible Benefits Plan Administration ______
(Including Medical and Dependent Care Flexible Spending Accounts)
Group Term Life ______
Permanent Whole / Universal Life ______
Short-Term Disability ______
Cancer/Intensive Care ______
Critical Illness ______
Accident Plan ______
Hospital Indemnity – Sickness Plan ______
How many NC Public Sector clients do you currently provide with benefits administration
services?
Total Number ____________
IV. OTHER REQUIREMENTS
Person County requires interested brokers/consultants to submit a “Qualification Statement”. This
statement must be responsive to your firm’s value added approaches and services that you feel
distinguish you from other brokers/consultants and should include supplemental material that
further supports the brokers/consultants ability to provide the administration of the services
outlined in Section II.
Person County requires a North Carolina licensed agent with the expertise and capacity to provide
the products and services requested. Such expertise and capacity must be fully evident within the
proposal and verifiable through a minimum of four (4) references. These references must be from
NC Public Sector clients, in which you currently provide Benefit Administration Services. The
references should not only be able to verify the company’s ability, but also the agents and/or their
agency.
V. QUESTIONNAIRE
Please complete and return this questionnaire with your proposal. If needed to answer a question
or questions, you may attach a page or pages to this form. Please indicate on the Bid Form that
the question is answered on an attached page. Also, please designate any answer on an attached
page with the same number as the question on the Bid Form.
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1. Name of Firm Submitting Proposal:
_____________________________________
2. Names and Titles of Person(s) Submitting Proposal:
_____________________________________
_____________________________________
3. Address of Firm Submitting Proposal:
____________________________________
____________________________________
____________________________________
____________________________________
4. Phone Number(s) of Firm Submitting Proposal:
____________________________________
____________________________________
5. Contact Person(s) for Firm:
____________________________________
Telephone Number(s) for Contact Person:
____________________________________
____________________________________
6. Please provide four references, preferably North Carolina public sector, that your firm
has worked with.
Client Contact
a.____________________________________________________________
b.____________________________________________________________
c.____________________________________________________________
d.____________________________________________________________
7. Please feel free to provide other references if you either do not have references that meet
the requirements specified in question number 6 or as an opportunity to provide
additional references for your firm.
Client Contact
a.____________________________________________________________
b.____________________________________________________________
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c.____________________________________________________________
d.____________________________________________________________
8. Briefly describe your company’s organization, philosophy, and management. Also,
please provide a brief company history. Identify the account team structure your firm
would use to service our account. List the names of the proposed account service team
and describe each member’s service role.
9. Describe how you propose to build an understanding of the direction and priorities of
Person County and how you would utilize this information in order to anticipate our
needs in relation to benefits.
10. Detail how your organization participates in developing a strategic benefit plan with your
clients.
11. Describe your organization’s involvement in the annual renewal process. Include
information regarding process timeframes, negotiation of rates and vendor selection.
12. Describe what resources your firm will provide to keep us in compliance with ACA and
legislative updates.
13. Describe what types of Wellness services your firm will provide.
14. Describe in detail the communication and enrollment process.
a. Who will be conducting the enrollments?
b. What is their experience in benefit communication and enrollment with the NC Public
Sector?
c. Include brochures or information you will be using during the enrollment process.
d. Do you offer online or web enrollment and if so, please describe.
e. Do you have a 365/24/7 platform to manage eligibility? Please describe its
capabilities.
15. Please provide a copy of a benefit election form that you have used that can serve as a
sample of a benefit election form to be submitted to our employees for benefit
enrollment.
16. Describe your annual post-enrollment data return processes to Person County.
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17. Describe the customer service and support your firm can provide to Person County
administration and our employees. Do you provide a toll free phone number for our
employees for service questions?
a. Do you provide personalized interactive website?
b. Do you provide personalized benefit videos?
c. Do you provide comprehensive benefit books?
18. Please provide any professional education opportunities that your firm delivers to Person
County staff.
19. Provide any additional information regarding your organization or services that you feel
would be beneficial in helping Person County to select a benefits broker.
20. Please provide a list of all fees that your firm will charge to administer our
Employee Benefits and/or other insurance products you will offer.
VI. CERTIFICATION
I certify that I have read this Request for Proposals and have answered all questions on this Bid
Form.
I certify that our firm will honor all commitments made on this Bid Form.
I certify that our firm and all representatives are licensed and will be licensed in North Carolina to
provide all services offered during the life of this contract.
_________________________________ _____________________________
Signature of Representative Firm Name
______________________________
Date of Signature
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AGENDA ABSTRACT
Meeting Date: July 18, 2016
Agenda Title: Designation of Voting Delegate to NC Association of County
Commissioners (NCACC) Annual Conference
Summary of Information: Voting Credentials for the 2016 NCACC Annual Conference
scheduled on August 11-14, 2016 in Forsyth County must be submitted by August 5, 2016
in order for Person County’s delegate to participate in the association’s annual election of
officers and policy adoption.
Recommended Action: Designate a commissioner attending the Conference as Person
County’s delegate. Commissioners Clayton and Jeffers both plan to attend the full
conference.
Submitted By: Chairman Newell
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