Agenda Packet July 20 2015PERSON 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 20, 2015
9:00am
CALL TO ORDER…………………………………………………. Chairman Puryear
INVOCATION
PLEDGE OF ALLEGIANCE
DISCUSSION/ADJUSTMENT/APPROVAL OF AGENDA
RECOGNITION
ITEM #1
Resolution of Appreciation for Retiree …………………………... Chairman Puryear
Wes Lail
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.
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ITEM #2
DISCUSSION/ADJUSTMENT/APPROVAL OF CONSENT AGENDA
A. Approval of Minutes of June 1, 2015, June 3, 2015 and June 15, 2015,
B. Budget Amendment #1,
C. Resolution – Stepping Up Initiative to Reduce the Number of People with
Mental Illnesses in Jails,
D. DSS Attorney Contracts, and
E. Tax Adjustments for the month of July 2015
a. Tax Releases,
b. NC Vehicle Tax System pending refunds
UNFINISHED BUSINESS:
ITEM #3
Cancer Death Rate Study – Within a 2-mile Radius of the
Upper Piedmont Landfill ……………………………………………….. Janet Clayton
NEW BUSINESS:
ITEM #4
Economic Development Commission ………………………………….. Kenneth Perry
ITEM #5
Resolution Authorizing a Contract between Person County and the
Roxboro Building Company, Inc. which involves a County
Commissioner as shareholder ………………………………...................... Ron Aycock
ITEM #6
Tax Collector Settlement ………………………………………………… Russell Jones
ITEM #7
Order to Collect Taxes …………………………………………………… Russell Jones
ITEM #8
Re-appointment of County Assessor ……………………………………. Russell Jones
ITEM #9
Designation of Voting Delegate to NC Association of
County Commissioners Annual Conference ……………………... Chairman Puryear
CHAIRMAN’S REPORT
MANAGER’S REPORT
COMMISSIONER REPORTS/COMMENTS
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, Wes Lail has served the people of Person County during
his tenure working for Person County as the Emergency
Services Director; and
WHEREAS, Wes Lail has served the citizens of Person County with
honor, integrity, sincerity and dedication, providing
accurate, concise services for three years, March, 2012 –
July, 2015 with a career spanning over 25 years in
emergency services; and
WHEREAS, Wes Lail 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
Wes Lail has made to the County and offers him sincere
best wishes for his retirement.
NOW, THEREFORE, I, Kyle Puryear, Chairman of the Person County
Board of Commissioners, do hereby extend this Resolution of Appreciation
to Wes Lail for continually striving to make Roxboro and Person County a
better place to live and work.
Adopted this 20th day of July, 2015.
____________________________________
Kyle Puryear, Chairman
Person County Board of Commissioners
Attest:
____________________________________
Brenda B. Reaves
Clerk to the Board
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June 1, 2015
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PERSON COUNTY BOARD OF COMMISSIONERS JUNE 1, 2015
MEMBERS PRESENT OTHERS PRESENT
Kyle W. Puryear Heidi York, County Manager
David Newell, Sr. C. Ronald Aycock, County Attorney
B. Ray Jeffers Brenda B. Reaves, Clerk to the Board
Jimmy B. Clayton
Tracey L. Kendrick
The Board of Commissioners for the County of Person, North Carolina, met in
regular session on Monday, June 1, 2015 at 7:00pm in the Person County Office Building
Auditorium.
Chairman Puryear called the meeting to order. Commissioner Kendrick gave an
invocation and Vice Chairman Newell led the group in the Pledge of Allegiance.
DISCUSSION/ADJUSTMENT/APPROVAL OF AGENDA:
Chairman Puryear stated a request was before the Board to add an item to the
agenda for action to Call for a Public Hearing for Economic Development Project G.
A motion was made by Commissioner Kendrick and carried 5-0 to add an item to
the agenda for action to Call for a Public Hearing for Economic Development Project G
and to approve the agenda as adjusted.
PUBLIC HEARING:
CONSIDERATION TO APPROPRIATE COUNTY GENERAL FUNDS TO
PERSON COUNTY BUSINESS AND INDUSTRIAL CENTER, INC., TO ASSIST
PROJECT GMERCER TO LOCATE IN PERSON COUNTY:
A motion was made by Vice Chairman Newell and carried 5-0 to open the
duly advertised public hearing for consideration to appropriate County General Funds to
Person County Business and Industrial Center, Inc., to assist Project Gmercer to locate in
Person County.
Economic Development Director, Stuart Gilbert stated the public hearing to
consider the appropriation of county general funds to be made available to Person County
Business and Industrial Center, Inc., in compliance with applicable law, to assist Project
Gmercer to locate a manufacturing, warehousing, and corporate headquarters in Person
County. Mr. Gilbert noted the project will include 260 new jobs with an annual average
wage of $40,000.00 and $57,800,000.00 capital investment in the first five years.
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Mr. Gilbert outlined the requested assistance as follows:
A financial grant incentive to be based on net new capital investments subject to
property taxes and will be provided over a ten year time period at an estimated total
cost of $1,229,040.40.
A financial match for a potential NC Department of Commerce Rural Division
Building Reuse Grant up to $500,000.00 requiring a match from Person County
estimated at a maximum of $25,000.00.
Mr. Gilbert recommended a “motion to approve the financial grant incentive to
allow the appropriation of county general funds to be made available to Person County
Business and Industrial Center, Inc. in compliance with applicable law to assist Project
Gmercer to locate a manufacturing, warehousing, and corporate headquarters in Person
County and that the net new capital investment is anticipated to be $57,800,000.00 and the
260 new jobs with an annual average wage of $40,000.00 over the five year period with a
minimum number of 90% of the new jobs to be created over the 5 years as follows:
Dec. 31, 2015- 75 new jobs
Dec. 31, 2016- 50 new jobs
Dec. 31, 2017- 50 new jobs
Dec. 31, 2018- 50 new jobs
Dec. 31, 2019- 35 new jobs
Mr. Gilbert said the estimated financial cash grants would be provided over a 10
year time period at an estimated cost of $1,229,040.40 that would fluctuate based on actual
capital investment levels.
There were no individuals appearing before the Board to speak in favor of or in
opposition to the appropriation of County General Funds to Person County Business and
Industrial Center, Inc., to assist Project Gmercer to locate in Person County.
A motion was made by Commissioner Jeffers and carried 5-0 to close the public
hearing for consideration to appropriate County General Funds to Person County Business
and Industrial Center, Inc., to assist Project Gmercer to locate in Person County.
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CONSIDERATION TO GRANT OR DENY REQUEST TO APPROPRIATE
COUNTY GENERAL FUNDS TO PERSON COUNTY BUSINESS AND
INDUSTRIAL CENTER, INC., TO ASSIST PROJECT GMERCER TO LOCATE
IN PERSON COUNTY:
A motion was made by Commissioner Clayton and carried 5-0 to approve the
financial grant incentive to allow the appropriation of county general funds to be made
available to Person County Business and Industrial Center, Inc. in compliance with
applicable law to assist Project Gmercer to locate a manufacturing, warehousing, and
corporate headquarters in Person County and that the net new capital investment is
anticipated to be $57,800,000.00 and the 260 new jobs with an annual average wage of
$40,000.00 over the five year period with a minimum number of 90% of the new jobs to
be created over the 5 years as follows:
Dec. 31, 2015- 75 new jobs
Dec. 31, 2016- 50 new jobs
Dec. 31, 2017- 50 new jobs
Dec. 31, 2018- 50 new jobs
Dec. 31, 2019- 35 new jobs
PUBLIC HEARING:
FISCAL YEAR 2015-2016 RECOMMENDED BUDGET:
A motion was made by Commissioner Kendrick and carried 5-0 to open the duly
advertised public hearing for the Fiscal Year 2015-2016 Recommended Budget.
County Manager, Heidi York summarized the Fiscal Year 2015-2016
Recommended Budget with the following points:
General Fund = $54,965,286 (represents a 2.45% increase),
No Tax Increase (remains flat for 9th consecutive year),
1 cent on the tax rate =$422,065,
Reduced reliance on fund balance at $2.7M, a decrease of approximately $343,000,
$2.96M construction funds for a new Senior Center,
9.26% increase for Person County Schools which includes capital and current
expense (represents $11.4M appropriation),
Charter Schools do not receive the capital outlay portion but do receive current
expense as well as fines and forfeitures; appropriates $1.8M to Charter Schools, an
increase in $118,000 or a 6.94%,
No new positions, and
Eight positions are proposed for reduction for county government positions.
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Chairman Puryear announced a 2.5 minute time limit per speaker for the Fiscal
Year 2015-2016 Recommended Budget.
Speaking in favor of the Fiscal Year 2015-2016 Recommended Budget were:
Dr. Walter Bartlett of 451 Wimbledon Drive, Roxboro, and President of Piedmont
Community College (PCC) thanked the Board for continued support and partnership noting
as there was no increase to PCC current expense, he appreciated the recommended budget
accommodated the salary increase. Dr. Bartlett stated PCC, an entity for investment, tried
to keep their budget request close to flat comparable to county departments noting he
appreciated the increase in capital outlay which will help to take care of things at the
college.
Mr. Gordon Powell of 299 N. Ridge Circle, Roxboro, and Chairman of the Board
of Education stated his support for the 2015-2016 budget as presented by the County
Manager Heidi York. Mr. Powell commended Ms. York and Superintendent Dan
Holloman for working together to develop a school’s budget based on district needs for
current expense and capital outlay. Mr. Powell stated the proposed budget included a
generous increase over last year’s allocation for technology, initiatives and other programs.
Mr. Powell thanked the Board for its continued support of Person County Schools.
Speaking in opposition to the Fiscal Year 2015-2016 Recommended Budget were:
Mr. Derrick Sims of 2409 Flat Woods Road, Timberlake and Chairman of the
Roxboro Area Chamber of Commerce requested Board consideration to appropriate $3,000
in the Fiscal Year 2015-2016 budget to help fund the Personality Festival scheduled for
August 28-29, 2015 noting the profits made from the festival will help keep the doors open
at the Chamber. Mr. Sims stated the festival will bring 10,000-15,000 people into Uptown
Roxboro which will impact the economy and showcase the Roxboro Uptown area. Mr.
Sims thanked the Board for its continued support.
Lauren Wrenn of 390 Bethel Hill School Road, Roxboro, and Roxboro
Development Group Director addressed the Board on behalf of the Director’s Roundtable
to seek consideration to support funding in the upcoming budget for the Independence Day
fireworks display to be held on the evening of July 3, 2015. Ms. Wrenn informed the group
that the City of Roxboro has accepted the responsibility of ensuring the fireworks’ event
will continue by signing all necessary contracts. While local businesses have expressed an
interest in assisting with sponsorships, Ms. Wrenn stated there is a sizable amount
remaining to fulfill the $8,500 total costs of the event. The Directors Roundtable requested
the Board to consider support of the county-wide fireworks’ event.
Mr. Kenny Rickman of 3936 Allensville Road, Roxboro stated he no longer needed
to address the Board related to the Recommended Budget.
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Mr. Brad Cothran of 833 Younger Road, Roxboro and a local contractor spoke in
opposition to the proposed reduction of one position in the Inspections Department noting
business has picked up and the need for inspections in a timely matter.
Ms. Portia Lewis of 3068 Chub Lake Road, Roxboro addressed the Board on behalf
of her son, Retrac Lewis of Jimmy Lewis & Sons, a local grading and septic tank business
who advocated for the County to fill the vacant positon in the Environmental Health
Department that is proposed for reduction in the budget. Ms. Lewis read comments from
her son noting home owners and builders have received great service with timely responses
to questions and inspections. Ms. Lewis asked the Board should another inspector leave,
how long would it take to hire and train the position when the department is already down
one position.
Mr. Avie Lester of 7455 Virgilina Road, Roxboro addressed the Board on behalf
of the Person County Branch NAACP to express concerns about the current state of law
enforcement and community relations. Mr. Lester stated there are fundamental flaws in the
unbridled authorization of some police officers to use force against individuals who are not
involved in the commission of a violent felony and are not posing an immediate physical
threat to the officers or a third party. Mr. Lester stated additionally there is an absence of
an independent review mechanism which is deliberately designed to avoid effective
oversight of police misconduct allegations. Mr. Lester encouraged elected officials to
support the recommendations for local law enforcement departments for mandatory
training on bias and police use of force, the required use of police officer Body-Worn
Cameras to record every police-civilian encounter, the universal use of dash cameras in
police vehicles, community training to educate residents of their right when dealing with
law enforcement, greater and more effective community oversight over local law
enforcement and policing tactics and the establishment of a law enforcement commission
to review policing tactics that would include representatives from the most impacted
communities.
Ms. Natalie Brozy of 4009 Pixley Pritchard Road, Roxboro and Managing
Executive Director for Roxboro Community School (RCS) addressed the funding for
student laptops through the capital outlay fund in the recommended budget. Ms. Brozy
stated the capital outlay fund is typically reserved for building and construction projects
and as a public charter school, RCS provides the facilities for their students. Ms. Brozy
stated, in her opinion, the creators of the statutes of the capital outlay fund never intended
to use that fund to deny access for student use devices, i.e., computer, microscopes, etc.,
noting a computer is comparable to a textbook and pencil in that students use these tools
in their everyday school routine. Ms. Brozy asked if the funding plan was equitable to all
Person County students noting the charter school families do not feel it is equitable due to
charter school students are excluded from the technology funds as recommended. Ms.
Brozy noted budgetary restrictions prevent RCS from covering the funds by accessing
usage fees (not permitted to access fees unless the LEA in the same district accesses fees).
Ms. Brozy requested Board consideration to move all funding for student laptops back into
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the current expense fund so that every Person County student (1,025 students in public
charter schools) have support for their digital learning initiatives as well. Ms. Brozy, on
behalf of the RCS administration, Board of Directors and teachers, noted appreciation of
the Board’s support.
Mr. Joe Berryhill of 705 Berryhill Road, Roxboro and Chairman of Bethel Hill
Charter School commended the Board for funding technology but wanted to address how
technology is funded noting charter schools do not receive any capital funding. Mr.
Berryhill stated if technology is funded through capital, the two charter schools with 1,025
students will not receive any portion. Mr. Berryhill stated charter schools are tested and
held to the same standards as traditional schools and should be funded the same. Mr.
Berryhill requested the Board fund technology through its operating fund so all students
will share it equally.
A motion was made by Commissioner Kendrick and carried 5-0 to close the public
hearing for the Fiscal Year 2015-2016 Recommended Budget.
INFORMAL COMMENTS:
The following individuals appeared before the Board to make informal comments:
Ms. Margaret McMann of 303 Windsor Drive, Roxboro and Tourism Development
Authority (TDA) Director told the Board that she will present TDA’s annual report in
August but wanted to inform the group of the many happenings in Roxboro and Person
County. Ms. McMann thanked Vice Chairman Newell, Roxboro Community School,
Roxboro Police Department and other private citizens for assisting in securing location
shots for a film crew for a movie to be released later this year. Ms. McMann stated that
Sunset Ridge Buffalo Farm has become a major wedding destination site for Person County
and noted another unique attraction is Jiptopia Wake Park located in Semora that offers
lessons for wake boarding, water skiing, trails for horseback riding, sand volleyball and
music concerts. Ms. McMann stated Person County’s lakes are busy and a new disc golf
course (third course for Person County) at Hyco has been completed. Other Uptown events
include the cruise-ins, the Alive After 5’s and art exhibits at the Kirby Gallery.
Mr. Reggie Horton of 310 Broad Street, Roxboro, on behalf of the Veterans
Council, updated the Board on the Veteran’s Park that is located adjacent to the County
Office Building. Mr. Horton noted the flag poles are erected, the walkway is 95%
complete, the two walls at the front of the Park are currently in construction as well as the
donor recognition stones and the stones with engraving for each conflict are in progress
and should be ready in the near future. Mr. Horton publicly thanked Chief Torain and the
Roxboro Fire Department as well as Spencer Farrish for their volunteer work at the Park.
Mr. Horton told the Board that once a completion date/dedication date was set, the Board
will be informed. Mr. Horton encouraged anyone wishing to make a contribution or
remember a veteran there is still time to do so. Mr. Horton thanked the Board for its
continued support of the Veterans Park.
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Ms. Lawrie Ira of 123 S. Morgan Street, Roxboro, and member of the Arts Council
acknowledged the Board’s support of the Kirby Cultural Arts Complex. Ms. Ira announced
that on June 15-16, 2015 there will be auditions for Shrek Jr noting this opportunity
provides children with a chance to express themselves, boost their self-esteem, teach public
speaking skills, and interact with community members in a way that has an impact on them
as adults.
Mr. Kenny Rickman of 3936 Allensville Road, Roxboro, with Ms. Ollie Jeffers
standing alongside, spoke on behalf of victims of drunk drivers. Mr. Rickman stated that
Chairman Puryear walked away from a DWI. Mr. Rickman stated his understanding that
there was a deal prior to the proceedings without no appeal to Superior Court. Mr. Rickman
read a comment from Commissioner Kendrick in the press “If someone goes to a Court of
law and is found innocent, we should not judge them in our own opinion, we should judge
them on what the Court says is right or wrong.” Mr. Rickman referred to Mike Nifong’s
case related to three young males that would be in prison for a rape that they did not
commit. Mr. Rickman stated courts are run by human beings, and they make mistakes.
Mr. Rickman stated Ms. Jeffers is a member of the MADD organization and gave the
following statistics: 82% of all people get caught drunk driving get caught again, and in
2012 twenty-eight people per minute got killed each day due to drunk drivers. Mr.
Rickman asked Chairman Puryear to step down from the Board of Commissioners.
DISCUSSION/ADJUSTMENT/APPROVAL OF CONSENT AGENDA:
A motion was made by Commissioner Kendrick and carried 5-0 to approve the
Consent Agenda with the following items:
A. Approval of Minutes of May 18, 2015,
B. Budget Amendment #18, and
C. Memorandum of Agreement between Person County United Way and funded
partner agencies
NEW BUSINESS:
ELDER ABUSE AWARENESS DAY PROCLAMATION:
Person County’s Senior Center Interim Aging Services Director, Maynell Harper
requested approval of a Proclamation designating June 2, 2015 as Person County Elder
Abuse Awareness Day explaining the day focuses local and regional attention on the
problem of physical, emotional, and financial abuse of elders. It also seeks to understand
the challenges and opportunities presented by an aging population, and brings together
senior citizens, and their caregivers, local government, agencies, and the private sector to
exchange ideas about how best to reduce incidents of violence towards elders, increase
reporting of such abuse, and to develop elder friendly policies. Ms. Harper stated the Person
County Senior Center is hosting a Regional Event, “Elder Abuse Awareness Walk” on June
2, 2015. Seniors, family members, Agency personnel from Person, Granville, Vance,
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Warren and Franklin Counties have committed to attend this event with approximately 150
expected.
A motion was made by Commissioner Clayton and carried 5-0 to approve an Elder
Abuse Awareness Day Proclamation.
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DESIGNATE NACO VOTING DELEGATE FOR THE 2015 ANNUAL
CONFERENCE:
Voting Credentials for the 2015 Annual Conference to be held July 10-13, 2015, in
Mecklenburg County, NC, must be submitted by June 19, 2015 in order for Person
County’s delegate to participate in the association’s annual election of officers and policy
adoption.
Chairman Puryear asked the Board’s desire to designate Commissioner Clayton or
Commissioner Jeffers as Person County’s delegate.
A motion was made by Commissioner Jeffers and carried 5-0 to designate
Commissioner Clayton as Person County’s delegate for the 2015 NACo annual conference.
CALL FOR A PUBLIC HEARING FOR ECONOMIC DEVELOPMENT
PROJECT G
A motion was made by Commissioner Jeffers and carried 5-0 to call for a Public
Hearing for Economic Development Project G to be held on June 15, 2015 at 9:00am and
to cause action for the Clerk to advertise such.
CHAIRMAN’S REPORT:
Chairman Puryear reported that on June 3, 2015 at 8:00am the Chamber of
Commerce will be holding its Good Morning Coffee Hour at the Golden Corral and the
Board has a 9:00am budget work session on the same date.
MANAGER’S REPORT:
County Manager, Heidi York invited the Board to attended the County’s Safety
Committee luncheon on June 4, 2015 at 11:30am.
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COMMISSIONER REPORT/COMMENTS:
There was no report or comments from Commissioner Jeffers, Commissioner
Kendrick or Vice Chairman Newell.
Commissioner Clayton reminded everyone in attendance of the Elder Abuse
Awareness Day event scheduled for June 2, 2015 at 9:30am at Huck Sansbury Park.
RECESS:
A motion was made by Vice Chairman Newell and carried 5-0 to recess the
meeting at 7:41pm until June 3, 2015 at 9:00am for the purpose of a budget work session.
_____________________________ ______________________________
Brenda B. Reaves Kyle W. Puryear
Clerk to the Board Chairman
(Draft Board minutes are subject to Board approval).
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June 3, 2015
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PERSON COUNTY BOARD OF COMMISSIONERS JUNE 3, 2015
MEMBERS PRESENT OTHERS PRESENT
Kyle W. Puryear Heidi York, County Manager
David Newell, Sr.
B. Ray Jeffers Brenda B. Reaves, Clerk to the Board
Jimmy B. Clayton
Tracey L. Kendrick
The Board of Commissioners for the County of Person, North Carolina, met in
recessed session on Wednesday, June 3, 2015 at 9:00am in the Commissioners’ meeting
room in the Person County Office Building for the purpose of a budget work session.
Chairman Puryear called the recessed meeting to order.
DISCUSSION/ADJUSTMENT/APPROVAL OF AGENDA:
A motion was made by Commissioner Kendrick and carried 5-0 to approve the
agenda.
BUDGET WORK SESSION ITEMS FOR DISCUSSION:
1. Minor Budget Adjustments since proposed
County Manager, Heidi York told the Board that since the Recommended Budget
was presented on May 18, 2015, there have been some minor changes in revenues and
expenditures. Ms. York asked the Budget Manager, Laura Jensen to provide an overview
of the items listed in the handout titled Expenditure Changes from County Manager
Recommended to BOCC Adopted (see below). Ms. Jensen told the group the biggest
change was a reconsideration of E911 funding from the state, an increase of $122,081. Ms.
Jensen noted a net reduction in expenditures of $3,396.
Commissioner Jeffers informed the Board he was leaving the meeting at 9:03am to
retrieve a folder from his vehicle. He rejoined the meeting at 9:07am.
Ms. York explained the $7,500 costs to Person Industries (PI) Material Recycling
Facility (MRF) budget was removed due to the Board’s inclusion of an efficiency study for
the Recycling Center in the Landfill Request for Proposals which is budgeted in the
Governing Body at $100,000.
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Vice Chairman Newell asked staff to explain the PI expenditure line budgeted for
commissions. Finance Director, Amy Wehrenberg noted a salaried employee (base salary
of $45,210) also has the opportunity to earn commission (up to $9,308 in the recommended
budget) for PI job recruitment. PI Director, Becky Clayton stated there is one position for
a Production Manager who, in addition to his duties of oversight and quality, seeks work
contracts with local companies and earns commission based on a percentage of the
contract. Human Resources Director, Angie Warren stated the job description listed the
commission rate at 1% for existing contracts and 2% for new contracts. Ms. Clayton stated
the community contracts are desired to be partnerships for long term recurring work. Ms.
Clayton confirmed the contracts are revenue positive with the exception for recycling.
2. Personnel Positions
County Manager, Heidi York presented the Board with the following handout titled
Positions Reductions illustrating the total savings in the Recommended Budget. Ms. York
outlined the two positions the Board has discussed of possibly reinstating in the budget
explaining the associated costs of vehicles, training, and cell phones.
Commissioner Kendrick commended the County Manager for holding the line on
positions as directed by the Board for savings and not increasing taxes. Commissioner
Kendrick recommended having a plan in place related to the Inspector and Environmental
Health Specialist positions for services to be completed in a timely manner (i.e. 48-hour
turnaround) . Commissioner Kendrick further recommended the County continue with the
budget freezes and reductions as proposed.
Commissioner Jeffers stated issue only with the two positions (Inspector and
Environmental Health Specialist) due to they were frozen because there was a vacancy and
not offered by the Departmental Director and which will have an impact on business
without the appropriate data to support.
Commissioner Clayton noted the education requirement, training and certification
for the two positions can take up to six months with a new hire; there are more ramifications
than just the salary and budget savings and Commissioner Clayton advocated to reinstate
the two positon in the budget.
Vice Chairman Newell stated expectations for the Departmental Directors to
prioritize, reorganize scheduling and do more with less people. Vice Chairman Newell
stated his willingness to allocate funds to Contingency in case the data proves another
position was needed.
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Commissioner Kendrick read the following statistics “in nine years, Person County
Government has added 154 employees. The third largest company added 140 employees.”
Person County Government moved from the fifth in total employment to second largest
employer in that nine year period. Where Person County has not grown is in commercial
or industrial. Commissioner Kendrick noted that when your county government grows
faster than your economy, there is a problem.
A motion was made by Commissioner Jeffers and failed 2-3 to add the two
positons for an Inspector and an Environmental Health Specialist back to the budget.
Commissioners Jeffers and Clayton voted in favor of the motion. Chairman Puryear, Vice
Chairman Newell and Commissioner Kendrick voted in opposition to the motion.
Vice Chairman Newell asked for the process should the positions, upon review,
were needed to be added back to the budget. Ms. York stated she could bring back data in
three months or six months related to the impact of the positon reductions and should the
Board desire to fund mid-year, a Fund Balance appropriation would be required.
Commissioner Kendrick requested that both departmental directors report back to
the Board with a proactive contingency plan within two months of this date. Ms. York
stated staff would bring back data in two months for review.
3. Education Funding
County Manager, Heidi York led the discussion related to the capital appropriation
for the schools noting charter schools are not entitled to receive any capital. Ms. York
referenced a memo from the County Attorney citing the Sugar Creek case which confirms
that the County cannot make an appropriation to capital for charter schools. Ms. York
stated there is a formula for funding current expense where the charter schools receive a
per pupil allotment for their share of the expense. Ms. York estimated 18%-19% of the
amount of current expense recommended will be for charter schools.
Ms. York noted some counties, i.e. Union, Forsyth, Orange, fund laptops through
current expense however, the laptops are being leased which is considered a recurring
expense. Ms. York stated the local school system was not leasing the laptops, but will
purchase to acquire a physical asset which is a capital expenditure. A special appropriation
to the charter schools is also not legal noting counties are mandated to use the funding
formula derived from the state to fund the traditional schools with charter schools receiving
the per pupil expenditure. Ms. York provided the Board with the following handout titled
Charter School Disbursement Projection 2015-16 (Based on County Manager’s
Recommended Budget) to illustrate the many charter schools and appropriation that
follows the student per the formula noting an overall increase by $118,153 or a 6.94%.
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Ms. York reminded the Board of the general statute that related to supplanting funds
to school systems, i.e., should the $800,000 be included in the current expense fund, that
$800,000 becomes a recurring expense and that amount could not be cut from current
expense unless the same amount is cut by proportion by every other county funded agency.
Commissioner Clayton stated the state law is explicit and read an excerpt of the
School Budget and Fiscal Control Act 115C-426(f)(3) “The acquisition or replacement of
furniture and furnishings, instructional apparatus, data-processing equipment, business
machines, and similar items of furnishings and equipment.”
Commissioner Kendrick asked the County Manager if the professional
development in the school budget is a county mandate. Ms. York confirmed there is no
mandate to fund current expense and professional development is a current expense (an
operating expense); the mandate is to provide for the capital funding of the schools.
Finance Director, Amy Wehrenberg stated the recommended school funding minus
the technology ($834,889) recommended for the overall increase for operating portion of
education is .55%. The total overall increase in education funding is 9.26% includes
current expense, capital and technology. Commissioner Kendrick stated he felt that was
more in line with the inflation rate.
Commissioner Kendrick voiced support to fund Person County Schools with
technology in capital funding as recommended by the County Manager.
Commissioner Kendrick stated until the state legislature decides the outcome for
driver’s education, he would like to propose holding the $98,000 from the budget.
Superintendent of Person County Schools, Dan Holloman stated the funding is the
local responsibility should the state not include in its budget. Person County Schools
currently assesses the maximum allowable fee of $65.00 per student.
A motion was made by Vice Chairman Newell and carried 3-2 to fund the Schools
as proposed by the County Manager with the stipulation that the driver’s education funding
in the amount of 98,000 be removed from the school’s budget and placed into the County’s
Contingency Fund until legislation is finalized. Vice Chairman Newell, Chairman Puryear
and Commissioner Jeffers voted in favor of the motion. Commissioners Kendrick and
Clayton voted against the motion.
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4. Volunteer Fire Department Capital Funding
County Manager, Heidi York reminded the Board that a Capital Funding Program
budget has been created for capital purchases only for the volunteer fire departments
(VFDs) and rescue. Ms. York asked the Board what amount from the Revolving Loan
Fund budget which has a current balance of $181,256 should be transferred to the Capital
Funding Program for FY 2015-2016. Ms. York noted the VFDs and rescue would not
receive flat appropriations but may apply up to a certain amount that will be based on the
total amount available in the Capital Funding Program as determined by the Board. Ms.
York told the Board that staff recommended the Board not fund the full amount of $181,256
into the Capital Funding Program to ensure carry forward funds to start the following fiscal
year.
A motion was made by Commissioner Kendrick and carried 5-0 to transfer one-
half of the total amount in the Revolving Loan Fund or $90,628 to the Capital Funding
Program.
Commissioner Jeffers asked Ms. York to outline the amounts by which the VFDs
and rescue would be eligible to request capital purchases. Vice Chairman Newell asked
Commissioner Jeffers to find out from the Chiefs the sustainable funding needs. Finance
Director, Amy Wehrenberg noted a better understanding of the VFDs and rescue financial
situation upon the completion of the FY14 audits.
Vice Chairman Newell noted if staff could include FY15 to date actual in the budget
document, it would be helpful.
5. Rox Sportsplex
County Manager, Heidi York reminded the Board that though adoption of its CIP,
an appropriation has been made for the purchase and up-fitting of the Rox Sportsplex site
budgeted at $559,500. The operating costs are budgeted in Recreation, Governing Body
and General Services for a total of $93,673. Assistant County Manager, Sybil Tate stated
projected revenues are estimated at $66,000. Ms. Tate confirmed that through the Little
League rules, a charge can be accessed for parking.
Commissioner Kendrick advocated for upgrading existing facilities without
increasing personnel in lieu of purchasing another property to add salaries and become a
recurring expense for citizens.
A motion was made by Commissioner Kendrick and failed 2-3 to not purchase the
Rox Sportplex and not create the budget line items for FY2015-2016. Commissioner
Kendrick and Chairman Puryear voted in favor of the motion. Vice Chairman Newell and
Commissioners Clayton and Jeffers voted in opposition to the motion.
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6. Summary of Adjustments to the Recommended Budget
County Manager, Heidi York stated the summary of adjustments to the
Recommended Budget reflects $3,396 to the positive at this point in the budget process.
Commissioner Kendrick advocated for the Board to consider not funding any non-
profits noting by doing so, the Board is placing preference on certain non-profits above
others in the community. Commissioner Kendrick stated his support to incrementally cut
the funding from the Person County Senior Center. Commissioner Kendrick stated he has
had discussions with another non-profit that may be interested. Commissioner Kendrick
noted he serves on the Senior Center Advisory Board and feels appropriating funds to non-
profits is not a function of county government.
Commissioner Clayton recounted that the Person County Senior Center remained
open only due to the government operated regional non-profit agreeing to do so and without
the local funding, the program may cease to operate.
Commissioner Jeffers stated opposition to cut the senior programs when the Board
has committed to build a facility to house the Senior Center and its programming.
Chairman Puryear suggested for Commissioner Kendrick to further discuss his
ideas with the advisory members and the possibly interested non-profit to create a plan.
A motion was made by Commissioner Kendrick and failed 1-4 to cut the Senior
Center budget by $25,000. Commissioner Kendrick was the lone vote in favor of the
motion.
A motion was made by Commissioner Jeffers and failed 2-3 to add $7,200 to the
Senior Center appropriation to restore to $100,000 and to fund from the Contingency Fund.
Commissioners Jeffers and Clayton voted in favor of the motion. Chairman Puryear, Vice
Chairman Newell and Commissioner Kendrick voted against the motion.
Commissioner Clayton stated that the Region K Community Assistance (non-profit
running the Person County Senior Center) would like to meet jointly with the Board of
Commissioners in July or August, following the completion of the budget process.
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Commissioner Kendrick stated opposition to Piedmont Community College (PCC)
capital appropriation for a tractor and snow blower but suggested setting aside a certain
amount, i.e., $10,000 in a fund for PCC to have a contingency plan in place for snow
removal in lieu of purchasing a piece of equipment that may or may not be utilized. Finance
Director, Amy Wehrenberg stated the request was for a state-contract priced John Deere
tractor for $60,000 and a snow blower for $1,180.
A motion was made by Commissioner Kendrick and carried 3-2 to reduce the PCC
budget by $61,180 as recommended for a tractor and snow blower. Commissioner
Kendrick, Chairman Puryear and Vice Chairman Newell voted in favor of the motion.
Commissioners Clayton and Jeffers voted against the motion.
A motion was made by Commissioner Kendrick and carried 4-1 to appropriate
$10,000 in Contingency Plan for PCC’s snow removal on an as needed basis pending a
pre-approved agreement with a service contractor. Commissioner Jeffers cast the lone
dissenting vote.
Chairman Puryear stated the City of Roxboro was appropriating $2,000 to the
Fireworks event.
A motion was made by Chairman Puryear and failed 2-3 to match the City of
Roxboro’s appropriation for the Fourth of July Fireworks and be funded with the surplus
budget. Chairman Puryear and Commissioner Jeffers voted in favor of the motion. Vice
Chairman Newell and Commissioners Kendrick and Clayton voted against the motion.
Chairman Puryear stated the Board had received a request for $3,000 for
Personality.
A motion was made by Chairman Puryear and failed 1-4 to grant the request to
fund $3,000 for Personality from the surplus. Chairman Puryear cast the lone vote in favor
of the motion.
Commissioner Kendrick stated the Board had received a request for $10,000 to help
sustain the Drug Treatment Court program. Commissioner Kendrick noted the program is
not mandated but the program saves money and allows people to be productive members
of society versus putting law enforcement or court systems into place.
A motion was made by Commissioner Kendrick to appropriate $10,000 to Drug
Treatment Court. Ms. York stated there is currently $5,000 unencumbered funds remaining
in the current fiscal year’s budget of $10,000, offering to carry over to next fiscal year.
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An amended motion was made by Commissioner Kendrick and carried 4-1 to
appropriate $5,000 to Drug Treatment Court to be combined with the $5,000 carry-over
funds from the current year for a total of $10,000. Commissioner Jeffers cast the lone
dissenting vote.
Commissioner Kendrick noted the Board’s recent action to approve a self-funded
insurance plan for the next fiscal year; part of the plan is to keep employees in good health
to save costs with the claims. Commissioner Kendrick stated the employees currently have
access to an employee fitness gym for a small fee. Commissioner Kendrick advocated for
the employees to have the ability to use the showers in the gym area.
A motion was made by Commissioner Kendrick and carried 5-0 to appropriate
Recreation, Arts & Parks’ budget with $10,000 to retrofit the employee’s gym existing
showers.
Recreation, Arts & Parks Director, John Hill stated the $10,000 was an estimate
only.
Commissioner Kendrick stated opposition to Person Industries (PI) starting new
programs, i.e., household hazard waste disposal day, that are costly without finding
programs to sell recyclable goods to get closer to revenue neutral.
Commissioner Kendrick pointed out the PI temporary service labor budget line
increased by 124% or $391,000 and suggested trying to decrease the labor intensive costs
maybe with the processing machine that Vice Chairman Newell referred to in a recent
meeting. Ms. York explained the $391,000 increase was due to the Eaton contract which
increased with more work which caused more labor costs. Ms. York stated the contract
with Eaton is in effect through December 2015 noting the Affordable Care Act was the
biggest driving factor for the increased costs.
Vice Chairman Newell asked if there were P&L statements available for the PI
contracts. Ms. Tate noted the budgetary view was conservative with revenues and over-
estimating expenditures as compared to the actual numbers. Ms. Tate provided the Board
with the following slides for informational purposes:
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A motion was made by Commissioner Kendrick to reduce PI’s budget by $12,000
for the household hazardous waste program.
Commissioner Clayton stated the design of the household hazardous waste program
was to provide an avenue for those types of items to be disposed of properly and not be put
in to the landfill or disposed improperly into the environment.
Commissioner Kendrick stated support to change the line item to utilize the $12,000
to find avenues to get closer to making revenue.
An amended motion was made by Commissioner Kendrick and failed 2-3 for the
$12,000 be utilized as an avenue to find revenue sources for the existing materials that are
not revenue positive. Commissioner Kendrick and Chairman Puryear voted in support of
the motion. Vice Chairman Newell and Commissioners Clayton and Jeffers voted in
opposition to the motion.
A motion was made by Vice Chairman Newell and carried 5-0 to place the
remaining budget surplus in the amount of $39,576 into the Contingency Fund.
A motion was made by Chairman Puryear and carried 3-2 for the County Manager
to prepare Fiscal Year 2015-2016 Budget Ordinance for the Board’s adoption on June 15,
2015. Chairman Puryear, Vice Chairman Newell and Commissioner Kendrick voted in
support of the motion. Commissioners Clayton and Jeffers cast the dissenting votes.
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ADJOURNMENT:
A motion was made by Vice Chairman Newell and carried 4-1 to adjourn the
meeting at 11:34 am. Commissioner Jeffers cast the lone dissenting vote.
_____________________________ ______________________________
Brenda B. Reaves Kyle W. Puryear
Clerk to the Board Chairman
(Draft Board minutes are subject to Board approval).
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June 15, 2015
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PERSON COUNTY BOARD OF COMMISSIONERS JUNE 15, 2015
MEMBERS PRESENT OTHERS PRESENT
Kyle W. Puryear Heidi York, County Manager
David Newell, Sr. C. Ronald Aycock, County Attorney
B. Ray Jeffers Brenda B. Reaves, Clerk to the Board
Jimmy B. Clayton
Tracey L. Kendrick
The Board of Commissioners for the County of Person, North Carolina, met in
regular session on Monday, June 15, 2015 at 9:00am in the Commissioners’ meeting room
in the Person County Office Building.
Chairman Puryear called the meeting to order. Commissioner Kendrick gave an
invocation and Vice Chairman Newell led the group in the Pledge of Allegiance.
DISCUSSION/ADJUSTMENT/APPROVAL OF AGENDA:
Chairman Puryear requested the Board move item #3 Annual Budget Ordinance
& Fee Schedule Adoption to the end of the agenda.
A motion was made by Commissioner Kendrick and carried 5-0 to move item #3
Annual Budget Ordinance & Fee Schedule Adoption to the end of the agenda and to
approve the agenda as adjusted.
PUBLIC HEARING:
REQUEST TO CANCEL PUBLIC HEARING FOR CONSIDERATION TO
APPROPRIATE COUNTY GENERAL FUNDS TO PERSON COUNTY BUSINESS
& INDUSTRIAL CENTER, INC. TO ASSIST ECONOMIC DEVELOPMENT
PROJECT G TO LOCATE TO PERSON COUNTY:
A motion was made by Commissioner Kendrick and carried 5-0 to open the duly
advertised public hearing for consideration to appropriate County General Funds to Person
County Business & Industrial Center, Inc., to assist Economic Development Project G to
locate to Person County.
Chairman Puryear requested Board action to cancel the public hearing in its
entirety.
A motion was made by Commissioner Kendrick and carried 5-0 to cancel the
public hearing for consideration to appropriate County General Funds to Person County
Business & Industrial Center, Inc., to assist Economic Development Project G to locate to
Person County in its entirety.
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INFORMAL COMMENTS:
The following individuals appeared before the Board to make informal comments:
Mr. Andy Withers of 42 Lakeview Estates Road, Semora advocated for the Board
to pursue local government efficiency experts to review Person County’s staffing and
structure. Mr. Withers supported Person County to reduce its staffing levels noting the
County, as the second highest employer in the county, should not employ more than a small
percentage of the County’s total workforce.
Ms. Christie Canter of 191 Jasper Clayton Road, Roxboro stated the importance of
technology in schools noting technology allows teachers to meet individual reading and
learning levels in one classroom through use of adaptive software programs. Ms. Canter
further noted students can take virtual fieldtrips all over the world. Ms. Canter asked the
Board to consider students’ technology needs as the budget was being finalized as well as
she wanted to thank the Board for past and continued support on behalf of the students,
educators, and parents.
Mr. Gordon Powell of 299 N. Ridge Circle, Roxboro and Chairman of the Board
of Education stated support of the Recommended Budget and he commended the Board
for placing education as a priority.
Mr. Jarrod Dennis of 427 Fletcher Ridge Road, Timberlake and Director of
Accountability and Technology for Person County Schools stated the importance of
appropriate technology as the schools move to blended learning models for its students.
Mr. Kenneth Rickman of 3936 Allensville Road, Roxboro asked Chairman Puryear
to resign from the Person County Commissioners. Mr. Rickman asked Vice Chairman
Newell and Commissioners Kendrick, Clayton and Jeffers to publicly issue a statement
that they do not tolerate drunk driving in Person County. Mr. Rickman called upon District
Attorney Wallace Bradsher to charge Chairman Puryear with careless and reckless driving.
Ms. Ollie Jeffers of 285 Dunnaway Road, Semora gave the Board a brief history of
how she became an advocate of victims of drunk drivers noting she takes her advocacy
seriously. Ms. Jeffers noted she has received many citizens’ calls related to recent events
to which there has not been an apology. Ms. Jeffers said it could not be business as usual.
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DISCUSSION/ADJUSTMENT/APPROVAL OF CONSENT AGENDA:
A motion was made by Commissioner Kendrick and carried 5-0 to approve the
Consent Agenda with the following items:
A. Approval of Minutes of May 26, 2015,
B. Budget Amendment #19,
C. Memorandum of Agreement between Person County United Way and funded
partner agencies (Sheriff’s Department),
D. Person County Resolution to revise the Kerr-Tar Workforce Development
Consortium Agreement,
E. Kerr-Tar Workforce Development Consortium Agreement,
F. Letter of Support and Resolution to Maintain and Support the Reauthorization of
the Land Water Conservation Fund Equitable Treatment of the State Assistance
Program,
G. Tax Adjustments for the month of June 2015
a. Tax Releases, and
b. NC Vehicle Tax System pending refunds
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NEW BUSINESS:
VOLUNTEER FIRE DEPARTMENT AND RESCUE CAPITAL RESERVE FUND
PROGRAM AND ORDINANCE:
Heidi York, County Manager stated the Board has two components for
consideration to approve: 1) program requirements for Volunteer Fire Department (VFD)
and Rescue Capital Reserve Program, and 2) VFD and Rescue Capital Reserve Fund
Ordinance.
Amy Wehrenberg, Finance Director stated the Board, at its budget work session on
June 3, 2015 took action to appropriate one-half of the funds available in the Revolving
Fund Loan to the VFD and Rescue for capital support.
Ms. Wehrenberg presented to the Board the VFD and Rescue Capital Reserve
Program that outlines the mechanism for providing capital funds to local volunteer fire and
rescue agencies as well as the Capital Reserve Fund Ordinance that is statutorily required
when a capital fund is established.
Ms. Wehrenberg stated the program offers guidelines and summarizes the requests
and approval process required for the expenditures to be authorized and paid. The program
outlines the eligible and ineligible funding items.
Ms. Wehrenberg noted the Capital Reserve Fund Ordinance establishes the purpose
of the fund, the process for allowing the funds to roll from year to year, schedules the
effective date of the program to begin on July 1, 2015 and lists the source of funds in the
amount of $90,625 as well as lists the distribution of expenditures to each fire and rescue
agency.
Commissioner Jeffers asked staff for an update related to the fire services audits.
Ms. Wehrenberg stated the auditors are in contact with each VFD and Rescue requesting
documents to perform the audit by June 30, 2015.
Commissioner Jeffers asked Ms. Wehrenberg the process by which VFD and
Rescue can request items. Ms. Wehrenberg stated VFD and Rescue agencies will submit
a list of requested items and the County will requisition, order and pay for the items.
Ms. York stated she planned to have a point of contact for the VFD and Rescue by
the end of the day.
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PERSON COUNTY
VFD AND RESCUE
CAPITAL RESERVE PROGRAM
What is it and how does it work?
• Offers additional source of funding to VFD’s & Rescue Squad for
vehicle/equipment capital with no payback requirement; allocated on a pro-rata
basis
• Eligible for purchases/repairs of capital equipment that are non-recurring in nature;
does not cover recurring operating costs (i.e. overhead, office supplies, furniture).
[See next page for complete list of eligible and non-eligible items].
• Approved funding for first year
o One-half of the existing balance in the Revolving Loan Program Fund for
Small Business Loans ($90,625)
o Funding to be determined as available for all years thereafter or until
program is terminated
• Funds are appropriated similar to the operational funds (based on # of stations in
each fire district) and become part of the County’s adopted budget.
• Remaining funds from less than 100% requested expenditures will roll forward to
the following year, to be added to any Board approved funds.
Benefits and Advantages:
• Flexibility to plan ahead for larger capital needs, as well as address their most
critical needs per year
• Prevents a department from waiting 5+ years for capital support (old Capital
Rotation Program)
• Buying Power: County to make approved purchases from agency’s capital
appropriation, securing possible discounts from bulk ordering and netting out the
sales tax as county governments are authorized to do
• Equipment Compatibility: purchasing same brand and type of items that can be
used at an event by all responding agencies
• Provides agencies with control in their requests to prevent exceeding required
thresholds set by the State for grant opportunities
• Can contribute to lowering fire insurance rating, reducing the homeowner’s
insurance cost for residents in those districts
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Request & Approval Process:
• Fire and rescue agencies submit capital expenditure requests at specified times
during the fiscal year to Fire Inspector for amounts up to their approved capital
budget.
• Fire Inspector reviews and determines if capital expenditures are eligible costs;
completes necessary forms and submits to the Finance Office for payment.
• After equipment is delivered, County donates the equipment to the requesting
agency.
• Fire Inspector submits a summary of capital expenditures incurred by agency to the
Board of Commissioners on an annual basis for reporting purposes and evaluation
of the program.
Types of purchases eligible for capital funding:
• Emergency vehicles
• Emergency vehicle apparatus
• Emergency service equipment
• Emergency protective equipment
• Maintenance and repair costs for emergency vehicles/equipment
• Grant match for capital item
• One-time payment on new or existing loan for capital item
• Loan down-payment for capital expenditures (exception: not to be
associated with any loan program that may be established with the County)
Types of purchases ineligible for capital funding:
• Recurring operating costs (i.e. utilities, maintenance agreements, dues,
fundraising supplies, fuel, travel, office supplies, furniture, facility
maintenance)
• Vehicles or equipment used for general purposes or that may be considered
for personal use;
• Construction projects or facility improvements;
• Equipment related to facilities such as meeting halls, social rooms, etc.
• Projects in which any director, officer, general manager, or supervisory
employee of Person County, or close relative thereof, has a financial
interest; projects in which any subsidiary or affiliated organization of
Person County has a financial interest; or projects which, based on the
judgment of the Board, would create a conflict of interest, potential for
conflict of interest, or any appearance of a conflict of interest.
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A motion was made by Commissioner Jeffers and carried 5-0 to adopt the VFD
& Rescue Capital Reserve Program and Ordinance that provides supplemental capital
funding to local volunteer fire and rescue agencies.
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FISCAL YEAR 2015-2016 HOME AND COMMUNITY CARE BLOCK GRANT
FUNDING:
Maynell Harper, Interim Aging Services Director presented the Fiscal Year 2015-
2016 Home and Community Care Block Grant (HCCBG) for Older Adults County Funding
Plan in the amount of $323,421to the Board for approval. Ms. Harper stated the Person
County HCCBG Committee elected funding to the following agencies:
Region K Community Assistance Corp for the Person County
Senior Center with a total of $290,172 allocated between
Congregate and Home Delivered Nutrition, Transportation, In-
Home Aide, and Operations, and
Person County Department of Social Services with a total of
$33,249 allocated for In-Home Aide services.
Ms. Harper noted the state and federal funding is for mandated services for the most
vulnerable senior population. The local match required is funded through the Senior Center
allocation in the proposed budget. Ms. Harper stated both named agencies have waiting
lists for services.
A motion was made by Commissioner Jeffers and carried 5-0 to approve of Fiscal
Year 2015-2016 Home & Community Care Block Grant Funding as presented.
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RENEWAL OF THE AGREEMENT BETWEEN PERSON COUNTY AND THE
CITY OF ROXBORO FOR ECONOMIC DEVELOPMENT:
County Manager, Heidi York stated the current agreement between the County and
the City of Roxboro for an economic development partnership began in 2012 for a period
of three years. The City and County Managers have proposed a renewal of this Agreement
for an additional three years. Ms. York noted the only update proposed was the inclusion
of the City’s contribution of $7,500 towards the administrative support position which was
added after the initial agreement had been approved. The revised agreement formalizes
that contribution. Ms. York said the Agreement was presented and approved by City
Council on June 9, 2015 without any adjustments.
Ms. York told the Board that the agreement can be modified at any time with written
consent of both parties. In the absence of any adjustments at the end of the three year
renewal, the Agreement will automatically renew for an additional three years.
A motion was made by Commissioner Kendrick and carried 5-0 to approve the
renewal Agreement between Person County and the City of Roxboro for Economic
Development.
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RENEWAL OF THE CONTRACT BETWEEN PERSON COUNTY AND THE
CITY OF ROXBORO TO PROVIDE E-911 COMMUNICATIONS:
County Manager, Heidi York stated the current contract between the County and
the City of Roxboro to provide E-911 services went into effect on October 1, 1999 for a
period of (10) ten years, with a clause to automatically renew at the end of the agreement
for an additional (5) five year period in the absence of any duly adopted resolution and
notice. The City and County Managers have proposed a few minor updates to the
Agreement which included:
• language to reflect the reorganization of the 911 department to work under
Emergency Services Director;
• formalize the cost sharing of repairs to the building, owned by the City of
Roxboro;
• formalize the use of the Roxboro Police Department as a potential back-up
location; and
• language to create a partnership for use of the current 911 Tower on Hill
Street.
Ms. York noted City Council approved the renewal contract at its meeting on June
9, 2015 with an adjustment. Ms. York stated the City of Roxboro’s preference to negotiate
a separate agreement with Person County related to the sharing and use of the 911 Tower
on Hill Street should the City acquire the Piedmont Communications tower.
Ms. York said the proposed contract has an initial term of ten years with an
automatic renewal of an additional ten years. The agreement can be modified at any time
with written consent of both parties.
Commissioner Jeffers stated opposition to approving a contract subject to the terms
of a separate agreement between the parties when the terms are unknown at this time.
Commissioner Jeffers noted the Manager’s proposal read “…the City agrees to allow the
County to utilize the tower for public safety purposes at no additional cost to the County.
Both entities may enter a separate agreement for shared responsibilities of the tower in the
future.”
Commissioner Clayton requested for the County Attorney to advise the Board.
County Attorney, Ron Aycock stated there has been continued negotiations with the tower
company noting the City’s lease with the tower owner had expired and have they have
proceeded on a month-to-month basis. Mr. Aycock stated the current arrangement does
provide the County the ability to use that tower under the City’s lease without charge. Mr.
Aycock stated absent some language in the agreement that the tower use is authorized,
there is no legal compulsion for the City to allow the County to use that tower without
charge.
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Commissioner Clayton stated the County provides 911 services for Person County
and the City of Roxboro which creates mutual interests.
Ms. York offered to hold up the process to bring both agreements to the Board at
the same time should the acquisition of the tower take place soon.
A motion was made by Commissioner Kendrick and carried 4-1 to approve the
renewal of Contract between Person County and the City of Roxboro to provide E-911
Communications. Commissioner Jeffers cast the lone dissenting vote.
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PROPOSED PERSON COUNTY BOARD OF HEALTH RULE:
“RULES PROHIBITING THE USE OF TOBACCO PRODUCTS, INCLUDING E-
CIGARETTES, IN COUNTY/MUNICIPAL BUILDINGS AND ON HEALTH
DEPARTMENT AND SOCIAL SERVICES GROUNDS”
Person County Health Director, Janet Clayton stated the Board of Health is charged
with protecting public health. Ms. Clayton noted lung cancer is the leading type of cancer
in Person County and the number of individuals with chronic lower respiratory diseases
have increased. The Health Department has received calls of concerns related to members
of the public and employees utilizing tobacco products, including e-cigarettes in
government buildings. Ms. Clayton noted the use of various tobacco products, including
e-cigarettes (electronic nicotine delivery systems) non regulated aerosolized nicotine has
increased the last few years.
Due to health risks of tobacco use and exposure to e-cigarette aerosol, Ms. Clayton
stated the Person County Board Health wishes to minimize the harmful effects of tobacco
use among county and municipal employees and those individuals who enter government
facilities. Ms. Clayton told the Board that on May 18, 2015, the Person County Board of
Health, in consultation with Ron Aycock, County Attorney, developed a Rule which will
prohibit the use of tobacco products including e-cigarettes in all County and Municipal
buildings and within 35 linear feet of a building which houses the health department and
social services (similar to the 2008 Board of Health Rule adopted in 2008 to prohibit
smoking in those locations). Ms. Clayton defined smoking as a lighted product and e-
cigarettes are not lighted but contain a heating element that causes aerosolization of the
nicotine and other products.
Ms. Clayton informed the Board that the Board of Health desired the draft Rule be
presented to both governing bodies for Person County and the City of Roxboro prior to
adoption. Ms. Clayton stated the funds to cover the costs of signage and community
education are available in the Healthy Personians’ budget. Ms. Clayton, on behalf of the
Board of Health, requested the Board’s support of the proposed Board of Health Rule
which will prohibit the use of tobacco products including e-cigarettes in both County and
Municipal buildings and within 35 linear feet of a building which houses the health
department and social services.
Ms. Clayton clarified the proposed Board of Health Rule only covers the locations
as presented and the authority to limit use on the County grounds would be with the Board
of Commissioners. Ms. Clayton encouraged the Board to review Person County Non-
Smoking Ordinance banning smoking in county recreational facilities and grounds except
in designated areas.
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A motion was made by Vice Chairman Newell to include e-cigarettes in the
original ordinance.
Commissioner Kendrick said the Board adopted a self-insured health insurance
plan that will be directly impacted by use of individuals smoking e-cigarettes and
smokeless tobacco and suggested working toward a healthier workforce.
County Attorney, Ron Aycock explained to the group that the Board of Health
Rule(s) are applicable county-wide and in the city as well. The proposed Rule is under the
general authority of the Health Department to regulate matters that threaten public health.
Mr. Aycock noted that any such county ordinance is valid only in the county unless
the city specifically authorizing such county ordinance to apply. Person County has
authorized a non-smoking ordinance under specific authority subject to statutory
limitations.
Mr. Aycock recommended the Board to 1) support the proposed Board of Health
Rule, and 2) consider review and possible amendment to the local county non-smoking
ordinance.
Vice Chairman Newell rescinded his motion on the floor.
Commissioner Jeffers asked Ms. Clayton if e-cigarettes were allowed on school
property. Ms. Clayton stated school property is considered tobacco free and e-cigarettes
should not be allowed. Commissioner Kendrick noted general statute dictates prohibition
for a lighted tobacco products and e-cigarettes are not a lighted product. Ms. Clayton added
that state law dictates authority over restaurants as well.
A motion was made by Vice Chairman Newell to instruct the County Attorney to
bring back to the Board the proper language for consideration.
Mr. Aycock stated the request from the Board of Health before the Board is for
support or input to advise the Health Director and the Board of Health to proceed with
adopting the Rule. Mr. Aycock stated Board endorsement of the Rule would be the first
step and following such Rule implementation county-wide, the Board could review its
ordinance for amendment.
Vice Chairman Newell rescinded his motion on the floor.
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A motion was made by Commissioner Kendrick and carried 5-0 to support the
proposed Person County Board of Health Rule which will prohibit the use of tobacco
products including e-cigarettes in both County and Municipal buildings and with 35 linear
feet of a building which houses the health department and social services as well as direct
the County Attorney to propose language to integrate such prohibitions into Person
County’s Non-Smoking Ordinance.
The proposed Board of Health Rule as presented:
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APPOINTMENTS TO BOARDS AND COMMITTEES
Clerk to the Board, Brenda Reaves stated 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
13, 2015 with notice to submit applications by the deadline of June 2, 2015. 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. Ms.
Reaves asked the Board to direct the Clerk to organize and inform the applicants of the
informal interview date as set by the Board should the Board be interested in holding the
informal interview process for some or all of the competitive boards. Should the Board
consider waiving the process, Ms. Reaves respectively requested that the Board nominate
and appoint as deemed appropriate. Ms. Reaves presented the interested citizen
applications for consideration for appointment.
A motion was made by Chairman Puryear and carried 5-0 to appoint or reappoint
the individuals to the following boards, commissions, authorities and committees that had
no competing applications for the position:
- ABC Board
3-Year Term: 1 position available
1) John R. Bradsher requested reappointment
- Animal Services Advisory Committee
Unspecified Term: 1 citizen-at-large position available
1) Kathryn A. Snider requested appointment
- Board of Adjustment
1 position to a 3-Year Term:
1) Lindsay T. Wagstaff, Jr. requested reappointment,
1 position to fill an unexpired term to 6/30/16 - no application received.
1 position for an unspecified term for an alternate - no application received.
- Board of Health
3-Year Term: 1 position each representing
a veterinarian: 1) Dr. Claudia Berryhill requested reappointment
a physician: 1) Dr. Kimberly Yarborough requested reappointment
a nurse: 1) Patsy Clayton requested appointment
2 public positions: 1) Jack Hester requested reappointment
2) Benjamin Tillett, Jr. requested reappointment
- Home and Community Care Block Grant Committee
Unspecified Term: Kelly Foti requested appointment in her capacity as the United
Way Executive Director replacing Jayne Bremer who is retiring.
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June 15, 2015
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- Home Health and Hospice Advisory Committee
3-Year Term: 1 position for a physician
1) Dr. Taineisha Bolden requested reappointment
- Industrial Facilities and Pollution Control Financing Authority
6-Year Term; 2 positions available – no application received.
- Juvenile Crime Prevention Council
1-Year Initial Term; 2-Year Reappointment
1 position available for a member of the business community - no application
received.
1 position available for a substance abuse professional - no application received.
1 position available for a representative of United Way.
1) Kelly Foti requested appointment
2-Year Term:
3 citizens-at-large positions;
1) Kay Farrell requested appointment
2) Shiron Terrell requested appointment
1 position for the Chief of Police or his designee - no application received.
1 position for the District Attorney or his designee - no application received.
1 position for a representative from the Department of Social Services - no
application received.
- Nursing Home Advisory Committee
1-Year Initial Term; 3-Year Reappointment; 3 positions available- no applications
received.
- OPC Community Operations Center Advisory Board representing Person County
3-Year Term: 1 position available
1) Amanda T. Blanks requested reappointment
- Person Area Transportation System Board
3-Year Term; 3 positions available, seeking citizens that can represent or are
affiliated with:
the senior center: 1) Maynell J. Harper requested appointment
parks and recreation: 1) John Hill requested reappointment
the school system: 1) Treco Lea-Jeffers requested reappointment
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June 15, 2015
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- Recreation Advisory Board
3-Year Term: 2 positions available
1) Charles Reaves requested reappointment
2) Kirk Redman requested reappointment
- Region K Aging Advisory
1 position available for an unexpired term to 12/31/2016
1) Angela Jones requested reappointment
- Research Triangle Regional Partnership (RTRP)
3 positions for FY 2015-2016 representatives
Stuart Gilbert, Person County Economic Development Director,
Randy Reynolds, Chairman of the Person County Economic Development
Commission, and
Lauren Wrenn, Uptown Development Director.
- Voluntary Agriculture District
3-Year Term; 1 position each representing
Cunningham Township: 1) Johnny R. Rogers requested reappointment
Holloway Township: 1) Cal Berryhill requested reappointment
Woodsdale Township: 1) Paul Bailey requested reappointment
- Workforce Development Board
1-Year Initial Term; 2-Year Reappointment
2 positions available representing private industry;
1) Nikki Ward requested appointment
2) Philippe R. Forton requested appointment
1 position available for a member or an officer of organized labor; No application
During the application period, Kerr Tar Council of Government Workforce Development
Director Vincent Gilreath advised there were new composition requirements for the
Workforce Development Board effective July 1, 2015. For the new appointments, the
recommendation from Vincent Gilreath to the Board of Commissioners was for
consideration to appoint Nikki Ward (HR Manager for private industry) and to hold Mr.
Forton’s application for a future vacancy.
Application secured by Mr. Gilreath to fulfill new board composition requirements:
1) Ms. Debra B. Harlow requested appointment to represent Adult Education
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June 15, 2015
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A motion was made by Commissioner Jeffers and carried 5-0 to hold the informal
interview process for the following boards, commissions, authorities, and committees on
August 3, 2015 at 6:00pm.
- Jury Commission
2-Year Term; 1 position available
1) Bayard R. Crumpton requested reappointment
2) Carmen Lou Giggey requested appointment
- Library Advisory Board
3-Year Term: 2 positions available
1) Riley J. Oakley, Jr. requested appointment
2) Charles Harvey requested appointment
3) Margaret McMann requested reappointment
4) Robert A. Bridges requested appointment
- Person-Caswell Lake Authority
3-Year Term: 1 position available
1) Gil Stovall requested reappointment
2) Michael Boucher requested appointment
- Piedmont Community College Board of Trustees
4-Year Term; 1 position available
1) James J. Woody requested appointment
2) Merilyn P. Newell requested appointment
3) Charles Harvey requested appointment
4) Tommy Humphries requested appointment
5) Alan R. Whitlow requested appointment
- Planning Board
3-Year Term: 2 positions available
1) Sandra Majors requested reappointment
2) Michael Riley requested appointment
3) Michael Brandon requested reappointment
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June 15, 2015
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FISCAL YEAR 2015-2016 ANNUAL BUDGET ORDINANCE & FEE SCHEDULE:
Heidi York, County Manager and Amy Wehrenberg, Finance Director presented to
the Board the Fiscal Year 2015-2016 Annual Budget Ordinance and Fee Schedule for
adoption. Ms. York stated the Fiscal Year 2015-2016 General Fund stands at $54,966,390
which represents $1,314,589 or a 2.45% increase over Fiscal Year 2014-2015 budget.
Ms. York stated that 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 noting the
Board had fulfilled the legal requirement of conducting a public hearing.
Commissioner Clayton requested Board consideration to add two positons vital to
economic growth, the Environmental Health Specialist and an Inspector, back to Fiscal
Year 2015-2016 budget and asked the County Manager and the Finance Director to offset
the costs within the budget.
Ms. York stated $172,941 would be needed to reinstate the two noted positions
which included salary, vehicles, training and cell phone for a full year.
Commissioner Jeffers suggested the Board to use the Contingency Fund ($98,000
for driver education) and/or the funds allocated for the senior center construction (debt
service payment funds) to cover the costs associated with the two noted positions. Ms.
Wehrenberg told the Board $255,000 was allocated for a debt service payment in Fiscal
Year 2015-2016 and that given the timing of the construction process could be pushed to
Fiscal Year 2016-2017.
Commissioner Kendrick stated support to add the two positions back into the
budget for multiple years if consideration to remove the acquisition costs for the Rox
Sportsplex. Commissioner Kendrick stated opposition to growing government.
A motion was made by Vice Chairman Newell to accept the Budget Ordinance as
presented. Commissioner Jeffers stated he could not support an increase of $1.3M over
the current year budget. Commissioner Clayton voiced opposition to the budget without
the two positions (Environmental Health Specialist and an Inspector). Commissioner
Jeffers added data was not available to support permanently cutting the two noted positions.
A substitute motion was made by Commissioner Jeffers and failed 2-3 to direct
staff to prepare a Budget Ordinance reflecting reinstatement of the two positions
(Environmental Health Specialist and an Inspector) at $172,941 using funds from the debt
service allocated for the senior center construction and decrease the overall budget with the
remainder of the debt service funds ($82,059 allocated to Fund Balance).
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Ms. York stated staff planned one debt service payment in Fiscal Year 2015-2016
on the borrowing of the senior center construction at $255,000. Ms. York noted the first
debt service payment could be pushed to Fiscal Year 2016-2017.
Vice Chairman Newell voiced his support for the county to be run more efficient
suggesting that Inspections prioritize scheduling versus scheduling on a first come, first
serve basis.
Ms. York reminded the Board that at its last work session the Board directed staff
to bring back a contingency proposal for both positions in two months with data in terms
of the impacts seen with the two vacancies along with a plan to address the efficiency using
the current employees.
Chairman Puryear asked the County Manager what would be the costs based on
three-fourths of the year for the two positions discussed. Ms. York stated the approximate
costs are estimated at $129,705 for three-fourths of the year.
A substitute motion was made by Chairman Puryear and carried 3-2 to adopt the
Budget Ordinance with $129,000 allocated from the debt service funds in the event after a
90-day review of the data to reinstate the two positions back into the budget. Chairman
Puryear, Vice Chairman Newell and Commissioner Kendrick voted in support of the
substitute motion. Commissioners Clayton and Jeffers voted in opposition to the substitute
motion.
Ms. Wehrenberg advised the Board that the $129,000 as noted for the funding
required for three-fourths of the year was only an estimate and she wanted the Board to
know the amount could look different, i.e. $145,000 once staff analyzed the salaries along
with vehicle, training and cell phones. Ms. Wehrenberg suggested the Board, at any such
time, the positions are reinstated, the amount that it is determined to be is to be funded from
the debt service payment allocation. It was the consensus of the Board to accept Ms.
Wehrenberg’s suggestion.
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CHAIRMAN’S REPORT:
Chairman Puryear reported two recent ribbon cuttings for Farm Credit and Studio
You.
MANAGER’S REPORT:
County Manager, Heidi York reported an Economic Development Commission
meeting scheduled for June 18, 2015 at 8:00am in the Tax Office Conference Room. Ms.
York stated she would follow up with each board member related to the continuation of
the hiring freeze.
COMMISSIONER REPORT/COMMENTS:
Commissioner Jeffers stated a complaint from an Uptown business owner regarding
vehicles parked adjacent to the Courthouse that are designated for customers.
Commissioner Clayton passed out a copy of the Person County Board of County
Commissioners Code of Ethics to each commissioner. Commissioner Clayton stated his
lack of comment on Chairman Puryear’s drawn out legal situation has led some to believe
that he supports Chairman Puryear’s actions. Commissioner Clayton said what he knew
about it was what he saw on TV, read in the newspaper, and heard at Board meetings. As
Chairman Puryear was not found guilty in a court of law, Commissioner Clayton said to
his knowledge, there is no action warranted by the Board of Commissioners and he told
Chairman Puryear that it was up to him to do the right thing. Just because Chairman
Puryear was declared not guilty does not always make it easy for him to do the right thing.
Commissioner Clayton stated people have asked him to make a statement and in his
opinion, it was a legal situation that Chairman Puryear had to work out on his own.
Commissioner Clayton noted the Board has a Code of Ethics and elected officials are held
to a higher standard.
Commissioner Kendrick commented that statements are sometimes misquoted or
left unsaid. Commissioner Kendrick noted he remains available to speak with individuals.
Commissioner Kendrick further noted the people in November understood Chairman
Puryear’s position and he was elected as the second highest number of votes in Person
County. Commissioner Kendrick said when a person goes into a court of law and is found
not guilty, the court of public opinion can continue, but the law has spoken. Commissioner
Kendrick stated he would not ask Chairman Puryear to step down noting his work on the
Board has not been hindered by his legal situation.
Vice Chairman Newell had no report.
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ADJOURNMENT:
A motion was made by Commissioner Kendrick and carried 5-0 to adjourn the
meeting at 10:38am.
_____________________________ ______________________________
Brenda B. Reaves Kyle W. Puryear
Clerk to the Board Chairman
(Draft Board minutes are subject to Board approval).
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7/20/2015
Dept./Acct No.Department Name Amount
Incr / (Decr)
EXPENDITURES General Fund
Public Safety (2,543)
Human Services 5,000
Education 70,000
Transportation 3,250
REVENUES General Fund
Intergovernmental Revenues 67,457
Other Revenues 5,000
Fund Balance Appropriation 3,250
Explanation:
BUDGET AMENDMENT
Receipt of United Way grant for the Drug Court ($5,000); receipt of lottery funds for Person County
Schools ($70,000); reduction of VIP Grant (-$2,543); appropriate fund balance for PATS insurance
claim payment that was deposited to FY15 ($3,250).
BA 176
“Stepping Up Initiative to Reduce the Number of People
with Mental Illnesses in Jails”
WHEREAS, counties routinely provide treatment services to the estimated 2 million people with
serious mental illnesses booked into jails each year; and
WHEREAS, prevalence rates of serious mental illnesses in confinement facilities are three to six
times higher than for the general population, with statistics showing that almost 13% of North
Carolina’s prison population requires some type of intervention due to mental health issues; and
WHEREAS, almost three-quarters of adults with serious mental illnesses in jails have co-occurring
substance use disorders; and
WHEREAS, adults with mental illnesses tend to stay longer in jail and upon release are at a higher
risk of recidivism than people without these disorders; and
WHEREAS, county jails spend two to three times more on adults with mental illnesses that require
interventions compared to those without these treatment needs; and
WHEREAS, without the appropriate treatment and services, people with mental illnesses can
continue to cycle through the criminal justice system, often resulting in tragic outcomes for these
individuals, their families, and their communities; and
WHEREAS, county jails are generally an unsafe environment for those with mental health
treatment needs; and
WHEREAS, the North Carolina Association of County Commissioners has undertaken a serious
effort to address the local service needs of those with mental illnesses through the appointment of
a special Task Force; and
WHEREAS, Person County, like all counties, takes pride in our responsibility to protect and
enhance the health, welfare and safety of our residents in efficient, safe, and socially just ways;
and
WHEREAS, through the Stepping Up Initiative, the National Association of Counties, the Council
of State Governments Justice Center and the American Psychiatric Foundation are encouraging
counties to reduce the number of people with mental illnesses in county jails.
NOW THEREFORE, BE IT RESOLVED by the Person County Board of Commissioners:
1. That the Board of Commissioners does hereby sign on to the Call to Action to reduce
the number of people with mental illnesses in our county jail and commits to sharing
lessons learned with other counties in North Carolina and across the country to support the
Stepping Up Initiative;
2. That the Board of Commissioners will utilize resources available through the Stepping
Up Initiative and other resources provided by the Council of State Governments Justice
Center to convene a diverse team of leaders and decision makers from multiple agencies
who are committed to safely reducing the number of people with mental illnesses in jails;
and
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3. That this team will utilize the comprehensive resources available through the Stepping
Up Initiative to develop a plan to reduce the number of people with mental illness in the
county jail for 2016-2020, consistent with the Council of State Governments Justice Center
report and recommendations, to be presented to the Board of Commissioners at its first
meeting in December 2015.
Adopted, this, the 20th day of July, 2015.
_______________________________
Kyle W. Puryear, Chairman
Attest:
_______________________________
Brenda B. Reaves, Clerk to the Board
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Meeting Date: July 20, 2015
Please include this information in the agenda packet for the Person County
Commissioners meeting (Consent Agenda) on July 20, 2015 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
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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 2015-2016
Date: June 30, 2015
Effective for the State Fiscal Year 2016, 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.
Page 2: Added:
Reversion of Funds:
Any unexpended grant funds shall revert to the County Department of Social Services upon termination
of this contract.
Page 2: Replaced:
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.
Page 4: Replaced:
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:
Page 5: Transportation of Clients by Contractor - Deleted:
Providing and maintaining adequate insurance coverage is a material obligation of the Contractor and is of the essence of this contract.
The Contractor may meet its requirements of maintaining specified coverage and limits by demonstrating to the County that there is in
force insurance with equivalent coverage and limits that will offer at least the same protection to the County. All such insurance shall
meet all laws of the State of North Carolina. Such insurance coverage shall be obtained from companies that are authorized to provide
such coverage and that are authorized by the Commissioner of Insurance to do business in North Carolina. The Contractor shall at all
times comply with the terms of such insurance policies, and all requirements of the insurer under any such insurance policies, except
as they may conflict with existing North Carolina laws or this contract. The limits of coverage under each insurance policy maintained
by the Contractor shall not be interpreted as limiting the contractor’s liability and obligations under the contract.
PERSON COUNTY
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Page 5: Termination Without Cause - Deleted:
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.
Page 6: Health Insurance Portability and Accountability Act (HIPAA) - Added:
(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.
Page 7: Record Retention - Replaced:
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.
Page 7: E-Verify - Added:
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
Page 7: Miscellaneous - Replaced:
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.
Page 15: Certification - Replaced:
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.
Page 16 - 17: Certification Regarding Lobbing - Replaced:
Certification for Contracts, Grants, Loans and Cooperative Agreements
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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 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
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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.
Page 25: Certifications – Pursuant to G.S. 143-48.5 and G.S. 147-33.95(g) - Added:
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.
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Contract # 1006 Fiscal Year Begins July 1, 2015 Ends June 30, 2016
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)
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, 2015 and shall terminate on
June 30, 2016. 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
Kyle W. Puryear
____________________________ _________________________
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
NORTH CAROLINA
DUPLICATE ORIGINAL
PERSON COUNTY
LEGAL SERVICES AGREEMENT
THIS Agreement, made and entered into this the 1st day of July, 2015, 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, 2016. 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
Kyle W. Puryear
____________________________ _________________________
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
Kyle W. Puryear
____________________________ _________________________
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 ______________________, 2015.
___________________________
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
______________, 2015
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 ______________________, 2015.
___________________________
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
Kyle W. Puryear
____________________________ _________________________
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
Kyle W. Puryear
____________________________ _________________________
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, 2015, 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
Kyle W. Puryear
____________________________ _________________________
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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Contract # 1007 Fiscal Year Begins July 1, 2015 Ends June 30, 2016
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)
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, 2015 and shall terminate on
June 30, 2016. 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
Kyle W. Puryear
____________________________ _________________________
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, 2015, 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, 2015, and unless sooner terminated by 30
days’ notice of either party shall exist and continue through June 30, 2016.
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
Kyle W. Puryear
____________________________ _________________________
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
Kyle W. Puryear
____________________________ _________________________
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 ______________________, 2015.
___________________________
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
______________, 2015
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 ______________________, 2015.
___________________________
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
Kyle W. Puryear
____________________________ _________________________
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
Kyle W. Puryear
____________________________ _________________________
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, 2015, 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
Kyle W. Puryear
____________________________ _________________________
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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Contract # 1008 Fiscal Year Begins July 1, 2015 Ends June 30, 2016
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)
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, 2015 and shall terminate on
June 30, 2016. 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
Kyle W. Puryear
____________________________ _________________________
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, 2015, 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, 2016. 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 maximum 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-five cents ($0.55) 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
Kyle W. Puryear
____________________________ _________________________
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
Kyle W. Puryear
____________________________ _________________________
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 ______________________, 2015.
___________________________
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
______________, 2015
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 ______________________, 2015.
___________________________
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
Kyle W. Puryear
____________________________ _________________________
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
Kyle W. Puryear
____________________________ _________________________
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, 2015, 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
Kyle W. Puryear
____________________________ _________________________
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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Contract # 1009 Fiscal Year Begins July 1, 2015 Ends June 30, 2016
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)
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, 2015 and shall terminate on
June 30, 2016. 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
Kyle W. Puryear
____________________________ _________________________
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, 2015, 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, 2015, and unless sooner terminated by 30
days’ notice of either party shall exist and continue through June 30, 2016.
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-five cents
($0.55) 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 maximum 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
Kyle W. Puryear
____________________________ _________________________
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
Kyle W. Puryear
____________________________ _________________________
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 ______________________, 2015.
___________________________
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
______________, 2015
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 ______________________, 2015.
___________________________
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
Kyle W. Puryear
____________________________ _________________________
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
Kyle W. Puryear
____________________________ _________________________
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, 2015, 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
Kyle W. Puryear
____________________________ _________________________
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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Contract # 1010 Fiscal Year Begins July 1, 2015 Ends June 30, 2016
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)
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, 2015 and shall terminate on
June 30, 2016. 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
Kyle W. Puryear
____________________________ _________________________
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, 2015, 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, 2016. 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
Kyle W. Puryear
____________________________ _________________________
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
Kyle W. Puryear
____________________________ _________________________
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 ______________________, 2015.
___________________________
Notary Public
My Commission expires: __________________
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ATTACHMENT E – OVERDUE TAXES
______________, 2015
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 ______________________, 2015.
___________________________
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
Kyle W. Puryear
____________________________ _________________________
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
Kyle W. Puryear
____________________________ _________________________
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, 2015, 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
Kyle W. Puryear
____________________________ _________________________
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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Contract # 1011 Fiscal Year Begins July 1, 2015 Ends June 30, 2016
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)
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, 2015 and shall terminate on
June 30, 2016. 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
Kyle W. Puryear
____________________________ _________________________
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, 2015, 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, 2015, and unless sooner terminated by 30
days’ notice of either party shall exist and continue through June 30, 2016.
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
Kyle W. Puryear
____________________________ _________________________
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
Kyle W. Puryear
____________________________ _________________________
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 ______________________, 2015.
___________________________
Notary Public
My Commission expires: __________________
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ATTACHMENT E – OVERDUE TAXES
______________, 2015
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 ______________________, 2015.
___________________________
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
Kyle W. Puryear
____________________________ _________________________
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
Kyle W. Puryear
____________________________ _________________________
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, 2015, 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
Kyle W. Puryear
____________________________ _________________________
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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Contract # 1012 Fiscal Year Begins July 1, 2015 Ends June 30, 2016
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)
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, 2015 and shall terminate on
June 30, 2016. 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
Kyle W. Puryear
____________________________ _________________________
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, 2015, 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, 2016. 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
Kyle W. Puryear
____________________________ _________________________
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
Kyle W. Puryear
____________________________ _________________________
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 ______________________, 2015.
___________________________
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
______________, 2015
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 ______________________, 2015.
___________________________
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
Kyle W. Puryear
____________________________ _________________________
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
Kyle W. Puryear
____________________________ _________________________
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, 2015, 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
Kyle W. Puryear
____________________________ _________________________
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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Contract # 1013 Fiscal Year Begins July 1, 2015 Ends June 30, 2016
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)
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, 2015 and shall terminate on
June 30, 2016. 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
Kyle W. Puryear
____________________________ _________________________
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, 2015, 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, 2015, and unless sooner terminated by 30
days’ notice of either party shall exist and continue through June 30, 2016.
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
Kyle W. Puryear
____________________________ _________________________
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
Kyle W. Puryear
____________________________ _________________________
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 ______________________, 2015.
___________________________
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
______________, 2015
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 ______________________, 2015.
___________________________
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
Kyle W. Puryear
____________________________ _________________________
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
Kyle W. Puryear
____________________________ _________________________
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, 2015, 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
Kyle W. Puryear
____________________________ _________________________
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.
292
AGENDA ABSTRACT
Meeting Date: July 20, 2015
Agenda Title: Tax Adjustments for July 2015
Summary of Information: Attached please find the tax releases and motor vehicle pending
refunds June 2015.
1. July 2015 tax releases.
2. July 2015 North Carolina Vehicle Tax System (NCVTS) pending refunds.
Recommended Action: Motion to accept reports and authorize refunds.
Submitted By: Russell Jones, Tax Administrator
293
COSSYS PERSON COUNTY TAX OFFICE COLLECTION SCROLL-12:LEVY ADJUSTMENTS ALL TAX YEARS 07062015 PAGE: 1
ACCOUNT # COLREC COUNTY-TAX DISTRICT DISTRICT DOG PENALTY INT/DISC LIEN-COST TOTAL NUMBER TRNREC CLRK DATE
DISTRICT-"
63933 3012014 DAVIE ERIN LONG SW/LH ON WILLIE BROOKS
63933 301 27905 -80.19 0.00- 0 0.00- 0 0.00 0.00 -4.60 0.00 -84.79 15419R 1896 CW 06182015
REASON:WAS BILLED TWICE FOR SAME MOBILE HOME
8991 1052005 MITCHELL SHIRLEY TUCKER INTREPID 4S 8991 105 42414 -31.62 0.00- 0 0.00- 0 0.00 0.00 -28.45 0.00 -60.07 15212R 1897 BSG 06192015
-40.21-50 0.00 -36.17 -76.38__________
-136.45 REASON:BANKRUPTCY DISCHARGE 6/16/15
8991 1042004 MITCHELL LAMBERTH ELLIOTT DEVILLE 4S
8991 104 42063 -6.00 0.00- 0 0.00- 0 0.00 0.00 -0.27 0.00 -6.27 15212R 1898 BSG 06192015
-12.66-50 0.00 -0.57 -13.23__________ -19.50 REASON:BANKRUPTCY DISCHARGE 6/16/15
3410 1112011 RAMSEY JAMES & PERKINS CHARLES 0 & 12/100 ACRES
3410 111 60164 -0.51 0.00- 0 0.00- 0 0.00 0.00 -0.16 0.00 -0.67 2011R 1926 SRJ 06302015 REASON:UNDER ONE DOLLAR
3410 1122012 RAMSEY JAMES & PERKINS CHARLES 0 & 12/100 ACRES
3410 112 60165 -0.51 0.00- 0 0.00- 0 0.00 0.00 -0.12 0.00 -0.63 2012R 1927 SRJ 06302015
REASON:UNDER ONE DOLLAR
6235 1122012 WARREN R T COMPANY INC 0 & 07/100 ACRES 6235 112 60168 -0.19 0.00- 0 0.00- 0 0.00 0.00 -0.04 0.00 -0.23 2012R 1928 SRJ 06302015
REASON:UNDER ONE DOLLAR
40272 1132013 SHAW MELISSA DAVIS IMPALA LT 3 5 4S 40272 113 55597 -0.02 0.00- 0 0.00- 0 0.00 0.00 0.00 0.00 -0.02 2013R 1929 SRJ 06302015 REASON:UNDER ONE DOLLAR
6235 1132013 WARREN R T COMPANY INC 0 & 07/100 ACRE 6235 113 60169 -0.55 0.00- 0 0.00- 0 0.00 0.00 -0.08 0.00 -0.63 2013R 1930 SRJ 06302015 REASON:UNDER ONE DOLLAR
28386 1012014 A 1 BAIL BONDS BUSINESS PERSONAL
28386 101 41840 -0.29 0.00- 0 0.00- 0 0.00 0.00 0.00 0.00 -0.29 2014R 1931 SRJ 06302015 -0.28-50 0.00 0.00 -0.28__________ -0.57 REASON:UNDER ONE DOLLAR
37258 3012014 ALLEN GARY WAYNE BEECHWOOD FRM/A/LT7/DW&L 37258 301 8815 -0.07 0.00- 0 -0.01-30 0.00 0.00 0.00 0.00 -0.08 2014R 1932 SRJ 06302015 REASON:UNDER ONE DOLLAR
64377 1012014 BUMPHUS BESSIE W HOUSE & LOT
64377 101 9458 -0.01 0.00- 0 0.00- 0 -0.01 0.00 0.00 0.00 -0.02 2014R 1933 SRJ 06302015 -0.01-50 0.00 0.00 -0.01__________ -0.03 REASON:UNDER ONE DOLLAR
57980 3012014 CARDEN WALLACE L & BRENDA WOODBERRY/LT8/H&L 57980 301 26004 -0.02 0.00- 0 -0.01-30 0.00 0.00 0.00 0.00 -0.03 2014R 1934 SRJ 06302015 REASON:UNDER ONE DOLLAR
63647 2012014 CLAYTON SHERRY HUFF PERSONAL/BOAT
63647 201 39803 -0.15 0.00- 0 0.00- 0 0.00 0.00 0.00 0.00 -0.15 2014R 1935 SRJ 06302015 REASON:UNDER ONE DOLLAR
57048 2012014 CSS HOLDINGS LLC PERSONAL/AIRPLANE
57048 201 36641 -0.23 0.00- 0 0.00- 0 0.00 0.00 0.00 0.00 -0.23 2014R 1936 SRJ 06302015
REASON:UNDER ONE DOLLAR
6712 3012014 HORNER BOBBY GENE & SUSAN LEE 2&07/100/DW&MH/C&MTLPK 6712 301 22083 0.00 0.00- 0 -0.01-30 0.00 0.00 0.00 0.00 -0.01 2014R 1937 SRJ 06302015
REASON:UNDER ONE DOLLAR
10871 3012014 HUEY JAMES & MARILYN S LOT C CARVER AC 10871 301 11579 -0.01 0.00- 0 0.00- 0 0.00 0.00 0.00 0.00 -0.01 2014R 1938 SRJ 06302015 -0.01-50 0.00 0.00 -0.01__________
-0.02
REASON:UNDER ONE DOLLAR
7118 3012014 JOHNSON ISAAC & ELIZABETH L/E 1/2 ACRE & HOUSE 7118 301 600 -0.02 0.00- 0 -0.01-30 0.00 0.00 0.00 0.00 -0.03 2014R 1939 SRJ 06302015
REASON:UNDER ONE DOLLAR
294
COSSYS PERSON COUNTY TAX OFFICE COLLECTION SCROLL-12:LEVY ADJUSTMENTS ALL TAX YEARS 07062015 PAGE: 2
ACCOUNT # COLREC COUNTY-TAX DISTRICT DISTRICT DOG PENALTY INT/DISC LIEN-COST TOTAL NUMBER TRNREC CLRK DATE
DISTRICT-"
60078 3012014 MCGHEE CURTIS C SR & SHELIA J COLONIAL EST/H&L
60078 301 5835 -0.01 0.00- 0 -0.01-30 0.00 0.00 0.00 0.00 -0.02 2014R 1940 SRJ 06302015
REASON:UNDER ONE DOLLAR
10492 3012014 PETTIFORD BRYCE S L/EST HOUSE & LOT 10492 301 14164 -0.01 0.00- 0 0.00- 0 0.00 0.00 0.00 0.00 -0.01 2014R 1941 SRJ 06302015
-0.01-50 0.00 0.00 -0.01__________
-0.02 REASON:UNDER ONE DOLLAR
63021 3022014 TEMPLE WANDA LEIGH 1 ACRE LOT 2
63021 302 27618 -0.02 0.00- 0 -0.01-30 0.00 0.00 0.00 0.00 -0.03 2014R 1942 SRJ 06302015
REASON:UNDER ONE DOLLAR
6596 3012014 VILLINES WINSTON S 3 & 9/10 ACRES/BLDGS 6596 301 7366 -0.17 0.00- 0 -0.03-30 0.00 0.00 0.00 0.00 -0.20 2014R 1943 SRJ 06302015
REASON:UNDER ONE DOLLAR
6235 1122014 WARREN R T COMPANY INC 0 & 07/100 ACRE 6235 112 60170 -0.55 0.00- 0 0.00- 0 0.00 0.00 -0.03 0.00 -0.58 2014R 1944 SRJ 06302015 REASON:UNDER ONE DOLLAR
22847 3012014 WILLIAMSON ELEANOR LEE/DWAYNE PROVIDENCE RD LOT 22847 301 14885 -0.37 0.00- 0 0.00- 0 0.00 0.00 0.00 0.00 -0.37 2014R 1945 SRJ 06302015 -0.35-50 0.00 0.00 -0.35__________ -0.72
REASON:UNDER ONE DOLLAR
295
COSSYS PERSON COUNTY TAX OFFICE COLLECTION SCROLL-12:LEVY ADJUSTMENTS ALL TAX YEARS 07062015 PAGE: 3
TRANSACTION TOTALS PAGE
TRANSACTIONS FROM 1 THROUGH 3614 IN SY0:TAX .MOD AMOUNTS FROM -999999999.99 THROUGH 999999999.99TRANSACTION TYPES:R
TRANSACTIONS 06032015->99992027 0 PAYMENTS 0 DISC/CORR 23 RELEASES TOTAL CREDIT NET CREDIT (PAYMENT+RELEASE) (TOTAL-DISC/CORR)PERSON COUNTY TAX OFFICE 0.00 0.00 -121.52 121.52 121.52LATE LISTING 0.00 0.00 0.00 0.00 0.00
DOG 0.00 0.00 -0.01 0.01 0.01
CODE DISTRICT NAME 30 STORMWATER FEE 0.00 0.00 -0.09 0.09 0.09 --------------- --------------- --------------- --------------- --------------- SUB-TOTAL 0.00 0.00 -121.62 121.62 121.62
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 -33.75 33.75 33.75LIEN SALE COST 0.00 0.00 0.00 0.00 0.00 --------------- --------------- --------------- --------------- ---------------
TOTAL 0.00 0.00 -155.37 155.37 155.37
50 CITY OF ROXBORO 0.00 0.00 -53.53 53.53 53.53LATE LISTING 0.00 0.00 0.00 0.00 0.00 --------------- --------------- --------------- --------------- ---------------
SUB-TOTAL 0.00 0.00 -53.53 53.53 53.53
DISCOUNT 0.00 0.00 0.00 0.00 0.00INTEREST 0.00 0.00 -36.74 36.74 36.74 --------------- --------------- --------------- --------------- --------------- TOTAL 0.00 0.00 -90.27 90.27 90.27
TOTAL TAXES 0.00 0.00 -175.15 175.15 175.15TOTAL 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 -70.49 70.49 70.49
TOTAL STATE 3PCT INTEREST 0.00 0.00 0.00 0.00 0.00 =============== =============== =============== =============== =============== GRAND TOTAL 0.00 0.00 -245.64 245.64 245.64
296
Payee Name Address 3Transaction #Refund Refund ReasonCreate DateTax Jurisdiction Levy Type Change Interest Change Total Change01Tax ($26.34) ($1.71) ($28.05)50Tax ($24.83) ($1.61) ($26.44)Refund $54.4901Tax ($34.43)$0.00 ($34.43)Refund $34.4301Tax ($61.75)$0.00 ($61.75)Refund $61.7501Tax ($15.28)$0.00 ($15.28)Refund $15.2801Tax ($49.84)$0.00 ($49.84)Refund $49.8401Tax ($9.24)$0.00 ($9.24)50Tax ($8.71)$0.00 ($8.71)Refund $17.9501Tax ($3.55)$0.00 ($3.55)Refund$3.5501Tax ($20.42)$0.00 ($20.42)Refund $20.4201Tax ($52.99)$0.00 ($52.99)Refund $52.9901Tax ($24.66)$0.00 ($24.66)Refund $24.6601Tax ($53.08) ($2.65) ($55.73)Refund $55.7301Tax ($16.60)$0.00 ($16.60)Refund $16.6001Tax ($54.48)$0.00 ($54.48)Refund $54.4801Tax ($41.53)$0.00 ($41.53)50Tax ($39.16)$0.00 ($39.16)Refund $80.6901Tax ($46.95)$0.00 ($46.95)Refund $46.9501Tax ($137.00)$0.00 ($137.00)Refund $137.00Vehicle Sold 06/15/2015HILL, TERRY HURDLE MILLS, NC 27541Proration 15147197 Refund Vehicle Sold 06/15/201515147198 RefundHILL, TERRY HURDLE MILLS, NC 27541ProrationHARRIS, CALVIN ROXBORO, NC 27573Proration 45566436 Refund Vehicle Sold 06/16/2015Vehicle Sold 06/17/2015HAMLETT, NEAL ROXBORO, NC 27574Proration 15147277 Refund Vehicle Sold 06/15/201515219938 RefundHAMIL, EARL ROXBORO, NC 27574ProrationGRIESCH, MATTHEW ROXBORO, NC 27574Proration 15189002 Refund Vehicle Sold 06/16/2015Vehicle Sold 06/08/2015GRIESCH, MATTHEW ROXBORO, NC 27574Proration 15189003 Refund Vehicle Sold 06/16/201514977701 RefundGENTRY, RACHEL ROXBORO, NC 27574ProrationEVANS, JAMIE TIMBERLAKE, NC 27583Proration 15219610 Refund Vehicle Sold 06/17/2015Vehicle Sold 06/17/201515219819 RefundDORTHY, CYNTHIA TIMBERLAKE, NC 27583ProrationDIXON, TONY ROXBORO, NC 27573Proration 46594152 Refund Vehicle Totalled06/30/2015Vehicle Sold 06/19/2015BYRD, JESSICA ROUGEMONT, NC 27572Proration 15442007 Refund Vehicle Totalled06/26/201515281615 RefundBRANN, GEOFFREY TIMBERLAKE, NC 27583ProrationBLALOCK, TERRY TIMBERLAKE, NC 27583Proration 15147257 Refund Vehicle Sold 06/15/2015Vehicle Sold 06/29/2015BERRY, FRANK SEMORA, NC 27343Proration 15488257 Refund Vehicle Sold 06/29/201546463430 RefundBARNETTE, HAYWOOD ROXBORO, NC 27573ProrationRefund Type297
01Tax ($20.16)$0.00 ($20.16)Refund $20.1601Tax ($42.64) ($3.09) ($45.73)Refund $45.7301Tax ($53.55)$0.00 ($53.55)Refund $53.5501Tax$0.00$0.00$0.0050Tax ($183.48)$0.00 ($183.48)50 Vehicle Fee ($10.00)$0.00 ($10.00)Refund $193.4801Tax ($60.76)$0.00 ($60.76)Refund $60.7601Tax ($57.17)$0.00 ($57.17)Refund $57.1701Tax ($57.87)$0.00 ($57.87)50Tax ($54.56)$0.00 ($54.56)Refund $112.4301Tax ($6.82)$0.00 ($6.82)Refund$6.8201Tax ($1.87)$0.00 ($1.87)Refund$1.8701Tax ($15.90)$0.00 ($15.90)Refund $15.9001Tax ($12.46)$0.00 ($12.46)Refund $12.4601Tax ($11.71)$0.00 ($11.71)Refund $11.7101Tax ($10.78)$0.00 ($10.78)Refund $10.7801Tax ($62.20)$0.00 ($62.20)Refund $62.2001Tax$0.00$0.00$0.0050Tax ($126.52)$0.00 ($126.52)50 Vehicle Fee ($10.00)$0.00 ($10.00)Refund $136.5201Tax ($41.19)$0.00 ($41.19)Refund $41.1901Tax ($5.25)$0.00 ($5.25)Refund$5.25Vehicle Sold 06/26/201515442251 RefundWHITT, MARTIN ROXBORO, NC 27574ProrationWHITLOW, MICHAEL ROXBORO, NC 27574Proration 15219924 Refund Vehicle Sold 06/17/2015Over Assessment06/08/2015THOMASSON, BRENDA SEMORA, NC 27343Adjustment >= $10044933364 Refund Situs error 06/08/201514977626 RefundSWEET, THOMAS ROUGEMONT, NC 27572Adjustment < $100REGAN, BARRY ROXBORO, NC 27574Proration 15353632 Refund Vehicle Sold 06/23/2015Vehicle Totalled06/23/2015PULLIAM, WILLIAM TIMBERLAKE, NC 27583Proration 15071387 Refund Vehicle Sold 06/11/201515353800 RefundNORRIS, DEBBIE ROXBORO, NC 27574ProrationMILLER, CLEMETH TIMBERLAKE, NC 27583Proration 15442175 Refund Vehicle Sold 06/26/2015Vehicle Sold 06/19/2015MARTIN, KENNETH ROXBORO, NC 27573Proration 15353873 Refund Vehicle Sold 06/23/201515281550 RefundLINTON, RHONDA ROXBORO, NC 27574ProrationLEEZER, MICHAEL ROXBORO, NC 27573Proration 46326048 Refund Vehicle Sold 06/26/2015Vehicle Sold 06/26/2015LAWSON, MICHAEL FUQUAY VARINA, NC 27526Proration 15487880 Refund Vehicle Sold 06/29/201515442065 RefundKING, PAUL TIMBERLAKE, NC 27583ProrationJACKSON, JOSHUA TIMBERLAKE, NC 27583Adjustment >= $10044932881 Refund Situs error 06/08/2015Vehicle Sold 06/10/2015HUMPHRIES, RICHARD ROXBORO, NC 27574Proration 15487816 Refund Vehicle Sold 06/29/201515042056 RefundHORTON, CHARLENE HURDLE MILLS, NC 27541ProrationHOLT, CANDACE TIMBERLAKE, NC 27583Proration 15281579 Refund Vehicle Sold 06/19/2015298
01Tax ($9.80)$0.00 ($9.80)Refund$9.8001Tax ($13.42)$0.00 ($13.42)Refund $13.42YARBOROUGH, JAMES ROXBORO, NC 27574Proration 15219935 Refund Vehicle Sold 06/17/2015WILKERSON, DERRICK ROXBORO, NC 27574Proration 15147183 Refund Vehicle Sold 06/15/2015299
AGENDA ABSTRACT
Meeting Date: 07/20/2015
Agenda Title: Cancer Death Rate Study-
Within a 2-mile Radius of the Upper Piedmont Landfill
Summary of Information: As a follow-up to the initial cancer death rate study of Person
County dated April 1, 2015, a cancer death rate study was requested to more specifically
investigate a 2-mile radius surrounding 9550 Oxford Road, also known as the Upper
Piedmont Landfill. The results of this study are attached. Dr. Rick Langley of the
Occupational and Environmental Epidemiology Branch of the North Carolina Division of
Public Health and Dr. Ken Rudo, State Toxicologist, will expound on the results received by
the Health Director, Janet Clayton dated May 28, 2015.
Recommended Action: Receive as follow-up information
Submitted By: Janet Clayton, Health Director
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North Carolina Department of Health and Human Services Division of Public Health
Pat McCrory Aldona Z. Wos, M.D. Governor Ambassador (Ret.)
Secretary DHHS
Daniel Stanley
Acting Division Director
www.ncdhhs.gov • www.publichealth.nc.gov
Tel 919-707-5000 • Fax 919-870-4829 Location: 5605 Six Forks Road • Raleigh, NC 27609
Mailing Address: 1931 Mail Service Center • Raleigh, NC 27699-1931 An Equal Opportunity / Affirmative Action Employer
May 28, 2015
Dear Director Clayton,
Thank you for your inquiry to the Central Cancer Registry regarding cancer cases in Person County. We receive many requests such
as yours for information about cancers in local areas throughout the state. The Central Cancer Registry compiles information on cancers across North Carolina and we monitor cancer rates for many types of cancer for each county annually to see if there appear to be areas of the state that need special attention.
Although much has been learned about cancer over the past couple of decades, there is still much that is not known about the causes of cancer. What we do know is that cancer is not one disease, but a group of diseases that behave similarly. We know that different
types of cancers are caused by different things. For example, cigarette smoking has been implicated in causing lung cancer, some
chemical exposures are associated with leukemia, and prolonged exposure to sunlight causes some types of skin cancer. Genetic research has shown that defects in certain genes result in a much higher likelihood that a person will get cancer. What is not known is how genetic factors and exposures to cancer causing agents interact.
Many people do not realize how common cancers are. It is estimated that one out of every two men and one out of every three women
will develop a cancer of some type during his or her lifetime. As a result, it is common to find what appear to be cancer cases clustering in neighborhoods over a period of years. This will occur in any neighborhood. As people age, their chance of getting cancer increases, and so as we look at a community, it is common to see increasing numbers of cancer cases as the people in the community age.
Cancers are diseases that develop over many years. As a result, it is difficult to know when any specific cancer began to develop, and
consequently, what the specific factor was which caused the cancer. Because people in our society move several times during their lives, the evaluation of clusters of cancer cases is quite challenging. One can never be certain that a specific cancer was caused by something in the community in which the person currently resides.
When clusters of cancer cases are investigated, we look for several things that are clues to likely associations with exposures in the community. These are:
1. Groups of cases of all the same type of cancer (such as brain cancer or leukemia). Because different things cause different types of cancer, cases of many different types of cancer do not constitute a cluster of cases. 2. Groups of cases among children, or ones with an unusual age distribution.
3. Cases diagnosed during a relatively short time interval. Cases diagnosed over a span of years do not constitute a cluster of cases unless there is consistency in the type of cancer. 4. Clusters of rare cancers. Because lung, breast, colon, and prostate cancers are so common, it is very difficult to find any association between them and exposures in a community.
This report is updated based on cases reported to the North Carolina Central Cancer Registry (CCR) as of April 2015, diagnosed
during 1990 - 2014, address at the time of diagnosis in North Carolina and diagnosis codes as reflected in the pathology and medical
reports reported from the hospitals and facilities. Further, cases diagnosed out of the state and country but may be receiving treatment in facilities in North Carolina are not included as they are not required to be reported. The CCR does not have real time data because it takes hospitals at least six months after the diagnosis of a malignancy to submit cancer diagnosis reports. The reason for this is that,
per General Statute 130A-209, CCR requires facilities to report complete first course of treatment data and many cases have an extended period of first course treatment. The patient may have surgery, followed by multiple courses of chemotherapy, followed by
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radiation therapy. In order to obtain complete and accurate data from the facilities there is a lag time of at least six months. For some
cases, CCR receives multiple reports from different facilities, which are reviewed and consolidated on an ongoing basis. CCR continues to receive reports from the hospitals for cases diagnosed in 2013, 2014 and prior years. Therefore, all cases diagnosed in
2013 and 2014 may not be included in this report.
In order to evaluate the cancer risk in the county requested, all of the cases of cancer in our database diagnosed from 1990 to 2014 were identified. During this time a total of 4,583 cancer cases were diagnosed in Person County. Across the county, the four major
cancers - female breast, colon/rectum, prostate, and lung - comprised 57 percent of the cases. Pediatric cancers comprised less than 1 percent of the total number of cases and 86 percent of the cases were age 50 or older, when cancer diagnoses are quite common. These
cases were spread out over the 25 years, not concentrated in a short time period.
Further, we examined the age-adjusted cancer incidence rates in Person County for the 2008-2012 diagnosis years and found that the rates for colorectal, lung/bronchus, female breast and prostate cancers were similar to the state rates. Overall there were 1,205 cases
reported in Person County for this five year period.
In addition, we looked at cancers that have been shown to be associated with environmental risk factors (liver, pancreas, leukemia, brain, bladder, kidney, multiple myeloma and non-Hodgkin lymphoma) and identified a total of 870 cases for Person County between
1990 and 2014. These cases were spread out over the 25 years and not concentrated in any time period.
Concern was also expressed over the incidence of lung/bronchus and brain/other CNS cancers in Person County. Between 1990 and 2014, there were 763 cases (or about 17 percent of all cancer cases) of lung/bronchus cancer and 66 cases (about 1 percent of all
cases) of brain/other CNS cancer in Person County while there were 151,909 cases (or about 15 percent of all cancer cases) of lung/bronchus cancer and 13,484 cases (or about 1 percent of all cases) of brain/other CNS cancer statewide. Further analysis of the
age-adjusted cancer incidence rates in Person County for the 2008-2012 diagnosis years showed that the rates for lung/bronchus and brain/other CNS cancers were similar to the state rates.
Additionally, the area surrounding the landfill located at 9550 Oxford Road, Rougemont, NC was of particular interest. From 1990 to
2014, there were 473 cases reported in the 2-mile radius area around the site. The top four cancers comprised 55 percent of the cases. About 81 percent of the cases were diagnosed in people age 50 and older while 1 percent of the cases were pediatric cancers. Between
2010 and 2014, there were 127 cases reported in this area. Further analysis showed that there were 21 cases of lung/bronchus (17 percent of total) and no cases of brain/other CNS cancers reported in the area.
Overall, no consistent pattern of cases was observed other than those previously stated. It is possible that there is an environmental
risk for cancer in the area; however, we do not see a higher occurrence of cancers in the populations usually associated with environmental factors at this time or any evidence of a clustering of cancer cases in any of these areas.
On the CCR website (www.schs.state.nc.us/SCHS/data/cancer.cfm), there is additional North Carolina cancer information, including
the NC Cancer Profile and the Cancer Profile for Person County. There are also fact sheets regarding the leading cancers in the state. If you have questions regarding any of this information or you want additional resources about cancer, please do not hesitate to contact
me at Gary.YH.Leung@dhhs.nc.gov or (919) 715-4559.
Copies of neighborhood cancer evaluations are sent to local health department and the Office of Occupational and Environmental Epidemiology Branch.
Sincerely,
Gary Leung, PhD.
N.C. Department of Health and Human Services Statistician, North Carolina Central Cancer Registry, Division of Public Health
222 N. Dawson Street, Cotton Classing Building, Raleigh, NC 27603 (Office) 919-715-4559
Gary.YH.Leung@dhhs.nc.gov http://www.schs.state.nc.us/schs/data/cancer.cfm
CC: Janet Clayton, Person County Health Department
Dr. Rick Langley, MD, MPH, Occupational and Environmental Epidemiology Branch
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AGENDA ABSTRACT
Meeting Date: July 20, 2015
Agenda Title: Economic Development Commission
Summary of Information: At the last Economic Development Commission (EDC) meeting,
officers were elected. The former Chair resigned and Mr. Kenneth Perry is now serving as the
Chairman of the EDC. He has requested to address the Board and would like to pose two
questions for the Board’s consideration:
• What are your expectations for the Economic Development Commission?
• What is one thing that you feel the EDC could do better?
Recommended Action: No action required.
Submitted By: Kenneth Perry, Chairman of the Economic Development Commission
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AGENDA ABSTRACT
Meeting Date: July 20, 2015
Agenda Title: Resolution Authorizing a Contract between the County and the Roxboro
Building Company, Inc. which involves a County Commissioner as shareholder
Summary of Information: Person County recently contracted for the renovations of the Kirby
Theatre. The parking lot located behind the Kirby Theatre, accessed by Reams Avenue, is owned
by the Roxboro Building Company, Inc. (RBC). This parking lot has been used by patrons of the
Kirby for many years. During the renovation, this parking lot was damaged. The County and
RBC wish to partner on the repaving of the parking lot. The total cost of the full repaving is
$22,340 with both the County and the RBC paying $11,170. The agreement for this cost sharing
is contingent upon the approval of this Resolution.
Vice Chairman David Newell, Sr. is a shareholder of Roxboro Building Company, Inc. owning in
excess of a 10% interest. North Carolina General Statute 14-234 titled Public officers or
employees benefiting from public contracts; exceptions- provides for an exemption of the
prohibition of contracting on behalf of a public agency when they will derive a direct benefit
from a contract. The exemption is allowed for counties with no city population over 15,000. The
following requirements must be met in order to allow the exemption:
a) The contract may not exceed $40,000 in value
b) The affected commissioner must abstain from voting
c) The County must post on the County Bulletin Board, notice showing the name of the
county commissioner, the amount of the contract, and a brief explanation
d) The contract must be noted in the independent auditor’s next fiscal audit
Recommended Action: Adopt the Resolution to authorize the contract.
Submitted By: Ron Aycock, County Attorney
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A RESOLUTION AUTHORIZING A CONTRACT INVOLVING A COUNTY
COMMISSIONER PURSUANT TO NCGS 14-234
WHEREAS Person County recently contracted to have major renovations done to the Kirby
Theatre; and
WHEREAS equipment and supplies used in the renovation was staged in the parking lot owned
by the Roxboro Building Company, Inc. (RBC) which such Parking lot (Parking Lot) is located
behind a building owned RBC on Main Street in Roxboro NC and is accessed via Reams Avenue;
and
WHEREAS during the renovation damage was done to the Parking Lot; and
WHEREAS for many years RBC has allowed patrons of the Kirby Center to use Parking Lot free
of charge; and
WHEREAS in lieu of repairing the damaged Parking Lot and in compensation for future use of
the Parking Lot for Kirby patrons RBC and The County have agreed, subject to the approval of
the Person County Board of County Commissioners herein, to jointly repave the Parking Lot for a
total cost of $22,340 ($11,170 to be paid by the County); and
WHEREAS County Commissioner David B. Newell, Sr. owns in excess of a 10% interest in
RBC; and
WHEREAS NCGS 14-234 authorizes an exemption from its provisions for Counties with no city
over 15,000 population; and
WHEREAS the population of Roxboro does not exceed 15,000; and
WHEREAS NCGS 14-234 the following requirements must be met in order to take advantage of
the small county exemption:
a) The contract may not exceed $40,000 in value;
b) The affected commissioner does not vote on the item;
c) The County must post on the County Bulletin Board a notice showing the name of the
county commissioner involved, the amount of the contract and a brief explanation of the
subject matter;
d) The contract must be noted in the independent auditor’s next fiscal audit; and
WHEREAS the Person County Board of County Commissioners desires to enter into the contract
attached hereto and to authorize the exception to NCGS 14-234.
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NOW THEREFORE BE IT RESOLVED by the Person County Board of County
Commissioners that:
1- Commissioner David B. Newell, Sr. be permitted not to vote on this matter,
2- A posting on the County Bulletin Board be ordered as indicated above,
3- The independent auditor provide the notation in the next annual financial audit as indicated
above, and
4- The attached contract between the County and RBC is hereby approved and authorized to
be executed by the County Manager.
Adopted this the 20th day of July, 2015.
_______________________________
Kyle W. Puryear, Chairman
Attest:
_______________________________
Brenda B. Reaves, Clerk to the Board
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AGENDA ABSTRACT
Meeting Date: July 20, 2015
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
310
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•–•–••315
••–•–•–316
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••••322
AGENDA ABSTRACT
Meeting Date: July 20, 2015
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 2015 and all
delinquent taxes from prior years.
Submitted By: Russell Jones, Tax Administrator
323
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. 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 20th day of July, 2015.
__________________________________________________
Kyle Puryear, Chairman
Board of Commissioners of Person County
Attest:
_________________________________________________
Brenda B. Reaves, Clerk to the Board
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AGENDA ABSTRACT
Meeting Date: July 20, 2015
Agenda Title: Re-appointment of County Assessor
Summary of Information:
As required by G.S. 105-294(a), the Person County Board of Commissioner's must appoint a Tax
Assessor. The Board of Commissioners appointed the current tax assessor, Russell Jones, on
July 5, 2011 for a 4 year term, which will expire this month. The current tax assessor is certified
by the North Carolina Department of Revenue as an Assessor, and therefore eligible for a 4 year
appointment. It is customary for counties to appoint an Assessor for the full 4 year term.
The oath is included in Attachment III.
§ 105-294. County assessor.
(a) Appointment. – Persons occupying the position of county assessor on July 1, 1983, shall continue
in office until the first Monday in July, 1983. At its first regular meeting in July, 1983, and every two
years or four years thereafter, as appropriate, the board of county commissioners of each county shall
appoint a county assessor to serve a term of not less than two nor more than four years; provided,
however, that no person shall be eligible for initial appointment to a term of more than two years
unless such person is deemed to be qualified as provided in subsection (b) of this section or has been
certified by the Department of Revenue as provided in subsection (c) of this section. The board of
commissioners may remove the assessor from office during his term for good cause after giving him
notice in writing and an opportunity to appear and be heard at a public session of the board.
Whenever a vacancy occurs in this office, the board of county commissioners shall appoint a
qualified person to serve as county assessor for the period of the unexpired term.
Recommended Action: Appoint a County Tax Assessor for a designated term and
administer oath.
Submitted By: Russell Jones, Tax Administrator
325
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
July 20, 2015
Person County
Oath for County Tax Assessor
I, Russell Jones, do solemnly swear (or affirm) that I will support and maintain the
Constitution and laws of the United States, and the Constitution and laws of North
Carolina not inconsistent therewith, and that I will faithfully discharge the duties of
my office as Tax Assessor, and that I will not allow my actions as assessor to be
influenced by personal or political friendship or obligations, so help me God."
____________________________________________
Russell Jones
County Tax Assessor
____________________________________________
Kyle Puryear
Chairman, Board of Commissioners of Person County
Attest:
____________________________________________
Brenda B. Reaves, Clerk to the Board
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AGENDA ABSTRACT
Meeting Date: July 20, 2015
Agenda Title: Designation of Voting Delegate to NC Association of County
Commissioners (NCACC) Annual Conference
Summary of Information: Voting Credentials for the 2015 NCACC Annual Conference
scheduled on August 20-23, 2015 in Pitt County must be submitted by August 7, 2015 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 Puryear
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