Agenda Packet August 19 2013PERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
MEETING AGENDA
304 South Morgan Street, Room 215
Roxboro, NC 27573-5245
336-597-1720
Fax 336-599-1609
August 19, 2013
9:00 am
CALL TO ORDER…………………………………………………. Chairman Clayton
INVOCATION
PLEDGE OF ALLEGIANCE
DISCUSSION/ADJUSTMENT/APPROVAL OF AGENDA
ITEM #1
Person County Government Quarterly Safety Award …………………… Heidi York
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.
APPROVAL OF MINUTES:
ITEM #2
August 5, 2013
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OLD BUSINESS:
NEW BUSINESS:
ITEM #3
Request from District Attorney Bradsher for
Portrait of Jim Ramsey ………………………………………………Wallace Bradsher
ITEM #4
Presentation on broadband planning for Person County …………….. Stuart Gilbert
ITEM #5
Broadband update ………………………………………………………….... Sybil Tate
ITEM #6
Former Bromma Building Purchase for Person Industries and
Person County Recycling Center Co-location …………………………...... Heidi York
& Wanda Rogers
ITEM #7
Revisions to the Person County Addressing Ordinance …………………... Sybil Tate
ITEM #8
Review of School Recycling Grant …………………………………….. Becky Clayton
ITEM #9
DSS Attorney Contracts Fiscal Year 2013-2014 ……………………… Carlton Paylor
ITEM #10
Steering Committee for the Old Helena School Property …………………Heidi York
CHAIRMAN’S REPORT
MANAGER’S REPORT
COMMISSIONER REPORTS/COMMENTS
CLOSED SESSION #1
A motion to enter into Closed Session per General Statute 143-318.11(a)(6) for the
purpose to discuss personnel.
Note: All Items on the Agenda are for Discussion and Action as deemed
appropriate by the Board.
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AGENDA ABSTRACT
Meeting Date: August 19, 2013
Agenda Title: Person County Government Quarterly Safety Award
Summary of Information:
The Person County Safety Committee implemented a new safety recognition program in July
2012. Each quarter, the Person County Safety Committee selects a county department safety
winner. This is a competitive award based on established criteria including: attendance at county
trainings, reporting accidents in a timely manner, submitting accident investigation forms,
reporting hazards, performance on facility inspections, and emergency procedures testing and
other outstanding safety acts.
The department will be presented a certificate and plaque with their department’s name listed.
The plaque is located in the hallway outside the Commissioners’ Meeting Room. An article will
be in the county newsletter and submitted to the local paper to highlight the outstanding measures
of the county department.
This award is presented quarterly and this is the fourth recipient to achieve this honor.
Recommended Action: Allow the County Manager to recognize the county department that has
earned the second Person County Government Safety Award.
Submitted By: Heidi York, County Manager
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August 5, 2013
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PERSON COUNTY BOARD OF COMMISSIONERS AUGUST 5, 2013
MEMBERS PRESENT OTHERS PRESENT
Jimmy B. Clayton Heidi York, County Manager
Kyle W. Puryear C. Ronald Aycock, County Attorney
B. Ray Jeffers Brenda B. Reaves, Clerk to the Board
Frances P. Blalock
David Newell, Sr. - ABSENT
The Board of Commissioners for the County of Person, North Carolina, met in
regular session on Monday, August 5, 2013 at 7:00 pm in the Commissioners’ meeting
room in the Person County Office Building.
Chairman Clayton called the meeting to order, led invocation and asked Vice
Chairman Jeffers to lead the Pledge of Allegiance. Commissioner Newell was absent
from the meeting.
DISCUSSION/ADJUSTMENT/APPROVAL OF AGENDA:
Chairman Clayton stated a need to add an agenda item for a commissioner
alternate to the Work Force Development Board.
A motion was made by Vice Chairman Jeffers and carried 4-0 to add the agenda
item for a commissioner alternate to the Work Force Development Board and to approve
the agenda as adjusted.
PUBLIC HEARING:
FINANCIAL GRANT INCENTIVE FOR PROJECT LINE5 ESTIMATED AT
$1,074,290 OVER TEN YEARS:
A motion was made by Vice Chairman Jeffers and carried 4-0 to open the
recessed public hearing related to a financial grant incentive for Project Line5 estimated
at $1,074,290 over ten years.
Economic Development Director, Stuart Gilbert stated Project Line5 is a code
name of a business that is interested in establishing a new manufacturing operation in
Person County. Mr. Gilbert noted a public hearing notice has already been provided and
a public hearing was originally scheduled for May 20, 2013 at which time the Board took
action at the request of the company representatives to recess the public hearing on May
20, 2013, June 17, 2013, and July 15, 2013 to August 5, 2013. Mr. Gilbert informed the
Board that Project Line5 company representatives have modified the actual net new
investment to $6 million in new real estate and $29 million in new capital equipment
investment. Based on these slight changes, Mr. Gilbert outlined the new estimated
financial grant incentive to be decreased to $1,011,966.00 over ten years.
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August 5, 2013
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Mr. Gilbert requested Board consideration to authorize a motion to approve
$1,011,966.00 over ten years to Project Line5 in financial cash grants based on net new
investment in the amount as follows:
Year 1: 85%, Year 2: 85%, Year 3: 85%, Year 4: 80%, Year 5: 75%, Year 6: 50%, Year
7: 25%, Year 8: 20%, Year 9: 15%, Year 10: 10%, and authorize Person County Board of
Commissioners’ Chairman, Jimmy B. Clayton and County Clerk, Brenda B. Reaves to
affix their signatures to documents outlining this financial cash grant investment by
Person County based on the hiring of 40 new jobs at an average annual salary of $42,000
by 2016 and the creation of $35 million dollars of net new investment by 2016.
Furthermore, the Board of Commissioners authorize Person County officials to submit a
One NC application to the NC Department of Commerce and pay the required match out
of the financial cash grant investments outlined above.
There were no individuals appearing before the Board to speak in favor or in
opposition to the financial grant incentive for Project Line5.
A motion was made by Vice Chairman Jeffers and carried 4-0 to close the public
hearing related to a financial grant incentive for Project Line5.
CONSIDERATION TO APPROVE FINANCIAL GRANT INCENTIVE FOR
PROJECT LINE5:
A motion was made by Commissioner Blalock and carried 4-0 to approve
$1,011,966.00 over ten years to Project Line5 in financial cash grants based on net new
investment in the amount as follows:
Year 1: 85%, Year 2: 85%, Year 3: 85%, Year 4: 80%, Year 5: 75%, Year 6: 50%, Year
7: 25%, Year 8: 20%, Year 9: 15%, Year 10: 10%, and to authorize Person County Board
of Commissioners’ Chairman, Jimmy B. Clayton and County Clerk, Brenda B. Reaves to
affix their signatures to documents outlining this financial cash grant investment by
Person County based on the hiring of 40 new jobs at an average annual salary of $42,000
by 2016 and the creation of $35 million dollars of net new investment by 2016.
Furthermore, the Board of Commissioners authorize Person County officials to submit a
One NC application to the NC Department of Commerce and pay the required match out
of the financial cash grant investments outlined above.
INFORMAL COMMENTS:
There were no comments from the public.
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August 5, 2013
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APPROVAL OF MINUTES:
A motion was made by Vice Chairman Jeffers and carried to approve the
minutes of July 15, 2013.
OLD BUSINESS:
REVIEW OF JUNKYARD ORDINANCE:
Aaron Holland, Joint City-County Planning Director reminded the Board at their
July 15, 2013 meeting staff was requested to review current enforcement effectiveness
and to review possible options for enforcement.
Currently, the Person County Sheriff’s Office provides enforcement for both the
Junkyard Ordinance and the Unregistered Vehicle Ordinance. It was stated that in the
past, the court system has dismissed cases regarding ordinance violations due to lack of
representation of the individual making the complaint. Mr. Holland noted a suggestion
was made to amend the enforcement procedures to be similar to those found in the Person
County Zoning Ordinance and allow for assessment and collection of civil penalties.
Mr. Holland outlined the proposed enforcement procedure would consist of a
collaborative effort between the Sheriff’s Office and the Planning Department. Once a
complaint has been received, the Sheriff’s Office would verify the complaint and advise
the defendant of their options. If the complaint has not been brought into compliance by
the designated date, the Planning Department will issue a Notice of Violation letter which
will outline a deadline to initiate daily fines and filing of court charges. The Planning
Department will represent the County as plaintiff, and both the Sheriff’s Office and the
Planning Department will be present in court if the complaint reaches court proceedings.
The fines accumulated will be placed on the property as a lien (if possible).
County Manager, Heidi York stated no text amendments are needed to clarify
enforcement and allow for collection of civil penalties. Instead, changes to the
enforcement process will allow the Sheriff’s Office and the Planning Department to
collect fines more quickly. Ms. York suggested the Board authorize the new procedures
noting after a one-year trial an evaluation could take place to consider changes to the
ordinance(s) if warranted.
A motion was made by Vice Chairman Jeffers and carried 4-0 to authorize the
Planning Department and Sheriff’s Office to work under the new procedures as
presented.
It was the consensus of the Board for staff to issue a press release advising
citizens of the new procedures.
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August 5, 2013
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NEW BUSINESS:
CDBG MONTHLY REPORTING:
County Manager, Heidi York presented to the Board the CDBG monthly activities
report and a Monthly Performance Status Report for July 2013 that is due to be submitted
to the Division of Community Assistance.
A motion was made by Commissioner Blalock and carried 4-0 to accept the
monthly report as presented.
BUDGET AMENDMENT:
Finance Director, Amy Wehrenberg presented and explained the following
Budget Amendment.
Upon a motion by Vice Chairman Jeffers and majority vote (4-0), the Board of
Commissioners of Person County does hereby amend the Budget of the General Fund(s)
on this, the 5th day of August 2013, as follows:
Dept./Acct No. Department Name Amount
Incr / (Decr)
EXPENDITURES General Fund
Public Safety 60,000
Human Services 19,854
Education (40,000)
Culture and Recreation 40,000
REVENUES General Fund
Intergovernmental Revenues 60,000
Fund Balance Appropriation 19,854
Explanation:
Moving capital funds to Kirby Theater department for Kirby Rebirth project;
appropriate DSS fund balance for temporary help for the conversion of all income
maintenance files to NCFAST ($19,854); and receive Hazard Mitigation Grant funds for
purchase and installation of backup generator for Person County Emergency Operations
Center ($60,000).
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August 5, 2013
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COMMISSIONER ALTERNATE TO THE WORK FORCE DEVELOPMENT
BOARD:
Chairman Clayton stated his reason to add this item to the agenda was due to a
special called Work Force Development Board meeting for Thursday, August 8, 2013 at
5:30 pm to be held at the Kerr Tar Regional Council of Government (COG) office in
Henderson and the fact Commissioner Newell, the commissioner representative on the
Work Force Development Board is out of town and unavailable to attend. Chairman
Clayton volunteered to attend the meeting.
A motion was made by Commissioner Puryear, and carried 4-0 to appoint
Chairman Clayton as the alternate commissioner representative to the Work Force
Development Board.
CHAIRMAN’S REPORT:
Chairman Clayton bid congratulations to Vice Chairman Jeffers on his recent
appointment to Chair on the NACo Rural Action Caucus Committee as well as his
upcoming installation on August 24, 2013 to President of the NC Association of County
Commissioners (NCACC). County Attorney, Ron Aycock stated the significant honor of
Vice Chairman Jeffers becoming the youngest ever and first Personian to serve as the NC
ACC President.
Chairman Clayton reminded the Board to submit their County Manager
Evaluation Forms to the Clerk by August 9, 2013.
MANAGER’S REPORT:
County Manager, Heidi York reminded the Board of the open house and ribbon
cutting for the Person County Learning Academy to be held on August 8, 2013 at 5:30pm
in the new facility. Ms. York pointed out the new technical upgrades (two new screens,
one each located at the front and back of the room) provided and installed by the IT and
General Services’ staff in the Commissioners’ board room. Ms. York informed the group
a white board will be added to the room as well following staff training.
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August 5, 2013
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COMMISSIONER REPORT/COMMENTS:
Commissioner Blalock stated her desire for representation at the Hoke County
(Raeford) open house (ribbon cutting 11:00 am) and tour (up to 4:00 pm) of their school
that is energy neutral scheduled for August 17, 2013. Commissioner Blalock also noted
she would be attending a reorganization meeting for the Retry Program on August 8,
2013 with interested citizens at the Burris House.
Commissioner Puryear stated thanks to the Governor of NC for securing $500,000
in grant funds for use in Person County for economic development. Commissioner
Puryear asked for an update on the High Speed Internet/Broadband outsourcing bid
process. Assistant County Manager, Sybil Tate responded that bids have been received
with a selection committee review of bids scheduled for August 6, 2013. County
Manger, Heidi York noted an update would be given to the Board at their next meeting
along with a presentation from Andrew Cohill focusing on community collaboration,
alternatives and innovative ideas related to broadband initiatives.
Vice Chairman Jeffers stated he would be speaking to the Rotary Club on August
8, 2013 regarding his new roles with NCACC and NACo.
Chairman Clayton stated a need for a committee to be formed for citizen input
related to the old Helena School site potential uses. County Manager, Heidi York stated
she would include on the next Board agenda a mission statement with a list of names of
citizens interested in being a part of the revitalization of this county property. Chairman
Clayton urged interested citizens to contact the County Manager.
Vice Chairman Jeffers requested the County Manager and the Finance Director to
participate in a conference call on August 9, 2013 related to public/private partnerships.
CLOSED SESSION #1
A motion was made by Vice Chairman Jeffers, and carried 4-0 to enter Closed
Session per General Statute 143-318.11(a)(5) to consider the acquisition or lease of real
property at 7:28 pm with the following individuals permitted to attend: County Manager,
Heidi York, Clerk to the Board, Brenda Reaves, County Attorney, Ron Aycock, Assistant
County Manager, Sybil Tate, General Services Director, Ray Foushee, Person Industries
Director, Wanda Rogers, Person Industries Assistant Director, Becky Clayton and
Summer Intern, Brittany Bennett.
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August 5, 2013
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A motion was made by Vice Chairman Jeffers, and carried 4-0 to return to open
session at 7:48 pm.
Following Closed Session #1, Chairman Clayton requested Board consideration
of an Offer to Purchase and Contract received from Dansco LLC regarding property
located at 2285 Durham Road, Roxboro containing 11.18 acres and warehouse and
buildings on Tax Map 99 Lot #5 in the amount of $1,520,000.
A motion was made by Commissioner Blalock and carried 3-1 to accept the
offer from the Seller subject to clarification of the offer as follows: 1) compliance with all
county legally required procedures; and 2) $20,000 deposit to be returned to the Buyer if
the following conditions are not met: a) completion of rezoning from B-1 Highway
Commercial to L-1 Light Industrial, b) railroad easement agreement, and c)
environmental assessment related to certification of brownfield compliance.
Commissioner Puryear cast the lone dissenting vote.
CLOSED SESSION #2
A motion was made by Vice Chairman Jeffers and carried 4-0 to enter Closed
Session per General Statute 143-318.11(a)(5) to consider the acquisition or lease of real
property at 7:51 pm with the following individuals permitted to attend: County Manager,
Heidi York, Clerk to the Board, Brenda Reaves, County Attorney, Ron Aycock, Assistant
County Manager, Sybil Tate, General Services Director, Ray Foushee and IT Director,
Gary Latta.
A motion was made by Vice Chairman Jeffers and carried 4-0 to return to open
session at 7:54 pm.
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August 5, 2013
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ADJOURNMENT:
A motion was made by Vice Chairman Jeffers and carried 4-0 and carried to
adjourn the meeting at 7:54 pm.
_____________________________ ______________________________
Brenda B. Reaves Jimmy B. Clayton
Clerk to the Board Chairman
(Draft Board minutes are subject to Board approval).
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AGENDA ABSTRACT
Meeting Date: August 19, 2013
Agenda Title: Request from District Attorney Bradsher for Portrait of Jim Ramsey
Summary of Information: District Attorney Wallace Bradsher is requesting the Board of
Commissioners’ consideration to commission a portrait of Mr. Jim Ramsey to be hung in the
County Courthouse. He is seeking an appropriation of $2,000 for a local artist and permission to
hang the portrait. The Bar Association will hold a ceremony to honor Jim Ramsey on October
29th.
Recommended Action: Receive the request
Submitted By: Wallace Bradsher, District Attorney 9A
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AGENDA ABSTRACT
Meeting Date: August 19, 2013
Agenda Title: Presentation on broadband planning for Person County
Summary of Information: Please find enclosed a report from Dr. Cohill for Person County Board
of Commissioners Board meeting on August 19, 2013. Dr. Cohill’s visit is a follow up to the Person
County Economic Development Day held earlier this year when Dr. Cohill shared that Person
County’s Broadband is a $6 billion dollar industry that should receive future planning from Person
County and the City of Roxboro.
Recommended Action: Receive Dr. Cohill’s report and long range planning ideas for Person
County
Submitted By: Stuart C. Gilbert, MPA, MURP
Person County Economic Development Director
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Suggested Broadband Strategies
for Person County
July 29, 2013
Getting Started
•Open ditch policy -- Sewer and water extensions, road repairs and upgrades, sidewalk improvements...all pub-
lic works projects in Roxboro and the County should be evaluated for the potential to incrementally add tele-
com conduit and/or fiber cable.
•Fiber overlay plan -- The open ditch policy is most effective when the City and the County both have a fiber
overlay plan that shows where fiber is needed. It then becomes simple, if there is a public works project, to
look at the fiber overlay plan and the route of the new project and determine if conduit or fiber cable should be
included.
•Fiber to Economic Zones -- To be competitive with other communities, the County and City should get some
fiber to targeted economic development zones as quickly as possible. This would include business and indus-
trial parks, greenfield industrial/commercial areas, downtown Roxboro, and any other areas targeted for devel-
opment and growth.
•Make it easy to use the MCNC fiber -- The NCNC fiber passes through the community, but the infrastructure
needed for local providers, businesses and local government to affordably tap into it is still lacking. A modest
colocation facility (could be just a pre-fab shelter) should be provisioned on the MCNC fiber route (e.g. near
the Northern Middle School). The shelter would provide physical access to the MCNC fiber, terminated patch
panels, rack space for provider network equipment, and a generator for back up power. This would also be an
ideal location for a wireless broadband tower to provide point to point links to rural areas of the county where
residential wireless services might be offered (convenient access to MCNC Internet providers will help keep
the cost of rural wireless services low).
•Re-evaluate economic development zones -- The MCNC fiber should spark a re-evaluation of economic de-
velopment areas in the County, as access to Gigabit fiber is increasingly becoming a key relocation decision for
businesses and entrepreneurs. Roxboro has great potential to attract more workers and businesses to the down-
town area with local fiber to buildings that can or do provide Class A office space.
•Get Class A office space in inventory -- Many business relocation decisions are made in 90 days or less. It is
essential to have some high quality Class A office space in inventory. This could and should include some
downtown Roxboro buildings that have received high quality renovations or are candidates for such renova-
tions. Existing buildings will have higher lease/purchase value if fiber is available at the premises.
•Build fiber to all K12 schools -- Building fiber to all K12 schools could be financed in part from savings from
replacing leased lines with new county-owned fiber. A properly designed fiber network to all schools in the
county could be shared with other county departments (e.g. monitoring water pumping stations, other facili-
ties), public safety needs (e.g. fiber to public safety towers to improve radio communications), business uses,
and fiber to the home.
Why do this?
•The County, local K12 schools, and the City should be able to save money on Internet, telephone, and connec-
tion costs and/or get more bandwidth without increasing expenditures.
•Increase the local tax base by having the infrastructure needed to attract new businesses and jobs.
•Retain and attract residents who want the excellent life style and quality of life in Person County but need high
performance fiber services for work from home and business from home activities.
we build networks that perform
DESIGN NINE
!
! ! ! !
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Success Factors
•Identify community and economic development goals first--It will be important for the City and the County
to tie broadband expenditures to broader community and economic development goals. In our experience,
communities that cannot describe what they want their community to be like in ten or fifteen years usually do
not see their broadband investments deliver the expected impact.
•Aggregate demand by focusing on getting homes and businesses connected and growing the size of the mar-
ket, thereby attracting service providers.
•Local champions are essential to building the local support for building the network
•Build something--too many communities get caught up in imagining some very large, very expensive project.
Identify your budget and what you can afford this year, even if it is just a few blocks of downtown. Get
started, get connected to the MCNC backbone, and expand year by year.
•Focus on a modern, multi-service network with multiple providers (open access network). Open Access
works where the incumbents have said that they “can’t afford to build fiber” because open access shares a sin-
gle network among several providers--it is a different business model that generates more revenue than the fifty
year old incumbent business model. Open access works because it is not trying to use the same business model
as the incumbents.
•Avoid over-reliance on wireless broadband--Wireless broadband will not bring businesses and jobs to Person
County. Wireless broadband in rural parts of the County may be an important bridge technology until fiber
arrives in those parts of the County, but to be economically attractive to relocating companies, Person County
needs Gigabit fiber in at least the Roxboro area and in any business and industrial parks.
Sources of Funding
•Cash
•Sweat Equity -- done very successfully in some rural areas. Property owners install their own conduit from the
home or business to the hand hole or splice closure on the rural road.
•Loans
•Grants
•One time payments to connect to the network
•Ongoing monthly payments to be connected to the network
•Special Assessment -- One town in Massachusetts voted a special assessment on all property owners and was
able to immediately build fiber to the whole community
Worst Practice
•Do nothing--leave the community and the region at the mercy of what the incumbents are willing to provider
•Build too slowly--financially most risky, as connected customers grows too slowly and revenue may not ex-
ceed fixed operational expenses of operating the network
•Disconnect between E.D. and fiber investments--many communities make a fiber infrastructure investment and
then fail to adjust their economic development marketing to highlight “Gigabit” connectivity
we build networks that perform
DESIGN NINE
!
! ! ! !
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Person County: MCNC Fiber
¯0 20,000 40,000 60,00010,000 Feet
Drawing: Person County
Date: 7/29/2013
Drawn By: M. Vellines
Legend
Proposed Colo Facility
k Public Schools
3 MCNC Handholes with Splice Cases
2 MCNC Handholes
MCNC Fiber
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Person County: Roxboro MCNC Fiber
¯0 3,250 6,500 9,7501,625 Feet
Drawing: Roxboro
Date: 7/29/2013
Drawn By: M. Vellines
Legend
Medical Services
Proposed Colo Facility
k Public Schools3MCNC Handholes with Splice Cases2MCNC Handholes
MCNC Fiber
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AGENDA ABSTRACT
Meeting Date: August 19, 2013
Agenda Title: Broadband Update
Summary of Information: The Request for Proposals to extend coverage to the unserved areas for
broadband was reissued on May 30, 2013 with a response deadline of July 31st. One new application
was received. All total, three applications were received from the following vendors: CenturyLink;
North Carolina Rural Broadband; and NC Wireless (Light Leap).
The selection committee met on August 6th to review the applications. The selection committee
included Gary Latta (IT Director), Stuart Gilbert (ED Director) and Sherry McCuller (Peregrine
Consulting) and a representative from the State, as a non-voting member. The selection committee
recommends contracting with NC Wireless (Light Leap) to carry out the project, but only if it is
combined with improving public safety communication needs. The selection committee felt that
there were opportunities to link this project with public safety communication needs that should be
explored fully before moving forward. The selection committee also recommended investigating
linkages with economic development, electric cooperatives and cell phone coverage. The
representative from the State noted that Graham, Avery, McDowell, and Buncombe counties have a
combined public safety and broadband service system that could serve as a model for Person County.
Based on the recommended vendor’s proposal, the cost to Person County will be approximately
$100,000 (total project costs are $200,000). However, this cost does not include the cost of installing
towers in five locations in the county. The cost of installing a tower varies based on the height and
the amount/type of equipment on the tower.
Currently, the Emergency Services staff is working with a consultant to develop a recommendation
for improving the existing public safety communication system. Volunteer Fire Departments have
had some issues communicating recently, so improvements need to be made to our existing system.
The consultant will have a complete report with recommendations this fall. Emergency Services
plans to have public safety focus groups review the options presented by the consultant and provide
input on the recommendations. Improving the public safety communication system is an urgent need
and a system upgrade is a planned request for the upcoming Capital Improvement Plan.
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If the Board of Commissioners would like staff to move forward with the broadband project only, the
next step is to price out the cost of installing the towers. If the Board of Commissioners would like
staff to move forward with a combined broadband and public safety communication project, our next
step will be to host focus groups to discuss the findings from the public safety communication
consultant and conduct further research on linkages with other projects, such as economic
development. Since the cost for implementing these projects together will likely be greater than
$50,000, they could be included in the FY15 CIP.
Recommended Action: Provide staff with feedback on how to move forward with this project.
Submitted By: Assistant County Manager, Sybil Tate
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AGENDA ABSTRACT
Meeting Date: August 19, 2013
Agenda Title: Former Bromma Building Purchase for Person Industries and Person
County Recycling Center Co-location
Summary of Information: At the Board of Commissioner’s meeting on August 9th, the board voted
to move forward with the purchase of the BROMMA building located on Old Durham Road. The
BROMMA building will serve as the new location for both Person Industries and the Person County
Recycling Center. The purchase price of the building is $1.52M.
Efficiency, safety, long-term stability and cost were the driving factors for this purchase.
Efficiency
Person Industries currently operates out of two locations - 601 North Madison Blvd. (Person
Industries) and 741 Martin Street (Person County Recycling Center). Combining the two
operations will decrease staff time spent driving between the buildings and reduce fuel costs.
Currently, 4-5 truckloads of recycling materials are driven between the two buildings every day.
Estimated operating savings for fuel and staff time is $21,500 annually.
The utility cost for the existing buildings is estimated at $45,000 annually, while the BROMMA
building utility cost is estimated at $30,000, a savings of $15,000 annually.
Merging the two facilities will make the recycling workflow more efficient allowing us to
separate more recyclables and increase revenues.
Currently, the county pays $115,498/yr in rent for both facilities. Rent has increased since the
county began renting the PCRC building in FY07 and we anticipate that it will continue to
increase in the future. Using a ten year debt service model with a rate of 2.49%, the average
annual debt service for the new facility will be approximately $216,979. In addition, PCRC will
make a final equipment debt service payment of ~$99,000/year in December 2013. Since FY07
when Person Industries joined the county, we have spent $726,000 on rent, insurance, utilities
and repairs on the existing PCRC building and we do not have a tangible asset to show for this
investment.
Finally, one of our main contractors –Eaton - is located close to the BROMMA building, which
decreases staff travel time.
Safety
Currently, the Person County Recycling Center building does not have a smoke alarm system or
sprinklers in place. The BROMMA building has smoke alarms, sprinklers and strobes. The new
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facility will allow individuals with the more severe disabilities to be protected behind walls- they
will be out of the way of equipment such as forklifts and skid loaders. Employee and client safety
is our highest priority.
Long-term stability
Our current lease at the Person County Recycling Center ends April 30, 2014. The lease on the
Person Industries land expires in 12 years, 2025.
The recycling center opened in June 2009, and since then has gained in popularity. Person
County prefers to own a facility rather than continuing to lease.
Cost
The Board of Commissioners has considered a number of buildings in Person County, including
our current recycling facility location. The current PCRC location is large enough to house a
merged organization, but to purchase, repair the existing deficiencies, and renovate the space
according to a feasibility study would cost $2,200,000.
The current PI building would cost an estimated $3,265,000 to purchase and up-fit the facility to
meet the needs of a recycling facility.
A new 50,000 sq. foot facility on Person County owned property was considered, but the cost
was $4,250,000.
The cost of purchasing and up-fitting the BROMMA building is estimated at $1,870,000.
Owning versus leasing: Due to the retirement of the equipment financing and the current lease
obligation, Person Industries will require less support from the General Fund. Since opening, the
Person County Recycling Center has utilized the following allocation from the General Fund:
PCRC
County
Appropriation
Actual
Spent
FY 2009 $0.00 $0.00
FY 2010 $193,752.00 $147,759.97
FY 2011 $310,993.00 $136,212.84
FY 2012 $208,928.00 $184,095.10
Totals $504,745.00
$468,067.91
Note the allocation has gone toward $107,000 (lease) & the $99,000 (equipment financing)
In addition, the location is much more visible and includes a fenced area, multiple loading docks,
additional buildings, a large break room & better bathrooms.
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Recommended Action: Receive the information
Submitted By: Heidi York, County Manager and Wanda Rogers, Person Industries Director
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County Manager’s Office
Memorandum
To: Members of the Board of County Commissioners
From: Heidi York, County Manager
Date: August 13, 2013
Re: Bromma Building Purchase Information
The Board of County Commissioners has been discussing options for relocating the Person County Recycling Center
and Person Industries since the Fall of 2012. These discussions were held in closed session under General Statute
143-318.11(a)(5). Closed sessions allowed for the confidentiality of negotiations of price prior to making an offer to
purchase property.
At the Board’s August 9, 2013 meeting, the board voted to move forward with the purchase of the former Bromma
building located on Old Durham Road. The Bromma building will serve as the new location for both Person
Industries and the Person County Recycling Center. The purchase price of the building is $1.52M. The current tax
value is $689,086. The appraised value was $1.1M ($925k for building and 5.59 acres; $25,000 per additional acre
for a total of 11.18 acres).
Person Industries currently employs 96 people: 60 with disabilities, 13 without disabilities and 23 staff.
The following information was considered by the Board in making their decision to purchase this property:
· Feasibility Study was commissioned in the fall of 2012 to explore all options for co-locating the Person
County Recycling Center and Person Industries. MHA Works presented a report shared with the Board in
November of 2012 which outlined five viable options including:
purchasing the current Recycling Center site; purchasing the current Person Industries site and
expanding that facility; building a stand-alone new facility on county-owned land; and purchasing two
other warehouses on Old Durham Road.
A copy of these options from this Feasibility Study is attached.
· Deficiencies of the current Recycling Center building were also identified in the Feasibility Study noting that
an additional $375,000 would be required to bring that building up to current building and fire safety codes
· Roof replacement for the current Person Industries building was estimated at $470,000
· Certified MAI appraisals were sought for the former Bromma Building in April 2013, the current Person
Industries facility in January 2013, and for the current Recycling Center facility in November 2012. Copies of
the summary conclusions for these appraisals are attached.
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· Current Lease Agreements:
-Recycling Center site- rental rate is presently $107,000 plus all utilities. Since FY07, the County has paid
approximately $726,401 for rent, repairs, and renovations. In March of 2010, the landowner presented an
additional five year lease arrangement with payments starting at $117,500 for the first three years and
increasing to $129,500 for year’s nine and ten. If agreed to the County would have spent $1.34M in rent
alone.
-Person Industries site- rental rate is presently $6500 annually extending to 2025.
· After receiving the appraisals, staff was directed to negotiate with the Walker family, owners of the current
Person Industries site, on a purchase price. Agreement on price was not reached.
· Staff was also directed to consider additional warehouse sites off of 501. These findings were presented to
the Board in June 2013.
· Staff was directed in July 2013 to pursue negotiations on the Bromma site and a purchase agreement was
reached in August 2013. The agreement is contingent on a clean environmental report as this property is a
brownfields site.
· The costs of remodeling the Bromma facility are estimated at $360,000.
· It is the Board’s intention to finance the purchase of the former Bromma site in the winter of 2013.
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Recycling / Person Industries combined facility options:
Option criteria are based on a minimum 50,000 sq. ft. combined facility that includes 8,000 sq.
ft. of conditioned space to house office and break areas. Included in conditioned space will be a
sorting area and a small retail space for Person Industries.
Option 1:
Recycling Center Site – Purchase existing building……………………………………………….….. $900,000.00
Repair existing deficiencies…………………………………….………… $1,000,000.00
Renovate space to include Person Industries………………………. $300,000.00
Total = $2,200,000.00
Option 2:
Person Industries add on – Purchase property (Estimated)……………………………………… $800,000.00
Add 33,000 square ft. of warehouse……………………….……… $1,815,000.00
Minor renovations for Recycling office space………….………… $100,000.00
Erosion control measures to existing site……………..……..……. $250,000.00
Total = $2,965,000.00
Option 3:
New Facility on Critcher-Wilkerson Road -
50,000.00 sq. ft. combined facility………………………….…….… $4,250,000.00
Option 4:
Purchase and relocate to warehouse (W & H Associates 2) on Old Durham Road –
Purchase 75,000 sq. ft. warehouse………………….…………….. $1,360,000.00
Adapt building to fit recycling needs…………………………………. $250,000.00
Minor renovations to existing office space………………………..… $80,000.00
Renovate space to include Person Industries…………….………. $340,000.00
Deficiency allowance……………………………………………..……………$250,000.00
Total = $2,280,000.00
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Option 5
Purchase and relocate to warehouse (L. Dan Winstead Warehouse 3) on Old Durham Road –
Purchase 45,917 sq. ft. warehouse………………….……………….. $825,000.00
Adapt building to fit recycling needs…………………………………. $250,000.00
Construct Additional Warehouse space (4,083 Sq. Ft.)………. $225,000.00
Minor renovations to existing office space………………………..… $60,000.00
Renovate space to include Person Industries…………….………. $360,000.00
Deficiency allowance……………………………………………..……………$250,000.00
Total = $1,970,000.00
Option 1 – Recycling Center Site:
Pros Cons
- Currently occupy building (Recycling) - Building in need of extensive repairs
- Location is familiar to residents
- Large lot allows for future expansion
Option 2 – Person Industries Site:
Pros Cons
- Currently occupy building (PI) - Anticipate area resident opposition
- Currently own building - Small lot, limited expansion possibilities
- Erosion control / impervious surface issues
Purchase price of property is estimated, and hopefully on the high side.
Option 3 – Critcher-Wilkerson Site:
Pros Cons
- Currently own property - Highest cost option
- Brand new facility - Neighborhood opposition????
- Large lot allows for future expansion
- Lowered energy and maintenance costs
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Option 4 – Old Durham Road Site (W & H Associates 2):
Pros Cons
- 75,000 sq. ft. already allows for future - No deficiency study, could impact costs
- Location would limit area resident
opposition
Without doing a more in depth study of building deficiencies this number could go up
considerably or reduce cost by $250,000.00. We have included a $250,000.00 deficiency
allowance at this time.
Option 5 – Old Durham Road Site (L. Dan Winstead Warehouse 3):
Pros Cons
- Lowest Cost Option - No deficiency study, could impact costs
- Location would limit area resident - Eave height (13’) Ridge Height (16’)
opposition
Without doing a more in depth study of building deficiencies this number could go up
considerably or reduce cost by $250,000.00. We have included a $250,000.00 deficiency
allowance at this time. Purchase price was based on $18.00 per sq. ft., matching current
recycling facility and W & H Associates asking prices.
______________________________________________________________________________
*All estimates are based on current construction costs and similar projects that have recently
been completed.
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AGENDA ABSTRACT
Meeting Date: August 19, 2013
Agenda Title: Revisions to the Person County Addressing Ordinance
Summary of Information: As part of the FY14 budget process, the Board of Commissioners
approved a position within EMS to manage the county’s addressing services. This new position
allowed the county to bring addressing in-house and provide offsetting revenues to fund the
position. Prior to FY14 addressing services were provided by a contractor.
As a result of bringing these services in-house, staff from EMS, Planning, GIS and Building
Inspections reviewed county ordinances that pertain to addressing. Staff is recommending
updating and combining the Road Naming Ordinance and the House, Building and Mobile Home
Numbers Ordinance into one ordinance – the Addressing and Road Naming Ordinance. Unifying
the ordinances into one ordinance clarifies the process for naming and assigning numbers and is a
more user-friendly document for both staff and citizens. Updating the ordinance enables the
addressing system to work with the new in-house addressing position.
The draft of the new ordinance includes the following major changes by Section:
· Purpose
o Call for correction of inaccurate addresses
o Declare standard addressing and street naming guidelines
· Authority
o Reference NC GS and Police Powers as legal standing for ordinance
· Jurisdiction
o Allows for the creation and entering of an intergovernmental agreement with
municipalities (ie: Roxboro) that will give the address coordinator authority over
their addressing and road naming.
· Definitions
o Defines new EMS address coordinator position, GIS and inspections department.
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o Also defines Master Street Address Guide foe E911
· Administration
o Defines the role and duties of the new addressing coordinator position (ie:
Planning is no longer the primary authority for addressing and roads)
o References future MOA between Addressing Coordinator position and the GIS
Department (which now maintains all geospatial data regarding addressing and
roads)
o Calls for the addressing of individual mobile homes for 911 purposes
· Street Naming
o Stronger regulations regarding use and types of street suffixes (CT, PL, RD, etc)
and street directions (N, W, E, S)
o Prohibit the use of EXT for road extensions
o Require unique road names with directional changes of 90 degrees or more
o Abbreviation of street name regulation
o Requires one name for a contiguous road way
o Defines current cost and purchasing requirement for subdivision developers for
road signs through the county and for renaming of streets by citizens
o Requires PVT streets signs to be created using a BLUE background to help
emergency response personnel easily identify PVT streets
· Street Numbering and Address Assignment
o New procedures for assignment of addresses based on planning dept's approval of
preliminary plat submissions
o Requires the final plat for a proposed plan to be submitted to addressing
coordinator for the assignment of a final approved address
· Guidelines for numbering/addressing streets
o Defined addressing interval (5.28 ft) standard
o Defined even/odd, left/right sequential numbering standard
o Prohibits the use of lot numbers as address numbers for mobile homes
o Prohibits fractional address numbers
o Allows for the addressing of vacant properties, by request, for location purposes
only. (ie: property assessment, etc)
o Provides the addressing coordinator the power to renumber streets/re-assign
address based on defined just cause
o Stronger regulations on the display of addressing numbers for emergency response
(ex: "curb" stencil addresses are not a substitute for building addressing numbers,
recommendation of a 2' x2' sign for buildings 100 feet from road access, etc)
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· Penalty
o Clearly defined enforcement authority given to addressing coordinator.
o No building permits will be issued without a preliminary address assigned to lot.
Any changes to the county’s addressing ordinances require a public hearing with 10 days public
notice. If the Board approves moving forward with combining and updating the addressing
ordinance into one ordinance, staff recommends having a public hearing and reviewing the final
draft of the ordinance at the September 9th meeting.
Recommended Action: Provide staff with feedback
Submitted By: Sybil Tate, Assitant County Manager
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An Ordinance Regulating Addressing and Road Naming in Person County
DRAFT 4- AUGUST 9, 2013
Whereas the Person County Board of Commissioners has previously adopted Road Naming ordinance and the House,
Building and Mobile Home Numbering ordinance on August 2, 1993.
And, whereas the Person County Board of Commissioners finds it prudent to coordinate, revise, update and consolidate
all road naming and addressing ordinances into a single document.
Then, now therefore be it resolved by the Person County Board of Commissioners that the Board of Commissioners
hereby adopts the ordinance as follows:
Article I. Title, Authority, Purpose, and Jurisdiction
SECTION 101 Title
This Ordinance shall be known and may be cited as the road Naming and Addressing Ordinance for the County of
Person, North Carolina.
SECTION 102 Purpose
The purpose and intent of this ordinance is to hereby establish a uniform system of road naming and re-naming along
both public and private streets and roadways. It also provides for a uniform system of addressing and numbering all
houses and buildings within the jurisdiction of the county, and to establish a process for changing existing addresses,
streets and road names so that street, road, and highway names are not duplicated, or phonetically similar, in the
county. The ordinance provides a method to correct inaccurate addresses that will help to greatly improve emergency
service response to all parts of the County.
Standard addressing rules will provide guidelines for assigning house numbers and street names. A standard database
format for recording address information will simplify the maintenance, exchange, and interpretation of address
information between governmental agencies and the community.
An additional purpose of this ordinance is to ensure that street name identification signs are placed at all street
intersections and establishes a procedure for reviewing street names. This is necessary to facilitate public safety and
emergency response service in locating properties and buildings for service to public.
Finally, this ordinance is further designed to establish an official map and listing of all streets and roadways in Person
County
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SECTION 103 Authority
This ordinance is hereby adopted under the authority and provisions of General Statutes of North Carolina GS 153A-238
and 153A-239.1(a) and GS 147-54.7, and the Police Powers of the county to protect the health, safety and welfare of its
citizens.
SECTION 104 Jurisdiction
The provisions and regulations provided by this Ordinance shall apply within the ordinance-making jurisdiction of Person
County. Application of this Ordinance within a municipal jurisdiction shall require a mutually-entered intergovernmental
agreement between said municipality and the County of Person.
Article II. Definition of Terms
For the purposes of this Ordinance, certain terms of words used herein shall be defined as follows:
Address Coordinator - The official or officials of Person County charged with the administration of this ordinance.
Board of Commissioners - Person County Board of Commissioners.
Building- Any structure having a roof supported by columns or by walls, and intended for shelter, housing or enclosure
of persons, animals, chattels or equipment. For the purposes of this Ordinance , the term "building" may also include
other man-made structures.
Business Address -A house number.
Developer - A person, firm or corporation submitting an application for development for a subdivision , planned unit
development, industrial park or mobile home park and upon whom final responsibility for ensuring compliance with the
terms and conditions of this Ordinance rests.
Driveway - A private way, beginning at the property line of a lot abutting a public road , private road, easement or
private right-of-way , giving access from that public road, recorded easement, recorded private road or private right-of-
way , and leading to a building, use of structure on that lot.
Dwelling, Single-Family - A building arranged or designed to be occupied by one (1) family .
GIS Department - Person County Geographic Information Services Department
House Number - Number assigned to any house, residence , dwelling, business , warehouse, or other structure or
property in a sequential manner.
Inspections Department - Person County Inspections Department
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Mailing Address - Assigned or used by the U.S. Postal Service for the purpose of delivery of the U.S. Mail. Mailing
Address may or may not be identical to property address.
Mobile Home - A portable manufactured housing unit designed for transportation on its own chassis and placement on a
temporary or semi-permanent foundation having a measurement of 32 feet or more in length and 8 feet or more in
width . As used in this Ordinance, mobile home also means a double-wide mobile home which is two or more portable
manufactured housing units designed for transportation on their own chassis, which connect on site for placement on a
temporary or semi-permanent foundation having a measurement of 32 feet or more in length and 8 feet or more in
width.
Mobile Home Space -Any parcel of ground within a mobile home park designed
for the exclusive use of one mobile home.
Mobile Home Park - Shall be the land leased or rented, being used or proposed to be used by mobile homes occupied for
dwelling or sleeping purposes .
Master Street Address Guide (MSAG) - Consists of the street name, addresses and emergency providers for that range.
This lookup became the key step for Enhanced 9-1-1.
Official Name - The name of any roadway in the unincorporated area of Person
County as approved by the Person County Planning and Zoning Department.
Planning Department - Person County Planning and Zoning Department.
Private Mobile Home Park Road - Any street, roadway or driveway which serves two or more mobile homes for
residential purposes, and which has not been dedicated to the public use.
Public Road - A street located on public right-of-way and which meets the total improvement requirements for a public
street as set forth by the North Carolina Department of Transportation in its publication "Subdivision Roads - Minimum
Construction Standards".
Private Road - A street not maintained by the North Carolina Department of Transportation which is not intended to
become a public street but which shall be used for access to a particular site, group development or business.
Property Address - The house number and roadway name shall serve as the property address.
Roadway - Any road, street, drive, lane, cartway, tramway , easement, right-of- way, access area, thoroughfare ,
highway , boulevard , or any other corridor used for or having the potential use as a means of conveyance by a motor
vehicle.
State Road Number - A number assigned by the North Carolina Department of
Transportation; also known as the SR number for secondary state maintained roads.
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Street Name - The official name of any roadway , designated by the Board of Commissioners or, in the case of public
roads, by the North Carolina Department of Transportation.
Suffix - The following list shall be used after a road name- avenue, boulevard , circle, court, crossing, drive, estate,
extension, gardens, heights , highway , landing, lane, park, place, plaza, point, ridge, road , roadway, square, street,
terrace, trace, trail , village or way.
Travel Trailer - A vehicular portable structure less than 32 feet in length primarily designed as a temporary dwelling for
travel, recreation or vacation uses.
Travel Trailer Park - A parcel of land designed and equipped to accommodate
travel trailers.
Article III. Administration
The Official Street Addressing and Road Naming Authority in the Person County, NC- The Person County Board of
Commissioners hereby assigns overall authority and responsibility for addressing and naming of both public and private
roads as directed by the provisions of this ordinance to the County Address Coordinator. It shall be the duty of the
Address Coordinator and in accordance with the general direction of the Person County Commissioners, County
Manager and County GIS Department to prepare and maintain street address numbering maps of the entire County and,
when a new building is built, or for any reason a number is required, to be issued*. It shall be the duty of the Addressing
Coordinator from time to time, and upon request, to review street number assignments, resolve conflicts in address
numbering, reassign numbers or propose any changes which, in his/her opinion, are necessary for the public safety,
welfare and mail delivery. This includes any authorized staff representative acting on the Coordinator’s behalf, and
hereby assigns overall authority and responsible for all activities necessary for the enforcement, interpretation and
administration of this Ordinance to the Address Coordinator. The Address Coordinator (s) are assigned by the 911
Communications Manager for Person County.
* It shall be the duty of the County GIS Department to maintain the database required for the implementation of the
aforementioned maps. As such the County Address Coordinator and County GIS Department recognize and agree to a,
separately defined, Memorandum of Understanding outlining a well regulated relationship between the two parties
concerning equipment usage, data collection, data entry and data maintenance standards.
Further requests or petitions for changing street names will be filed with the Address Coordinator(s) who will then
transmit such requests to the necessary departments for approval. The Address Coordinator(s) will prepare a
recommendation to the County Board of Commissioners for each request within sixty (60) days of its filing. The County
Commissioners shall schedule a time to hold a public hearing on the matter.
Pursuant to General Statutes of North Carolina GS 153A-238 and G.S. 153A-239.1(a), the County Commissioners shall at
least 10 days before the day of the public hearing, cause notices of the time, place and subject matter of the hearing to
be prominently posted at the county courthouse and in at least two public places in the township or townships where
the said street is located, and shall publish a notice of such hearing in a newspaper of general circulation published in
the county. The Address Coordinator(s) responsibilities are:
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A. Assigning address numbers for houses and buildings of any kind within the jurisdiction of the county.
B. Keeping a record of the date, copy of the notation, and the address to which the new address was assigned.
C. Recommending change of existing addresses when necessary to facilitate house numbers along a street.
(Houses and buildings will be numbered according to a lineal system in which all numbers are assigned
consecutively from the beginning of a street along its length to its end without regard to how it integrates with
the rest of the rural area.)
D. Designating individual unit addresses within the multiple housing units in conformity with this Ordinance.
(Apartment Complexes and Mobile Home Parks).
E. Insuring that all streets which require naming have street identification signs, and that all signs are uniform in
construction, that all signs are placed at proper locations and properly installed, and that all signs that are either
destroyed or lost are reinstalled in a timely manner.
F. The Address Coordinator(s) will compile a database of fiscal addresses for each property or building in
conjunction with the County Tax Department.
G. The Address Coordinator(s) will be responsible for compiling the Master Street Address Guide (MSAG) as
required for E911 Database.
H. The Address Coordinator(s) will be the agent assigned for all activities necessary for the interpretation and
administration of this Ordinance.
Article IV. New Street Naming
SECTION 401 Street Names
The names of streets currently in place and listed in the current Master Street Address Guide (MSAG) that are located
within the jurisdiction of Person County, whether public or private shall not be changed by any methods except those
set forth in this ordinance. A copy of this ordinance and a list of street names shall be forwarded to the Department of
Transportation pursuant to G.S. 153A-239.1.
SECTION 402 New Street Names
A. No new public or private streets shall be named without review and approval of the Address Coordinator(s). In
the event a street name is denied, the Address Coordinator(s) shall provide a written explanation as to why the
name was denied. An appeal of this denial must be filed with the Address Coordinator in writing within thirty
(30) working days of written notification of required owner action. Further appeals can be made to the Person
County Board of County Commissioners. Any appeal must be filed, in writing, with the Address Coordinator(s)
and will be placed on the next available meeting agenda.
B. The name of any new street, whether it is public or private, shall not duplicate or be phonetically similar to any
other street name in the entire county; including municipalities.
C. Directional names cannot be part of any street or street name (examples - WESTOVER RD or NORTHFIELD DR are
not acceptable).
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D. Alternate spelling, and homonyms (dear and deer) are not acceptable. All street names must use the common
spelling as found in a standard dictionary.
E. Street names must not contain any punctuation or symbols. Only letters of the alphabet and blank spaces may
be included in street names.
F. Names that are numbers must be expressed as alphabet (spelled out) and not numeric (for example, Second
Street is acceptable, not 2nd Street, because of the MSAG setting in E911 Database). State and federal highways
numbered are not to be used as names.
G. New subdivision streets, Apartment Complexes, and Mobile Home Parks whether public or private, shall be
named when created through the subdivision process in accordance with those procedures outlined in the
Person County Subdivision Ordinance.
H. Private streets, shall be required to be named and structures addressed off of when they meet the minimum
standard of serving at least three (3) households and having a length of 200ft or greater.
I. Those people who live on private streets that do not meet these minimum standards may be addressed off the
public street from which it intersects.
J. This subsection shall not apply to the extension of existing streets, which should whenever possible be given the
same name.
K. “EXT” is not to be used as a suffix when a street is extended. Instead the name remains the same and the
address range extended to accommodate the new section or street.
L. Any roads or streets that make a directional change at an intersection of 90 degrees must have a unique name
after each directional change.
M. Abbreviations of the main title of the street or road name cannot be used except for the following streets (MT
for Mount, ST for Saint, NC for North Carolina, I for Interstate, and US for United States.)
N. A Street with one name shall serve all multifamily dwelling complexes, including apartment complexes,
townhouses and condominium developments, and other similar uses unless the Address Coordinator(s) finds
that, in the interest of public safety, the naming of more than one street in or near the development is
warranted.
O. Street names must be limited to a maximum of twenty-one (21) characters to aid in keeping sign manufacturing
costs to a minimum.
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P. Only one name may be assigned along a continuous roadway. Where permanent breaks in a street exist, a new
name must be assigned to each segment. A permanent break may consist of but is not limited to a river, stream,
and / or intersecting street where continuous access is not available between the two (2) segments without
using another street.
Q. Approved street name suffixes may not be used as part of a street name (examples - DEER RUN DR or EAGLE
WAY CT are not acceptable)
R. Owners and / or developers of subdivision roads shall be responsible for the purchase of road sign(s) at a cost
established by the board of commissioners (current cost is $125 per sign/post - TS) and collected by the county
Planning and Zoning Department. This fee will be established in the annual county budget. The developer shall
pay the fee to the county for required street name signs prior to final plat approval. Street name signs shall be
erected at each street intersection where said streets having three or more lots are proposed for development.
The county will purchase and erect the street name signs in accordance with the Manual of Uniform Traffic
Control Devices for Streets and Highways 2009 edition, as amended:
Public Street Sign Color and Reflective Letters - Color of signs, white lettering on reflective Green
background
Private Street Sign Color and Placement - Color of signs, white lettering on Blue reflective background.
Street name signs installed in areas, which have not been
dedicated to public use
SECTION 403 Subdivisions with Proposed New Streets
For all subdivisions which are developed in conformance with the Person County Planning Ordinance and Subdivision
Regulations and in which new streets are proposed , the following items must be submitted to the Addressing
Coordinator for approval before any property can be subdivided and recorded:
A. A scaled map of the overall tract illustrating street layout,
B. The name proposed for each street identified on the map, and
C. An alphabetical list of the proposed street names, together with an alternate name for each name proposed.
The Addressing Coordinator will review the proposed street names for duplication and for overall compliance
with the street naming and numbering policy. The approved street names shall be included in the final plat
submitted for recordation.
SECTION 404 Street Suffixes - The following street name suffixes and their official abbreviations must be used
in the naming of new roads and streets:
AV = Avenue- Any thoroughfare that is continuous and not limited to a single subdivision.
PT = Point- Street adjacent to a waterway.
BLVD = Boulevard- Street with a landscaped median dividing the roadway.
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RD = Road- Any thoroughfare that is continuous and found mainly in the rural area of any county.
CT = Court- Permanently dead-end street or terminating in a cul-de-sac, not longer than 600 feet in length.
RUN = RUN-A straight street in a undeveloped area.
CIR = Circle- Discouraged but allowed, at discretion of the Address Coordinator(s).
ST = Street- Any thoroughfare that is continuous and used mainly in city and town.
DR = Drive- For a curving, continuous thoroughfare. This is the default suffix.
SQ = Square- Central Square set up for centralized development.
HWY = Highway- State, Interstate, or Federal Highway.
TER = Terrace- Curvilinear street of less than a 1,000 feet.
LN = Lane- A minor street.
TRC = Trace- Small community Street.
LOOP = LOOP- Street that loops around and terminated onto itself.
TRL = Trail- Street serving as a collector for one or more local thoroughfares.
PKWY = Parkway-Collector or arterial street with a raised median.
WAY = Way- A curvilinear street.
PL = Place- For a permanently dead-end street ending in a cul-de-sac, not longer than 660 feet in length.
SECTION 405 Street Directionals - Street Directionals can be used with the approval of the Address
Coordinator(s) based on the following standards:
A. Directions must be placed ahead of the street name in a separate field separate from the street name (for
example, E SMITH ST).
B. Directionals cannot be used as a suffix or placed after the street name.
C. Directionals must be used in a complimenting set. If a North directional is used there must also be a South
directional. If an East directional is used their must be a West directional.
D. The prefix "N" (for North) shall be used for the northern portion of roadways having the same name.
E. The prefix "S" (for South) shall be used for the southern portion of roadways having the same name.
F. The prefix "E" (for East) shall be used for the eastern portion of roadways having the same name.
G. The prefix "W" (for West) shall be used for the western portion of roadways having the same name.
SECTION 406 Renaming Streets - Official Street Renaming Process in Person County’s. Existing street names
may be changed for just cause. Examples of just cause are:
A. Property owners who want to have the name of a public or private street changed must submit a petition to the
Address Coordinator(s) for verification. In addition to complying with Section 402 of this Ordinance the street
name must comply with GS 147-54.7. The Address Coordinator(s) will make recommendations to the Person
County Board of Commissioners after the following additional criteria have been met:
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1. A petition should include the existing street name, the proposed street name, and the reasons why the
person(s) are requesting the change, the signatures of 75% of those persons owning property adjacent
to the street, and 75% of street frontage.
2. In renaming streets, no requests will be considered that is a duplicate or phonetically similar to any
existing street name already established by this Ordinance, any subsequent ordinances, and
amendments thereto or within a municipality, city or town located in Person County, irrespective of the
use of a suffix such as street, drive, place, court, etc.
3. The Address Coordinator(s) shall request a public hearing date be set by the Person County Board of
Commissioners and cause the same to be advertised pursuant to G.S. 153A-239.1(a).
4. Upon approval of the petitioned street name, by the Address Coordinator(s) and Board of
Commissioners, the petitioners shall pay to Person County the cost of purchasing the new signs and
erecting them.
B. In the event an existing street name has jeopardized the public's health, safety, or general welfare by impeding
timely emergency response, or in the event an existing street name reasonably could be perceived to jeopardize
the public's health, safety, or general welfare by impeding timely emergency response.
SECTION 407 Street Renaming Guidelines and Limitations - When having to rename one of the streets with
similar names consider the following circumstances:
A. In naming or renaming a public street, the county may not change the name, of any street name given to a
street by the Board of Transportation unless the Board of Transportation agrees to such changes. The Address
Coordinator(s) and Board of Commissioners shall not change any number assigned to a street by the Board of
Transportation. The Address Coordinator(s) and Board of Commissioners may give the street a name in addition
to its DOT Number.
B. Largest Impact - In most cases, the street with the larger number of homes, dwellings, or commercial structures
along the roadway should have priority and retain the name in order to minimize the number of people
affected.
C. Oldest Street - When renaming either of the two streets will have an equal impact, the street that has been
consistently signed for the longest period of time should retain the name.
D. Historical Significance - In some cases, the street with a name of historical significance should retain the
disputed name.
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Page 10 of 15
SECTION 407 Notice
The Address Coordinator(s) shall give notice following naming, or renaming of a public or private street, assigning or
reassigning street addresses on a public or private street(s), to the local Postal Service, to any major utilities serving the
addressed area, to any emergency services agency such as police, sheriff, fire departments and ambulance service with
jurisdiction over the addressed area. A copy of the newly assigned addresses will be forwarded to the Person County
School System, to the Board of Transportation, and to any city within five miles of the street.
Article V. Street Numbering and Address Assignment
SECTION 501 Application - The rules and guidelines in this section are designed to facilitate the proper
assignment of addresses to properties for every possible addressing scenario that occurs in Person County.
Properties and structures must be assigned addresses in a logical, easy to understand manner in order to help
citizens and emergency personnel quickly locate people, places and events.
A. When to assign address numbers - When the proper governing body has approved a new street, it must be
assigned an address range and each individual property, habitable, and/or substantial structure assigned
numbers in accordance with the standards defined in this document. Addresses should not be assigned to
structures that are simply accessory to another building or insubstantial in nature.
B. Street addressing process in Person County, NC - Address block ranges will be assigned to streets shown on
approved preliminary plans. Individual physical addresses must be assigned to lots and/or structures prior to
approval of final plan and/or the recordation of final plat, and a copy of the final plat (preferred as an electronic
file (AutoCAD or GIS File)) must be submitted to the Address Coordinator(s).
SECTION 502 Basic guidelines to follow when numbering/addressing streets - The rules and guidelines in this
section are designed to facilitate the proper assignment of addresses to properties for every possible
addressing scenario that occurs in Person County. Properties and structures must be assigned addresses in a
logical, easy to understand manner in order to help citizens and emergency personnel quickly locate people,
places and events.
A. Address Ranges - All required structures shall be assigned up to a five-digit number. No address range in Person
County shall conflict with another address range in a contiguous locality. For those rare duplicate street names
in the county, the address range will be different for each street. The range will be assigned consecutively for all
duplicate street names; however, the numbering of the second street will have a break of a minimum of one
thousand (1,000) addresses.
B. Addressing Interval - Structure numbers shall be assigned consecutively so that a new address is created ideally
every 5.28 linear feet. Addresses will be assigned at the point of access (driveway) or to a structure point along
the front of the structure. If the driveway enters from the side or rear of the property, the structure shall be
addressed on the street that it fronts at the approximate middle of the structure.
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Page 11 of 15
C. Even and odd numbering. Odd numbered addresses shall be assigned to the left in the direction of increase and
even numbered addresses shall be assigned to the right in the direction of the increase.
D. Each mobile home within Mobile Home Parks shall be assigned a primary 911 address. Addresses shall be
assigned from internal drives, using even and odd addressing. A Mobile Home Park owner may assign lot
numbers, but the lot number shall not be used in the address of the lot.
E. Addresses in Sequential Order. All addresses need to be in sequential numeric order, always increasing from the
point of origin, and should numerically balance on both sides of the street.
F. Addresses will be established as whole numbers and will not have fractions or decimals of a number.
G. Vacant Properties shall, upon request, be assigned addresses pre-development for location purposes only, but
once development occurs may have to be readdressed based on the final layout or plan.
SECTION 503 When a street must be renumbered - Official Street Renumbering Process in Person County.
Introduction - It shall be the duty of the Address Coordinator(s) from time to time, and upon request, to review
street number assignments, resolve conflicts in numbers assignment reassign numbers or propose any changes
which, in their opinion, are necessary. When due to conflicts, change in character or amount of occupancy of
any block, and it becomes necessary to assign and reassign numbers within that block, it is the authority and
responsibility of Address Coordinator(s) to assign approved numbers to the owners and tenants of each building
involved. The Address Coordinator(s) will then notify the local postmaster having jurisdiction over that area of
the address change.
1. Administration - When renumbering a street it shall be renumbered in accordance to the numbering rules in this
document and in anticipation of possible future changes. Individual numbers can be changed by the Address
Coordinator(s) and do not have to go through the process of a public hearing. When renumbering whole or
large sections of streets the Address Coordinator(s) notifies all adjacent property owners of the proposed street
numbering change. A public hearing is then scheduled to discuss the proposed street numbering. At least 10
days before the hearing, a notice of the subject matter shall be posted in the county courthouse, and in the local
newspaper for general circulation within the county.
2. Basic guidelines to follow when renumbering a street - Existing addresses may be changed for just cause.
Examples of just cause are:
A. Government Initiated Address Reassignment To Secure the Public's Health, Safety and General Welfare. In the
event an existing Address has jeopardized the public's health, safety, or general welfare by impeding timely
emergency response, or in the event an existing street name reasonably could be perceived to jeopardize the
public's health, safety, or general welfare by impeding timely emergency response.
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Page 12 of 15
B. Area where no addresses were left for vacant lot(s) or new development.
C. If the Street Name has officially been changed.
SECTION 504 Display of street address numbers - The owner, occupant or agent of the affected house or
building shall place or cause to be placed upon each house or building the numbers assigned under the
addressing system as provided in this article. The following criteria must be used to properly display the
number:
A. The cost of the number shall be paid for by the property owner and may be procured from any source
(example: hardware store). Such number or numbers shall be placed on existing buildings within 30 days from
the date of notification.
B. The numbers shall be conspicuously placed immediately above, on, or at the side of the proper door of each
building so that the number can be seen plainly from the street on which the number is based. Whenever any
building is situated or is more than one hundred (100) feet from the street front, and the number is not clearly
discernible from the street line, or vision of the building from the streets is otherwise obscured, the number
assigned is strongly recommended to be placed on a sign (minimum of 24 inches (2’) x 24 inches (2’)) attached
near the walk, driveway or common entrance to such buildings, and affixed upon the gatepost, fence, post or
other appropriate place so as to be easily discernible, and clearly identifies the entrance to a property.
Alternatively, numbers can be posted on an individual US mailbox or US mailbox stand/post for the building if:
1. The US mailbox is distant and separate from any other US mailbox so as to eliminate confusion
as to specific ownership, and;
2. The US mailbox is located adjacent to the driveway or access to said house or building, and;
3. That said house or building numbers are affixed to the US mailbox or US mailbox post/stand in
such a manner as to be visible and readable from any and/or all directions from the road or
street which it fronts, and;
4. That said house or building numbers on the US mailbox or US mailbox post/stand are no less
than three (3) inches in height.
Numbers painted or stenciled on the curb shall not be a lawful substitute for the display of address
numbers prescribed by this section.
C. Address numbers must be a minimum of three (3) inches in height for residential uses and shall be placed on the
front of the building facing the street or on the end of the building nearest the street so as to be visible from the
street on which the property fronts.
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D. Numbers for multiple dwelling units and nonresidential buildings shall be at least six (6) inches in height and
shall be placed on the front of the building facing the street or on the end of the building nearest the street in
which the building is accessed.
E. All numbers must be made of a durable, clearly visible material and must contrast with the color of the house,
building, or other structure. Reflective numbers for nighttime identification are strongly recommended.
F. When a property, (House or Buildings) is built on a corner lot. The address shall be assigned, from the street that
the building faces. (Front of the house)
G. Address numbers should be plain block numeric numbers and not in alpha print or any type of script writing.
H. The Address Coordinator(s) or the Person County Board of Commissioners will have the right to authorize and
approve alternate methods of displaying house numbers on existing and new structures that meet the intent of
this Ordinance.
Article V. General Standards
It shall be unlawful for any person(s) without the written consent of Person County to:
A. Name or designate the name of any public road, neighborhood public road, private subdivision street or
private mobile home park road, in the unincorporated areas.
B. Erect any street sign on any public road, neighborhood public road, private subdivision street or private mobile
home park road in the unincorporated areas of Person County, without the written approval of the Person
County Planning and Zoning Department.
C. Erect any street sign on any roadway , public or private, in Person County, which does not meet the current
County sign specifications.
D. Remove, deface, damage, or obscure any number or sign in the jurisdiction of this Ordinance.
E. Number or assign a number to any structure without the written approval of Person County.
F. Name a private street or road which duplicates or is substantially similar to the name of an existing street or
road within Person County.
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Page 14 of 15
Article VI. Penalty
SECTION 601 Enforcement
A. Owners of buildings already constructed will be required to comply with this ordinance. Those person(s) who do
not comply with this ordinance will be notified and requested, by the Address Coordinator, to meet the
requirements within 30 days from the date of notification. If the owner does not comply voluntarily with this
Ordinance within 30 days of receiving delivery of the notice by registered or certified mail or by hand delivery,
enforcement action pursuant to G.S. 153A-123 may be initiated. A fine of twenty-five dollars ($25.00) shall be
imposed on the property owner for each day that the address is not posted.
B. No building permit shall be issued until an official house number has been assigned for a lot.
C. The certificate of occupancy for any structure erected, repaired or modified after the effective date of this
Ordinance shall be withheld by the Inspections Department until the address is posted on the structure as
outlined in this Ordinance.
D. Any violation of the provisions of this Ordinance not specifically addressed in Article VI section 601, shall be
guilty of a misdemeanor and shall be subject to a fine of not more than fifty dollars ($50) or imprisonment of not
more than thirty (30) days, as provided by North Carolina General Statutes 14-4C. Violations of this Ordinance
may also be subject to further civil remedies as set forth in North Carolina General Statutes 153A-123.
Article VII. Amendment Procedure
The provisions of this ordinance may from time to time be amended, supplemented, changed, modified, or repealed by
the Board of Commissioners. The Person County Board of Commissioners, upon review and recommendation of the
Address Coordinator(s), may also authorize a variance from these regulations when in its opinion the interests of the
public would best be served by such variance.
Article VIII. Liability
Person County, its officers, agents or employees, together with any person following their instructions in rendering
services, are not liable for civil damages as a result of an act or omission under this Ordinance, including but not limited
to, developing, adopting, operating, or implementing an addressing system or plan. Person County will not be held
responsible or liable from owners or occupants for personal injury or damage to buildings or dwellings constructed
which do not comply with this ordinance.
Article IX. Repeal and Separability
The Road Naming ordinance originally adopted on August 2, 1993 and the House, Building and Mobile Home Number
ordinance originally adopted on August 2, 1993 are hereby repealed. All provisions in any other Ordinances for Person
County in conflict with this Ordinance are hereby repealed.
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Page 15 of 15
Should any section or provision of this Ordinance be declared by the courts to be unconstitutional or invalid, such
decisions shall not affect the validity of the Ordinance as a whole, or any part thereof other than the part so declared to
be unconstitutional or invalid.
Article X. Conflict
Insofar as the provisions of this Ordinance are inconsistent with the provisions or any other law except a provision of
state or federal law, the provisions of this Ordinance shall control.
Article XI. Effective Date
This Ordinance shall take effect upon final adoption by the Person County Board of Commissioners.
Adopted, this the ______ day of ________________, 2013.
PERSON COUNTY
BOARD OF COMMISSIONERS
____________________________
Jimmy B. Clayton, Chairman
Attest:
____________________________
Brenda B. Reaves, Clerk to the Person
County Board of County Commissioners
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,I
PERSON COUNTY
AN ORDINANCE WITH RESPECT
TO HOUSE.BUILDING AND MOBILE HOME NUMBERS
BE IT ORDAINED BY THE PERSON COUNTY BOARD OF COMMISSIONERS:
Article I.Definition of Terms
For the purpose of this Ordinance,certain terms of words used
herein shall be defined as follows:
Board of Commissioners -Person County Board of Commissioners.
Building -Any structure having a roof supported by columns or
by walls,and intended for shelter,housing or enclosure of
persons,animals,chattels or equipment.For the purposes of this
Ordinance,the term "building"may also include other manmade
structures.
Business Address - A house number.
Developer - A person,firm or corporation
application for development for a sUbdivision,
deve1opment,i ndustri a1 park or mobile home park
final responsibility for ensuring compliance with
conditions of this Ordinance rests.
sUbmi tti ng an
planned unit
and upon whom
the terms and
Driveway -A private way,beginning at the property line of a
lot abutting a public road,private road,easement or private
right-of-way,giving access from that public road,recorded
easement,recorded private road or private right-of-way,and
leading to a building,use or structure on that lot.
Dwelling,Single-Family -A building arranged or designed to
be occupied by one (1)family.
House Number Number assigned to any house,residence,
dwelling,business,warehouse,or other structure or property in a
sequential manner.
Mailing Address -Assigned or used by the
for the purpose of delivery of the U.S.Mail.
or may not be identical to property address.
U.S.Postal Service
Mailing Address may
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Mobile Home -A portable manufactured housing unit designed
for transportation on its own chassis and placement on a temporary
or semi-permanent foundation having a measurement of 32 ft.or more
in length and 8 ft.or more in width.As used in this Ordinance,
mobile home also means a double-wide mobile home which is two or
more portable manufactured housing units designed for
transportation on their own chassis,which connect on site for
placement on a temporary or semi-permanent foundation having a
measurement of 32 ft.or more in length and 8 ft.or more in width.
Mobile Home Space -Any parcel of ground within a mobile home
park designed for the exclusive use of one mobile home.
Mobile Home Park -Shall be the land leased or rented,being
used or proposed to be used by mobile homes occupied for dwelling
or sleeping purposes.
Official Name -The name of any roadway in the unincorporated
area of Person County as approved by the Person County Planning and
Zoning Department.
Planning Department
Department.
Person County Planning and Zoning
Private Mobile Home Park Road Any street,roadway or
driveway which serves two or more mobile homes for residential
purposes,and which has not been dedicated to the public use.
Public Road -A street located on public right-of-way and
which meets the total improvement requirements for a public street
as set forth by the North Carolina Department of Transportation in
its pUblication "Subdivision Roads Minimum Construction
Standards".
Private Road -A street not maintained by the North Carolina
Department of Transportat ion wh i ch is not intended to become a
public street but which shall be used for access to a particular
site,group development or business.
Property Address -The house number and roadway name shall
serve as the property address.
Roadway -Any road,street,dri ve,1ane,cartway,
easement,ri ght-of-way,access area,thoroughfare,
boulevard,or any other corridor used for or having the
use as a means of conveyance by a motor vehicle.
tramway,
highway,
potential
State Road Number -A number assigned
Department of Transportat i on;a1so known
secondary state maintained roads.
2
by the North Carolina
as the SR number for
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Street Name -The official name of any roadway,designated by
the Board of Commissioners or,in the case of public roads,by the
North Carolina Department of Transportation.
Suffix -The following list shall be used after a roadway
name:avenue,boulevard,circle,court,crossing,drive,estate,
extension,gardens,heights,highway,landing,lane,park,place,
plaza,point,ridge,road,roadway,square,street,terrace,trace,
trail,village or way.
Travel Trailer -A vehicular portable structure less than 32
feet in length primari 1y designed as a temporary dwell ing for
travel,recreation or vacation uses.
Travel Trailer Park - A parcel of land designed and equipped
to accommodate travel trailers.
Article II.Assigned House Number To Be Posted;Standards.
Within 90 days after written notice by the Person County Board
of Commissioners,its agent or authorized contractor,of the
assignment of or change of a number for any house,building,mobile
home park,or condominium complex,the owner or occupant of such
property shall be required to post the number (including any
1etters)so assi gned in an approved area on such property in
accordance with the requi rements of subsections (a),(b),(c),(d)
and (e)below.In addition,any owner or occupant of any house,
building or unit which has been previously assigned a number shall
comply with subsections (a),(b),(c),(d)and (e)no later than 90
days after adoption.
(a)The minimum height of the number(s)placed on a house,
bui lding,mobile home lot/site,or unit shall not be less than
three (3)inches in height;however,the building number of an
apartment,townhouse,or condominium complex shall be not less than
six (6)inches in height and shall be placed either in the
approx i mate center of the bui 1ding or on the street end of the
building so that it is clearly visible from either the pUblic or
private street by which it is accessed.
(b)Numbers shall be displayed in numeric format,not in
script.
(c)The house or building numbers shall be visible and
readable from the street or road on which it fronts.However,in
the event a building is not visible for 100 feet from the street or
road on which it fronts or the lot on which the building is located
is landscaped in such a manner that said numbers cannot be seen
from the street or road,the assigned building number shall also be
posted on the property at or near the property line at a driveway
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entrance or access to said property,or as an alternative,may be
posted on the individual us mailbox or us mailbox stand/post for
said structure if:
The US mailbox is distant and separate from any other US
mailbox so as to eliminate confusion as to specific
ownership,and;
The US mailbox is located adjacent to the driveway or
access to said house or building,and;
That said house or building numbers are affixed to the US
mailbox or US mailbox post/stand in such a manner as to
be visible and readable from any and/or all directions
from the road or street which it fronts,and;
That said house or building numbers on the US mailbox or
US mailbox post/stand are no less than three (3)inches
in height.
(d)A sign displaying the property number or street address
of a mobile home park shall be erected and displayed at the
driveway entrance of the mobile home park.Lots or sites within
the mobile home park shall be marked in a uniform manner within the
park by placement at or near the individual mobile home a pedestal
or post,no less than 3 feet nor higher than 5 feet above ground
level,containing the assigned number of the individual mobile
home.If an individual mailbox is placed at the mobile home
lot/site,the number shall be displayed thereon.If a central
cluster postal box site is provided,the assigned lot/site number
also shall be displayed on the individual boxes of the cluster.In
the event the mobile home rests on a permanent foundation,the
structure may be marked in accordance with paragraph (c)above.
(e)The color of the number(s)placed on the structure,post
or pedestal,as described in sections (a),(b),(c)and (d)above,
shall be of a contrasting color to the background so as to be
clearly·visible,and shall be maintained in a clearly visible
manner.The Building Inspector shall not issue a certificate of
occupancy or a certificate of compliance until the assigned number
is posted in accordance with this section.
(f)Following the posting of the assigned number as required,
the owner or occupant shall maintain such house or building number
at all times in compl iance with the above standards.Bui lding
numbers shall not be obstructed from view by shrubs or vegetation
as viewed from the public road.
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'.'.'
(g)Violation of the Ordinance is a misdemeanor as provided
by North Caro1ina General Statute 14-4 and may be pun i shed as
provi ded there in.Each day the vi 0 1at i on conti nues after the
offending owner or occupant has been notified of the violation
shall constitute a separate violation of this ordinance.
(h)Notice of violation of this Ordinance sufficient to allow
da i1 y cr i mi na1 pena 1ties of subsection (g)to be invoked may be
given by the Person County Inspections Division,the Person County
Emergency Medical Services Department,the Person County Sheriff's
Department,the Person County Fire Marshal's Office or Roxboro City
Manager's Office.Such notice must be in writing to the owner or
occupant of the dwelling or building and set forth what action is
necessary in order for the offender to be in compliance.
Adopted thi s 2nd'day of August ,1993.
PERSON COUNTY
."\.
ATTEST:
'/':~cL/
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AGENDA ABSTRACT
Meeting Date: August 19, 2013
Agenda Title: Review of School Recycling Grant
Summary of Information: Funding for a school recycling grant program was adopted in the
FY 13-14 budget in the amount of $14,490.
Attached are the School Recycling Grant flier and a Request for Proposals. These forms will be
distributed in hard copies and via email to all schools (traditional, private, charter, etc) located
within Person County. They will also be available on the Person County Recycling Center
webpage.
The deadline to submit a proposal is 5:00pm on September 23, 2013. Each proposal will be
reviewed by the selection committee during a blind review process in which all identifying
information will be removed from proposal applications. The selection committee includes:
Commissioner Blalock (BOC representative), Kenneth Hill (SWAC representative) and Becky
Clayton (PCRC representative).
Funding will be announced in October. Selected projects will be required to provide an annual
report in May that includes the amount of recyclables collected.
Recommended Action: Provide feedback on the grant process
Submitted By: Becky Clayton, Assistant Director of Person Industries
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Person County
School Recycling Grant Program
Apply for your school to receive funds from the first
Person County School Recycling Grant program!
In Person County we understand that recycling is important for sustaining our
community for the future. What better way to inspire more people to recycle
than by teaching our kids!
All K-12 schools located in Person County are encouraged to apply. We have a
total of $14,490 to award to selected schools to implement recycling programs.
The grant amounts will be determined by the number of awards given and the
overall proposal scores. Proposals can receive up to 100 points based on
Project Impact
Planning, Organization, and Sustainability
Cost
Education and Outreach
Proposals demonstrating matching funds will receive five (5) bonus points.
Proposal applications will be released electronically on the Person Industries page
of the County website at www.personcounty.net and emailed directly to schools
on August 19, 2013. The final date to submit your proposal is September 23,
2013. Awards will be announced in October 2013.
Questions? Contact Becky Clayton at
336.599.7571 ext. 2825 or bclayton@personcounty.net
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Person County
School Recycling Grant Program
Request for Proposals
Person County is excited to release the Request for Proposals for the new School Recycling Grant
Program! The purpose of this program is to encourage and assist all K-12 schools within Person County
in providing public outreach and education to students, parents and staff about recycling. Funding for
this grant is generated by money earned from recyclables. Person County Government is the grantor of
these funds by way of Person Industries. There is a total of $14,490 available for Fiscal Year 2013-2014.
This funding is based on the number of tons recycled in the County each year, so the more we recycle
the more funds available for the grant.
This Request for Proposals seeks proposals to fund any items necessary to initiate or continue recycling
programs in any school located within Person County. Please read this entire RFP before completing and
submitting your proposal. Proposals are due no later than 5:00pm on Monday, September 23, 2013. If
you have any questions, please contact Becky Clayton at 336.599.7571 ext. 2825 or
bclayton@personcounty.net.
Eligible Applicants: All K-12 schools located in Person County are eligible to apply. This includes all
public, private, or charter schools.
Eligible Projects: Award money must be used to promote recycling in Person County. Projects can target
families, students, institutions, etc., but must be implemented through the schools with student
involvement. Students, teachers, and administrators are encouraged to submit applications. Schools are
allowed to propose multiple projects. A separate proposal application must be submitted for each
project.
Funding: There is no cap to the amount of funds requested per proposal. Awards will be based on the
quality of each application and how well they explain the outlined criteria. Applicants are encouraged to
obtain funding matches and will be given bonus points for doing so.
Funds will be dispersed on a reimbursement basis. Awardees are expected to make all reimbursement
requests by June 30, 2014. No extensions will be granted.
Proposal Requirements: Each proposal must include, but is not limited to, the information in the
bulleted list below and must highlight the selection criteria (see Proposal Selection Process). All
proposals must be submitted on the attached form.
· Project Title
· Project Description
· Collection Plan
· Description of any existing recycling program
· Project Timeline/ Long-term plan
· Itemized Budget
· Matching Funds
Due Date: Proposals must be received by Person Industries by 5:00pm on Monday, September 23,
2013.
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Proposal Submission: Email completed proposals to:
Wanda Rogers, Director
Person Industries
wrogers@personcounty.net
Proposal Selection Process: A committee will evaluate proposals based on the given criteria and select
award recipients in a blind review process. Identifying school and contact information will be removed
from proposals before they are reviewed by the committee. Grant recipients will be announced in
October 2013.
Award Criteria Description Maximum
Points
Impact The pounds of recyclables that you estimate that your
project will divert from the landfill. The estimate should be
supported with evidence or an explanation of how the
estimate was derived.
25
Cost Using your estimate for the pounds recycled, we will
calculate the cost/lbs. Those with a low cost per lb. will
score higher in this category.
25
Education and Outreach How many individuals will be reached through this project? 25
Planning, Organization, and
Sustainability
The project has been well designed and planned. The
project has a high chance of succeeding.
25
Bonus: Matching Funds 5
TOTAL POSSIBLE POINTS 105
Reporting Requirements: Grant recipients will be required to submit an annual report to Person
Industries and the Person County Solid Waste Advisory Committee detailing itemized materials and
activities paid for with grant money during the funding period. A reminder and additional details will be
sent to grantees in April 2014 about final reporting requirements. Failing to submit the final report will
result in a penalty during next year’s proposal selection process.
Proposals must be received by 5:00pm on Monday, September 23, 2013. Proposals not received at
this time will not be accepted.
Important Dates
Funding announcement: October 2013
Funds available: October 2013
Annual report due: May 2014
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Person County
School Recycling Grant Program
2013-2014 Proposal Application
School Name ______________________ Contact Person _______________________
Contact Phone # ____________________ Contact Email Address_______________________
Project Title______________________________________________________________
1. Project Description (Please include outreach and education information).
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
2. Please explain your collection plan. (Please include estimated number of pounds
recycled, accepted recyclables, container locations, who is responsible for emptying
containers, frequency of collection).
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
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3. Please outline a timeline for implementing your project. Indicate how it will continue
after this year.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
4. Please provide a proposed itemized budget for your project.
Item Quantity Purpose Cost
Will you have matching funds for your project? (Yes or No) ______________
Please provide the amount of matching funds _________________
5. Does your school currently recycle at all? If yes, please briefly describe existing
programs.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
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6. Why do you think your project should receive an award? You may also attach no more
than three letters of support from school leadership, staff, or parents.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
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7. All indicated parties must include an electronic signature for your proposal to be
accepted.
__________________________________
School Contact Name
___________________________________ ______________________
School Contact Signature Date
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___________________________________
Principal Name
___________________________________ _______________________
Principal Signature Date
Thank you for submitting a proposal for the 2013 Person County School Recycling Grant Program. Awards will be
announced in October 2013. If you have questions, please contact Becky Clayton at 336.599.7571 ext. 2825 or
bclayton@personcounty.net. Email your application to Wanda Rogers at wrogers@personcounty.net.
69
AGENDA ABSTRACT
Meeting Date: August 19, 2013
Agenda Title: DSS Attorney Contracts Fiscal Year 2013-2014
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 so attached are two contracts
per attorney.
Listed below are revisions made to all attorney contracts for the Department of Social Services as
required by NC DHHS Division of Social Services:
Page 2-3:
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:
70
(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.
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.
Signature Warranty: The undersigned represent and warrant that they are authorized to bind
their principals to the terms of this agreement.
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.
Page 6:
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.
Page 19-21:
1. BACKGROUND
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.
71
2. DEFINITIONS
f. “Secretary” shall mean the Secretary of the United States Department of Health and Human
Services or his designee.
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
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.
Recommended Action: Approval
Submitted By: Carlton B. Paylor, Sr.
Interim Director, Person County Department of Social Services
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Contract # 1008
Thomas L. Fitzgerald
Page 1
``Contract # 1008 Fiscal Year Begins July 1, 2013 Ends June 30, 2014
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)
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, 2013 and shall terminate on
June 30, 2014. 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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Contract # 1008
Thomas L. Fitzgerald
Page 2
Reporting Requirements: Contractor shall comply with audit requirements as described in
N.C.G.S. § 143C-6-22 & 23 and OMB Circular A-133. 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.
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.
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Contract # 1008
Thomas L. Fitzgerald
Page 3
Signature Warranty: The undersigned represent and warrant that they are authorized to bind
their principals to the terms of this agreement.
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.
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
Jimmy B. Clayton
____________________________ _________________________
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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Contract # 1008
Thomas L. Fitzgerald
Page 4
ATTACHMENTATTACHMENTATTACHMENTATTACHMENT AAAA
General Terms and ConditionsGeneral Terms and ConditionsGeneral Terms and ConditionsGeneral Terms and Conditions
Relationships of the PartiesRelationships of the PartiesRelationships of the PartiesRelationships of the Parties
Independent Contractor: Independent Contractor: Independent Contractor: 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: Subcontracting: Subcontracting: 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: Assignment: Assignment: 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: Beneficiaries: Beneficiaries: 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 InsuranceIndemnity and InsuranceIndemnity and InsuranceIndemnity and Insurance
Indemnification: Indemnification: Indemnification: 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: Insurance: Insurance: 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 CompensationWorker’s CompensationWorker’s CompensationWorker’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 LiabilityCommercial General LiabilityCommercial General LiabilityCommercial 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.)
AutomobileAutomobileAutomobileAutomobile - Automobile Liability Insurance, to include liability coverage, covering all owned, hired and non-owned
vehicles used in performance of the contract. The minimum combined single limit shall be $500,000.00 bodily injury
and property damage; $500,000.00 uninsured/under insured motorist; and $25,000.00 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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Contract # 1008
Thomas L. Fitzgerald
Page 5
The Contractor is not required to provide and maintain automobile liability insurance on any vehicle – owned,
hired, or non-owned -- unless the vehicle is used in the performance of this contract.
(d) The insurance coverage minimums specified in subparagraph (a) are exclusive of defense costs.
(e) The Contractor understands and agrees that the insurance coverage minimums specified in subparagraph (a) are
not limits, or caps, on the Contractor’s liability or obligations under this contract.
(f) The Contractor may obtain a waiver of any one or more of the requirements in subparagraph (a) by
demonstrating that it has insurance that provides protection that is equal to or greater than the coverage and
limits specified in subparagraph (a). The County shall be the sole judge of whether such a waiver should be
granted.
(g) The Contractor may obtain a waiver of any one or more of the requirements in paragraph (a) by demonstrating
that it is self-insured and that its self-insurance provides protection that is equal to or greater than the coverage
and limits specified in subparagraph (a). The County shall be the sole judge of whether such a waiver should be
granted.
(h) Providing and maintaining the types and amounts of insurance or self-insurance specified in this paragraph is a
material obligation of the Contractor and is of the essence of this contract.
(i) The Contractor shall only obtain insurance from companies that are authorized to provide such coverage and
that are authorized by the Commissioner of Insurance to do business in the State of North Carolina. All such
insurance shall meet all laws of the State of North Carolina.
(j) The Contractor shall comply at all times with all lawful terms and conditions of its insurance policies and all
lawful requirements of its insurer.
(k) The Contractor shall require its subcontractors to comply with the requirements of this paragraph.
(l) The Contractor shall demonstrate its compliance with the requirements of this paragraph by submitting
certificates of insurance to the County before the Contractor begins work under this contract.
Transportation of Clients by ContractorTransportation of Clients by ContractorTransportation of Clients by ContractorTransportation 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.
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.
Default and TerminationDefault and TerminationDefault and TerminationDefault and Termination
Termination Without Cause:Termination Without Cause:Termination Without Cause:Termination Without Cause: The County may terminate this contract without cause by giving 30 days30 days30 days30 days written noticewritten noticewritten noticewritten notice to the
Contractor. 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.
Termination for Cause: Termination for Cause: Termination for Cause: 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.
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Contract # 1008
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Waiver of Default: Waiver of Default: Waiver of Default: 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: Availability of Funds: Availability of Funds: 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: Force Majeure: Force Majeure: 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.
Survival of Promises: Survival of Promises: Survival of Promises: 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 RightsIntellectual Property RightsIntellectual Property RightsIntellectual Property Rights
Copyrights and Ownership of Deliverables:Copyrights and Ownership of Deliverables:Copyrights and Ownership of Deliverables: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:Federal Intellectual Property Bankruptcy Protection Act:Federal Intellectual Property Bankruptcy Protection Act: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 LawsCompliance with Applicable LawsCompliance with Applicable LawsCompliance with Applicable Laws
CompliaCompliaCompliaCompliance with Laws: nce with Laws: nce with Laws: nce 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 ComplianceTitle VI, Civil Rights ComplianceTitle VI, Civil Rights ComplianceTitle 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: Equal Employment Opportunity: Equal Employment Opportunity: 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): Health Insurance Portability and Accountability Act (HIPAA): Health Insurance Portability and Accountability Act (HIPAA): 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.
Trafficking Victims Protection Act of 2000Trafficking Victims Protection Act of 2000Trafficking Victims Protection Act of 2000Trafficking 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: Executive Order # 24: Executive Order # 24: 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.
ConfidentialityConfidentialityConfidentialityConfidentiality
Confidentiality: Confidentiality: 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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OversightOversightOversightOversight
Access to Persons and Records: Access to Persons and Records: Access to Persons and Records: 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: Record Retention: Record Retention: Record Retention: Records shall not be destroyed, purged or disposed of without the express written consent of the County.
The Department of Health and Human Services' basic records retention policy requires all records to be retained for a
minimum of three years following completion or termination of the contract. If the contract is subject to Federal policy and
regulations, record retention will normally be longer than three 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 three 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 three year period described above, whichever is later.
Warranties and Certifications Warranties and Certifications Warranties and Certifications Warranties and Certifications
Date and Time Warranty:Date and Time Warranty:Date and Time Warranty: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 TaxesCertification Regarding Collection of TaxesCertification Regarding Collection of TaxesCertification 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.
MiscellaneousMiscellaneousMiscellaneousMiscellaneous
Choice of Law: Choice of Law: Choice of Law: 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 Wake County, North Carolina. The place of this
contract and all transactions and agreements relating to it, and their situs and forum, shall be Wake County, North Carolina,
where all matters, whether sounding in contract or tort, relating to the validity, construction, interpretation, and enforcement
shall be determined.
AmendmentAmendmentAmendmentAmendment: 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: Severability: Severability: 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.
Headings: Headings: Headings: 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 of the Essence: Time of the Essence: Time of the Essence: Time is of the essence in the performance of this contract.
Key Personnel: Key Personnel: Key Personnel: 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.
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Care of Property:Care of Property:Care of Property: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: Travel Expenses: Travel Expenses: 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: Sales/Use Tax Refunds: Sales/Use Tax Refunds: 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: Advertising: Advertising: 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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ATTACHMENTATTACHMENTATTACHMENTATTACHMENT B B B B –––– ScScScScope of Work Federal Tax Id. ope of Work Federal Tax Id. ope of Work Federal Tax Id. ope of Work Federal Tax Id. 20202020----2272227222722272----781781781781
NORTH CAROLINA
DUPLICATE ORIGINAL
PERSON COUNTY
LEGAL SERVICES AGREEMENT
THIS Agreement, made and entered into this the 1st day of July, 2013, 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, 2014. 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.
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ATTACHATTACHATTACHATTACHMENT CMENT CMENT CMENT 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
_________________________________ _________________________
Signature Date
Carlton B. Paylor, Sr.
_________________________________ _________________________
Signature Date
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ATTACHMENT D:ATTACHMENT D:ATTACHMENT D:ATTACHMENT D:
CONFLICT OF INTERESTCONFLICT OF INTERESTCONFLICT OF INTERESTCONFLICT 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.
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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
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
_________________________________ _________________________
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 ______________________, 2013.
___________________________
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
______________, 2013
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. 143-6.2(b2) is guilty of a criminal offense punishable as provided by N.C.G.S. 143-34(b).
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 ______________________, 2013.
___________________________
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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ATTACHMENTATTACHMENTATTACHMENTATTACHMENT G
PERSON COUNTY DEPARTMENT OF SOCIAL SERVICES
CERTIFICATION REGARDING LOBBYING
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 agency, a Member of Congress, an officer or employee of Congress, or an employee of a
Member of Congress in connection with the awarding of any Federal contract, continuation,
renewal, amendment, or modification of any Federal 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 agency, a
Member of Congress, an officer or employee of Congress, or an employee of a Member of
Congress in connection with this Federally funded contract, grant, loan, or cooperative
agreement, the undersigned shall complete and submit Standard Form SF-LLL, “Disclosure of
Lobbying Activities,” in accordance with its instructions.
3. The undersigned shall require that the language of this certification be included in the award
document for subawards at all tiers (including subcontracts, subgrants, and contracts under
grants, loans, and cooperative agreements) who receive federal funds of $100,000.00 or more
and that all subrecipients shall certify and disclose accordingly.
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 $10,000.00 and not more than $100,000.00 for each such failure.
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ATTACHMENTATTACHMENTATTACHMENTATTACHMENT 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.
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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
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.
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ATTACHMENTATTACHMENTATTACHMENTATTACHMENT I
PERSON COUNTY
DEPARTMENT OF SOCIAL SERVICES
BUSINESS ASSOCIATE ADDENDUM
This Agreement is made effective the 1st day of July, 2013, 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 (identify contract)
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.
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Thomas L. Fitzgerald
_________________________________ _________________________
Signature Date
NORTH CAROLINA
PERSON COUNTY
I, __________________________, a Notary Public of said county 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.
Sworn to and subscribed before me this _________ day of ______________________, 2013.
___________________________
Notary Public
My Commission expires: __________________
*****************************************************************************************
Carlton B. Paylor, Sr.
_________________________________ _________________________
Signature Date
NORTH CAROLINA
PERSON COUNTY
I, __________________________, a Notary Public of said county do hereby certify that Carlton B. Paylor, Sr.
personally appeared before me this date and acknowledged the due execution of the foregoing agreement for the purposes
therein expressed.
Sworn to and subscribed before me this _________ day of ______________________, 2013.
___________________________
Notary Public
My Commission expires: __________________
*****************************************************************************************
PERSON COUNTY
Jimmy B. Clayton
____________________________ _________________________
Chairman, County Commissioners Date
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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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Contract # 1006 Fiscal Year Begins July 1, 2013 Ends June 30, 2014
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 56565656----153 8949153 8949153 8949153 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)
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, 2013 and shall terminate on
June 30, 2014. 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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Reporting Requirements: Contractor shall comply with audit requirements as described in
N.C.G.S. § 143C-6-22 & 23 and OMB Circular A-133. 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.
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.
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Signature Warranty: The undersigned represent and warrant that they are authorized to bind
their principals to the terms of this agreement.
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.
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
Jimmy B. Clayton
____________________________ _________________________
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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ATTACHMENTATTACHMENTATTACHMENTATTACHMENT AAAA
General Terms and ConditionsGeneral Terms and ConditionsGeneral Terms and ConditionsGeneral Terms and Conditions
Relationships of the PartiesRelationships of the PartiesRelationships of the PartiesRelationships of the Parties
Independent Contractor: Independent Contractor: Independent Contractor: 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: Subcontracting: Subcontracting: 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: Assignment: Assignment: 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: Beneficiaries: Beneficiaries: 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 InsuranceIndemnity and InsuranceIndemnity and InsuranceIndemnity and Insurance
Indemnification: Indemnification: Indemnification: 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: Insurance: Insurance: 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 CompensationWorker’s CompensationWorker’s CompensationWorker’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 LiabilityCommercial General LiabilityCommercial General LiabilityCommercial 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.)
AutomobileAutomobileAutomobileAutomobile - Automobile Liability Insurance, to include liability coverage, covering all owned, hired and non-owned
vehicles used in performance of the contract. The minimum combined single limit shall be $500,000.00 bodily injury
and property damage; $500,000.00 uninsured/under insured motorist; and $25,000.00 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 ContractorTransportation of Clients by ContractorTransportation of Clients by ContractorTransportation 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.
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.
Default and TerminationDefault and TerminationDefault and TerminationDefault and Termination
Termination Without Cause:Termination Without Cause:Termination Without Cause:Termination Without Cause: The County may terminate this contract without cause by giving 30 days30 days30 days30 days written noticewritten noticewritten noticewritten notice to the
Contractor. 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.
Termination for Cause: Termination for Cause: Termination for Cause: 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.
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Waiver of Default: Waiver of Default: Waiver of Default: 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: Availability of Funds: Availability of Funds: 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: Force Majeure: Force Majeure: 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.
Survival of Promises: Survival of Promises: Survival of Promises: 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 RightsIntellectual Property RightsIntellectual Property RightsIntellectual Property Rights
Copyrights and Ownership of DeliverablesCopyrights and Ownership of DeliverablesCopyrights and Ownership of DeliverablesCopyrights 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 ProtectiFederal Intellectual Property Bankruptcy ProtectiFederal Intellectual Property Bankruptcy ProtectiFederal Intellectual Property Bankruptcy Protection Act:on Act:on Act:on 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 ApplicableCompliance with ApplicableCompliance with ApplicableCompliance with Applicable LawsLawsLawsLaws
Compliance with Laws: Compliance with Laws: Compliance with 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 ComplianceTitle VI, Civil Rights ComplianceTitle VI, Civil Rights ComplianceTitle 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: Equal Employment Opportunity: Equal Employment Opportunity: 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): Health Insurance Portability and Accountability Act (HIPAA): Health Insurance Portability and Accountability Act (HIPAA): 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.
Trafficking Victims Protection Act of 2000Trafficking Victims Protection Act of 2000Trafficking Victims Protection Act of 2000Trafficking 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: Executive Order # 24: Executive Order # 24: 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.
ConfidentialityConfidentialityConfidentialityConfidentiality
Confidentiality: Confidentiality: 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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OversightOversightOversightOversight
Access to Persons and Records: Access to Persons and Records: Access to Persons and Records: 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: Record Retention: Record Retention: Record Retention: Records shall not be destroyed, purged or disposed of without the express written consent of the County.
The Department of Health and Human Services' basic records retention policy requires all records to be retained for a
minimum of three years following completion or termination of the contract. If the contract is subject to Federal policy and
regulations, record retention will normally be longer than three 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 three 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 three year period described above, whichever is later.
Warranties and Certifications Warranties and Certifications Warranties and Certifications Warranties and Certifications
Date and Time Warranty:Date and Time Warranty:Date and Time Warranty: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 TaxesCertification Regarding Collection of TaxesCertification Regarding Collection of TaxesCertification 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.
MiscellaneousMiscellaneousMiscellaneousMiscellaneous
Choice of Law: Choice of Law: Choice of Law: 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 Wake County, North Carolina. The place of this
contract and all transactions and agreements relating to it, and their situs and forum, shall be Wake County, North Carolina,
where all matters, whether sounding in contract or tort, relating to the validity, construction, interpretation, and enforcement
shall be determined.
AmendmentAmendmentAmendmentAmendment: 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: Severability: Severability: 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.
Headings: Headings: Headings: 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 of the Essence: Time of the Essence: Time of the Essence: Time is of the essence in the performance of this contract.
Key Personnel: Key Personnel: Key Personnel: 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.
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Care of Property:Care of Property:Care of Property: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: Travel Expenses: Travel Expenses: 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: Sales/Use Tax Refunds: Sales/Use Tax Refunds: 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: Advertising: Advertising: 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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ATTAATTAATTAATTACHMENTCHMENTCHMENTCHMENT B B B B –––– Scope of Work Federal Tax Id. Scope of Work Federal Tax Id. Scope of Work Federal Tax Id. Scope of Work Federal Tax Id. 56565656----153 8949153 8949153 8949153 8949
NORTH CAROLINA
DUPLICATE ORIGINAL
PERSON COUNTY
LEGAL SERVICES AGREEMENT
THIS Agreement, made and entered into this the 1st day of July, 2013, 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, 2014. 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.
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ATTACHMENT CATTACHMENT CATTACHMENT CATTACHMENT 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.
_________________________________ _________________________
Signature Date
Carlton B. Paylor, Sr.
_________________________________ _________________________
Signature Date
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ATTACHMENT D:ATTACHMENT D:ATTACHMENT D:ATTACHMENT D:
CONFLICT OF INTERESTCONFLICT OF INTERESTCONFLICT OF INTERESTCONFLICT 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.
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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
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 ______________________, 2013.
___________________________
Notary Public
My Commission expires: __________________
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ATTACHMENT E – OVERDUE TAXES
Joe Weinberger, Jr.Joe Weinberger, Jr.Joe Weinberger, Jr.Joe Weinberger, Jr.
Attorney and Counselor at LawAttorney and Counselor at LawAttorney and Counselor at LawAttorney 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
______________, 2013
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. 143-6.2(b2) is guilty of a criminal offense punishable as provided by N.C.G.S. 143-
34(b).
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 ______________________, 2013.
___________________________
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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ATTACHMENTATTACHMENTATTACHMENTATTACHMENT G
PERSON COUNTY DEPARTMENT OF SOCIAL SERVICES
CERTIFICATION REGARDING LOBBYING
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 agency, a Member of Congress, an officer or employee of Congress, or an employee of a
Member of Congress in connection with the awarding of any Federal contract, continuation,
renewal, amendment, or modification of any Federal 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 agency, a
Member of Congress, an officer or employee of Congress, or an employee of a Member of
Congress in connection with this Federally funded contract, grant, loan, or cooperative
agreement, the undersigned shall complete and submit Standard Form SF-LLL, “Disclosure of
Lobbying Activities,” in accordance with its instructions.
3. The undersigned shall require that the language of this certification be included in the award
document for subawards at all tiers (including subcontracts, subgrants, and contracts under
grants, loans, and cooperative agreements) who receive federal funds of $100,000.00 or more
and that all subrecipients shall certify and disclose accordingly.
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 $10,000.00 and not more than $100,000.00 for each such failure.
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ATTACHMENTATTACHMENTATTACHMENTATTACHMENT 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.
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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
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.
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ATTACHMENTATTACHMENTATTACHMENTATTACHMENT I
PERSON COUNTY
DEPARTMENT OF SOCIAL SERVICES
BUSINESS ASSOCIATE ADDENDUM
This Agreement is made effective the 1st day of July, 2013, 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 (identify contract)
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.
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Joseph Weinberger, Jr.
_________________________________ _________________________
Signature Date
NORTH CAROLINA
PERSON COUNTY
I, __________________________, a Notary Public of said county 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.
Sworn to and subscribed before me this _________ day of ______________________, 2013.
___________________________
Notary Public
My Commission expires: __________________
*****************************************************************************************
Carlton B. Paylor, Sr.
_________________________________ _________________________
Signature Date
NORTH CAROLINA
PERSON COUNTY
I, __________________________, a Notary Public of said county do hereby certify that Carlton B. Paylor, Sr.
personally appeared before me this date and acknowledged the due execution of the foregoing agreement for the purposes
therein expressed.
Sworn to and subscribed before me this _________ day of ______________________, 2013.
___________________________
Notary Public
My Commission expires: __________________
*****************************************************************************************
PERSON COUNTY
Jimmy B. Clayton
____________________________ _________________________
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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Page 1
Contract # 1010 Fiscal Year Begins July 1, 2013 Ends June 30, 2014
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 56565656----135 0472135 0472135 0472135 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)
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, 2013 and shall terminate on
June 30, 2014. 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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Reporting Requirements: Contractor shall comply with audit requirements as described in
N.C.G.S. § 143C-6-22 & 23 and OMB Circular A-133. 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.
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.
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Signature Warranty: The undersigned represent and warrant that they are authorized to bind
their principals to the terms of this agreement.
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.
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
Jimmy B. Clayton
____________________________ _________________________
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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ATTACHMENTATTACHMENTATTACHMENTATTACHMENT AAAA
General Terms and ConditionsGeneral Terms and ConditionsGeneral Terms and ConditionsGeneral Terms and Conditions
Relationships of the PartiesRelationships of the PartiesRelationships of the PartiesRelationships of the Parties
Independent Contractor: Independent Contractor: Independent Contractor: 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: Subcontracting: Subcontracting: 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: Assignment: Assignment: 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: Beneficiaries: Beneficiaries: 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 InsuranceIndemnity and InsuranceIndemnity and InsuranceIndemnity and Insurance
Indemnification: Indemnification: Indemnification: 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: Insurance: Insurance: 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 CompensationWorker’s CompensationWorker’s CompensationWorker’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 LiabilityCommercial General LiabilityCommercial General LiabilityCommercial 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.)
AutomobileAutomobileAutomobileAutomobile - Automobile Liability Insurance, to include liability coverage, covering all owned, hired and non-owned
vehicles used in performance of the contract. The minimum combined single limit shall be $500,000.00 bodily injury
and property damage; $500,000.00 uninsured/under insured motorist; and $25,000.00 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 ContractorTransportation of Clients by ContractorTransportation of Clients by ContractorTransportation 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.
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.
DefaulDefaulDefaulDefault and Terminationt and Terminationt and Terminationt and Termination
Termination Without Cause:Termination Without Cause:Termination Without Cause:Termination Without Cause: The County may terminate this contract without cause by giving 30 days30 days30 days30 days written noticewritten noticewritten noticewritten notice to the
Contractor. 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.
TerminatioTerminatioTerminatioTermination for Cause: n for Cause: n for Cause: n 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.
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Waiver of Default: Waiver of Default: Waiver of Default: 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 oAvailability oAvailability oAvailability of Funds: f Funds: f Funds: f 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.
FoFoFoForce Majeure: rce Majeure: rce Majeure: rce 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.
Survival of Promises: Survival of Promises: Survival of Promises: 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 RightsIntellectual Property RightsIntellectual Property RightsIntellectual Property Rights
Copyrights and Ownership of Deliverables:Copyrights and Ownership of Deliverables:Copyrights and Ownership of Deliverables: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:Federal Intellectual Property Bankruptcy Protection Act:Federal Intellectual Property Bankruptcy Protection Act: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 LawsCompliance with Applicable LawsCompliance with Applicable LawsCompliance with Applicable Laws
Compliance with Laws: Compliance with Laws: Compliance with 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 VITitle VITitle VITitle VI, Civil Rights Compliance, Civil Rights Compliance, Civil Rights Compliance, 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: Equal Employment Opportunity: Equal Employment Opportunity: 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): Health Insurance Portability and Accountability Act (HIPAA): Health Insurance Portability and Accountability Act (HIPAA): 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.
TraffickiTraffickiTraffickiTrafficking Victims Protection Act of 2000ng Victims Protection Act of 2000ng Victims Protection Act of 2000ng 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: Executive Order # 24: Executive Order # 24: 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.
ConfidentiConfidentiConfidentiConfidentialityalityalityality
Confidentiality: Confidentiality: 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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OversightOversightOversightOversight
Access to Persons and Records: Access to Persons and Records: Access to Persons and Records: 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 Record Record Record Retention: Retention: Retention: Retention: Records shall not be destroyed, purged or disposed of without the express written consent of the County.
The Department of Health and Human Services' basic records retention policy requires all records to be retained for a
minimum of three years following completion or termination of the contract. If the contract is subject to Federal policy and
regulations, record retention will normally be longer than three 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 three 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 three year period described above, whichever is later.
Warranties and Certifications Warranties and Certifications Warranties and Certifications Warranties and Certifications
Date and Time Warranty:Date and Time Warranty:Date and Time Warranty: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 TaxesCertification Regarding Collection of TaxesCertification Regarding Collection of TaxesCertification 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.
MiscellaneousMiscellaneousMiscellaneousMiscellaneous
Choice of Law: Choice of Law: Choice of Law: 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 Wake County, North Carolina. The place of this
contract and all transactions and agreements relating to it, and their situs and forum, shall be Wake County, North Carolina,
where all matters, whether sounding in contract or tort, relating to the validity, construction, interpretation, and enforcement
shall be determined.
AmendmentAmendmentAmendmentAmendment: 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: Severability: Severability: 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.
Headings: Headings: Headings: 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 of the Essence: Time of the Essence: Time of the Essence: Time is of the essence in the performance of this contract.
Key Personnel: Key Personnel: Key Personnel: 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.
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Care of Property:Care of Property:Care of Property: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: Travel Expenses: Travel Expenses: 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: Sales/Use Tax Refunds: Sales/Use Tax Refunds: 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: Advertising: Advertising: 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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ATTACHMENTATTACHMENTATTACHMENTATTACHMENT B B B B –––– Scope of Work FedScope of Work FedScope of Work FedScope of Work Federal Tax Id. eral Tax Id. eral Tax Id. eral Tax Id. 56565656----135 0472135 0472135 0472135 0472
NORTH CAROLINA
DUPLICATE ORIGINAL
PERSON COUNTY
LEGAL SERVICES AGREEMENT
THIS Agreement, made and entered into this the 1st day of July, 2013, 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, 2014. 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.
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ATTACHMENT CATTACHMENT CATTACHMENT CATTACHMENT 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
_________________________________ _________________________
Signature Date
Carlton B. Paylor, Sr.
_________________________________ _________________________
Signature Date
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ATTACHMENT D:ATTACHMENT D:ATTACHMENT D:ATTACHMENT D:
CONFLICT OF INTERESTCONFLICT OF INTERESTCONFLICT OF INTERESTCONFLICT 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.
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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
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 ______________________, 2013.
___________________________
Notary Public
My Commission expires: __________________
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ATTACHMENT E – OVERDUE TAXES
______________, 2013
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. 143-6.2(b2) is guilty of a criminal offense punishable as provided by N.C.G.S. 143-34(b).
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 ______________________, 2013.
___________________________
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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ATTACHMENTATTACHMENTATTACHMENTATTACHMENT G
PERSON COUNTY DEPARTMENT OF SOCIAL SERVICES
CERTIFICATION REGARDING LOBBYING
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 agency, a Member of Congress, an officer or employee of Congress, or an employee of a
Member of Congress in connection with the awarding of any Federal contract, continuation,
renewal, amendment, or modification of any Federal 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 agency, a
Member of Congress, an officer or employee of Congress, or an employee of a Member of
Congress in connection with this Federally funded contract, grant, loan, or cooperative
agreement, the undersigned shall complete and submit Standard Form SF-LLL, “Disclosure of
Lobbying Activities,” in accordance with its instructions.
3. The undersigned shall require that the language of this certification be included in the award
document for subawards at all tiers (including subcontracts, subgrants, and contracts under
grants, loans, and cooperative agreements) who receive federal funds of $100,000.00 or more
and that all subrecipients shall certify and disclose accordingly.
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 $10,000.00 and not more than $100,000.00 for each such failure.
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ATTACHMENTATTACHMENTATTACHMENTATTACHMENT 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.
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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
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.
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ATTACHMENTATTACHMENTATTACHMENTATTACHMENT I
PERSON COUNTY
DEPARTMENT OF SOCIAL SERVICES
BUSINESS ASSOCIATE ADDENDUM
This Agreement is made effective the 1st day of July, 2013, 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 (identify contract)
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, 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.
b. Except as otherwise limited in this Agreement or by other applicable law or agreements, if the
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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.
2) In the event that Business Associate determines that returning or destroying the
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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.
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Walter B. Cates
_________________________________ _________________________
Signature Date
NORTH CAROLINA
PERSON COUNTY
I, __________________________, a Notary Public of said county 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.
Sworn to and subscribed before me this _________ day of ______________________, 2013.
___________________________
Notary Public
My Commission expires: __________________
*****************************************************************************************
Carlton B. Paylor, Sr.
_________________________________ _________________________
Signature Date
NORTH CAROLINA
PERSON COUNTY
I, __________________________, a Notary Public of said county do hereby certify that Carlton B. Paylor, Sr.
personally appeared before me this date and acknowledged the due execution of the foregoing agreement for the purposes
therein expressed.
Sworn to and subscribed before me this _________ day of ______________________, 2013.
___________________________
Notary Public
My Commission expires: __________________
*****************************************************************************************
PERSON COUNTY
Jimmy B. Clayton
____________________________ _________________________
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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Contract # 1012
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Page 1
Contract # 1012 Fiscal Year Begins July 1, 2013 Ends June 30, 2014
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 56565656----199 9585199 9585199 9585199 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)
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, 2013 and shall terminate on
June 30, 2014. 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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Reporting Requirements: Contractor shall comply with audit requirements as described in
N.C.G.S. § 143C-6-22 & 23 and OMB Circular A-133. 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 601
355B South Madison Boulevard 25 Abbitt Avenue
Roxboro, NC 27573 Roxboro, NC 27573
(336) 599-8361 (336) 599-3193
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.
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.
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Signature Warranty: The undersigned represent and warrant that they are authorized to bind
their principals to the terms of this agreement.
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.
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
Jimmy B. Clayton
____________________________ _________________________
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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ATTACHMENTATTACHMENTATTACHMENTATTACHMENT AAAA
General Terms and ConditionsGeneral Terms and ConditionsGeneral Terms and ConditionsGeneral Terms and Conditions
Relationships of the PartiesRelationships of the PartiesRelationships of the PartiesRelationships of the Parties
Independent Contractor: Independent Contractor: Independent Contractor: 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: Subcontracting: Subcontracting: 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: Assignment: Assignment: 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: Beneficiaries: Beneficiaries: 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 InsuranceIndemnity and InsuranceIndemnity and InsuranceIndemnity and Insurance
Indemnification: Indemnification: Indemnification: 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: Insurance: Insurance: 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 CompensationWorker’s CompensationWorker’s CompensationWorker’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 her employees engaged in any work under the
contract.
Commercial General LiabilityCommercial General LiabilityCommercial General LiabilityCommercial 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.)
AutomobileAutomobileAutomobileAutomobile - Automobile Liability Insurance, to include liability coverage, covering all owned, hired and non-owned
vehicles used in performance of the contract. The minimum combined single limit shall be $500,000.00 bodily injury
and property damage; $500,000.00 uninsured/under insured motorist; and $25,000.00 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 ContractorTransportation of Clients by ContractorTransportation of Clients by ContractorTransportation 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.
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.
DefaulDefaulDefaulDefault and Terminationt and Terminationt and Terminationt and Termination
Termination Without Cause:Termination Without Cause:Termination Without Cause:Termination Without Cause: The County may terminate this contract without cause by giving 30 days30 days30 days30 days written noticewritten noticewritten noticewritten notice to the
Contractor. 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.
TerminatioTerminatioTerminatioTermination for Cause: n for Cause: n for Cause: n 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.
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Waiver of Default: Waiver of Default: Waiver of Default: 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 oAvailability oAvailability oAvailability of Funds: f Funds: f Funds: f 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.
FoFoFoForce Majeure: rce Majeure: rce Majeure: rce 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.
Survival of Promises: Survival of Promises: Survival of Promises: 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 RightsIntellectual Property RightsIntellectual Property RightsIntellectual Property Rights
Copyrights and Ownership of Deliverables:Copyrights and Ownership of Deliverables:Copyrights and Ownership of Deliverables: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:Federal Intellectual Property Bankruptcy Protection Act:Federal Intellectual Property Bankruptcy Protection Act: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 LawsCompliance with Applicable LawsCompliance with Applicable LawsCompliance with Applicable Laws
Compliance with Laws: Compliance with Laws: Compliance with 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 VITitle VITitle VITitle VI, Civil Rights Compliance, Civil Rights Compliance, Civil Rights Compliance, 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: Equal Employment Opportunity: Equal Employment Opportunity: 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): Health Insurance Portability and Accountability Act (HIPAA): Health Insurance Portability and Accountability Act (HIPAA): 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.
TraffickiTraffickiTraffickiTrafficking Victims Protection Act of 2000ng Victims Protection Act of 2000ng Victims Protection Act of 2000ng 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: Executive Order # 24: Executive Order # 24: 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.
ConfidentiConfidentiConfidentiConfidentialityalityalityality
Confidentiality: Confidentiality: 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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OversightOversightOversightOversight
Access to Persons and Records: Access to Persons and Records: Access to Persons and Records: 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 Record Record Record Retention: Retention: Retention: Retention: Records shall not be destroyed, purged or disposed of without the express written consent of the County.
The Department of Health and Human Services' basic records retention policy requires all records to be retained for a
minimum of three years following completion or termination of the contract. If the contract is subject to Federal policy and
regulations, record retention will normally be longer than three 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 three 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 three year period described above, whichever is later.
Warranties and Certifications Warranties and Certifications Warranties and Certifications Warranties and Certifications
Date and Time Warranty:Date and Time Warranty:Date and Time Warranty: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 TaxesCertification Regarding Collection of TaxesCertification Regarding Collection of TaxesCertification 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.
MiscellaneousMiscellaneousMiscellaneousMiscellaneous
Choice of Law: Choice of Law: Choice of Law: 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 Wake County, North Carolina. The place of this
contract and all transactions and agreements relating to it, and their situs and forum, shall be Wake County, North Carolina,
where all matters, whether sounding in contract or tort, relating to the validity, construction, interpretation, and enforcement
shall be determined.
AmendmentAmendmentAmendmentAmendment: 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: Severability: Severability: 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.
Headings: Headings: Headings: 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 of the Essence: Time of the Essence: Time of the Essence: Time is of the essence in the performance of this contract.
Key Personnel: Key Personnel: Key Personnel: 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.
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Care of Property:Care of Property:Care of Property: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:Travel Expenses:Travel Expenses: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: Sales/Use Tax Refunds: Sales/Use Tax Refunds: 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: Advertising: Advertising: 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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ATTACHMENTATTACHMENTATTACHMENTATTACHMENT B B B B –––– Scope of Work FeScope of Work FeScope of Work FeScope of Work Federal Tax Id. deral Tax Id. deral Tax Id. deral Tax Id. 56565656----199 9585199 9585199 9585199 9585
NORTH CAROLINA
DUPLICATE ORIGINAL
PERSON COUNTY
LEGAL SERVICES AGREEMENT
THIS Agreement, made and entered into this the 1st day of July, 2013, 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, 2014. 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.
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ATTACHMENT CATTACHMENT CATTACHMENT CATTACHMENT 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:
25 Abbitt Avenue, 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
_________________________________ _________________________
Signature Date
Carlton B. Paylor, Sr.
_________________________________ _________________________
Signature Date
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ATTACHMENT D:ATTACHMENT D:ATTACHMENT D:ATTACHMENT D:
CONFLICT OF INTERESTCONFLICT OF INTERESTCONFLICT OF INTERESTCONFLICT 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 her
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.
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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
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
_________________________________ _________________________
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 ______________________, 2013.
___________________________
Notary Public
My Commission expires: __________________
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ATTACHMENT E – OVERDUE TAXES
______________, 2013
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. 143-6.2(b2) is guilty of a criminal offense punishable as provided by N.C.G.S. 143-34(b).
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 ______________________, 2013.
___________________________
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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ATTACHMENTATTACHMENTATTACHMENTATTACHMENT G
PERSON COUNTY DEPARTMENT OF SOCIAL SERVICES
CERTIFICATION REGARDING LOBBYING
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 agency, a Member of Congress, an officer or employee of Congress, or an employee of a
Member of Congress in connection with the awarding of any Federal contract, continuation,
renewal, amendment, or modification of any Federal 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 agency, a
Member of Congress, an officer or employee of Congress, or an employee of a Member of
Congress in connection with this Federally funded contract, grant, loan, or cooperative
agreement, the undersigned shall complete and submit Standard Form SF-LLL, “Disclosure of
Lobbying Activities,” in accordance with its instructions.
3. The undersigned shall require that the language of this certification be included in the award
document for subawards at all tiers (including subcontracts, subgrants, and contracts under
grants, loans, and cooperative agreements) who receive federal funds of $100,000.00 or more
and that all subrecipients shall certify and disclose accordingly.
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 $10,000.00 and not more than $100,000.00 for each such failure.
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ATTACHMENTATTACHMENTATTACHMENTATTACHMENT 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.
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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
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.
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ATTACHMENTATTACHMENTATTACHMENTATTACHMENT I
PERSON COUNTY
DEPARTMENT OF SOCIAL SERVICES
BUSINESS ASSOCIATE ADDENDUM
This Agreement is made effective the 1st day of July, 2013, 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 (identify contract)
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.
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Julie A. Ramsey
_________________________________ _________________________
Signature Date
NORTH CAROLINA
PERSON COUNTY
I, __________________________, a Notary Public of said county 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.
Sworn to and subscribed before me this _________ day of ______________________, 2013.
___________________________
Notary Public
My Commission expires: __________________
*****************************************************************************************
Carlton B. Paylor, Sr.
_________________________________ _________________________
Signature Date
NORTH CAROLINA
PERSON COUNTY
I, __________________________, a Notary Public of said county do hereby certify that Carlton B. Paylor, Sr.
personally appeared before me this date and acknowledged the due execution of the foregoing agreement for the purposes
therein expressed.
Sworn to and subscribed before me this _________ day of ______________________, 2013.
___________________________
Notary Public
My Commission expires: __________________
*****************************************************************************************
PERSON COUNTY
Jimmy B. Clayton
____________________________ _________________________
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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Contract # 1009 Fiscal Year Begins July 1, 2013 Ends June 30, 2014
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 20202020----2272227222722272----781781781781....
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)
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, 2013 and shall terminate on
June 30, 2014. 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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Reporting Requirements: Contractor shall comply with audit requirements as described in
N.C.G.S. § 143C-6-22 & 23 and OMB Circular A-133. 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.
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.
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Signature Warranty: The undersigned represent and warrant that they are authorized to bind
their principals to the terms of this agreement.
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.
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
Jimmy B. Clayton
____________________________ _________________________
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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ATTACHMENTATTACHMENTATTACHMENTATTACHMENT AAAA
General Terms and ConditionsGeneral Terms and ConditionsGeneral Terms and ConditionsGeneral Terms and Conditions
Relationships of the PartiesRelationships of the PartiesRelationships of the PartiesRelationships of the Parties
Independent Contractor: Independent Contractor: Independent Contractor: 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: Subcontracting: Subcontracting: 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: Assignment: Assignment: 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: Beneficiaries: Beneficiaries: 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 InsuranceIndemnity and InsuranceIndemnity and InsuranceIndemnity and Insurance
Indemnification: Indemnification: Indemnification: 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: Insurance: Insurance: 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 CompensationWorker’s CompensationWorker’s CompensationWorker’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 LiabilityCommercial General LiabilityCommercial General LiabilityCommercial 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.)
AutomobileAutomobileAutomobileAutomobile - Automobile Liability Insurance, to include liability coverage, covering all owned, hired and non-owned
vehicles used in performance of the contract. The minimum combined single limit shall be $500,000.00 bodily injury
and property damage; $500,000.00 uninsured/under insured motorist; and $25,000.00 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 ContractorTransportation of Clients by ContractorTransportation of Clients by ContractorTransportation 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.
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.
Default and TerminationDefault and TerminationDefault and TerminationDefault and Termination
Termination Without Cause:Termination Without Cause:Termination Without Cause:Termination Without Cause: The County may terminate this contract without cause by giving 30 days30 days30 days30 days written noticewritten noticewritten noticewritten notice to the
Contractor. 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.
Termination for Cause: Termination for Cause: Termination for Cause: 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.
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Waiver of Default: Waiver of Default: Waiver of Default: 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: Availability of Funds: Availability of Funds: 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: Force Majeure: Force Majeure: 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.
Survival of Promises: Survival of Promises: Survival of Promises: 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 RightsIntellectual Property RightsIntellectual Property RightsIntellectual Property Rights
Copyrights and Ownership of Deliverables:Copyrights and Ownership of Deliverables:Copyrights and Ownership of Deliverables: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:Federal Intellectual Property Bankruptcy Protection Act:Federal Intellectual Property Bankruptcy Protection Act: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 LawsCompliance with Applicable LawsCompliance with Applicable LawsCompliance with Applicable Laws
CompliCompliCompliCompliance with Laws: ance with Laws: ance with Laws: ance 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 ComplianceTitle VI, Civil Rights ComplianceTitle VI, Civil Rights ComplianceTitle 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: Equal Employment Opportunity: Equal Employment Opportunity: 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): Health Insurance Portability and Accountability Act (HIPAA): Health Insurance Portability and Accountability Act (HIPAA): 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.
Trafficking Victims Protection Act of 2000Trafficking Victims Protection Act of 2000Trafficking Victims Protection Act of 2000Trafficking 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: Executive Order # 24: Executive Order # 24: 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.
ConfidentialityConfidentialityConfidentialityConfidentiality
Confidentiality: Confidentiality: 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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OversightOversightOversightOversight
Access to Persons and Records: Access to Persons and Records: Access to Persons and Records: 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: Record Retention: Record Retention: Record Retention: Records shall not be destroyed, purged or disposed of without the express written consent of the County.
The Department of Health and Human Services' basic records retention policy requires all records to be retained for a
minimum of three years following completion or termination of the contract. If the contract is subject to Federal policy and
regulations, record retention will normally be longer than three 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 three 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 three year period described above, whichever is later.
Warranties and Certifications Warranties and Certifications Warranties and Certifications Warranties and Certifications
Date and Time Warranty:Date and Time Warranty:Date and Time Warranty: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 TaxesCertification Regarding Collection of TaxesCertification Regarding Collection of TaxesCertification 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.
MiscellaneousMiscellaneousMiscellaneousMiscellaneous
Choice of Law: Choice of Law: Choice of Law: 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 Wake County, North Carolina. The place of this
contract and all transactions and agreements relating to it, and their situs and forum, shall be Wake County, North Carolina,
where all matters, whether sounding in contract or tort, relating to the validity, construction, interpretation, and enforcement
shall be determined.
AmendmentAmendmentAmendmentAmendment: 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: Severability: Severability: 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.
Headings: Headings: Headings: 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 of the Essence: Time of the Essence: Time of the Essence: Time is of the essence in the performance of this contract.
Key Personnel: Key Personnel: Key Personnel: 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.
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Care of Property:Care of Property:Care of Property: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: Travel Expenses: Travel Expenses: 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: Sales/Use Tax Refunds: Sales/Use Tax Refunds: 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: Advertising: Advertising: 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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ATTACHMENTATTACHMENTATTACHMENTATTACHMENT B B B B –––– SSSScope of Work Federal Tax Id. cope of Work Federal Tax Id. cope of Work Federal Tax Id. cope of Work Federal Tax Id. 20202020----2272227222722272----781781781781
STATE OF NORTH CAROLINA )
)
) CONTRACT FOR LEGAL SERVICES
)
COUNTY OF Person )
THIS CONTRACT made and entered into this the 1st day of July, 2013, 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, 2013, and unless sooner terminated by 30
days’ notice of either party shall exist and continue through June 30, 2014.
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.
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ATTACHMENT CATTACHMENT CATTACHMENT CATTACHMENT 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
_________________________________ _________________________
Signature Date
Carlton B. Paylor, Sr.
_________________________________ _________________________
Signature Date
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ATTACHMENT D:ATTACHMENT D:ATTACHMENT D:ATTACHMENT D:
CONFLICT OF INTERESTCONFLICT OF INTERESTCONFLICT OF INTERESTCONFLICT 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
_________________________________ _________________________
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 ______________________, 2013.
___________________________
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
______________, 2013
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. 143-6.2(b2) is guilty of a criminal offense punishable as provided by N.C.G.S. 143-34(b).
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 ______________________, 2013.
___________________________
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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ATTACHMENTATTACHMENTATTACHMENTATTACHMENT G
PERSON COUNTY DEPARTMENT OF SOCIAL SERVICES
CERTIFICATION REGARDING LOBBYING
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 agency, a Member of Congress, an officer or employee of Congress, or an employee of a
Member of Congress in connection with the awarding of any Federal contract, continuation,
renewal, amendment, or modification of any Federal 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 agency, a
Member of Congress, an officer or employee of Congress, or an employee of a Member of
Congress in connection with this Federally funded contract, grant, loan, or cooperative
agreement, the undersigned shall complete and submit Standard Form SF-LLL, “Disclosure of
Lobbying Activities,” in accordance with its instructions.
3. The undersigned shall require that the language of this certification be included in the award
document for subawards at all tiers (including subcontracts, subgrants, and contracts under
grants, loans, and cooperative agreements) who receive federal funds of $100,000.00 or more
and that all subrecipients shall certify and disclose accordingly.
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 $10,000.00 and not more than $100,000.00 for each such failure.
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ATTACHMENTATTACHMENTATTACHMENTATTACHMENT 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.
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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
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.
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ATTACHMENTATTACHMENTATTACHMENTATTACHMENT I
PERSON COUNTY
DEPARTMENT OF SOCIAL SERVICES
BUSINESS ASSOCIATE ADDENDUM
This Agreement is made effective the 1st day of July, 2013, 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 (identify contract)
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.
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Thomas L. Fitzgerald
_________________________________ _________________________
Signature Date
NORTH CAROLINA
PERSON COUNTY
I, __________________________, a Notary Public of said county 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.
Sworn to and subscribed before me this _________ day of ______________________, 2013.
___________________________
Notary Public
My Commission expires: __________________
*****************************************************************************************
Carlton B. Paylor, Sr.
_________________________________ _________________________
Signature Date
NORTH CAROLINA
PERSON COUNTY
I, __________________________, a Notary Public of said county do hereby certify that Carlton B. Paylor, Sr.
personally appeared before me this date and acknowledged the due execution of the foregoing agreement for the purposes
therein expressed.
Sworn to and subscribed before me this _________ day of ______________________, 2013.
___________________________
Notary Public
My Commission expires: __________________
*****************************************************************************************
PERSON COUNTY
Jimmy B. Clayton
____________________________ _________________________
Chairman, County Commissioners Date
*****************************************************************************************
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal
Control Act.
______________________________ ___________________________
Signature of County Finance Officer Date
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Contract # 1007 Fiscal Year Begins July 1, 2013 Ends June 30, 2014
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 56565656----153 8949153 8949153 8949153 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)
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, 2013 and shall terminate on
June 30, 2014. 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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Reporting Requirements: Contractor shall comply with audit requirements as described in
N.C.G.S. § 143C-6-22 & 23 and OMB Circular A-133. 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.
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.
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Signature Warranty: The undersigned represent and warrant that they are authorized to bind
their principals to the terms of this agreement.
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.
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
Jimmy B. Clayton
____________________________ _________________________
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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ATTACHMENTATTACHMENTATTACHMENTATTACHMENT AAAA
General Terms and ConditionsGeneral Terms and ConditionsGeneral Terms and ConditionsGeneral Terms and Conditions
Relationships of the PartiesRelationships of the PartiesRelationships of the PartiesRelationships of the Parties
Independent Contractor: Independent Contractor: Independent Contractor: 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: Subcontracting: Subcontracting: 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: Assignment: Assignment: 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: Beneficiaries: Beneficiaries: 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 InsuranceIndemnity and InsuranceIndemnity and InsuranceIndemnity and Insurance
Indemnification: Indemnification: Indemnification: 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: Insurance: Insurance: 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 CompensationWorker’s CompensationWorker’s CompensationWorker’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 LiabilityCommercial General LiabilityCommercial General LiabilityCommercial 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.)
AutomobileAutomobileAutomobileAutomobile - Automobile Liability Insurance, to include liability coverage, covering all owned, hired and non-owned
vehicles used in performance of the contract. The minimum combined single limit shall be $500,000.00 bodily injury
and property damage; $500,000.00 uninsured/under insured motorist; and $25,000.00 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 ContractorTransportation of Clients by ContractorTransportation of Clients by ContractorTransportation 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.
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.
Default and TerminationDefault and TerminationDefault and TerminationDefault and Termination
Termination Without Cause:Termination Without Cause:Termination Without Cause:Termination Without Cause: The County may terminate this contract without cause by giving 30 days30 days30 days30 days written noticewritten noticewritten noticewritten notice to the
Contractor. 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.
Termination for Cause: Termination for Cause: Termination for Cause: 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.
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Waiver of Default: Waiver of Default: Waiver of Default: 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: Availability of Funds: Availability of Funds: 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: Force Majeure: Force Majeure: 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.
Survival of Promises: Survival of Promises: Survival of Promises: 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 RightsIntellectual Property RightsIntellectual Property RightsIntellectual Property Rights
Copyrights and Ownership of DeliverablCopyrights and Ownership of DeliverablCopyrights and Ownership of DeliverablCopyrights and Ownership of Deliverables:es:es:es: 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 ProtecFederal Intellectual Property Bankruptcy ProtecFederal Intellectual Property Bankruptcy ProtecFederal Intellectual Property Bankruptcy Protection Act:tion Act:tion Act:tion 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 ApplicabCompliance with ApplicabCompliance with ApplicabCompliance with Applicable Lawsle Lawsle Lawsle Laws
Compliance with Laws: Compliance with Laws: Compliance with 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 ComplianceTitle VI, Civil Rights ComplianceTitle VI, Civil Rights ComplianceTitle 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: Equal Employment Opportunity: Equal Employment Opportunity: 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): Health Insurance Portability and Accountability Act (HIPAA): Health Insurance Portability and Accountability Act (HIPAA): 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.
Trafficking Victims Protection Act of 2000Trafficking Victims Protection Act of 2000Trafficking Victims Protection Act of 2000Trafficking 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: Executive Order # 24: Executive Order # 24: 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.
ConfidentialityConfidentialityConfidentialityConfidentiality
Confidentiality: Confidentiality: 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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OversightOversightOversightOversight
Access to Persons and Records: Access to Persons and Records: Access to Persons and Records: 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: Record Retention: Record Retention: Record Retention: Records shall not be destroyed, purged or disposed of without the express written consent of the County.
The Department of Health and Human Services' basic records retention policy requires all records to be retained for a
minimum of three years following completion or termination of the contract. If the contract is subject to Federal policy and
regulations, record retention will normally be longer than three 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 three 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 three year period described above, whichever is later.
Warranties and Certifications Warranties and Certifications Warranties and Certifications Warranties and Certifications
Date and Time Warranty:Date and Time Warranty:Date and Time Warranty: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 TaxesCertification Regarding Collection of TaxesCertification Regarding Collection of TaxesCertification 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.
MiscellaneousMiscellaneousMiscellaneousMiscellaneous
Choice of Law: Choice of Law: Choice of Law: 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 Wake County, North Carolina. The place of this
contract and all transactions and agreements relating to it, and their situs and forum, shall be Wake County, North Carolina,
where all matters, whether sounding in contract or tort, relating to the validity, construction, interpretation, and enforcement
shall be determined.
AmendmentAmendmentAmendmentAmendment: 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: Severability: Severability: 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.
Headings: Headings: Headings: 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 of the Essence: Time of the Essence: Time of the Essence: Time is of the essence in the performance of this contract.
Key Personnel: Key Personnel: Key Personnel: 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.
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Care of Property:Care of Property:Care of Property: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: Travel Expenses: Travel Expenses: 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 RefundsSales/Use Tax RefundsSales/Use Tax RefundsSales/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: Advertising: Advertising: 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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ATATATATTACHMENTTACHMENTTACHMENTTACHMENT B B B B –––– Scope of Work Federal Tax Id. Scope of Work Federal Tax Id. Scope of Work Federal Tax Id. Scope of Work Federal Tax Id. 56565656----153 8949153 8949153 8949153 8949
STATE OF NORTH CAROLINA )
)
) CONTRACT FOR LEGAL SERVICES
)
COUNTY OF Person )
THIS CONTRACT made and entered into this the 1st day of July, 2013, 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, 2013, and unless sooner terminated by 30
days’ notice of either party shall exist and continue through June 30, 2014.
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
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services provided by the attorney under this agreement.
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.
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ATTACHMENT CATTACHMENT CATTACHMENT CATTACHMENT 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.
_________________________________ _________________________
Signature Date
Carlton B. Paylor, Sr.
_________________________________ _________________________
Signature Date
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AAAATTACHMENT D:TTACHMENT D:TTACHMENT D:TTACHMENT D:
CONFLICT OF INTERESTCONFLICT OF INTERESTCONFLICT OF INTERESTCONFLICT 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 ______________________, 2013.
___________________________
Notary Public
My Commission expires: __________________
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ATTACHMENT E – OVERDUE TAXES
Joe Weinberger, Jr.Joe Weinberger, Jr.Joe Weinberger, Jr.Joe Weinberger, Jr.
Attorney and Counselor at LawAttorney and Counselor at LawAttorney and Counselor at LawAttorney 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
______________, 2013
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. 143-6.2(b2) is guilty of a criminal offense punishable as provided by N.C.G.S. 143-
34(b).
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 ______________________, 2013.
___________________________
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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ATTACHMENTATTACHMENTATTACHMENTATTACHMENT G
PERSON COUNTY DEPARTMENT OF SOCIAL SERVICES
CERTIFICATION REGARDING LOBBYING
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 agency, a Member of Congress, an officer or employee of Congress, or an employee of a
Member of Congress in connection with the awarding of any Federal contract, continuation,
renewal, amendment, or modification of any Federal 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 agency, a
Member of Congress, an officer or employee of Congress, or an employee of a Member of
Congress in connection with this Federally funded contract, grant, loan, or cooperative
agreement, the undersigned shall complete and submit Standard Form SF-LLL, “Disclosure of
Lobbying Activities,” in accordance with its instructions.
3. The undersigned shall require that the language of this certification be included in the award
document for subawards at all tiers (including subcontracts, subgrants, and contracts under
grants, loans, and cooperative agreements) who receive federal funds of $100,000.00 or more
and that all subrecipients shall certify and disclose accordingly.
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 $10,000.00 and not more than $100,000.00 for each such failure.
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ATTACHMENTATTACHMENTATTACHMENTATTACHMENT 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.
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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
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.
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ATTACHMENTATTACHMENTATTACHMENTATTACHMENT I
PERSON COUNTY
DEPARTMENT OF SOCIAL SERVICES
BUSINESS ASSOCIATE ADDENDUM
This Agreement is made effective the 1st day of July, 2013, 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 (identify contract)
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.
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Joseph Weinberger, Jr.
_________________________________ _________________________
Signature Date
NORTH CAROLINA
PERSON COUNTY
I, __________________________, a Notary Public of said county 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.
Sworn to and subscribed before me this _________ day of ______________________, 2013.
___________________________
Notary Public
My Commission expires: __________________
*****************************************************************************************
Carlton B. Paylor, Sr.
_________________________________ _________________________
Signature Date
NORTH CAROLINA
PERSON COUNTY
I, __________________________, a Notary Public of said county do hereby certify that Carlton B. Paylor, Sr.
personally appeared before me this date and acknowledged the due execution of the foregoing agreement for the purposes
therein expressed.
Sworn to and subscribed before me this _________ day of ______________________, 2013.
___________________________
Notary Public
My Commission expires: __________________
*****************************************************************************************
PERSON COUNTY
Jimmy B. Clayton
____________________________ _________________________
Chairman, County Commissioners Date
*****************************************************************************************
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal
Control Act.
______________________________ ___________________________
Signature of County Finance Officer Date
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Contract # 1011 Fiscal Year Begins July 1, 2013 Ends June 30, 2014
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 56565656----135 0472.135 0472.135 0472.135 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)
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, 2013 and shall terminate on
June 30, 2014. 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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Reporting Requirements:
Contractor shall comply with audit requirements as described in N.C.G.S. § 143C-6-22 & 23 and
OMB Circular A-133. 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.
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.
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Signature Warranty: The undersigned represent and warrant that they are authorized to bind
their principals to the terms of this agreement.
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.
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
Jimmy B. Clayton
____________________________ _________________________
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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ATTACHMENTATTACHMENTATTACHMENTATTACHMENT AAAA
General Terms and ConditionsGeneral Terms and ConditionsGeneral Terms and ConditionsGeneral Terms and Conditions
Relationships of the PartiesRelationships of the PartiesRelationships of the PartiesRelationships of the Parties
Independent Contractor: Independent Contractor: Independent Contractor: 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: Subcontracting: Subcontracting: 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: Assignment: Assignment: 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: Beneficiaries: Beneficiaries: 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 InsuranceIndemnity and InsuranceIndemnity and InsuranceIndemnity and Insurance
Indemnification: Indemnification: Indemnification: 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: Insurance: Insurance: 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 CompensationWorker’s CompensationWorker’s CompensationWorker’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 LiabilityCommercial General LiabilityCommercial General LiabilityCommercial 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.)
AutomobileAutomobileAutomobileAutomobile - Automobile Liability Insurance, to include liability coverage, covering all owned, hired and non-owned
vehicles used in performance of the contract. The minimum combined single limit shall be $500,000.00 bodily injury
and property damage; $500,000.00 uninsured/under insured motorist; and $25,000.00 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 ContractorTransportation of Clients by ContractorTransportation of Clients by ContractorTransportation 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.
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.
DefauDefauDefauDefault and Terminationlt and Terminationlt and Terminationlt and Termination
Termination Without Cause:Termination Without Cause:Termination Without Cause:Termination Without Cause: The County may terminate this contract without cause by giving 30 days30 days30 days30 days written noticewritten noticewritten noticewritten notice to the
Contractor. 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.
TerminatiTerminatiTerminatiTermination for Cause: on for Cause: on for Cause: on 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.
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Waiver of Default: Waiver of Default: Waiver of Default: 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 Availability Availability Availability of Funds: of Funds: of Funds: 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.
FFFForce Majeure: orce Majeure: orce Majeure: orce 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.
Survival of Promises: Survival of Promises: Survival of Promises: 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 RightsIntellectual Property RightsIntellectual Property RightsIntellectual Property Rights
Copyrights and Ownership of Deliverables:Copyrights and Ownership of Deliverables:Copyrights and Ownership of Deliverables: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:Federal Intellectual Property Bankruptcy Protection Act:Federal Intellectual Property Bankruptcy Protection Act: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 LawsCompliance with Applicable LawsCompliance with Applicable LawsCompliance with Applicable Laws
Compliance with Laws: Compliance with Laws: Compliance with 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 VTitle VTitle VTitle VI, Civil Rights ComplianceI, Civil Rights ComplianceI, Civil Rights ComplianceI, 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: Equal Employment Opportunity: Equal Employment Opportunity: 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): Health Insurance Portability and Accountability Act (HIPAA): Health Insurance Portability and Accountability Act (HIPAA): 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.
TraffickTraffickTraffickTrafficking Victims Protection Act of 2000ing Victims Protection Act of 2000ing Victims Protection Act of 2000ing 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: Executive Order # 24: Executive Order # 24: 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.
ConfidentConfidentConfidentConfidentialityialityialityiality
Confidentiality: Confidentiality: 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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OversightOversightOversightOversight
Access to Persons and Records: Access to Persons and Records: Access to Persons and Records: 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.
RecordRecordRecordRecord Retention: Retention: Retention: Retention: Records shall not be destroyed, purged or disposed of without the express written consent of the County.
The Department of Health and Human Services' basic records retention policy requires all records to be retained for a
minimum of three years following completion or termination of the contract. If the contract is subject to Federal policy and
regulations, record retention will normally be longer than three 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 three 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 three year period described above, whichever is later.
Warranties and Certifications Warranties and Certifications Warranties and Certifications Warranties and Certifications
Date and Time Warranty:Date and Time Warranty:Date and Time Warranty: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 TaxesCertification Regarding Collection of TaxesCertification Regarding Collection of TaxesCertification 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.
MiscellaneousMiscellaneousMiscellaneousMiscellaneous
Choice of Law: Choice of Law: Choice of Law: 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 Wake County, North Carolina. The place of this
contract and all transactions and agreements relating to it, and their situs and forum, shall be Wake County, North Carolina,
where all matters, whether sounding in contract or tort, relating to the validity, construction, interpretation, and enforcement
shall be determined.
AmendmentAmendmentAmendmentAmendment: 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: Severability: Severability: 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.
Headings: Headings: Headings: 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 of the Essence: Time of the Essence: Time of the Essence: Time is of the essence in the performance of this contract.
Key Personnel: Key Personnel: Key Personnel: 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.
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Care of Property:Care of Property:Care of Property: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:Travel Expenses:Travel Expenses: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: Sales/Use Tax Refunds: Sales/Use Tax Refunds: 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: Advertising: Advertising: 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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ATTACHMENTATTACHMENTATTACHMENTATTACHMENT B B B B –––– Scope of Work FeScope of Work FeScope of Work FeScope of Work Federal Tax Id. deral Tax Id. deral Tax Id. deral Tax Id. 56565656----135 0472135 0472135 0472135 0472
STATE OF NORTH CAROLINA )
)
) CONTRACT FOR LEGAL SERVICES
)
COUNTY OF Person )
THIS CONTRACT made and entered into this the 1st day of July, 2013, 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, 2013, and unless sooner terminated by 30
days’ notice of either party shall exist and continue through June 30, 2014.
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.
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ATTACHMENT CATTACHMENT CATTACHMENT CATTACHMENT 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
_________________________________ _________________________
Signature Date
Carlton B. Paylor, Sr.
_________________________________ _________________________
Signature Date
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ATTACHMENT D:ATTACHMENT D:ATTACHMENT D:ATTACHMENT D:
CONFLICT OF INTERESTCONFLICT OF INTERESTCONFLICT OF INTERESTCONFLICT 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 ______________________, 2013.
___________________________
Notary Public
My Commission expires: __________________
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ATTACHMENT E – OVERDUE TAXES
______________, 2013
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. 143-6.2(b2) is guilty of a criminal offense punishable as provided by N.C.G.S. 143-34(b).
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 ______________________, 2013.
___________________________
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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ATTACHMENTATTACHMENTATTACHMENTATTACHMENT G
PERSON COUNTY DEPARTMENT OF SOCIAL SERVICES
CERTIFICATION REGARDING LOBBYING
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 agency, a Member of Congress, an officer or employee of Congress, or an employee of a
Member of Congress in connection with the awarding of any Federal contract, continuation,
renewal, amendment, or modification of any Federal 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 agency, a
Member of Congress, an officer or employee of Congress, or an employee of a Member of
Congress in connection with this Federally funded contract, grant, loan, or cooperative
agreement, the undersigned shall complete and submit Standard Form SF-LLL, “Disclosure of
Lobbying Activities,” in accordance with its instructions.
3. The undersigned shall require that the language of this certification be included in the award
document for subawards at all tiers (including subcontracts, subgrants, and contracts under
grants, loans, and cooperative agreements) who receive federal funds of $100,000.00 or more
and that all subrecipients shall certify and disclose accordingly.
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 $10,000.00 and not more than $100,000.00 for each such failure.
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ATTACHMENTATTACHMENTATTACHMENTATTACHMENT 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.
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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
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.
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ATTACHMENTATTACHMENTATTACHMENTATTACHMENT I
PERSON COUNTY
DEPARTMENT OF SOCIAL SERVICES
BUSINESS ASSOCIATE ADDENDUM
This Agreement is made effective the 1st day of July, 2013, 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 (identify contract)
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.
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Walter B. Cates
_________________________________ _________________________
Signature Date
NORTH CAROLINA
PERSON COUNTY
I, __________________________, a Notary Public of said county 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.
Sworn to and subscribed before me this _________ day of ______________________, 2013.
___________________________
Notary Public
My Commission expires: __________________
*****************************************************************************************
Carlton B. Paylor, Sr.
_________________________________ _________________________
Signature Date
NORTH CAROLINA
PERSON COUNTY
I, __________________________, a Notary Public of said county do hereby certify that Carlton B. Paylor, Sr.
personally appeared before me this date and acknowledged the due execution of the foregoing agreement for the purposes
therein expressed.
Sworn to and subscribed before me this _________ day of ______________________, 2013.
___________________________
Notary Public
My Commission expires: __________________
*****************************************************************************************
PERSON COUNTY
Jimmy B. Clayton
____________________________ _________________________
Chairman, County Commissioners Date
*****************************************************************************************
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal
Control Act.
______________________________ ___________________________
Signature of County Finance Officer Date
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Contract # 1013 Fiscal Year Begins July 1, 2013 Ends June 30, 2014
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 56565656----199 9585199 9585199 9585199 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)
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, 2013 and shall terminate on
June 30, 2014. 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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Reporting Requirements: Contractor shall comply with audit requirements as described in
N.C.G.S. § 143C-6-22 & 23 and OMB Circular A-133. 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 601
355B South Madison Boulevard 25 Abbitt Avenue
Roxboro, NC 27573 Roxboro, NC 27573
(336) 599-8361 (336) 599-3193
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.
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.
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Signature Warranty: The undersigned represent and warrant that they are authorized to bind
their principals to the terms of this agreement.
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.
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
Jimmy B. Clayton
____________________________ _________________________
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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ATTACHMENTATTACHMENTATTACHMENTATTACHMENT AAAA
General Terms and ConditionsGeneral Terms and ConditionsGeneral Terms and ConditionsGeneral Terms and Conditions
Relationships of the PartiesRelationships of the PartiesRelationships of the PartiesRelationships of the Parties
Independent Contractor: Independent Contractor: Independent Contractor: 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: Subcontracting: Subcontracting: 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: Assignment: Assignment: 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: Beneficiaries: Beneficiaries: 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 InsuranceIndemnity and InsuranceIndemnity and InsuranceIndemnity and Insurance
Indemnification: Indemnification: Indemnification: 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: Insurance: Insurance: 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 CompensationWorker’s CompensationWorker’s CompensationWorker’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 her employees engaged in any work under the
contract.
Commercial General LiabilityCommercial General LiabilityCommercial General LiabilityCommercial 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.)
AutomobileAutomobileAutomobileAutomobile - Automobile Liability Insurance, to include liability coverage, covering all owned, hired and non-owned
vehicles used in performance of the contract. The minimum combined single limit shall be $500,000.00 bodily injury
and property damage; $500,000.00 uninsured/under insured motorist; and $25,000.00 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 ContractorTransportation of Clients by ContractorTransportation of Clients by ContractorTransportation 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.
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.
DDDDefault and Terminationefault and Terminationefault and Terminationefault and Termination
Termination Without Cause:Termination Without Cause:Termination Without Cause:Termination Without Cause: The County may terminate this contract without cause by giving 30 days30 days30 days30 days written noticewritten noticewritten noticewritten notice to the
Contractor. 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.
TermiTermiTermiTermination for Cause: nation for Cause: nation for Cause: nation 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.
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Waiver of Default: Waiver of Default: Waiver of Default: 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.
AvailabilAvailabilAvailabilAvailability of Funds: ity of Funds: ity of Funds: ity 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: Force Majeure: Force Majeure: 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.
Survival of Promises: Survival of Promises: Survival of Promises: 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 RightsIntellectual Property RightsIntellectual Property RightsIntellectual Property Rights
Copyrights and Ownership of Deliverables:Copyrights and Ownership of Deliverables:Copyrights and Ownership of Deliverables: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:Federal Intellectual Property Bankruptcy Protection Act:Federal Intellectual Property Bankruptcy Protection Act: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 LawsCompliance with Applicable LawsCompliance with Applicable LawsCompliance with Applicable Laws
Compliance with Laws: Compliance with Laws: Compliance with 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.
TitTitTitTitle VI, Civil Rights Compliancele VI, Civil Rights Compliancele VI, Civil Rights Compliancele 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: Equal Employment Opportunity: Equal Employment Opportunity: 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): Health Insurance Portability and Accountability Act (HIPAA): Health Insurance Portability and Accountability Act (HIPAA): 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.
TrafTrafTrafTrafficking Victims Protection Act of 2000ficking Victims Protection Act of 2000ficking Victims Protection Act of 2000ficking 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: Executive Order # 24: Executive Order # 24: 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.
ConfiConfiConfiConfidentialitydentialitydentialitydentiality
Confidentiality: Confidentiality: 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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OversightOversightOversightOversight
Access to Persons and Records: Access to Persons and Records: Access to Persons and Records: 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.
ReReReRecord Retention: cord Retention: cord Retention: cord Retention: Records shall not be destroyed, purged or disposed of without the express written consent of the County.
The Department of Health and Human Services' basic records retention policy requires all records to be retained for a
minimum of three years following completion or termination of the contract. If the contract is subject to Federal policy and
regulations, record retention will normally be longer than three 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 three 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 three year period described above, whichever is later.
Warranties and Certifications Warranties and Certifications Warranties and Certifications Warranties and Certifications
Date and Time Warranty:Date and Time Warranty:Date and Time Warranty: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 TaxesCertification Regarding Collection of TaxesCertification Regarding Collection of TaxesCertification 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.
MiscellaneousMiscellaneousMiscellaneousMiscellaneous
Choice of Law: Choice of Law: Choice of Law: 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 Wake County, North Carolina. The place of this
contract and all transactions and agreements relating to it, and their situs and forum, shall be Wake County, North Carolina,
where all matters, whether sounding in contract or tort, relating to the validity, construction, interpretation, and enforcement
shall be determined.
AmendmentAmendmentAmendmentAmendment: 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: Severability: Severability: 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.
Headings: Headings: Headings: 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 of the Essence: Time of the Essence: Time of the Essence: Time is of the essence in the performance of this contract.
Key Personnel: Key Personnel: Key Personnel: 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.
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Care of Property:Care of Property:Care of Property: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 ExpenTravel ExpenTravel ExpenTravel Expenses: ses: ses: ses: 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: Sales/Use Tax Refunds: Sales/Use Tax Refunds: 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: Advertising: Advertising: 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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ATTACHMENTATTACHMENTATTACHMENTATTACHMENT B B B B –––– Scope of Work Scope of Work Scope of Work Scope of Work Federal Tax Id. Federal Tax Id. Federal Tax Id. Federal Tax Id. 56565656----199 9585199 9585199 9585199 9585
STATE OF NORTH CAROLINA )
)
) CONTRACT FOR LEGAL SERVICES
)
COUNTY OF Person )
THIS CONTRACT made and entered into this the 1st day of July, 2013, 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, 2013, and unless sooner terminated by 30
days’ notice of either party shall exist and continue through June 30, 2014.
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 her 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 her 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.
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ATTACHMENT CATTACHMENT CATTACHMENT CATTACHMENT 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:
25 Abbitt Avenue, 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
_________________________________ _________________________
Signature Date
Carlton B. Paylor, Sr.
_________________________________ _________________________
Signature Date
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ATTACHMENT D:ATTACHMENT D:ATTACHMENT D:ATTACHMENT D:
CONFLICT OF INTERESTCONFLICT OF INTERESTCONFLICT OF INTERESTCONFLICT 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 her
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
_________________________________ _________________________
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 ______________________, 2013.
___________________________
Notary Public
My Commission expires: __________________
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ATTACHMENT E – OVERDUE TAXES
______________, 2013
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. 143-6.2(b2) is guilty of a criminal offense punishable as provided by N.C.G.S. 143-34(b).
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 ______________________, 2013.
___________________________
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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ATTACHMENTATTACHMENTATTACHMENTATTACHMENT G
PERSON COUNTY DEPARTMENT OF SOCIAL SERVICES
CERTIFICATION REGARDING LOBBYING
The undersigned certifies, to the best of her 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 agency, a Member of Congress, an officer or employee of Congress, or an employee of a
Member of Congress in connection with the awarding of any Federal contract, continuation,
renewal, amendment, or modification of any Federal 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 agency, a
Member of Congress, an officer or employee of Congress, or an employee of a Member of
Congress in connection with this Federally funded contract, grant, loan, or cooperative
agreement, the undersigned shall complete and submit Standard Form SF-LLL, “Disclosure of
Lobbying Activities,” in accordance with its instructions.
3. The undersigned shall require that the language of this certification be included in the award
document for subawards at all tiers (including subcontracts, subgrants, and contracts under
grants, loans, and cooperative agreements) who receive federal funds of $100,000.00 or more
and that all subrecipients shall certify and disclose accordingly.
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 $10,000.00 and not more than $100,000.00 for each such failure.
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ATTACHMENTATTACHMENTATTACHMENTATTACHMENT 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.
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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
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.
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ATTACHMENTATTACHMENTATTACHMENTATTACHMENT I
PERSON COUNTY
DEPARTMENT OF SOCIAL SERVICES
BUSINESS ASSOCIATE ADDENDUM
This Agreement is made effective the 1st day of July, 2013, 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 (identify contract)
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.
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Julie A. Ramsey
_________________________________ _________________________
Signature Date
NORTH CAROLINA
PERSON COUNTY
I, __________________________, a Notary Public of said county 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.
Sworn to and subscribed before me this _________ day of ______________________, 2013.
___________________________
Notary Public
My Commission expires: __________________
*****************************************************************************************
Carlton B. Paylor, Sr.
_________________________________ _________________________
Signature Date
NORTH CAROLINA
PERSON COUNTY
I, __________________________, a Notary Public of said county do hereby certify that Carlton B. Paylor, Sr.
personally appeared before me this date and acknowledged the due execution of the foregoing agreement for the purposes
therein expressed.
Sworn to and subscribed before me this _________ day of ______________________, 2013.
___________________________
Notary Public
My Commission expires: __________________
*****************************************************************************************
PERSON COUNTY
Jimmy B. Clayton
____________________________ _________________________
Chairman, County Commissioners Date
*****************************************************************************************
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal
Control Act.
______________________________ ___________________________
Signature of County Finance Officer Date
257
AGENDA ABSTRACT
Meeting Date: August 19, 2013
Agenda Title: Steering Committee for the Old Helena School Property
Summary of Information: The Board Chairman requested that the Manager draft a steering
committee to work on the future use planning of the Old Helena School Property. At present, the
Board has committed to a satellite Emergency Medical Services facility as well as a Sheriff’s satellite
office. The estimated cost to up-fit the facility for these purposes is $181,725 as approved in the
Board’s FY2014 Capital Improvement Plan. Other tentative plans include satellite classrooms for
Piedmont Community College as well as a potential library location.
This Steering Committee will be tasked with developing recommendations for use of this facility
including a projected timeframe with both short and long range visioning and development of a
budget for the Board’s consideration. These recommendations will require community input into this
important planning process.
Below is a list of some potential members whom have expressed interest in this project:
Dr. Walter Bartlett, PCC President
Mike Dossett, PCC
Jim Thomasson, citizen
Paul Hair, citizen
Commissioner Frances Blalock
Heidi York, County Manager
John Hill, Recreation, Arts, & Parks Director
Erin Ganey, Director of the Cultural Arts Program at the Kirby
Ray Foushee, General Services Director
Christy Bondy, Library Director
Recommended Action: Provide input on the creation of the Old Helena School Property Steering
Committee including members and direction
Submitted By: Heidi York, County Manager
258