HomeMy WebLinkAboutAgenda - 04-20-2010 - 4kORANGE COUNTY
BOARD OF COMMISSIONERS
ACTION AGENDA ITEM ABSTRACT
Meeting Date: April 20, 2010
Action Agenda
Item No. ~- f
SUBJECT: Contract between the Rural Advancement Foundation International -USA and
Orange County for 2010 Tobacco Communities Reinvestment Fund Grant for
Juicing Equipment at the Piedmont Food and Agricultural Processing Center
DEPARTMENT: Economic Development PUBLIC HEARING: (Y/N) No
ATTACHMENT(S):
Contract
Value-Added Processing Center Capital
Project Budget Ordinance
INFORMATION CONTACT:
Noah Ranells 245-2330
Brad Broadwell 245-2325
PURPOSE: To approve a contract between the Rural Advancement Foundation International -
USA and Orange County fora 2010 Tobacco Communities Reinvestment Fund Grant and
accept $28,819 for juicing equipment for the Piedmont Food and Agricultural Processing
Center.
BACKGROUND: In Fall 2009, a grant proposal was submitted to the Rural Advancement
Foundation International -USA seeking a 2010 Tobacco Communities Reinvestment Fund
Grant on behalf of the Piedmont Food & Agricultural Processing Center. Funds were requested
to purchase juicing equipment that will be stationed at the Piedmont Food and Agricultural
Processing Center. The grant was submitted by local fruit and berry producers who plan to use
the equipment on site. If the contract is approved and the grant accepted, the juicing
equipment will be owned and managed by Orange County and available to all users of the
facility.
FINANCIAL IMPACT: Approval of the contract, acceptance of the grant, and approval of the
Capital Project Ordinance will provide $28,819 for the purchase of juicing equipment for the
Piedmont Food and Agricultural Processing Center.
RECOMMENDATION(S): The Manager recommends the Board:
1) Approve the contract subject to County Attorney review and authorize the BOCC Chair to
sign the contract documents accepting the $28,819 grant; and
2) Approve the attached Capital Project Ordinance.
2
CONTRACT AGREEMENT
TOBACCO COMMUNITIES REINVESTMENT FUND
2010 Central Piedmout Demonstration Projects
This contract is between the Rural Advancement Fout2dation International-USA ("RAFI") and Piedmont
Food & AG Processing Center for the petxod beginning February 10, 2010 and ending January 30, 2011.
Source of Finds
This contract is made as a sub-grant of monies received by RAFI from the North Carolina Tobacco
Trust Fund Commission {"Commission"}, which is an agency of the State of North Carolina. As a
result, it is subject to the terms of the Grant Agreement between RAFI and the Commission and is also
subject to North Carolina laws and regulations regarding sub-grants of state funds. Copies of the
agreement between RAFI and the Commission are available for inspection at the RAFI office during
normal business hours, 9:00 am to 5:00 prn, Monday through Friday.
Tasks of Piedmont Food & AG Processing Center:
• Complete an on-farm demonstration and education project of a farm enterprise (hereafter
referred to as "the project" or "the demonstration"), which can supplement or replace lost
tobacco income. Piedmont Food & AG Processing Center's propose[ titled, Value-Added
juicing/CN at Piedmont Food & AG Processing Center, is hereby incorporated into this contract
by reference. The demonstration shall be conducted in accordance with the plan outlined in the
proposal titled, Value-Added juicing/IJV at Piedmont Food & AG Processing Center, and in
accordance with the provisions of this contract.
• Expenditure of grant funds must be in accordance with the budget line items presented in Project
Budget submitted in the proposal titled, Value-Added juicing/CTV at Piedmont Food & AG
Processing Center. Any requests for changes to the ptnject budget must be submitted by
Fiedmont Food & AG Processing Center in ~vriting to RAFI and approved by a representative of
RAFI prior to incurring expenses varying from the approved budget.
• Piedmont Food & AG Processing Center will maintain records and documentation of all
expenses for which RAFI funds are utilized.
• Piedmont Food & AG Processing Center will maintain records of all project related casts,
(including in-kind contributions), income, problems encountered, solutions developed, successes
with marketing, and employment generated. All records must be retained far five years fiom the
termination of this Agreement. The North Carolina State Auditor or the Auditor's designee shall
have the right to examine the records pursuant to N.C. Gen. Stet. 147-64.7.
• Piedmont Food & AG Processing Center will conduct outreach activities to inform other farmers,
business people, agricultural service providers, and/or other interested parties about the project
activities and impacts.
• Piedmont Food & AG Processing Center will maintain records of the number of people impacted
by outreach activities and haw those people were impacted by project activities.
• Piedmont Food & AG Processing Center will report on project activities, including expenditure
of grant funds, project related casts, income, problems encountered, solutions developed,
successes with marketing, employment generated, and outreach using photocopies of the forms
attached in Exhibit B (Report Form) by:
July 1, 2010 and
October 31, 2010.
Page 1 of 4
3
• These forms must be provided to RAFL
• In addition, Piedmont Food & AG Processing Center will meet all requirements of the North
Carolina State Auditor including reporting, upon request, an use of project funds to the S#ate
Auditor.
• Piedmont Food & AG Processing Center agrees to allow a RAFI representative to visit Piedmont
Food & AG Processing Center's farm operation to witness project activities at mutually
agreeable times. Piedmont Food & AG Processing Center further agrees to allow a RAFI
representative to gather photos and other infoi7nation necessary to document project progress.
Tasks of the RAFI:
• RAFI will pay a total of $28819 for this research and on-fairrr demonstration.
• Payment of $24496.15 will be made upon receipt of a signed copy of this contract and a
completed W-9.
• RAFI will make a second payment of $2881.90 after July 1, 2010 provided that Piedmont Food
& AG Processing Center has satisfactorily performed the tasks specified above, as determined by
RAFI affrceis or their designee.
• A final payment of $1440.95wi11 be paid after October 31, 2010, provided that «name» has
satisfactorily performed the tasks above, as determined by RAFI officers or their designee.
• RAFI may decline to disburse monies if Piedmont Food & AG Processing Center cannot show to
the satisfaction of RAFI that Piedmont Food & AG Processing Center has spent grant marries to
accomplish the teens of this Agreement. Any unexpended funds remaining at the termination of
this agreement must be refurned to RAFI.
• Failure by Piedmont Food & AG Processing Center to spend project funds in accordance with
this agreement may result in legal action to recover funds spent inconsistently with these tet7rrs
and conditions without further notice.
Other Conditions and Provisions:
Piedmont Food & AG Processing Center shall be an independent contractor and shall not act as an
employee. or agent of RAFI. RAFI or the Commission assume no liability with respect to accidents,
bodily injury, illness, breach of contract or any other damages, claims or losses arising out of any.
activities undertaken under this Agreement, with respect to persons or property of Piedmont Food & AG
Processing Center or third parties. Piedmont Food & AG Processing Center agrees to indemnify, defend
and save harmless RAFI and the Commission and its officers, agents and employees fiom any such
claims.
Piedmont Food & AG Processing Center shall not subcontract any of the work under this Agreement
without the agreement of RAFI.
At the request of RAFI or the Commission, Piedmont Food & AG Processing Center shall place~signage
at the Project site identifying it as receiving Commission funds. The signage shall be in mutually
agreeable writing and format.
Piedmont Food & AG Processing Center may publish or arrange for publication of information resulting
from work cazried out as part of this agreement. However, the information shall not be marketed for
profit by Piedmont Food & AG Processing Center.
Page 2 of 4
4
Piedmont Food & AG Processing Center agrees to indemnify, RAFI, the Commission, it officers, agents
and employees against any liability, including costs and expenses and attorneys fees far his or her
violation of any proprietary right or right of privacy arising out of the publication, translation,
reproduction ,delivery; performance use or disposition of any information published resulting from the
work under this Agreement ar based on any libelous or other unlawful material contained in such
informmation.
If work done as part of this demonstration results in any intellectual property right, Piedmont Food &
AG Processing Center hereby grants to RAFI and the Commission an assignable royalty-free, non-
exclusive irrevocable license to publish, translate, reproduce, deliver, perform or use the material
covered by the intellectual property right.
Any property purchased or leased by Piedmont Faod & AG Processing Center related to this contract or
with any proceeds of this contract shall be the obligation of Piedmont Food & AG Processing Center.
RAFI shall have no responsibility, title or interest to this property.
The obligation of RAFI to pay any amounts under this agreement is contingent upon the availability of
funds to it to fund the project. In the event that funds for this project become unavailable, RAFI may
terminate this agreement immediately upon notice to Piedmont Faod & AG Processing Center. In the
event of notice of the unavailability of funds, a!1 obligations of RAFI to make payments under this
agreement shall cease as of the termination date except for such work as shall have already been
perfazrmed prior to the termination date.
In the event that Piedmont Faod & AG Processing Center breaches any of the material terms ar
conditions of this Agreement, Piedmont Food & AG Processing Center agrees to repay to RAFI or the
Commission the full amount of sums awarded and any interest that has accrued on that sum.
Piedmont Food & AG Processing Center agrees to notify RAFI immediately, in the event that Piedmont
Food & AG Processing Center becomes unable to meet all requirements of this written contract.
Please note that RAFI-USA is required by the IRS and its audit firm to report all payments over the
required limit of $600 for the year. Please maintain your business records accordingly and consult your
tax advisor far advice.
Notices
Notice to RAFI shall be given to:
Mr. Julius Tillery
Rural Advancement Foundation International-USA
P.O. Box 640
Pittsboro, NC 27312
Tel: (919} 259 - 4101
Fax: (919 542-0069
Notice to Piedmont Food & AG Processing Center shall be given to:
Page 3 of 4
5
Noah Ranells
500 Valley Forge Rd
Hillsborough, NC 27278
Tel: 914-942-2754
Enforcement of Agreement
This written agreement constitutes the entire agreement between the parties regarding this project and
may .be amended only by a written document signed by a RAFT representative and Piedmont Food &
AG Processing Center. This agreement may be terminated by the mutual consent of RAFI and
Piedmont Food & AG Processing Center upon 60 days written notice. This agreement shall be
interpreted under the laws of North Carolina.
Signatures:
Gt;~. ~ ~w^~5.2~ ~ Date J' L} -1 U
Kath Za seil
Secretary, RAFT
Date
Noah Ranells
(Piedmont Food & AG Processing Center Project Manager)
Photo Release:
I hereby grant permission to RAFI to obtain photographs of the project described in this agreement and
related activities and to use said photographs in RAFI publications, mailings, brochures, websites, etc.
(including electronic and web publications).
Noah Ranells
Date
Page 4 of 4
L
Tobacco communities Reinvestment Fund
2010 Qemonstration Award Program
Intake Survey
The following information is collected, sa that RAFT can have a better understanding of who is
participating in the grant program. The information is helpful to RAFI in finding resources to continue
the program. AEI information that you provide in this survey is anonymous. Your name will never be
associated with the data. We thank you for your help.
Please provide the following information for yourself and your spouse or other family members who
are collaborating on your project with you:
Yourself Spouse or Other Family Members
Ethnicity:
Gender:
Age:
Number of Acres Farmed:
Total Household Income:
Gross Farm Income:
County (or counties) farmed:
Have you earned income from
tobacco? Were you a grower or
quota holder?
Please return this survey to RAFT-USA, PO Box 640, Pittsboro,lVC 27312.
AJ! information that you provide in this survey wilf be kept anonymous.
7
Form ~~V
(Rev. October 2007)
Department of the Treasury
lnterrti~ fteverwe Servke
Name {as spawn on your income Eax retrrm)
N
m
to
R
a
C
O
m C
a
o~
~[
d V
tC
.~
a
rn
~'
euslrtess name, tf different from above
Check appropriate box: ^ IndhAduaVSole proprietor ^ Corporation ^ Partnership
Exempt
^ Limbed liability company. Fetter the fax ciassirication (D=disregarded entity, C~arporation, P=partnership{ 1 . _ _ _ _: _ ^ payee
^ Otlzer (see inswctiatei -
Address (number, street, and apt. or suite no.)
City, state, and 21P code
test axount number(s) here (optional)
Requester's name and address (optionan
~~ Taxpayer Icit=ntification Number (TINY
Enter your TiN in the appropriate box. The TIN provided must match the name given on tine i to avoid Social security number
backup withholding. For individuals, this is your social security number (SSN). However, for a resident t
alien, sole proprietor, or disregarded entity, see the Part 1 instructions on page 3. For other entities, ii is
your employer identification number (E!N). If you do not have a number, see tfow to get a TIN an page 3. or
Mote. If the account is in more than one name, see the chart on page 4 far guidelines on whose Employer fdentificatlon number
number to enter.
cation
Under penalties of perjury, I certify that:
i. The number shown on this form is my correct taxpayer idenflRcation number (or I am waiting for a number to be Issued to me), and
2, I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) l have not been notified by the Internal
Revenue Service (IRS) that I am subject to backup vthholding as a result of a failure to report ail interest or dividends, or {c) the IRS has
notified ms that i am no longer subject to backup withholding, and .
3. I am a U.S. citizen or other U.S. person (defined below}.
Certification instruotions. You must cross out Item 2 above if you have been notified by the IRS that you are currently subject fo backup
withholding because you have failed to report alt interest and dividends on your tax return. For rest estate transactions, item 2 does not apply.
For mortgage interest paid, acquisition or abandonment of secured property, canceElatton of debt, contributions to an individual retirement
arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the Certification, but you must
provide your correct TIN. Sae the instructions on page 4.
SI®n Signature of
Here us. person - Date -
Reques# for Taxpayer ~ Give form to the
identification Number and Certification requester. Do not
send to the IRS.
General Instructions Deflnitian of a u.s. person. For federal tax purposes, you are
Section references are to the Internal Revenue Code untess considered a U.S. person it you are:
citizen ar U.S. resident alien
. qn individual who is a U
S
otherwise nofed. ,
.
.
PUrp05e Of 1=0rtYi • A partnership, corporation, company, or association created or
organized in the United States or under the laws of the United
A person who is required to file an information return with the States,
IRS must ob#atn your correct taxpayer identification number (TtN) • An estate {other than a foreign estate), or
to report, for example, income paid to you, real esta#e ~ A domestic trust {as defined in Reputations section
transactions, mortgage interest you paid, acquisition or 3t?1.770t-7}.
abandonment of secured property, cancellation of debt, or
contributions you made to an IRA. .Special rules far partnerships. Partnerships that conduct a
Use Form W-8 only if you are a U.S. person (including a trade or business to the United States are generally required to
pay a withholding tax on any foreign partners' share of income
resident alien}, to provide your correct T1N to the person from such business. Further, in certain oases where a Form W-9
requesting it {the requester) and, when applicable, to: has net been received, a partnership Is required to presume that
1. Certify that the TtN you are giving is correct {or you are a partner is a foreign person, and pay the withholding tax.
waiting for a number to be issued), Therefore, tf you ors a U.S. person that is a partner in a
2. Certify that you are not subject to backup withholding, or Partnership conducing a trade or business in the United States,
provide Form W-9 to the partnership to establish your U.S.
3. Claim exemption from backup withholding if you are a U.S. status and avoid withholding on your share of partnership
exempt payee. if applicable, you are also certifying that as a income.
U.S. person, your allocable share of any partnership income from Tyra person who glues Form W-3 to the partnership for
a U.S. trade or business is not subject to the withholding fax on
foreign partners' share of effectively connected (ncome. purposes of establishing its U.S. eta#us and avoiding withholding
on its allocable share of net income from the partnership
Note, if a requester gives you a form other than Form W-9 to conducting a trade or business in the United States is in the
request your T[N, you must use the reques#er's form if it is following cases:
substantial{y similar to Phis Form W-g. • The U.S. owner of a disregarded entity and not the entity,
Cat. No. t023iX Form W-9 (Rev. 10-2007)
8
Farm W-8 (Rev. id-2dd7)
~ The U.S. grantor or other owner of a grantor trust and not the
trust, and
• The U.S. trust {other than a grantor frost} and not the
beneficiaries of the trust.
Foreign person. if you are a foreign persori, do not use Form
W-9. Instead, use the appropriate Form W-S {see Publication
515, Withholding of Tax on Nonresident Aliens and Foreign
Entities}.
Nonresident alien who becomes a resident alien. Generally,
only a nonresident alien individual may use the terms of a tax
treaty to reduce or eliminate U.S. tax on certain types of income.
However, most tax treaties contain a provision known as a
"saving clause." Exceptions specified in the saving clause may
permit an exemption from tax to continue for certain types of
income even af#er the payee has othenviss become a U.S.
resident alien far tax purposes.
If you are a U.S. resident alien who is relying on an exception
contained in the saving clause of a tax treaty to claim an
exemption from U.S. tax on certain types of income, you must
attach a statement to Form W-9 that specifies the following five
items:
1. The treaty country. Generally, this must be the same treaty
under which you claimed exemption from tax as a nonresident
alien.
2. The treaty article addressing the income.
3. The article number (or Location} in the tax treaty that
contains the saving clause and its exceptions.
4. The Eype and amount of Income that qualifies for the
exemption from tax.
5. Sufficient facts to justify the exemption from tax under the
terms of the treaty article.
Example. Article 20 of the U.S: China income fax treaty aitovrs
an exemption from tax far scholarship income received by a
Chinese student temporarily present in the United States. Under
U.S. law, this student wilt become a resident alien far tax
purposes if his or her stay in the United States exceeds 5
calendar years. However, paragraph 2 of the first Protocol to the
U.S: China treaty {dated April 30, 1984} allows the provisions of
Article 20 to continue to apply even after the Chinese student
becomes a resident alien of the United States. A Chinese
student who qualifies for this exception (under paragraph 2 of
the first protaeof) and is relying on this exception to claim an
exemption from tax on his or her scholarship or fellowship
Income would attach #o Form W-9 a statement that includes the
Information described above to support that exemption.
If you are a nonresident a13en or a foreign entity not subject to
backup withholding, give the requester the appropriate
completed Form W-8.
What is backup withholding? Persons making certain payments
to you must under certain conditions withhold and pay to the
tRS 28% of such payments. This is calked "backup withholding °
Payments that may be subject to backup withholding lnc[ude
Interest, tax-exempt interest, dividends, broker and barter
exchange transactions, rents, royalties, nonemplayee pay, and
certain payments from fishing boat operators. Real estate
transactions are not subject #o backup withholding.
You will not be subject to backup withholding on payments
you receive if you give the requester your correct TiN, make the
proper certifications, and report all your taxable interest and
dividends on your tax return.
Payments you receive wiEl be subject to backup
withholding if:
1. You do not furnish your T!N to the requester,
2. You do not certify your TEN when required (see the Part II
instructions on page 3 for details),
3. The 1RS tells the requester that you famished an incorrect
TIN,
Page 2
4. The IRS tells you tha# you are sub}ect to backup
withholding because you did not report ail your interest and
dividends an your tax return {for reportable Interest and
dividends only), or
5. You do not certify to the requester that you are not subject
to backup withholding under 4 above {for reportable interesE and
dividend accounts opened after 19(33 only}.
Certain payees and payments are exempt from backup
withhotding. See the instructions below and the separate
lnstnrctions for the Requester of Form W-9.
Also see &pecfal rules for partnerships on page
Penalties
Failure fo furnish TIN. if you fail to furnish your correct TIN to a
requester, you are subject to a penalty of $50 for each such
failure unless your failure is due #o reasonable cause and not to
willful neglec#.
Givrl penalty for false information with respect to
withholding. ff you make a false statement with na reasonable
bass that results in no backup withholding, you are subjecE to a
$500 penalty.
Criminal penalty for falsifying information. Willfully falsifying
certiflcaElons or affirmations may subject you to criminal
penalties including fines and/or imprisonment.
Misuse of TINS. If the requester discloses or uses TINs to
violation of fedora[ law, the requester may be subject to civil and
criminal penalties.
Specific Instructions
Name
If you are an Individual, you must generally enter the name
shown on your income Fax return. However, if you have changed
your fast name, for instance, due #o marriage without lnformfng
the Social Security Administration of the name change, enter
your first name, the fast name shown on your social security
card, end your new East name.
If the account is in joint names, list first, and then circle, the
name of the person or entity whose number you entered in Part l
of the form.
Sole proprietor. Enter your fndivfduai name as shown on your
income tax return on the "Name" line. You may enter your
business, trade, or "doing business as (DBA)" name on the
"Business name" sine.
Limited liability company {LLG}. Check the. "Limited liability
company" box only and enter the appropriate code for the tax
classification ("D" for disregarded entity, "C" for corporation, "P"
for partnership) !n the space provided.
For a single-member LLC (ncluding a fore€gn LLC with a
domestic owner) that is disregarded as an entity sepazate from
its owner under Regulations section 301.7701-3, enter the
owner's name on the "Name" line. Enter the LLC's name on the
"Business name" line.
For an LLC classified as a partnership or a corporation, enter
the LLC's name on the "Name" Ifne and any business, trade, or
DBA name on the "business name" line.
Other entities. Enter your business name as shown on required
iedaral tax documents on the "Name" ifne. Thrs name should
match the name shown on the charter or other Eegal document
creating the entity. You may enter any business, trade, or DBA
name on the 'Business name° line.
Nate. You are requested to check the appropriate box for your
status (individuaUsote proprietor, corporation, etc.).
Exempt Payee
!f you are exempt from backup withholding, enter your name as
described above and check the appropriate bax for your status,
then check the "Exempt payee" box in the line following the
business name, sign and date the form.
Form W-9 (Rev. ta20Q7) Page 3
Generally, individuals (including sole proprietors} are not exempt
from hackup withholding. Corporations are exempt from backup
withhoiding #or certain payments, such as Interest and dividends.
Note. !f you are exempt from backup withholding, you should
still complete this form to avoid possible erroneous backup
withholding.
The following payees are exempt from backup withhoiding:
1. An organization exempt from tax under section 501(a), any
IRA, or a custodial account under section 403(6}(7} if the account
satisfies the requirements of section 401(f}(2),
2. The United States or any of its agencies or
instrumentaitties,
3. A state, the District of Columba, a possession of the United
States, or any of their political subdivisions or instnrmentalities,
4. A foreign government or any of its political subdivisions,
agencies, or instrumentaoties, or
5. An international organization or any of its agencies or
instrumentalit{es.
Other payees that may be exempt from backup withhoiding
include:
6. A corporation,
7. A foreign central bank of issue,
8. A dealer in securities or commodities required to register in
the United States, the District of Columbia, or a possession of
the United States,
9. A futures commission merchant regis#ered with the
Commodity Futures Trading Commission,
10. A real estate investment trust,
11. An entity registered at a[l times during the tax year under
the Investment Company Act of 1840,
12. A common tnust fund operated by a bank under section
584(a),
13. A financial institution,
14. A middleman known in the investment community as a
nominee or custodian, or
15. A trust exempt from tax under section 664 or described in
section 4947,
The chart below shows types of payments that may be
exempt• from backup withholding. The chart appties to the
exempt payees osted above, 1 through 15.
lF the payment is for ... THEN the payment is exempt
for . •
interest and dividend payments All exempt payees except
for 9
Broker transactions Exempf payees 1 through 13.
Also, a person registered under
fhe investment Advisers Act of
• 1940 who regularly acts as a
broker
Barter exchange transact€ons Exempt payees 1 Through 5
and patronage dividends
Payments over $600 required Qenerally exempt payees
z
to be reported and direct 1 through 7
sales over $5,000'
'See Form tQ99-MISC, Misceilaneous Income, and its instructbns.
=however, the folbvr~g payments made to a corporation (Including gross
proceeds paid to an attorney under section &045(fa, even ff Uie attorney is a
corporation) and reportable on Forrn tUg9-MISC are not exempt from
backup Cvithholding: medtcat and heaEth care payments, attorneys' fees, and
payments for services paid by a federal executive agency.
Part 1. Taxpayer identification
Number (TIN)
Enter your TIN in the appropriate boz, if you are a resident
alien and you do not have and are not eligible to get an SSN,
your TW is your iRS individual taxpayer identification number
(1TIN}. Enter it in the social security number box. If you do not
have an ITEN, see Now fc get a T!N below.
If you are a sole proprietor and you have an EIN, you may
enter either your SSN or EEN. However, the 1RS prefers that you
use your SSN.
If you are asingle-member LLC that is disregarded as an
entity separate from its owner {see Limited JJabitJiy company
(LLC) on page 2}, enter the owner`s SSN (or EIN, if the owner
has one}. Do not enter the disregarded entity's EiN. h the LLC is
classified as a corporation or partnership, enter the entity's EIN.
Note. See the chart on page 4 for further clarification of name
and TlN combinations.
How to get a TIN. if you do not have a TIN, apply for one
immediately. To apply for an SSN, get Form SS-5, Application
for a Social Security Card, from your local Social Security
Administration office or get this form online at wl,vw.ssa.gov. Ycu
may also get this form by calling 1-800-772-1213. Use Fomt
W-7, Application for iRS lndlviduai Taxpayer identification
Number, to apply for an ITIN, or Form SS-4, Applcation for
Employer Identification Number, to apply for an EIN. You can
apply for an EIN online by accessing the iRS website at
www.irs.gov/businesses and cocking on Employer ldentiflcation
Number (EIN} under Starting a Business. You can get Forms W-7
and SS-4 from the IRS by visiting www.frs.gov or by calling
1-800-TAX-FORM (1-800-828-3676}.
If you are asked to complete Form W-9 but do not have a TtN,
write °Applied For" in the space for the TIN, sign and date the
form. and give [t to the requester. For Interest and dividend
payments, and certain payments made with respect to readily
tradable instruments, genera[fy you wail have 60 days to get a
TIN and glue it fo the requester before you are subject to backup
withholding on payments. The 60-day rule does not apply to
other types of payments. You wilt be subject to backup
withholding on all such payments until you provide your TiN to
the requester.
Note. Entering "Applied For" means that you have already
applied far a TIN or that you intend to apply for one soon.
Caufton: R disregarded domesfic entity that has a foreign owner
must use the appropriate Form W-8.
Part 11. Certification
To establish to the withholding agent that you are a U.S. person,
or resident alien, sign Form W-9. You may be requested to sign
by the withholding agent even if items 1, 4, and 5 below indicate
otherwise.
For a Joint account, only the person whose TIN is shown in
Part i should sign {when required}. Exempt payees, see Exempt
Payee on page 2.
Signature requirements. Complete the certification as Indicated
in 1 through 5 below.
1. Interest, dividend, and barter exchange accounts
opened before i9t34 and broker accounts considered active
during 1983. You must give your correct TIN, but you do not
have to sign the certification.
2. Interest, dividend, broker, and barter exchange
accounts opened after i883 and broker accounts considered
inactive during i863. You must sign the certification or backup
withholding wall apply. if you are subject to backup withholding
and you are merely providing your correct TIN to the requester,
you must cross out item 2 fn the certi€ICatlon before signing the
form.
10
Form W-9 (Rev. 30-2007) Page 4
3. Real estate transactions. Yau must sign the ct:rtificatfon.
You may cross out item 2 of the certificat€on.
4. Other payments. You must give your correct TIN, but you
do not have to sign the certification unless you have been
notified that you have previously given an incorrect TIN. ^t]ther
payments" include payments made in the course of the
requester`s trade or business for rents, royalties, goods {other
than bills for merchandise), medical and health care services
(including payments to corporations), payments to a
nanemptoyee for services, payments to certain fishing boaf crew
members and fishermen, and grass proceeds paid to attorneys
(including payments to corporations).
5. Mortgage interest paid by you, acquisition or
abandonment of secured property, canceitation of debt,
qualified tuition program payments (under section 529), 1RA,
Coverdell ESA, Archer MSA or HSA contributions or
distributions, and pension distributions. You must give your
corcect TIN, bui you do not have to sign the certification.
What Name and Number To Give the Requester
For this type of account: Give name and SSN of:
1. tndiviriuai The Indivkrual
2. Two or more individuals (ioini The actual owner of the account of,
account) if combined funds, the test
IndNtdual on the account
3. Custodian account of a minor The minor
(Uniform Gift to Minors Act)
4. a. The usual revocable savings The grantor-Trustee'
trust (grantor is also trustee)
'
b. So-called frost account Thai Is The actual owner
not a legal w varid trust under
state !aw
5. Sole proprietorship or disregazded The owner'
entity owned by an individual
For this type of account: QNe name and EIN of:
6. Disregarded entity not owned by an The owner
Individual
7. A vafad Trust, estate, or pension trust Legal entdy
8. Corporate or LLC electing 'The corporation
corporato status on Form 8832
9. Assocfatbn, club, religious, The organizaton
charitable, educadona{, or other
tax-exempt organization
30. partnership or multi-member t1C The partnership
1 i. A broker or registered nominee The broker or rwminee
12. Account with the Department of 'The pubMc entity
Agriculture in the name of a public
entity (such as a state or beat
government, school district, or
prison) chat recehres agricultural
program payments
'Ust lust and code the name of rho Person vrFrosa number you famish If orrty one person
on a (dnt accaxK has an SSN. that persons ntmber must he furnfsrtad.
=Cirda the m4>o~s reme and lwnish the mimr's SSN.
sYou must show yar individual name and you may also enter your business or °aeA'
name on itra second name Me. You may use etlhet your SSN a EtN (tt you have one),
Fwl fhe IRS encourages you to use yow SSN.
` List first and circle the name d the trust, estate. or pensbn bust (tb rwt famish the TIN
of the personal representellve a bastes ureess iha legal entity itself h rwt designated in
the account title.) Afso see Spedat roles for partrlaratdAs on page 1.
Note. if no name is circled when mare than one name is listed,
The number will be considered to be that of the frrst name listed.
Secure Your Tax Records from Identify Theft
Identity theft occurs when someone uses your personal
information such as your name, social security number {SSNJ, or
other identifying Information, without your permission, to commit
fraud or other crimes. An idenflty thief may use your SSN #o get
a job or may file a tax return using your SSN to receive a refund.
To reduce your risk:
Protect your SSN,
Ensure your employer Is protecting your SSN, and
i3e careful when choosing a tax preparer.
Call the tRS at 1-800-829-1040 if you think your identity has
been used inappropriately for tax purposes.
Vtetims of identity theft who are experiencing economic harm
or a system problem, or are seeking help in resolving tax
problems that have not been resolved through normat channels,
may be eUgible for Taxpayer Advocate Service (TAS) assistance,
You can reach TAS by caning the TAS toll-free case intake line
at 1-877-777-4778 or lTY/TDD 1-800-829-4059.
Protect yourself from suspicious emails or phishing
schemes. Phishing is the creation and use of email and
websites designed to mimic iegit}mate business emails and
websltes. The most common act [s sending an small to a user
falsely claiming to be an established legitimate enterprise in an
attempt to seam the user info surrendering private information
that will be used for identity theft.
The iRS does not initiate contacts with taxpayers via emails.
Also, the IRS does not request personal detailed information
through small or ask taxpayers for the P!N numbers, passwords,
or similar secret access information for their credit card, bank, or
other. financial accounts.
If you receive an unsolicited email claiming to be from the IRS,
forward this mt3ssage to phfshing~lrs.gov. You may also report
misuse of the tR5 name, logo, or other IRS persanaf property to
the Treasury Inspector General for Tax Administration at
1-B00-366-4484. You can forward suspicious emails to the
Federal Trade Commission af: spam~uce.gov or contact them at
www.consumergov/idfheft or 1-877-iDTHEFT(43B-4338).
Visit the IRS websife at ivww.lrs.gov to team mare about
identity theft and how to reduce your risk.
Privacy Act Notice
Section 6109 of The internal Revenue Code requires you to provide your correct TIN to persons who must foe informatbn returns with the IRS to report kiterest,
dfvktands, and certain other income paid to you, mortgage Interest you paid, the acqulsifkxi or abandonment of secured property, canceilatbn of debt, or
contrilwtions you made to an 1RA, or Archer MSA or HSA. The IRS uses the numbers for Iderttitication purposes and to help verify the accuracy of Your tax return.
The iRS may also provide this information is the Department of Justice for civet and criminal litlgallan, arxf to cities, slates, the Distrbt of Columbia, and U.S.
possessxutS to carry out ihek tax laws. We may also discbse the iniarmarron to other countries under a tax treaty, to federal and state agencf~ to enforoe federal
norttax criminal taws, w to federal law enfaroement and lnteftigence agencies to combat terrorism.
You must provide your TfN whether or not you are required to ilia a tax return. Payers must generally withhold 28% of taxable interest, dividend, and certain other
payments to a payee who does not gNe a TiN to a payer. Certain penalties may also apply.
11
CONTRACT AGREEMENT
TOBACCO COivII~IUNITIES REINVESTI4IENT FUND
2014 Central Piedmont Demonstration Projects
This contract is between the Rural Advancement Foundation International-USA ("RAFT"} and Piedmont
Food & AG Processing Center for the period beginning February 10, 2010 and ending January 30, 2011.
Source of Funds
This contract is made as a sub-grant of monies received by RAFT from the North Carolina Tobacco
Trust Fund Commission ("Commission"}, ~vhich is an agency of the State of North Carolina. As a
result, it is subject to the terms of the Grant Agreement between RAFI and the Commission add is also
subject to North Carolina laws and regulations regarding sub-grants of state funds. Copies of the
agreement between RAFT and the Commission are available for inspection at the RAFI office during
normal business hours, 9:00 am to 5:00 pm, Monday through Friday.
Tasks of Piedmont Food & AG Processing Center:
• Complete anon-farm demonstration and education project of a farm enterprise (hereafter
referred to as "the:project" or "the demonstration"), which can supplement ar replace lost
tobacco income., Piedmont Food & AG Processing Center's proposal titled, Value-Added
juicing/UV at Piedmont Food & AG Processing Center, is hereby incorporated into this contract
by reference. The demonstration shall be conducted in accordance with the plan outlined in the
proposal titled, Value-Added juicing/UV at Piedmont Food & AG Processing Center, and in
accordance with the provisions of this. contract. .
• Expenditure of grant funds must be in accordance with the budget line items presented in Project
Budget submitted in the proposal titled, Value-Added juicingNV at Piedmont Food & AG
Processing Center. Any requests far changes to the project budget must be submitted by
Piedmont Food & AG Processing Center in writing to RAFT and approved by a representative of
RAFT prior to incurring expenses varying from the approved budget.
• Piedmont Food & AG Processing Center will maintain records and documentation of all
expenses for which RAFT funds are utilized.
• Piedmont Food & AG Processing Center will maintain records of all project related costs,
(including in-kind contributions), income, problems encountered, solutions developed, successes
with marketing,'and employment generated. All records must be retained far five years from the
termination of this Agreement. The North Carolina State Auditor or the Auditor's designee shall
have the right to examine the records pursuant to N.C. Gen. Stat. 147-64.7.
• Piedmont Food & AG Processing Center will conduct outreach activities to inform other farmers,
business people, agricultural service providers, and/or other interested parties about the project
activities and impacts.
• Piedmont Food & AG Processing Center will maintain records of the number of people impacted
by outreach activities and how those people were impacted by project activities.
• Piedmont Food & AG Processing Center will report an project activities, including expenditure
of grant funds, project related costs, income; problems encountered, solutions developed,
successes with marketing, employment generated, and outreach using photocopies of the forms
attached in Exhibit B {Report Fotm} by:
Juty 1, 2010 and
October 31, 2010.
Page 1 of 4
12
These forms must be provided to RAFI.
In addition, Piedmont-Food & AG Processing Center will meet all requirements of the North
Carolina State Auditor including reporting, upon request, on use of project funds to the State
Auditor.
Piedmont Food & AG Processing Center agrees to allow a RAFI representative to visit Piedmont
Food & AG Processing Center's farm operation to witness project activities at mutually
agreeable times. Piedmont Food & AG Processing Center fitrther agrees to allow a RAFI
representative to gather photos and other information necessary to document project progress.
Tasks of the RAFI:
• RAFI will pay a total of~288i9 for this research and on-farm demonstration.
• Payment of X24496.15 Evi11 be made upon receipt of a signed copy of this contract and a
completed W-9.
• RAFI will make a second payment of $2831.90 after July 1, 2010 provided that Piedmont Faod
& AG Processing Center has satisfactorily performed the tasks specified above, as determined by
RAFI officers or their designee.
• A final payment of $1440.95will be paid after October 31, 2010, provided that «name» has
satisfactorily performed the tasks above, as determined by RAFI officers ar their designee.
• RAFI may decline to disburse monies if Piedmont Food & AG Processing Center cannot show to
the satisfaction of RAFI that Piedmont Food & AG Processing Center has spent grant monies to
accomplish the terms of this Agreement. Any unexpended funds remaining at the termination of
this agreement must be returned to RAFI.
• Failure by Piedmont Food & AG Processing Center to spend project funds in accordance with
this agreement may result in legal action to recover funds spent inconsistently with these terms
and conditions without further notice.
other Conditions and Provisions:
Piedmont Food & AG Processing Center shalt be an independent contractor and shall not act as an
employee. or agent of RAFI. RAFI or the Commission assume no liability with respect to accidents,
bodily injury, illness, breach of contract or any other damages, claims or Losses arising out of any
activities undertaken under this Agreement, with respect to persons or property of Piedmont Food & AG
Processing Center or third parties. ~ Piedmont Food & AG Processing Center agrees to indemnify, defend
and save harmless RAFI. and the Commission and its officers, agents and employees from any such
claims.
Piedmont Faod & AG Processing Center shall not subcontract any of the work under this Agreement
without the agreement of RAFI.
At the request of RAFI or the Commission, Piedmont Faod & AG Processing Center shall place signage
at the Project site identifying it as receiving Commission funds. The signage shall be in mutually
agreeable writing and format.
Piedmont Food & AG Processing Center may publish or arrange for publication of information resulting
from work carried out as part of this agreement. However, the information shall not be marketed for
profit by Piedmont Food & AG Processing Center.
Page 2 of 4
13
Piedmont Food & AG Processing Center agrees to indemnify, RAFT, the Commission, it officers, agents
and employees against any liability, including costs and expenses and attorneys fees for his or her
violation of any proprietary right or right of privacy arising out of the publication, translation,
reproduction ,delivery; performance use or disposition of any information published resulting from the
work under this Agreement ar based on any libelous or other unlawful material contained in such
information.
If work done as part of this demonstration results in any intellectual property right, Piedmont Fvod &
AG Processing Ceriter hereby grants to RAFT and the Commission an assignable royalty-free, non-
exclusive irrevocable license to publish, translate, reproduce, deliver, perform or use the material .
covered by the intellectual property right.
Any property purchased or leased by Piedmont Food & AG Processing Center related to this contract or
with any proceeds of this contract shall be the obligation of Piedmont Food & AG Processing Center.
RAFT shall have na responsibility, title ar interest to this prape~~ty.
The obligation of RAFI to pay any amounts under this agreement is contingent upon the availability of
funds to it to fund the project. In the event that firnds for this project become unavailable, RAFI may
terminate this agreement immediately upon notice to Pied~nant Food & AG Processing Center. In the
event of notice of the unavailability of funds, all obligations of RAFI to make payments under this
agreement shall cease as of the termination date except far such work as shall have already been
performed prior to the termination date.
In the event that Piedmont Food & AG Processing Center breaches any of the material terms ar
conditions of this Agreement, Piedmont Food & AG Processing Center agrees to repay to RAFI or the
Commission the full amount of sums awarded and any interest that has accrued an that sum,
Piedmont Food & AG Processing Center agrees to notify RAFI immediately, in the event that Piedmont
Food & AG Processing Center becomes unable to meet all requirements of this written contract.
Please note that RAFT-USA is required by the IRS and its audit firm to report all payments over the
required limit of $600 for the year. Please maintain your business records accordingly and consult your
tax advisor for advice.
Notices
Notice to RAFI shall be given tv:
Mr. Julius Tillery
Rural Advancement Foundation International-USA
P.O. Box b40
Pittsboro, NC 27312
Tel: (919) 259 - 4101
Fax: (919 542-0069
Notice to Piedmont Food & AG Processing Center shall be given to:
Page 3 of 4
14
Noah Ranells
500 Valley Forge Rd
Hillsborough, NC 27278
Tel: 919-942-2754
Enforcement of Agreement
This written agreement constitutes the entire agreement bettiveen the parties regarding this project and
may be amended only 6y a written docurrient signed by a RAFT representative and Piedmont Food &
AG Processing Center. This agreement may be terminated by the mutual consent of RAFI and
Piedmont Food & AG Processing Center upon 60 days written notice. This agreement shall be
interpreted under the laws of North Carolina.
Signatures;
_Q~, Y ~ Date 3"~~'~~
Kathy Za mseil
Secretary, RAFI
Date
Noah Ranells
(Piedmont Food & AG Processing Center Project Manager)'
Photo Release:
I hereby grant permission to RAFI to obtain photographs of the project described in this agreement and
related activities and to use said photographs in RAFI publications, mailings, brochures, websites, etc.
(including electronic and web publications).
Noah Ranells
Date
Page 4 of 4
EXHIBIT B-Report Forr-t5
GRANT EXPENDITURES REPORT FOR.i~I
2010 Tobacco Communities Reinvestment Fund Demonstration Grant Program
Project Title:
Project Coordinator:
Re~o_rt date: (please /a box}
Interim
Final
Coordinator's Signature:
Please use this form to list all project related expenditures for the period since your last report. List your
personal expenses on the front and RAFI funded expenses on the back of this form. Far alt RAFT funded
expenditures, please attach a receipt or other documentation of the expense to this report.
Line Item Categories:
1. Analysis, Consultants,
Subcontractors and Other Off-
farm Services
2. Personnel Salaries
3. Use of farm Equipment
4. Supplies and Materials
5. Travel
b. Communication
7. Outreach
RAFI funded ex eases for the reporting period (ex eases c~id br with grant funds):
DATE DESCRIPTION OF EXPENSE AMOUNT LINE
" ITEM
Please attach additional pages if necessary.
16
EXIiIBIT B-Report Form
. PROJECT IMPACTS FORtyI
2010 Tobacco Communities Reinvestment Fund Demonstration Grant Pro~•am
Project Title:
Project Coordinator:
Report date: (please /a box}
Interim
Final
Coordinator's Signature:
Investment
Your out-of-pocket expenses (Cash, credit, etc.}
In-kind expenditures (The value of items that you contribute to the
project, for which you do not pay, e.g. your tabor, farm equipment, etc.}
Grant award amount
Total Investment (add above three tines)
Employment
Paid Inbor
How many people {including yourself or family members) were hired to
work on the pro}ect who would not otherwise work on the farm?
How many hours per week?
Is the job seasonal?
Do any other farm employees provide labor for the grant funded project?
How many hours per week?
Is the job seasonal?
tlitp~rid labor
Do you or others provide unpaid labor to the project?
How many hours per r~veek?
How has the project affected the outlook far labor on your farm?
17
EXHIBIT B-Report Form
Income
Current itTCOme
How much income have you earned from your project to date?
Gross:
Net:
Projected income
What do you project the income from your project will be in 2013?
Gross:
Net:
Beneficiaries
How many people have benefited in any way from your project? (Please
list beneficiaries in only one category below.}
Farmers earning income:
Others earning income:
Workers employed:
Participants in outreach
activities (e.g. field days):
People receiving information
about the project:
Customers:
Others who use project
equipment or resources:
Others:
Total number of
beneficiaries:
Please complete a Project Impacts Fornt and secbmit -~vith both your interim and final reports. Thanks!
18
EXHIBIT B--Report Farm
FI~iAL REPORT FORM
2010 Tobacco Communities Reinvestment Fund Demonstration Grant Program
Project Title:
Project Coordinator:
Coordinator's Signature:
Describe the progress you have made in completing the project tasks outlined in your contract. Please, specifically note how
project activities relate to expenses listed on the financial report form.
Describe any problems encountered, solutions developed, and any other insights you've arrived at through your work an the
project.
What steps have you t<~ken to inform others (farmers, extension agents, public officials, community members, etc.) about your
project? How many pea iep have you reached? ~'~hat are your future plans to let other farnsers know about your project?
19
EXHIBIT l3-Report Form
INTERIlYI REPORT FORM
2010 Tobacco Communities Reinvestment Fund Demonstration Grant Program
Project Title:
Project Coordinator:
Coordinator's Signature:
Describe the progress you have made in completing the project tasks outlined in your contract. Please, specifically note how
project activities relate Eo expenses listed on the financial report form.
What problems do you foresee in the future? Fn what areas may you need technical assistance?
Is the project on schedule? At this point, do you foresee any need to make alterations to the timeline or budget? I€ so, please
attach an additional sheet explaining the necessary changes.
C~RD-aD(0-o3~ 20
Value-Added Processing Center
Capital Project Ordinance
Be it ordained by the Orange County Board of County Commissioners that pursuant to
Section 13.2 of Chapter 159 of the General Statutes of North Carolina, the following
capital project is hereby adopted.
Section 1. The project authorized provides funds to transform the former Orange
Enterprises Facility located on Valley Forge Road in Hillsborough into a
Value-Added Processing Center. Grant funds from the North Carolina
Agriculture Development and Farmland Preservation Trust Fund, as well
as the North Carolina Tobacco Trust Fund finance the project.
Section 2. The officers of the County are hereby directed to proceed with the project
within the budget contained herein.
Section 3. The following revenue is anticipated to complete this project:
Through FY
2008-09
FY 2009-10 Through FY 2009
10
Sales Tax $0 $0 $0
2001 Bonds $0 $0 $0
2004 Two-Thirds Net Debt $0 $0 $0
Fees $0 $0 $0
Grant Funds $132,000 $28,819 $160,819
Total Funding $132,000 $28,819 $160,819
Section 4. The following amount is appropriated for this project:
Through FY
2008-09
FY 2009-10 Through FY
2009-10
Land/Buildin $0 $0 $0
Planning/ArchitectlEngineering $0 $0 $0
Construction $132,000 $0 $132,000
Equipment $0 $28,819 $28,819
Total Costs $132,000 $28,819 $160,819
Section 5. This ordinance shall remain in effect until the Board of County
Commissioners takes action to amend the ordinance or close the project
ordinance upon completion of the project.
Adopted this 20th day of April 2010.