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HomeMy WebLinkAbout1999 S 1999-2000 Contract Between N.C. Department of Health and Human Services and Orange County Health Department RETURN THIS COPY TO THE CLERK'S _ OFFICE FOR THE PERMANENT AGENDA FILE Page 1 of 11 CONSOLIDATED CONTRACT BETWEEN THE STATE OF NORTH CAROLINA AS REPRESENTED BY E THE STATE HEALTH DIRECTOR (Hereinafter called the "State") AND Orange Counly Health Department (Local Health Department-- Hereinafter called the "Department") FOR THE PURPOSE OF MAINTAINING AND PROMOTING THE ADVANCEMENT OF HEALTH IN NORTH CAROLINA This Contract Shall Cover a Period From July 01, 1999 to June 30, 2000 NOW, THEREFORE, the State and the Department agree that the provisions and clauses herein set forth shall be incorporated in and constitute the terms and conditions applicable for the following activities involving State funding. (State funding or funds means state, federal, and/or special funding or funds throughout this contract.) Page 2 of 11 A. WORK TO BE PERFORMED 1. The Department shall perform activities in compliance with applicable program rules contained in the North Carolina Administrative Code as well as all applicable Federal and State laws and regulations. 2. The Department shall perform the activities specified in the Program Contract Addenda for State funded budgets. 3. The Department shall administer and enforce all rules which have been adopted by the Commission for Health Services or approved by the State and adopted by the Local Board of Health. 4. The Department shall provide to the State copies of rules adopted by the Local Board of Health pursuant to G.S. 130A-39 and Public Health Ordinances adopted by the County Commissioners, within 30 days of adoption. 5. The Department shall provide to the State a Community Diagnosis Prioritization of Problems every biennium. The Department shall also provide a Community Diagnosis narrative, if completed. B. FUNDING STIPULATIONS 1. Funding for this contract is subject to the availability of State, Federal, and special funds for the purpose set forth in this Contract. 2. During the period of this Contract, the Department shall not use State, Federal or Special Project funds received under this Contract to reduce locally appropriated funds as reflected in the Local Health Department Budgets. 3. The Department shall not use personal health program funds to support environmental health personnel nor use environmental health program funds to support personal health programs. 4. Fees generated by the Food and Lodging fees collection program may only be used to support Environmental Health activities. 5. Funds for Childhood Lead Poisoning Prevention may be used to support both environmental health and child health activities. 6. The Department shall comply with Standards for Mandated Public Health Services, 15A NCAC 25, Section .0200; and Administrative Procedures Manual for Federal Block Grant Funds, 1 NCAC 33, Sections .0100- .1502. 7. The Department shall maintain employee time records to document employee salaries and fringe benefits charged to state funds. The percentage of time each employee spends in each activity shall be converted to dollars based upon the employees' salary and benefits 8. The Department participating in Medicaid Reimbursement shall: a. Comply with the terms of the Medicaid Interagency Agreement and the Provider Participation Agreement effective October 1, 1992 and any subsequent approved addenda or new Agreement approved and established during the period of this contract. Page 3 of 11 b. Make every reasonable effort to collect its cost in providing services, for which Medicaid reimbursement is sought, through public or private third party payors except where prohibited by Federal regulations or State law, No one shall be refused services solely because of an inability to pay. 9. Subject to the approval of the appropriate Division, a local health department may seek reimbursement for services covered by a program operating under 15A NCAC 24A rules when those services are not supported by other state or federal funds. All payment program rules and procedures as specified in the Purchase of Medical Care Services manual must be followed. 10. Programs and services supported in whole or in part with federal funds must provide interpreter services at no charge to non-English speaking clients. Only those programs and services funded entirely with state and/or local funds, unless prohibited by State law or rule, may charge non-English speaking clients for interpreter services. 11. Subject to the availability of funds and approval of the Office of Public Health Nursing, a local health department may request reimbursement for a. Nursing service personnel participating in the Introduction to Principles and Practices of Public Health and Public Health Nursing course.Reimbursement is limited to no more than $400.00 per participant upon successful completion of the course, b. Nursing service personnel participating in the the Public Health Nurse Supervisors Training Course. Reimbursement is limited to no more than $600.00 per participant upon successful completion of the course. C. Community Health Assistants and Public Health Nurses attending certain pre-approved Continuing Education courses offered by the Office of Public Health Nursing. Reimbursement is limited to $25.00 per participant per event. 12. The Department shall have an annual audit performed in accordance with The Single Audit Act of 1984 as implemented by OMB Circular A-1 33.The audit report should be submitted to the Controller's Office within (six) 6 months following the close of the contract. Audit findings and resolution of said findings shall be handled by the Controller's Office. 13. Equipment is a type of fixed asset consisting of specific items of property that: (1) are tangible in nature; (2) have a life longer than one year; and (3) have a significant value. a. For Inventory Purposes 1. Equipment must be accounted for in accordance with Local Government Accounting System Procedure No. 15. 2. Women, Infants and Children Program All equipment with an acquisition cost of$500.00 or more must be inventoried with the Division of Women's and Children's Health. b. For Prior Approval Purposes Page 4 of 11 1. All equipment purchased or leased where there is an option to purchase with State/Federal funds must receive prior written approval from the appropriate Division when the acquisition cost exceeds $500.00. . 2. Women, Infants and Children Program All medical equipment and computer equipment, regardless of cost and all other equipment with an acquisition cost of$500.00 or more must receive prior approval from the program office. 3. The use of Maternal and Child Health Medicaid fees for capital improvements requires prior written approval from the Division of Women's and Children's Health. C. FISCAL CONTROL 1. The Department shall comply with the Local Government Budget and Fiscal Control Act, North Carolina General Statute Chapter 159, Article 3. a. The Department shall maintain a purchasing and procurement system in accordance with generally accepted accounting practices and procedures set forth by the Local Government Commission. b. The Department shall execute written agreements with all parties who invoice the Department for payment for the provision of services to patients. C. When subcontracting, the following conditions must be met: 1. The Department is not relieved of any of the duties and responsibilities provided in this contract. 2. The subcontractor will agree to abide by the standards contained herein or to provide such information as to allow the Department to comply with these standards. 3. The subcontractor will agree to allow state and federal authorized representatives access to any records pertinent to its role as a subcontractor of the Department. 4. The Department will make available to the State upon request a copy of subcontracts supported with State/Federal funds. d. The Department must receive prior approval from the state to subcontract when any of the following conditions exist: 1. The Department proposes to subcontract to a single entity fifty percent(50%) or more of the total state and federal funds made available through this contract. 2. The Department proposes to subcontract fifty percent (50%) or more, or$50,000 which ever is greater, of the total state and federal funds made available through this contract for a single public health service or program. 3. The Department proposes to subcontract for services in the Women, Infants and Children Program. Page 5 of 11 e. The Department shall retain all budgets, budget revisions, contracts, contract addenda, and financial records in accordance with the current Records Disposition Schedule for County and District Health Departments issued by the Division of Archives and History, Department of Cultural Resources. 2. The Department shall prepare and maintain a budget for each activity covered by this contract in a manner consistent with instructions provided with Local Health Department Budget-WIC Form 3370 and Local Health Department Budget Form 2948. a. The Department shall prepare budget revisions for prior approval of the State when State funds will be increased or decreased. b. The Department shall submit all revisions prior to the end of the term specified in this Contract. Budget revisions received by the State after the end of the contract period will be returned without action. 3. The Department shall observe the following conditions when budgeting and reporting earned revenues: a. All payments from persons, and public or private third party payors, shall be utilized for the activity that generated the revenue and shall not reduce or replace locally appropriated funds during the period of this contract. The Department may use revenues from any Division of Women's and Children's Health supported activity in any other activity supported by the Division. b. All earned income must be budgeted in the program where earned, except that income earned by a program which has no activity budget can be budgeted in a program approved by the State. With regard to revenue generated by maternal and child health related services, program is defined as any activity supported by the Division of Women's and Children's Health. C. All fees collected shall be used in the current year or succeeding fiscal years. d. Use of program income generated by the expenditure of Federal categorical funds will be governed by applicable Federal regulations, including but not limited to 45 CFR 74. e. When budgeting: i Line item 9000 on the program budget must be used to budget the total of line items 101, 102 and 103. ii. Line item 102 on the program budget must be used to budget TXIX earned revenues. iii. Line item 103 on the program budget must be used to budget other earned revenues. f. When reporting expenditures: i. Line item 9000 on the Local Expenditure Report must be used to report the total of line items 101, 102, 103. Page 6 of 11 ii. Line item 102 on the Local Expenditure Report must be used to report TXIX earned revenues that were expended. iii. Line item 103 on the Local Expenditure Report must be used to report other earned revenues that were expended. g., A local account shall be maintained for unexpended TXIX fees. Accounts shall be maintained in sufficient detail to identify the program source generating the fees. h. The amount of Title XIX fees budgeted in FY 1999-2000 must equal or exceed the amount of Title XIX revenues earned during FY 1997-98. The state will not approve program activity budgets that do not include an amount of Title XIX fees sufficient to meet the requirements of this section. The state may waive this requirement if the Department provides sufficient justification. 4. The Department shall submit a quarterly report of actual receipts and expenditures of the Department according to instructions provided with Local Expenditure Reports, Form 2949 and Form 2950. a. The Department shall submit quarterly expenditure reports to the State within 45 days from the end of the reporting quarter. Failure to meet the reporting deadline will result in an immediate suspension of payments until the overdue report is received. b. The Department shall submit the final Expenditure Report to the State within 45 days after the end of the contract period. Report is due by August 14. C. The Department shall submit amended or corrected expenditure reports within four(4) months after the end of the contract period. Any such reports must be prepared for the specific quarter to be amended or corrected. Reports received after October 31 will be returned without action. d. The Department shall refund to the State all unexpended State funds within 45 days after notification of overpayment. When payment is not received by the State within 45 days, future payments to the Department may be reduced by the amount due or payments may be suspended until the refund is received by the State. e. The Department shall submit monthly WIC expenditure reports to the State no later than the 8th of the following month. Final expenditure report is due by August 14. f. Reimbursement of WIC approved expenditures for July, August, and September cannot exceed one-fourth of the total budget for the contract period. g. The Department shall submit monthly Minority Infant Mortality Reduction and Healthy Start expenditure reports to the state no later than the 15th of the following month. h. The Department shall submit expenditure reports for Mosquito Control activity in accordance with 15A NCAC 18B, Sections .0104 and .0107. Page 7 of 11 I. The Department shall submit request for payment for services provided under 15A NCAC 24 A rules to the Claims Processing Unit, Purchase of Medical Care Services, DHHS. j. The Department shall submit request for reimbursement for nurse training to the Office of Public Health Nursing. Form 3300- Public Health Nurse Training Activity must be used as the invoice for payment. 5. The Department shall submit on an annual basis Staff Time Activity Report, 3389, Environmental Health Report, 3738, and Food and Lodging Report, 3888. The reports shall accompany the final expenditure report and must be received by the State within 45 days after the end of the contract period. D. PERSONNEL POLICIES The Department shall adhere to and fully comply with State personnel policies as found in North Carolina General Statute, Chapter 126, and 1 NCAC 8. Such policies include, but are not limited to, the following: 1. Equal employment opportunity; 2. Affirmative action; 3. Policies for local government employment subject to the State Personnel Act; 4. "Local Classification and Salary Range"; 5. "Compensation Policy for Local Competitive Services Employees'; and 6. 'Recruitment and Selection Policy and Procedures'; 7. Environmental Health Specialists employed by the Department shall be delegated authority by the State to administer and enforce State environmental health rules and laws as directed by the State pursuant to G.S. 130A-4(b). This delegation shall be done according to 15A NCAC 10. 0100. a. Local health departments are responsible for sending their newly- employed environmental health specialists (intems) to centralized training within 180 days from date of employment. b. Arrangements for centralized training for newly-employed environmental health specialists will be handled by the Education and Training Staff, Division of Environmental Health. a C. A local health department which is contracting with an environmental health specialist employed by another department shall be responsible for assuring that all original documents, correspondence, and other public records be maintained in the health department using the contractor and the contract shall stipulate that the contractor shall be available for consultation to the public being served. 8. The Department shall comply with Minimum Standard Health Department Staffing 15A NCAC Section .0301(c), and shall assure that all nursing staff who provide public health services funded by this contract comply with this rule. Page 8 of 11 E. CONFIDENTIALITY All information as to personal facts and circumstances obtained by Department personnel in connection with the provision of services or other activity under this Contract shall be privileged communication, shall be held confidential, and shall not be divulged without the responsible person's written consent except as may be otherwise required by applicable law or regulation. Such information may be disclosed in summary, statistical, or other form which does not directly or indirectly identify particular individuals. F. CIVIL RIGHTS 1. The Department shall assure that no person, on the grounds of race, color, age, • , religion, sex, marital status, immigration status, or national origin (unless otherwise medically indicated) or otherwise qualified handicapped individual solely by reason of his/her handicap be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity covered by this Contract. 2. The Department shall complete HHS Form 690, Assurance of Compliance with Title VI of the Civil Rights Act of 1964, Section 504 of the Rehabilitation Act of 1973; Title IX of the Education Amendments of 1972, and the Age Discrimination Act of 1975; for the Women, Infants and Children Program, FNS-64, Assurance of Compliance with the Department of Agriculture Food and Nutrition Service, under Title VI of the civil Rights Act of 1964; 3. The American with Disabilities Act 1990 (ADA) makes it unlawful to discriminate in employment against a qualified individual with a disability and outlaws discrimination against individuals with disabilities in State and local government services and public accommodations. The Department certifies that it and its principals and subcontractors will comply with regulations in A.D.A. Title I (Employment), Title II (Public Services), and Title III (Public Accommodations) in fulfilling the obligations under this agreement. G. RESPONSIBILITIES OF THE STATE 1. The State shall provide to the Department upon request technical assistance in the preparation of the Consolidated Contract, Activity Budgets and Contract Addenda. 2. The State shall specify those administrative forms/reports and their respective revision dates that are required by particular activities pertaining to the Department's budget with the State in Listing of Required Fiscal and Statistical Reports (Addendum 1)for the contract period. New forms/reports not listed in Required Fiscal and Statistical Reports shall be implemented during a contract period only with the approval of the State Health Director. 3. The State shall provide to the Department within thirty(30) days after receiving an acceptable activity budget from the Department an approved signed copy of the budget. 4. The State shall provide funds to the Department upon approval of the Contract Addenda, activity budgets, and signing of this contract. 5. The State shall assist the Department to comply with all applicable laws, regulations, and standards relating to the activities covered in this contract. 6. The State reserves the right to conduct reviews to determine compliance with the terms of this contract. H:\WP61\CONTRACT\CONSOLID\99-OOCC.FRM Page 9 of 11 7. The State shall be assured that the Department maintains expenditure of locally appropriated funds for maternal health, child health, and family planning activities equal to or greater than that reported on the Staff Time Activity Report for the period beginning July 1, 1984, and ending June 30, 1985. This maintenance of effort shall be measured by salary equivalencies which are to W rnedr.tair'sed in accordance with Section S. 7. of this contract. H. DISBURSEMENT OF FUNDS The State shall disburse funds to the Department as follows: 1. Provided the Consolidated Contract is properly executed and all quarterly expenditure reports are filed within the established time frames, payments equal to 1/12 of the total program approved budget shall be made in the following months: July August September October November January February April May Based on expenditures reported for the first, second, and third quarters, payments shall be adjusted either upward or downward, in payments made in the following months: December March June 2. For departments selecting quarterly reimbursement option, payments shall be made when the quarterly expenditure report is received. Quarterly payment for reported expenditures shall be limited to one-fourth of the budgeted amount 3. For departments receiving Rural Obstetrical Care Incentive funds, payment of such funds shall be made in one Jump sum the month following receipt and approval of the activity budget. 4. For departments receiving Healthy Start or Minority Infant Mortality Reduction project funds, payment will be based on actual reported expenditures. Monthly payments will be made provided that expenditure reports are received as required in C. 4. g. 5. Food and lodging fees will be disbursed to the department in one sum the month following receipt and approval of the activity budget and any subsequent budget revisions. 6. Funds for Childhood Lead Poisoning Prevention will be disbursed once per year. The amount will be determined by the number of confirmed cases identified in each county. A separate contract addendum must be submitted with budget page in order to receive these funds. Funds for training will be disbursed upon request. 7. Increased or decreased payments necessitated by changes in the total budgeted amount will be reflected in the monthly payments subsequent to approval of the budget revision. 8 Payments shall be suspended when expenditure reports are not received by the time specified in C. 4. a,b, e and g. Payments will resume in the months subsequent to receipt of the expenditure reports. 9. Payment is limited to the total amount of the budget by line item as reported on Expenditure Report 2949. H:\WP61\CONTRACT\CONSOLI D\99-OOCC.FRM Page 10 of 11 10. Final payments will be made based on the 4th quarter expenditure report. Final payments will be equal to the difference between approved reported expenditures and the sum of previous payments. Final payments should be made not later than September provided that an original signed copy of an expenditure report for each quarter has been received by the Office of the Controller. Final payment will be made only after the Staff Time Activity Report, 3389, Environmental Health Report, 3788, and Food and Lodging, 3888 are received by the State. I. AMENDMENT OF CONTRACT Amendments, modifications, or waivers of this contract may be made at any time by mutual agreement of all parties. Amendments shall be in writing and signed by appropriate authorities. J. PROVISION OF TERMINATION This contract may be terminated for reasons other than non-compliance upon sixty (60) days written notice by either party. If termination should occur, the Department shall receive payment only for allowable expenditures. The State may withhold payment to the Department until the State can determine whether the Department is entitled to further payment or whether the State is entitled to a refund. K. COMPLIANCE 1. The State shall assure compliance with all terms of this contract. a. Upon determination of non-compliance, the State shall give the Department sixty (60) days written notice to come into compliance. If the deficiency is corrected, the Department shall submit a written report to the State which sets forth the corrective action taken. b. If the above deficiencies should not be corrected to the satisfaction of the State after the sixty(60) day period, disbursement of funds for the particular activity may be temporarily suspended pending negotiation of a plan of corrective action. C. If the deficiency is still not corrected within the next thirty (30) days following temporary suspension of funding, program funds may be permanently suspended until the Department can provide evidence that the deficiencies have been corrected. d. In the event of the Department's non-compliance with clauses of this contract, the State may cancel, terminate, or suspend this contract in whole or in part and the Department may be declared ineligible for further State contracts or agreements. Such terminations for non-compliance shall not occur until: (1) the provisions of Section K-1 (a-c) have been followed, documented, and have failed to provide a resolution, (2) all other reasonable administrative remedies have been exhausted. 2. If the Department or the State should be determined out of compliance with the provisions of the contract, either party may file a formal appeal with the Office of Administrative Hearings. e Page 11 of 11 IN WITNESS WHEREOF, the Department and the State have executed this agreement in duplicate originals, one of which is retained by each of the parties. LOCAL SIGNATURES STATE OF NORTH CAROLINA �� 1 �YU 1L�- i 21ru(z L41101 Health DirectoT Elate By f. 4 State Health Doctor or Authorized Agent Finan fficer Date Chairma of County Commissioners Date (when required) • s ASSURANCE OF COMPLIANCE ASSURANCE OF COMPLIANCE WITH TITLE VI OF THE CIVIL RIGHTS ACT OF 1964, SECTION 504 OF THE REHABILITATION ACT OF 1973,TITLE IX OF THE EDUCATION AMENDMENTS OF 1972,AND THE AGE DISCRIMINATION ACT OF 1975 The Applicant provides this assurance in consideration of and for the purpose of obtaining Federal grants, loans,contracts, property, discounts or other Federal financial assistance from the Department of Health and Human Services. THE APPLICANT HEREBY AGREES THAT IT WILL COMPLY WITH: 1. Title VI of the Civil Rights Act of 1964 (Pub. L. 88-352), as amended, and all requirements imposed by or pursuant to the Regulation of the Department of Health and Human Services (45 C.F.R. Part 80), to the end that, in accordance with Title VI of that Act and the Regulation, no person in the United States shall, on the ground of race, color, or national origin, be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any program or activity for which the Applicant receives Federal financial assistance from the Department. 2. Section 504 of the Rehabilitation Act of 1973 (Pub. L. 93-112), as amended, and all requirements imposed by or pursuant to the Regulation of the Department of Health and Human Services (45 C.F.R. Part 84), to the end that, in accordance with Section 504 of that Act and the Regulation, no otherwise qualified handicapped individual in the United States shall, solely by reason of his handicap, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity for which the Applicant receives Federal financial assistance from the Department. 3. Title IX of the Educational Amendments of 1972 (Pub. L. 92-318), as amended, and all requirements imposed by or pursuant to the Regulation of the Department of Health and Human Services (45 C.F.R. Part 86), to the end that, in accordance with Title IX and the Regulation, no person in the United States shall, on the basis of sex, be excluded from participation in, be denied the benefits of, or be otherwise subjected to discrimination under any education program or activity for which the Applicant receives Federal financial assistance from the Department. 4. The Age Discrimination Act of 1975 (Pub. L. 94-135), as amended, and all requirements imposed by or pursuant to the Regulation of the Department of Health and Human Services (45 C.F.R. Part 91), to the end that, in accordance with the Act and the Regulation, no person in the United States shall, on the basis of age, be denied the benefits of, be excluded from participation in, or be subjected to discrimination under any program or activity for which the Applicant receives Federal financial assistance from the Department. The Applicant agrees that compliance with this assurance constitutes a condition of continued receipt of Federal financial assistance, and that it is binding upon the Applicant, its successors, transferees and assignees for the period during which such assistance is provided. If any real property or structure thereon is provided or improved with the aid of Federal financial assistance extended to the Applicant by the Department, this assurance shall obligate the Applicant, or in the case of any transfer of such property, any transferee, for the period during which the real property or structure is used for a purpose for which the Federal financial assistance is extended or for another purpose involving the provision of similar services or benefits. If any personal property is so provided,this assurance shall obligate the Applicant for the period during which it retains ownership or possession of the property.The Applicant further recognizes and agrees that the United States shall have the right to seek judicial enforcement of this assurance. The person or persons whose signature(s) appear(s) below is/are authorized to sign this assurance, and commit the Applicant to the above provisions. Date Signature and Title of Authorized Official Otani a County Hw1th Depart amt Name of Applicant or Recipient 300 W. gym Street Street HillsboL+aigh, NC 27278 City,State,Zip Code Form HHS-690 5197 Y d . •e:e�"w D.S. DWARTMM Or ALXl=T-1Z mss•-��M«i••.s M M.sw. road and Nutrition Service ASSURANCE OF COMPLIANCE WITH THE DEPARTMENT OF AGRICULTURE. FOOD AND NUTRITION SERVICE. UNDER TITLE VI OF THE CIVIL RIGHTS ACT OF 1964 CRXM QX M HEALTH 1E"ARMIM wHsae of Applicant) (8erataafter called the "Applicant.") W=T A=7tW ZUT it will comply with Title VI any improvements made with Federal financial Of the Civil lights Act of 1964 (l.L. 88-332) assistance extended to the Applicant by the and all roqulsaments imposed by the Regulations Department. TAU includes any Federal agreement, of the Department of Agriculture (7 CTR Part 13), arrangement. or other. contract which has as one Department of justice (28 Cn Parts 62 i 30), of its purposes the provision of assistance ouch and FHS dirocttves or regulations issued as food, food stamps, cash assistance far the pursuant to that Act and the Regulations, to the purchase of food. and cash assistance for purchase affect that, to person in the United States #hall, or rental of food service equipment or any other on the ground of race, color. or national origin, financial assistance extended in reliance an the be excluded from participation in, be denied the representations and agreements made in this benefits of, or be otherwise subject to dis r.•=i- assurance. nation under any program: or activity for which the Applicant received Federal financial assistance BY ACCTTTINC THIS ASSMNCE, the applicar.: agrees from the Depar=en:; and XXEMI GIVES ASSUU%iCE to carne data, maintain records and submit MUT it will izmsdistsil take any measures reports as required, to pewit effective enforce- necessary to effectuate this agreement. sent of Title VI and pert authorized USDA personnel during normal working hours to review THIS ASSURANCE is ;Sven in considers•-ion of and such records. books mud accounts as needed to for the purpose of obtaining any and all Federal ascertain corliance with Title VI. If there are financial assistance. grants and loans of Federal any violations of this assurance, the Department funds, reimbursable expenditures. grant or of Agriculture.Joad and Nutrition Service. shall donation of Federal property and interest in have the right to seek judicial enforcement of property. the detail of Federal personnel, the this "Sur a. sale and lease of, and the pe—.—Usian to use. Federal property or interest in such property or This assurance is binding on the applicant, its the furnishing of services withmt eaasideratian successors, transferees, and assignses as long as or at a maximal consideration. or at a consider it receives assistance or retains possession of Ulan which is reduced for the purpose of assist- any assistance from the Department. The person ing the recipient, or in recognition of the or persons whose signatures appear below are Public interest to be served by such sale, lease. authorized to sign this assurance an the behalf of or furnishing of services to the recipient. a. the applicant. Dated ✓ (Applicant) Ry Obair, Otte County 0XN Smi0Vfir (Sttis of authorized official) 300 W. Tcym St. Hillsbacough, NC 27278 (Addraas of Applicant) No further sonies or other benefits say be paid out under Toad and Nutrition Service Federal assistance Programs unless this AasurinCe is cast,leted sad filed as required by existing regulations (7 CFR 15).-