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Home My WebLink AboutORD-2018-033 NC Governor’s Highway Safety Program grant ORD-2018-033 ORANGE COUNTY BOARD OF COMMISSIONERS ACTION AGENDA ITEM ABSTRACT Meeting Date: October 16, 2018 Action Agenda Item No. 8-k SUBJECT: North Carolina Governor’s Highway Safety Program: Orange County Sheriff’s Office Traffic Safety Project and Approval of Budget Amendment #2-B DEPARTMENT: Sheriff’s Office ATTACHMENT(S): Traffic Safety Project Contract Agreement of Conditions Local Government Resolution INFORMATION CONTACT: Sheriff Charles S. Blackwood, 919.245.2900 Jennifer Galassi, Legal Advisor, 919.245.2952 Sgt. T. Brian Whitehurst, Sheriff’s Deputy and North Carolina Governor’s Highway Safety Program Triangle Region Law Enforcement Liaison, 919.245.2900 PURPOSE: To: 1) Adopt a Resolution accepting federal funding for traffic safety projects for the Sheriff’s Office; 2) Authorize the Chair to sign the Resolution; and 3) Approve Budget Amendment #2-B for receipt of the funds. BACKGROUND: The North Carolina Governor’s Highway Safety Program (the “GHSP”) partners with Law Enforcement Liaisons to promote highway safety awareness and to reduce the number of traffic crashes and fatalities in the State. Law Enforcement Liaisons (“LEL”), located in the eleven regions in which the GHSP divides the State, are full time law enforcement officers. An LEL serves as a coordinator and organizer for highway safety activities in his/her respective region and as liaison to the GHSP Office in Raleigh. Some of the duties of an LEL include: • promoting traffic safety measures in the region, • supporting and informing law enforcement agencies within those regions of current and upcoming campaigns, • providing information and guidance in the grant process by assisting agencies with questions, and • directing them to the appropriate grant manager for their region. LELs communicate on a regular basis with the county coordinators in their region and assist them with their efforts to promote activities and campaigns on the county level. “Booze It & Lose It” and “Click It or Ticket” are well known GHSP campaigns. Additionally, LELs monitor 1 campaign reporting in their regions and ensure all agencies are participating in the reporting of campaign statistics. LELs are required to attend quarterly meetings held throughout the State with GHSP staff, the annual Lifesaver National Conference on Highway Safety Priorities in the spring, and assist with planning, set up, operations, and tear down of the annual North Carolina Highway Safety Symposium. To facilitate travel, training, and the other activities of the LELs, GHSP awards a grant to the employing agency of each LEL. The grant funds travel, training, and traffic safety equipment for the agency. Sgt. T. Brian Whitehurst of the Orange County Sheriff’s Office is the Law Enforcement Liaison for Region 5. The GHSP approved an application from the Sheriff’s Office’s for Fiscal Year 2018-2019 in the amount of $20,000. This funding will allow the Sheriff’s Office to purchase: 1) two (2) Radars, including shipping and installation; 2) one (1) Lidar, including shipping; 3) five (5) Alco-Sensor FST; 4) Intoxiclock Alcohol Education Kits with accessories; 5) meals for Law Enforcement County Coordinator (LECC) meetings; and 6) fund the LEL’s travel to the required meetings, conference, and symposium. FINANCIAL IMPACT: The Orange County Sheriff’s Office will receive $20,000 in grant funding. Funding comes from federal sources and requires no local cash appropriation. Budget Amendment #2-B provides for the receipt of these grant funds. SOCIAL JUSTICE IMPACT: The following Orange County Social Justice Goal is applicable to this item: • GOAL: CREATE A SAFE COMMUNITY The reduction of risks from vehicle/traffic accidents, childhood and senior injuries, gang activity, substance abuse and domestic violence. Receipt of GHSP grant funding will allow the Orange County Sheriff’s Office to advance the North Carolina Governor’s Highway Safety Program’s purpose to promote highway safety awareness and to reduce the number of traffic crashes and fatalities in the State, objectives which overlap with this Social Justice Goal. RECOMMENDATION(S): The Manager recommends that the Board: 1) Adopt the North Carolina Governor’s Highway Safety Program Local Governmental Resolution recognizing federal funding for traffic safety projects to the Sheriff’s Office; 2) Authorize the Chair to sign the Resolution; and 3) Approve Budget Amendment #2-B for the receipt of the $20,000 in federal grant funds. 2 3 North Carolina Governor's Highway Safety Program Traffic Safety Project Contract — Form GHSP-01 Zi 19 i A: : ii J 1. Agenc y 14. Contact Person for Agency: ORANGE COUNTY Timothy Whitehurst ................... ...................................._.1_..._..__.__............... ....................... 2. Agency Address: 5. Telephone Number: SHERIFF +1 (919) 245-2900 PO Box 8181 ----------- ........... ....................... HILLSBOROUGH, NC 27278 6. Cell Phone: 336-212-0608 .......................................... ............. 3. Physical Location of Agency 7. Email of Contact Person 106E Margaret Ln. Hillsborough, NC 27278 bwhitehurst@orangecountync.gov 8. .................................................... .......................................................................................................................................................................................................... Federal Tax ID Number/Type of Agency 19. Project Year Federal Tax ID Number: *56-6000327 New (97:Continuation DUNS No : 0-44041796 Year: C 1 (7 2 3 (-9,4+ County: *ORANGE COUNTY ........... .......................................................................... ......................................................................................................................... Type of Agency 10. Allocation of Funding State Non-Profit County Higher Education E Federal % 100.00 Local % 0.00 (7 Municipality (7. Hospital ..............................I................... ................................-..................................................................... ----- ............. 11.Project Title: * Region 5 LEL Source of Funds j12. Budget Total Project Amount Federal Amount State/Local Amount JPersonnel Costs ...............................-.............. I............................................ .._.._._-_.a.. ....................................I................... ................................................................................................................................. .................1--....................................*........................*...................*.................. Contractual Services .............. .............. ........................................................................................................................ .................................I....................................I..................................I...............................................................I.............. -. .... I.......................................................................................:........................ ...................... ......................... Commodities Costs ...........I................................................................................................................................- .................................... ....................1,.................. ........................................... ................ ' Other Direct Costs $20,000.00 $20,000.00'. ............... ..........*......................... .....................................................................................................................................................................................................I.............. ................................................................................. .......... ..............I.......................................................................................................................................... Indirect Costs f i 0 Total Project Costs $201'00 .00 $201000.0 ................ ............. 13. Specify How Non-Federal Share Will Be Provided: NIA ---------- ............. ..................................... ............ ................................................................ (Project Number: CFDA#: 20. 600-State and Community Highway Safety PT-19-06-15 Work Type: Law Enf Liaison 711 Statement of Problem Provide detailed information of the highway safety problems in your area to be addressed through this project.Include countywide crash data for the last three years and any other relevant information to validate the statements.For more detailed information see"How to write an effective traffic safety project"located at: htti2s.-Ilconnect.ncdotgovlmunicipalitiesILaw-EnforcementIPagesILaw-Enforcement-Reportinci,aspx) .............. ......................................- ................................................................. ...................-.......................... .......... ...............I.................... ................................................................................................................. ....................................................................... ........................ A Regional Law Enforcement Liaison serves as coordinator and organizer for highway safety activities in their respective region. The GHSP supports and oversees the statewide"Booze it& Lose it"and "Click it or Ticket" programs. Coordination of these programs is accomplished by utilizing 11 regional "Law Enforcement Liaison" positions. Through the guidance and coordination efforts of the Liaisons, planning and preparation and reporting activities from the event(s) occur. Efforts to continue to promote and involve law enforcement agencies in these lifesaving endeavors are of paramount importance to this statewide program. To this end, LELs are required to host events, attend and conduct meetings, assist County Coordinators with organizing highway safety campaigns, and encouraging agencies to report activities. The Orange County Sheriffs Office has continued to see an increase in speeding violations. The majority of enforcement taking place on major roadways due to their high crash volume, speeding continues to be a leading cause of crashes within our county. if ........................... ...................I............................................................................................. .............................................................................................................................................................................................. ................ Version 1.0 Page 1 of 6 4 1Nith funding for 2 additional Radars and 1-Lidar, more officers can be placed in areas to combat this concern. Our hope is that more enforcement leads to less crashes. Provide the agency's number of sworn officers 105 Does the agency currently have a dedicated traffic or DWI unit? Yes ( No ( , If a dedicated traffic or DWI unit exists, how many officers are assigned to the unit? tt s://connect.ncct, pOV/municipalities/Law-Enforcement/Paaes/Law-Enforcement-ReAOrting.asaxl Overall Fatality Ranking: 38 Alcohol Fatality Ranking: 31 Unrestrained Fatality Ranking: 57 Speed Related Fatalities: 23 Other Applicable Rankings: (Specify) Year 2015 Occupant Protection Citations 6i DWI Citations 11 Speed Citations 208' __ .. Year 2016 Occupant Protection Citations 2 DWI Citations 271 Speed Citations 337 _... . ..__.... ...._..._ _.......... --- Year 2017 Occupant Protection Citations 2 DWI Citations 341 Speed Citations 547; _._.... ........ .. ......... _... Goals and Objectives _(Provide at least one SMART(Specific, Measurable, Attainable, Realistic and Timely)goals and objectives. For more detailed information see "How to write an effective traffic safety project"located at: !https.//connect.ncdot.aov/municipalities/Law-Enforcement/Pages/Law-Enforcement-Reportingcaspx - -... . Goal#1: Promote highway safety within Region 5 with increased efforts to raise seatbelt use above 92.5% by September 30, 1 2019. Obtain 87% reporting of all law enforcement agencies in Region 5 by September 30, 2019. ........... .. ..... ... . ............... ..... ...... . . _..._._. ................... .. .............. ......... ......... ................ - .._. . ...._i Objectives: 1. Conduct a minimum of four Law Enforcement County Coordinator(LECC) meetings to discuss current highway 1 safety activities, GHSP issues, training opportunities, and legal updates and concerns. 2. Gather LECC monthly reports, awarding 25 GHSP STEP system credits for Coordinators each month they submit one. 3. Compile a quarterly regional report for GHSP that includes a summary of the reports from the LECC's and the activities by the RLEL. 4. Promote night time seatbelt initiatives, GHSP campaigns and events within Region 5. 5. Host annual "Kick Off' event meetings to set agendas, coordinate quarterly meetings and provide information flow in regards to GHSP campaigns. Goal#2: __. . ._... .._ ...._... .......... __.. . ... .. ...._._. _.__ ._._... -- . Objectives: _........ _............_._......._......_..................._._................................................................_........_........._..._......._..._.................._._......_......_.......-__.......__.............. i Goal#3: i ............ (Objectives: • • •. • • • • o • • • • • • • • • Version 1.0 Page 2 of 6 5 ......................I.................................................................. ..........................................................I.........................I................................................................ ........................................................................ Z Reduce NC's traffic-related fatalities by 25%from the 2008-2012 average of 1,317 to 988 by 2020. __._._...__...........................................................................................___..__._..._........................I............................._._..___._..___._...................................._.__._..----------- Reduce NC's alcohol-related fatalities by 35%from the 2008-2012 average of 386 to 251 by 2020. ......................I...........1 11..........11 1 1- 1..............................................................I...... I.....................................I..................... ................................... ... . .................................................................................................................................................................................................... .......... M Reduce NC's unrestrained fatalities by 30%from the 2008-2012 average of 407 to 285 by 2020. ................................................................................................. ...............................................................................................................................................................................................................................................................................................................................I...................................... ..................... Reduce NC's speed-related fatalities by 25%from the 2008-2012 average of 479 to 359 by 2020. ..................................................................................................................................................................... ..."........................................................................................................................................ ............................................................................................. .................................................................................................... Reduce NC's young driver-involved fatal crashes by 30% from the 2008-2012 average of 196 to 137 by 2020. .............................................................I..........I..-..................................................................................................................................................................................................................................................................................................................................I -,.................I..............................I...............................................I............................................ M Reduce NC's motorcycle fatalities by 25%from the 2008-2012 average of 177 to 133 by 2020. ............ .............................................................1 -.1-..........I.,...........................................................................................................................- I ....................................................................................................................................................................................................................................................................... Increase NC's seat belt usage rate 4.4 percentage points to 95% by 2020. -M r ER ' 'a a%WU # Personnel Position S ........................... ....................................................................................................................................... ...................................... ................................................................... ..................................................................................................................................................................................................... 2 .............. .............I.............. ......................................................... ................................................................... ........................................................................................................................................... ............................................................................................I................................................. 3 ...............................I....................................................I.-............................................................. ....................................................................................................................................................................................................................................................................................................................................... 4 .......................................................................................... ...................... ..................................................................................................................................................1.11...................................................................................................................................I........................._............................................ 5 ............................................................................................................... .................................................. ...............I........................ ....... ........... ................................................................................................................................................................................................ 6 11.......................................... ................... .......... ........... ................. 7 ............ .................................................--------- ........... .......................................... ................... ........ ........... ..........__............ ............. ........... ................ ............... -------- ------------ 9 10 ...................................................... ....................................................................................................................... ................... ................................................... ........... Total Salaries Cost: ...................... ........................................ ........... .................. ........................... Personnel Fringe Benefits .............. .. ....N..._..... .................................................................................... ................................................................... ................................................... .................. ............I......................... .................................. .................................................. ................................................ 2 ..................I..................... ...........................................................................�............................................................................................................................................................................... ............................................................................I.......................... ........................................................... 3 .................................... ................................................................................................................................................................................................................................................................................................................................................................................... ............ ................................................................................ 4 .................................................................................. ............-........................ ................. ....... ........._._.__............................ ----------------------- 5 ..........._,.................................................................................. .............................................. ........................................... ............................... ........................... ...... .........__................ .................... ........... ._..:..._.:._......._......_...__..____...__•-_-•__... .. . 7 ..................I............... .....................I........... 8 ............ ......... ............................. .....................................,............ 9 .............................. ..........I.............................................................. ..................................... ---------- 10 ............ ...............I...........................I......................._...................................................................................................................................................-.......................................................................................................................................................................................................................................................................... Total Fringe Benefits Cost: ................................11...................................................................................................................................................................................... .................................................................................................................................................................................................................................................................................... Total Personnel Costs: Contractuall Services # Contractual Service To Be Provided Cost ........... ........... ..................................................... ........................................................................................................................................................................................................................................................................................................................................................ .................................................................................................................... 2 ...........I.,.................................................................................................................................................................................................................................................................................................................................................................................................................................-............................-......................... 3 ...........-........................................................................................ ........................................................................................................................................................................................................................................................................................................................................................................................................ 4 ........................................... ............................................................................................................................................................................................................................. .............................................................................................. .......................................................... .................... 5 ........................... ................................ .....................'___,__.............................................................. 6 ................. ....................................... ......... ................ ............. 7 ................................. ......--------................................. Version 1.0 Page 3 of 6 6 ............. ..........__...._......... ............................................. ...................... ....................__............................................I....-,............. ................. ............. 8 ............................................................................................ 9 -.1............................I............... ........................................................1....................I............................................................................................................................................................................................................. ...................................... .......................................................I........................ 10 .............................................................................................................................................. ...................... ................... ...................................... ....................................................................................- ................................................. ......................I.,...................... i .. ........... .................... ..................... ......................... ................ ....................................... .......................................................................................................................................... ....................................................................................... Total Contractual Services: 9� .......... ' ' " Commodities ........... E It N SEEM ........... ............................................................................................................................................................................................................................... ........................................................................... ............................................................................................................................................................... 2 ............... ..........I........................................................._.......................... ........................................................................................................................... ........... .................. ................. ....................................................11..........................I................................I................................ 3 .......... ................. ........................................................................._...........................................................................................I..................................................... ................................. ............................................................. ............................I............................................. ............ 4 .......... .............................................. ................... ................ .........._..,............................ ..................................................... ........................................._.......... ........................................................................................ 5 ........... .............. ........... .............................. ............. ........... ....................................................... .......... .............. 6 -----------__................. ................ .............. ..........__......... ............... .................................... ....... 7 8 ............ -------...... ..........................................................................------- 9 ........... ........................ ...................................... ............................... ............... ...... 10 ............................................__...................I.............I.......................................................................................................................................... ....................................... ....................................................... ............................ ............................................................................................ 11 12 ..............I...............................__......................................................................................................................................... .......................................................-.1............................................................ ........................................................................................................................ . ............... .......................................................... ............................................ ....................................................................................................................................... .............................. ............................. ........................................................... .................................................. ................... Total Commodities Cost: Mimi # 'Equipment 'Quantity 'Cap Amount Cost .................. 1 Radar Includes installation and shipping 2 $2,500.001 $5,000.00i . ..................... ....................................................................................................................................................................................................................................... ...................I................................................................................................ i ........... ...................... 2 Lidar-Includes shipping 1 $3,500.001 $3,500.001, ''' "" ........... .................................. ............. ....................................................... .................. ..................... 3 .......................... . ............................................................................................................... ............................................................... ................. ............ 4 .................................... ........... ........... ..........I.,..,......-............. .................. .............. t .......... ------------- ------- 5 _.................__................................ ....................................................... ........... .............. ................. 6 ....................................................... ................... ...................... ................ ..................... 7 -------...... ........... ------ ............. ................................................ ..................... ......................... ..................................... Total Equipment Cost $8,500.001 ........... # Other items and Equipment Direct Cost: (Cost Limited to Less Than$5000 Per Item) Cost ...................... 1 5 Alco-Sensor FST $2,500.001 I ..................................................I...................................... ......................................... ........................................... .......... .................................................................... I.......... ..................................................... ............. .................... .......... 2 Intoxiclock Alcohol Education Kit w/accessories $3,600.001 ........................................................I.........................................................................11.1........................................................................ ................................................I.................... .............................. ........................................................................................ ......................................................................................i 3 Meals for LECC Meetings $400.001 ............ ................................................1.............................................................................................................. ............................................................................................................................................... ...................................................................................I.................................................................. 4 ........ ............. 5 ..........*.....................*............................... .............,...........*...............*...................... ..........*"*"**'*"**'""**"**'*"*"'"'*............................. .............J._,::........................... ........................................................ ............................... ........................................ .......................................................... ...............................................................__------ .................... 6 .................... ........... .......................I...................... ............................................... ........................1........----------- 7 ................... ..................................... .......................... 8 ....................... ....................................................I.-................................................................................................... Total Other Items and Equipment Direct Cost: $6,500.001 'Travel Cost ................ 1 -State Travel $2,000.00i ..........[In .......... ............................... ........ ......I..................................... ............. ..................................................... .............................................................................................................................................................. ....................................................... ................. .............................. ................................... Version 1.0 Page 4 of 6 7 J]Out-of-State Travel l $3,000.00` _..._......_.......:_....._._............_......_........................_..-- ...._..._-_.................._.__.._.........._...............__.._....._._._......... ................1..._...._........................... Total Travel Cost: $5,000.00; ..........................................................................................................._.........................................................._................._.......................-. . Total Other Direct Costs: $20,000.00 It Indirect Costs i Cost .......... ....-.-..............._... ................................. E 1.... . _ 2 3 .... ........... ............... . ........................... � • ..................... ... 4 f t To a Indirect C 3 n i Costs List the schedule of tasksby quarters, referring specifically to-the objectives in Section B: Tasks should be a bulleted list of activities to be performed in each quarter. Conditions for Enforcement Projects Only By checking rs ox, me above agency agrees to me terms below as additional activities to be perTo—rmed as part of rs project. A minimum of one (1) nighttime and one (1) daytime seat belt initiative per month; A minimum of one (1) impaired driving checkpoint per month; ® A minimum of 50% of seat belt initiatives must be conducted at night between the hours of 7:00 p.m. and 7:00 a.m.; Participation in all "Click It or Ticket" and "Booze It& Lose It"campaigns; Participation in any event or campaign as required by the GHSP; Attempt to utilize one of the Forensic Tests for Alcohol Branch's Mobile Breath Alcohol Testing (BATMobiles) units during at least one of the impaired driving checkpoints. ............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................ First Quarter(October, November, December) •Attend all GHSP meetings and events. i • Conduct a minimum of one county coordinator meeting. • Meet with a minimum of three non-participating/reporting agencies within the Region. • Collect monthly LECC reports and compile into the regional quarterly report. •Attend and/or conduct minimum two night time seat belt initiatives. • Conduct/provide support for a minimum of 3 presentations using the DWI Simulator j • Conduct/provide support for a minimum of 2 presentations using the Convincer ......................................................................................................................................................................................................................................-..................._...............-.............................._.......................................................................... Second Quarter(January, February, March) •Attend all GHSP meetings and events. • Conduct a minimum of one county coordinator meeting. • Meet with a minimum of three non-participating/reporting agencies within the Region. • Collect monthly LECC reports and compile into the regional quarterly report. •Attend and/or conduct minimum two night time seat belt initiatives. • Participate in yearly GHSP grant review meeting. • Conduct/provide support for a minimum of 3 presentations using the DWI Simulator • Conduct/provide support for a minimum of 2 presentations using the Convincer Third Quarter(April, May, June) •Attend all GHSP meetings and events. • Conduct a minimum of one county coordinator meeting. • Meet with a minimum of three non-participating/reporting agencies within the Region. • Collect monthly LECC reports and compile into the regional quarterly report. •Attend and/or conduct minimum two night time seat belt initiatives. • Participate in yearly GHSP grant review meeting. • Conduct/provide support for a minimum of 3 presentations using the DWI Simulator Conduct/provide support for a minimum of 2 presentations using the Convincer .....................--....................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................... Fourth Quarter(July,August, September) (•Attend all GHSP meetings and events. • Conduct a minimum of one county coordinator meeting. • Meet with a minimum of three non-participating/reporting agencies within the Region. • Collect monthly LECC reports and compile into the regional quarterly report. Version 1.0 Page 5 of 6 8 Attend an-d/&conduct minimum two night tilTle*S at belt Initiatives. ..... • Conduct/provide support for a minimum of 3 presentations using the DWI Simulator • Conduct/provide support for a minimum of 2 presentations using the Convincer Attend the NCGHSP Traffic Safety Conference ................ ........................—-—-------- ......... .............. AGENCY AUTHORIZING SIGNATURE I have read and accept terms and conditions of the grant funding and attached the Grant Agreement. The information supplied in this application is true to the best of my knowledge. ....................................I........................................................... ................................................... Name: PIN Date: !Oct 1, 2018 1 ............ ................................................. ............ ................................................................................................. .................................................................................................... ........................................................................................................................................... ............................... 1 Note--:—. ........... ........... ............**"*.......................................*.............. ..............................................*..... ......... ............. ............*............... ............................................ 1. Submitting grant application is not a guarantee of grant being approved. 2. Once form has been submitted, it cannot be changed unless it has a status of'Return ........................................................................................................................ ...................................................... ........................... .................................................................................................................................................................................................................................................................................................. ................ Version 1.0 Page 6 of 6 ' 9 AOC / INITIALS Revised 05/2018 North Carolina Governor's Highway Safety Program Agreement of Conditions This Agreement is made by and between the North Carolina Department of Transportation, hereinafter referred to as the "Department", to include the Governor's Highway Safety Program, hereinafter referred to as "GHSP"; and the applicant agency, for itself, its assignees and successors in interest, hereinafter referred to as the "Agency". During the performance of this contract, and by signing this contract, the Agency agrees as follows: A. Federal Provisions 1. Equal Opportunity/Nondiscrimination. The Agency will agree to comply with all Federal statutes and implementing regulations relating to nondiscrimination concerning race, color, sex, religion, national origin, handicaps, and age. These include but are not limited to: (a) Title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d et seq., 78 stat. 252); (b) The Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970, (42 U.S.C. 4601) (c) Federal-Aid Highway Act of 1973, (23 U.S.C. 324 et seq.), and Title IX of the Education Amendments of 1972, as amended (20 U.S.C. 1681-1683 and 1685-1686); (d) Non-Discrimination in Federally-assisted programs of the United States Department of Transportation - Effectuation of Title VI of the Civil Rights Act of 1964 (49 CFR Part 21), hereinafter referred to as "USDOT", as amended; (e) Section 504 of the Rehabilitation Act of 1973, (29 U.S.C. 794 et seq.), as amended, and 49 CFR Part 27; and (f) The Age Discrimination Act of 1975, as amended (42 U.S.C. 6101 et seq.); (g) The Civil Rights Restoration Act of 1987, (Pub. L. 100-209); (h) Titles II and III of the Americans with Disabilities Act (42 U.S.C. 12131-12189) and 49 CFR parts 37 and 38; (1) Executive Order 12898, Federal Actions to Address Environmental Justice in Minority Populations and Low-Income Populations; Q) Executive Order 13166, Improving Access to Services for Persons with Limited English Proficiency 2. Drug Free Workplace. The Agency agrees to comply with the provisions cited in the Drug-Free Workplace Act of 1988 (41 U.S.C. 8103). 3. Federal Grant Requirements and Contracts. The Agency shall comply with the following statutes and implementing regulations as applicable: (a) Highway Safety Act of 1966 (23 U.S.C. Chapter 4-), as amended; (b) Sec. 1906, Pub. L.109-59, as amended by Sec. 4011, Pub. L. 114-94; (c) Uniform Procedures for State Highway Safety Grant Programs (23 CFR part 1300); (d) Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (2 CFR Part 1201); (e) Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (2 CFR Part 200) and all other relevant Federal regulations covering the Highway Safety Program; (f) NHTSA Highway Safety Grant Funding Guidance, as revised, July 2015 (www.nhtsa.gov) and additions or amendments thereto. 4. Political Activity (Hatch Act) The Agency will comply with provisions of the Hatch Act (5 U.S.C. 1501- 1508), which limits the political activities of employees whose principal employment activities are funded in whole or in part with Federal funds. 5. Lobbying. (a) Certification Regarding Federal 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, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. Page 1 ' AOC / (/�✓ IMTIALS Revised 05/2018 10 (ii) 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 Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. (iii) The undersigned shall require that the language of this certification be included in the award documents for all sub-award at all tiers (including subcontracts, subgrants, and contracts under grant, loans, and cooperative agreements) 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 and not more than $100,000 for each such failure (b) Restriction on State Lobbying. None of the funds under this program will be used for any activity specifically designed to urge or influence a State or local legislator to favor or oppose the adoption of any specific legislative proposal pending before any State or local legislative body. Such activities include both direct and indirect (e.g., "grassroots") lobbying activities, with one exception. This does not preclude a State official whose salary is supported with NHTSA funds from engaging in direct communications with State or local legislative officials, in accordance'with customary State practice, even if such communications urge legislative officials to favor or oppose the adoption of a specific pending legislative proposal. 6. Audits. (a) Audit Required. Non-Federal entities that expend $750,000 or more in a year in Federal awards shall have a single or program-specific audit conducted for that year in accordance with the provisions of 2 CFR, Subpart F, §200.500. Guidance on determining Federal awards expended is provided in 2 CFR, Subpart F, §200.502. (b) Single Audit. Non-Federal entities that expend $750,000 or more in a year in Federal awards shall have a single audit conducted in accordance with 2 CFR, Subpart F, §200.501, except when they elect to have a program-specific audit conducted in accordance with 2 CFR, Subpart F, §200.501, paragraph (c). (c) Non-Governmental Entities. Non-governmental entities (not-for-profit and for-profit entities) must adhere to North Carolina General Statute 143C-6.22 and 09 NCAC Subchapter 03M. 7. Instructions for Lower Tier Certification. (a) By signing and submitting this proposal, the prospective lower tier participant (the Agency) is providing the certification set out below and agrees to comply with the requirements of 2 CFR Parts 180 and 1200. (b) The certification in this clause is a material representation of 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 or debarment. (c) The prospective lower tier participant shall provide immediate written notice to the person to which this 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. (d) The terms covered transaction, civil judgement, debarment, suspension, ineligible, participant, person, principal, and voluntarily excluded, as used in this clause, are defined in 2 CFR Part 180 and 1200. You may contact the person to whom this proposal is submitted for assistance in obtaining a copy of those regulations. (e) The prospective lower tier participant agrees by submitting this proposal that, should the proposed covered transaction be entered into, it shall not knowingly enter into any lower tier covered transaction with a person who is proposed for debarment under 48 CFR part 9, subpart 9.4, debarred, Page 2 11 AOC / 1 LI WTIALS Revised 05/2018 suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the department or agency with which this transaction originated. (f) The prospective lower tier participant further agrees by submitting this proposal that it will include the clause titled "Instructions for Lower Tier Participant Certification" including the "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 and will require lower tier participants to comply with 2 CFR Parts 180 and 1200. (g) 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 proposed for debarment under 48 CFR part 9, subpart 9.4, debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous. A participant is responsible for ensuring that its principals are not suspended, debarred, or otherwise ineligible to participate in covered transactions. To verify the eligibility of its principals, as well as the eligibility of any prospective lower tier participants, each participant may, but is not required to, check the System for Award Management Exclusions website (https://www.sam.gov/). (h) 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. (i) Except for transactions authorized under paragraph 7(e) of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is proposed for debarment under 48 CFR part 9, subpart 9.4, 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 or debarment. Q) Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion --Lower Tier Covered Transactions. (i) The prospective lower tier participant (the Agency) 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 covered transactions by any Federal department or agency. (ii) Where the prospective lower tier participant is unable to certify to any of the statements in this certification, such prospective participants shall attach an explanation to this contract proposal. 8. Buy America Act. The Agency and each subrecipient will comply with the Buy America requirement (23 U.S.C. 313) when purchasing items using Federal funds. Buy America requires a State, or subrecipient, to purchase with Federal funds only steel, iron and manufactured products produced in the United States, unless the Secretary of Transportation determines that such domestically produced items would be inconsistent with the public interest, that such materials are not reasonably available and of a satisfactory quality, or that inclusion of domestic materials will increase the cost of the overall project contract by more than 25 percent. In order to use Federal funds to purchase foreign produced items, the State must submit a waiver request that provides an adequate basis and justification for approval by the Secretary of Transportation. 9. Prohibition On Using Grant Funds To Check For Helmet Usage. The Agency and each subrecipient will not use 23 U.S.C. Chapter 4 grant funds for programs to check helmet usage or to create checkpoints that specifically target motorcyclists. 10. Conditions for State, Local and Indian Tribal Governments. State, local and Indian tribal government Agencies shall adhere to the standards established by 2 CFR Part 225, Cost Principles for State, Local, and Indian Tribal Governments and additions or amendments thereto, for principles for determining costs applicable to grants and contracts with state, local and Indian tribal governments. 11. Conditions for Institutions of Higher Education. If the Agency is an institution of higher education, it shall adhere to the standards established by 2 CFR Part 215 Uniform Administrative Requirements for Grants and Agreements with Institutions of Higher Education, Hospitals, and Other Non-Profit Organizations and 2 CFR 220 Cost Principles for Educational Institutions for determining costs applicable to grants and contracts with educational institutions. Page 3 12 AOC / [J� MTIALS Revised 05/2018 12. Conditions for Non-Profit Organizations. If the Agency is a non-profit organization, it shall adhere to the standards established by 2 CFR Part 215 Uniform Administrative Requirements for Grants and Agreements with Institutions of Higher Education, Hospitals, and Other Non-Profit Organizations and 2 CFR Part 230 Cost Principles for Non-Profit Organizations for determining costs applicable to grants and contracts with non-profit organizations. 13. Conditions for Hospitals. If the Agency is a hospital, it shall adhere to the standards established by 2 CFR Part 215 Uniform Administrative Requirements for Grants and Agreements with Institutions of Higher Education, Hospitals, and Other Non-Profit Organizations. B. General Provisions 1. Contract Changes. This document contains the entire agreement of the parties. No other contract, either oral or implied, shall supercede this Agreement. Any proposed changes in this contract that would result in any change in the nature, scope, character, or amount of funding provided for in this contract, shall require a written addendum to this contract on a form provided by the Department. 2. Subcontracts Under This Contract. The Agency shall not assign any portion of the work to be performed under this contract, or execute any contract, amendment or change order thereto, or obligate itself in any manner with any third party with respect to its rights and responsibilities under this contract without the prior written concurrence of the Department. Any subcontract under this contract must include all required and applicable clauses and provisions of this contract. Subcontracting does not relieve the Agency of any of the duties and responsibilities of this agreement. The subcontractor must comply with standards contained in this agreement and provide information that is needed by the Agency to comply with these standards. The Agency must submit any proposed contracts for subcontracted services to the Governor's Highway Safety Program for final approval no less than 30 days prior to acceptance. 3. Solicitation for Subcontracts, Including Procurements of Materials and Equipment. In all solicitations, either by competitive bidding or negotiation, made by the Agency for work to be performed under a subcontract, including procurements of materials or leases of equipment, each potential subcontractor or supplier shall be notified by the Agency of the Agency's obligations under this contract. Additionally, Agencies making purchases or entering into contracts as provided for by this contract must adhere to the policies and procedures of 2 CFR Part 200 and North Carolina General Statute 143-128.4. Historically underutilized business defined; statewide uniform certification as it pertains to Historically Underutilized Businesses. 4. Incorporation of Provisions in Subcontracts. The Agency shall include the provisions of section A-1 through A-13 of this Agreement in every subcontract, including procurements of materials and leases of equipment, unless exempted by the regulations, or directives issued pursuant thereto. The Agency shall take such action with respect to any subcontract or procurement as the Department, the State of North Carolina, hereinafter referred to as the "State", the National Highway Traffic Safety Administration, hereinafter referred to as "NHTSA", or the Federal Highway Administration, hereinafter referred to as "FHWA", may direct as a means of enforcing such provisions including sanctions for noncompliance. Provided, however, that in the event the Agency becomes involved in, or is threatened with, litigation with a subcontractor or supplier as a result of such direction, the Agency may request the Department or the State to enter into such litigation to protect the interests of the Department or the State. In addition, the Agency may request the NHTSA or FHWA to enter into such litigation to protect the interests of the United States. 5. Outsourcing. All work shall be performed in the United States of America. No work will be allowed to be outsourced outside the United States of America. 6. Property and Equipment. (a) Maintenance and Inventory. The Agency shall maintain and inventory all property and equipment purchased under this contract. (b) Utilization. The property and equipment purchased under this contract must be utilized by the Agency for the sole purpose of furthering the traffic safety efforts of the Agency for the entire useful life of the property or equipment. (c) Title Interest. The Department and NHTSA retain title interest in all property and equipment purchased under this contract. In the event that the Agency fails or refuses to comply with the provisions of this Agreement or terminates this contract, the Department, at its discretion, may take either of the following actions: (i) Require the Agency to purchase the property or equipment at fair market value or other mutually agreed to amount; or Page 4 13 AOC 77?V -INITIALS Revised 05/2018 (ii) Require the Agency to transfer the property or equipment and title of said property or equipment, if any, to the Department or to another Agency, as directed by the Department. (d) Non-expendable Property. Non-expendable property is defined as property or equipment having a value of $5000 or more with a life expectancy of more than one year. Non-expendable property purchased under this contract cannot be sold, traded, or disposed of in any manner without the expressed written permission of the Department. 7. Educational or Other Materials. If allowed, any educational or other materials developed using funds from this contract must be reviewed and approved by the GHSP prior to their production or purchase. The cost of these materials is generally limited to a maximum of$5.00 per item. The purchase of promotional items and memorabilia are not an allowable cost. 8. Review of Reports and Publications. Any reports, papers, publications, or other items developed using funds from this contract must be reviewed and approved by the GHSP prior to their release. 9. Reimbursement. (a) General. Payments are made on a reimbursement basis. There is no schedule of advance payments. Only actual allowable costs are eligible for reimbursement. Claims for reimbursement must be made a minimum of quarterly and no more than once a month via the Grants Management System. Claims for reimbursement not made within the three month threshold are subject to denial. The itemized invoice shall be supported by documentation of costs as prescribed by the Department. Reimbursements will not be processed if other required reports are incomplete or have not been submitted. Failure to submit complete reports by the required deadline may result in denial of reimbursement. (b) Approval. The Governor's Highway Safety Program and the Department's Fiscal Section shall approve the itemized invoice prior to payment. (c) Unapproved Costs. Any rejected or unaccepted costs shall be borne by the Agency. The Agency agrees that in the event the Department determines that, due to Federal or State regulations that grant funds must be refunded, the Agency will reimburse the Department a sum of money equal to the amount of Federal and State participation in the rejected costs. (d) Final Claims for Reimbursement. Final claims for reimbursement must be received by the GHSP within 30 days following the close of the approved contract period. Project funds not claimed by this date are subject to reversion. (e) Expending Funds Under This Contract. Under no circumstances will reimbursement be made for costs incurred prior to the contract effective date or after the contract ending date. 10. Project Costs. It is understood and agreed that the work conducted pursuant to this contract shall be done on an actual cost basis by the Agency. The amount of reimbursement from the Department shall not exceed the estimated funds budgeted in the approved contract. The Agency shall initiate and prosecute to completion all actions necessary to enable the Agency to provide its share of the project costs at or prior to the conclusion of the project. 11. Program Income. The Agency shall account for program income related to projects financed in whole or in part with federal funds in accordance with 2 CFR 200.307. Program income earned during the contract period shall be retained by the Agency and deducted from the federal funds committed to the project by the GHSP unless approved in advance by the Federal awarding agency as an addition to the project. Program income must be accounted for separately and the records made available for audit purposes. 12. Project Directors. The Project Director, as specified on the signature page of this Agreement, must be an employee of the Agency or the Agency's governing body. Any exception to this provision must have the expressed written approval of GHSP. 13. Reports Required. (a) Quarterly Progress Reports. Unless otherwise directed, the Agency must submit Quarterly Progress Reports to the GHSP, on forms provided by the Department, which reflect the status of project implementation and attainment of stated goals. Each progress report shall describe the project status by quarter and shall be submitted to GHSP no later than fifteen (15) days after the end of each quarter. If the Agency fails to submit a Quarterly Progress Report or submits an incomplete Quarterly Progress Report, the Agency will be subject to having claims for reimbursement withheld. Once a Quarterly Progress Report that substantiates adequate progress is received, cost reimbursement requests may be processed or denied at the discretion of GHSP. (b) Final Accomplishments Report. A Final Accomplishments Report must be submitted to the GHSP within fifteen (15) days of completion of the project, on forms provided by the Department, unless otherwise directed. If the Agency fails to submit a Final Accomplishments Report or submits an Page 5 ' l 14 AOC � INITIALS Revised 05/2018 incomplete Final Accomplishments Report, the Agency will be subject to having claims for reimbursement withheld. Once a Final Accomplishments Report that substantiates adequate progress is received, claims for reimbursement may be processed or denied at the discretion of GHSP. (c) Audit Reports. Audit reports required in Section A-6 above shall be provided to the Department within thirty (30) days of completion of the audit. 14. Out-of-State Travel. (a) General. All out-of-state travel funded under this contract must have prior written approval by the Governor's Highway Safety Program. (b) Requests. Requests for approval must be submitted to the GHSP, on forms provided by the Department, no less than thirty (30)days prior to the intended departure date of travel. (c) Agency Travel Policy Required. For Agencies other than state agencies, out-of-state travel requests must include a copy of the Agency's travel policy, to include allowances for lodging, meals, and other travel-related expenses. For state agencies, maximum allowable subsistence is limited to the prevailing per diem rates as established by the North Carolina General Assembly. (d) Agenda Required. Out-of-state travel requests must include a copy of the agenda for the travel requested. 15. Conditions for Law Enforcement. In addition to the other conditions provided for in this Agreement, grants to law enforcement agencies are subject to the following: (a) Certifications Required. (i) In-car Camera or Video System. For any in-car camera or video system purchased under this contract, it is required that the operator of that equipment has successfully completed Standardized Field Sobriety Testing training (SFST). A copy of this certificate must be filed with GHSP prior to reimbursement of in-car camera or video systems. (ii) Radar. For any radar equipment purchased under this contract, it is required that the operator of that equipment has successfully completed Radar Certification Training. A copy of this certificate must be filed with GHSP prior to reimbursement of radar equipment. (iii)Alcohol Screening Devices. For any preliminary alcohol screening devices purchased under this contract, it is required that the operator of that equipment has successfully completed the Alcohol Screening Test Device training offered by the Forensic Test for Alcohol Branch. (b) Report Required - Monthly Enforcement Data Report. In addition to the reports mentioned above, law enforcement agencies engaging in enforcement activities must submit a Monthly Enforcement Data Report on the form provided by the Department no later than fifteen (15) days after the end of each month. If the Agency fails to submit a Monthly Enforcement Data Report or submits an incomplete Monthly Enforcement Data Report, the Agency will be subject to having cost reimbursement requests withheld. Once a Monthly Enforcement Data Report that substantiates adequate progress is received, cost reimbursement requests will be processed. The agency head must sign the form. However, the agency head may assign a designee to sign the form by providing written signature authority to the GHSP. 16. Conditions for Local Governmental Agencies. (a) Resolution Required. If the Agency is a local governmental entity, a resolution from the governing body of the Agency is required on a form provided by the Department. (b) Resolution Content. The resolution must contain a commitment from the governing body to provide the local funds as indicated in this contract. Additionally, the resolution is required even if the funding is one hundred percent from federal sources, as it serves as recognition by the governing body of federal funding for purposes of Section A-6 above. 17. Seat Belt Policy and Use. Agency must adopt and enforce a seat belt use policy required for all seating positions unless exempted by state law. 18. Text Messaging Policy. Agency must adopt and enforce a policy banning text messaging while driving unless exempted by state law. 19. Prohibited Interests. No member, officer, or employee of the Agency during his or her tenure, and for at least one (1) year thereafter, shall have any interest, direct or indirect, in this contract or the proceeds thereof or therefrom. 20. Continued Federal and State Funding. (a) Federal Funding. The Agency agrees and understands that continuation of this project with Federal funds is contingent upon Federal funds being appropriated by the United States Congress specifically for that purpose. The Agency further agrees and understands that in the event funds originally Page 6 AOC / INITIALS Revised 05/2018 15 appropriated by Congress for these grants are subsequently reduced by further acts of Congress, funding to the Agency may be proportionately reduced. (b) State Funding. The Agency agrees and understands that continuation of this project with funds from the State of North Carolina is contingent upon State funds being appropriated by the General Assembly specifically for that purpose. The Agency also agrees that any state funds received under this contract are subject to the same terms and conditions stated in this Agreement. 21. Performance. All grants provided by the Governor's Highway Safety Program are performance-based and, as such, require that continual progress be made toward the reduction of the number and severity of traffic crashes. Any agency, whose performance is deemed unsatisfactory by the GHSP, shall be subject to the sanctions as provided for in this contract. Additionally, unsatisfactory performance shall be cause for the Department to reduce or deny future funding. 22. Resolution of Disputes. Any dispute concerning a question of fact in connection with the work not disposed of by contract by and between the Agency and the Department, or otherwise arising between the parties to this contract, shall be referred to the Secretary of the North Carolina Department of Transportation and the authorized official of the Agency for a negotiated settlement. In any dispute concerning a question of fact in connection with the project where such negotiated settlement cannot be resolved in a timely fashion, the final decision regarding such dispute shall be made by the Secretary of the North Carolina Department of Transportation, with the concurrence of the Federal funding agency, and shall be final and conclusive for all parties. 23. Department Held Harmless. (a) For State Agencies. Subject to the limitations of the North Carolina Tort Claims Act, the Agency shall be responsible for its own negligence and holds harmless the Department, its officers, employees, or agents, from all claims and liability due to its negligent acts, or the negligent acts of its subcontractors, agents, or employees in connection with their services under this contract. (b) For Agencies Other Than State Agencies. The Agency shall be responsible for its own negligence and holds harmless the Department, its officers, employees, or agents, from all claims and liability due to its negligent acts, or the negligent acts of its subcontractors, agents, or employees in connection with their services under this contract. 24. Records Access and Retention. The Agency shall provide all information and reports required by the regulations or directives issued pursuant thereto, and shall permit access to its books, records, accounts, other sources of information, and its facilities as may be determined by the Department, the State, NHTSA, or FHWA, as appropriate, to be pertinent to ascertain compliance with such regulations, orders and instructions. Furthermore, the Agency shall maintain such materials during the contract period, and for five (5) years from the date of final payment from the Department or until all audit exceptions have been resolved, for such inspection and audit. Where any information required of the Agency is in the exclusive possession of another who fails or refuses to furnish this information, the Agency shall so certify to the Department, State, NHTSA, or FHWA, as appropriate, and shall set forth what efforts it has made to obtain the information. Pursuant to N.C.G.S. §147-64.7, the Department, the State Auditor, appropriate federal officials, and their respective authorized employees or agents are authorized to examine all books, records, and accounts of the Agency insofar as they relate to transactions with any department, board, officer, commission, institution, or other agency of the State of North Carolina pursuant to the performance of this Agreement or to costs charged to this Agreement. 25. Sanctions for Non-Compliance. The applicant Agency agrees that if it fails or refuses to comply with any provisions and assurances in this contract, the Department may take any or all of the following actions: (a) Cancel, terminate, or suspend this contract in whole or in part; (b) Withhold reimbursement to the Agency until satisfactory compliance has been attained by the Agency; (c) Refrain from extending any further funding to the Agency under this contract with respect to which the failure or refusal occurred until satisfactory assurance of future compliance has been received from the Agency; (d) Refer the case to the United States Department of Justice for appropriate legal proceedings. 26. Cancellation, Termination, or Suspension of Contract. (a) By the Department. For noncompliance with any of the said rules, regulations, orders or conditions, due to management deficiencies or criminal activity this contract may be immediately canceled, terminated, or suspended in whole or in part by the Department. For noncompliance not indicative of management deficiencies or criminal activity the Department shall give sixty (60) days written notice Page 7 16 AOC INITIALS Revised 05/2018 to take corrective action. If the Agency has not taken the appropriate corrective action after sixty (60) days the Department may cancel, terminate, or suspend this contract in whole or in part. (b) By mutual consent. The Agency or the Department may terminate this contract by providing sixty (60) days advanced written notice to the other party. (c) Unexpended funds. Any unexpended funds remaining after cancelation or termination will revert to the Department. 27. Completion Date. Unless otherwise authorized in writing by the Department, the Agency shall commence, carry on, and complete the project as described in the approved Highway Safety Project Contract by September 30 of the Federal fiscal year for which it was approved. 28. E-Verify requirements. If this contract is subject to NCGS 143-133.3, the contractor and its subcontractors shall comply with the requirements of Article 2 of Chapter 64 of the NC General Statutes. 29. Certification of Eligibility Under the Iran Divestment Act. Pursuant to G.S. 147-86.59, any person identified as engaging in investment activities in Iran, determined by appearing on the Final Divestment List created by the State Treasurer pursuant to G.S. 147-86.58, is ineligible to contract with the State of North Carolina or any political subdivision of the State. The Iran Divestment Act of 2015, G.S. 147-55 et seq. requires that each Agency, prior to contracting with the State certify, and the undersigned Agency Authorizing Official on behalf of the Agency does hereby certify, to the following: (a) that the Agency is not now and was not at the time of the execution of the Contract dated below identified on the Final Divestment List of entities that the State Treasurer has determined engages in investment activities in Iran; (b) that the Agency shall not utilize on any contract with the State agency any subcontractor that is identified on the Final Divestment List; and (c) that the undersigned Agency Authorizing Official is authorized by the Agency to make this Certification. _ 30. Agency Fiscal Year.The end date for the Agency's fiscal year is J %c 30F. ZPf 9 31. Signature. By signing below, the Agency agrees to adhere to the terms and conditions of this Agreement. AGENCY PROJECT DIRECTOR NAME TITLE ADDRESS ifs�iN/,'jL /„C 2.127�f SIGNA URE DATE TELEPHONE NUMBER AGENCY AUTHORIZING OFFICIAL NAME TITLE ADDRESS SIGNATURE DATE TELEPHONE NUMBER AGENCY OFFICIAL AUTHORIZED TO RECEIVE FUNDS NAME TITLE ADDRESS SIGNATURE DATE TELEPHONE NUMBER Page 8 17 Resolution North Carolina Governor's Highway Safety Program LOCAL GOVERNMENTAL RESOLUTION WHEREAS, the Orange County Sheriffs Office (herein called the "Agency") (The Applicant Agency) has completed an application contract for traffic safety funding; and that Orange County Board of Commissioners (The Governing Body of the Agency) (herein called the"Governing Body") has thoroughly considered the problem identified and has reviewed the project as described in the contract; THEREFORE, NOW BE IT RESOLVED BY THE Orange County Board of Commissioners IN OPEN (Governing Body) MEETING ASSEMBLED IN THE CITY OF Chapel Hill NORTH CAROLINA, THIS 6 DAY OF October , 20 $ AS FOLLOWS: 1. That the project referenced above is in the best interest of the Governing Body and the general public; and 2. That Sheriff Charles Blackwood is authorized to file, on behalf of the Governing (Name and Title of Representative) Body, an application contract in the form prescribed by the Governor's Highway Safety Program for federal funding in the amount of$ 20,000 to be made to the Governing Body to assist in defraying (Federal Dollar Request) the cost of the project described in the contract application; and 3. That the Governing Body has formally appropriated the cash contribution of$0 as (Local Cash Appropriation) required by the project contract; and 4. That the Project Director designated in the application contract shall furnish or make arrangement for other appropriate persons to furnish such information, data, documents and reports as required by the contract, if approved, or as may be required by the Governor's Highway Safety Program; and 5. That certified copies of this resolution be included as part of the contract referenced above; and 6. That this resolution shall take effect immediately upon its adoption. DONE AND ORDERED in open meeting by (Chairperson/Mayor) ATTESTED BY SEAL (Clerk) DATE Rev. 7/11