AG 2018 09 17 - Laserfiche WebLink

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NORTH CAROLINA DEPARTMENT OF AGRICULTURE AND CONSUMER SERVICES Steven W. Troxler, Commissioner Contract Check Off List for Grantee (Government/University) INSTRUCTIONS: Check the "Yes" boxes in the left column for the document titles that are being returned with the two signed, dated and witnessed copies of the contract, with signatures in blue ink. Be sure to include all the other documents specified in your contract package. If "No" has been checked off for you, that document is not required for this grant program or project. GRANTEE ORGANIZATION NAME: Cabarrus Soil and Water Conservation District PROJECT TITLE/NAME: Hill Farm +/- 59.26 Acres Perpetual Conservation Easement, ADFP Trust Fund Tracking Number ADM-ADFP-18-006 CONTRACT #: 17-0954033 GO Entities Only Check One Box Document Title Department Use— Documents Attached or On File Grants and Contracts - Documents Attached or On File Yes No Contractual "Check Off List for Grantee Yes No Yes No Yes No Contract Cover To be signed, dated R witnessed)Yes I No Yes No Yes No Attachment A— General Terms and Conditions — Government/University Yes No Yes No Yes No Attachment B — Scope of Work includes Timeline and Line Item Budget) Yes No Yes No Yes No Attachment C — Certifications and Assurances Section Yes No Yes No Yes No Attachment D — NCO enBook Supplemental Information Yes No Yes No Yes No Attachment E — Si nature Card Yes No Yes No Yes No Attachment F—W-9 Tax information as No Yes No Yes No Attachment G — Vendor Electronic Payment Form Yes No Yes No Yes No Attachment H — FFATA Data Reporting Requirements if applicable) Yes No Yes No Yes No I Attachment I —Federal 0--- 1-1i... if licable Yes No Yes No Rev, 6117 F-7 Page 115