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C. 4 _i <br />North Carolina <br />I - RA R T M NT O I I aI SUR AiN~a_E Wayne Goodwin I Commissioner of Insurance <br />SENIORS' HEALTH INSURANCE INFORMATION PROGRAM <br />July 6. 2009 <br />Dear: Janice Holmes <br />The Seniors' Health Insurance Information Program (SI-111P) is pleased to inform you that <br />your agency has been selected to provide health insurance information, counseling and <br />assistance to Medicare beneficiaries in your county. The funds will also be used to <br />expand outreach and enrollment to Medicare beneficiaries who may be eligible for the <br />Medicare Part D Low Income Subsidy (LIS), Medicare Savings Programs, as well as <br />NCRx. <br />Enclosed in this letter are all attachments required with the contract- If you are a non- <br />profit organization you must sign Attachment 5 included in this packet. We would <br />encourage you to return the signed contract and Attachment 5 as soon as possible in order <br />for our office to process the award and get the funds to your agency. In addition, <br />Governor Perdue's NC OpenBook initiative, effective July 1, 2009, requires all non- <br />governmental grantees to obtain a DUNS number which should be noted on the top of <br />your signed contract and returned to the SH1111 office. <br />The DUNS (Data Universal Numbering System) is a unique number which is assigned <br />and maintained by Dun & Bradstreet. DUNS is a nine-digit identification number <br />referring to a single entity. The number is frequently used by the federal government and <br />is now required for use by NC government agencies and grantees. Grantees that do not <br />have a DUNS number can apply at http://fedgov.dnb.com/webform/. <br />In addition to these items above, grantees must include an initial budget (Attachment 3) <br />by July 31, 2009. A Progress Report is due by January 31, 2010, and a Final Project <br />Report is due by August 31, 2010. The Final Project Report list expenditures in same <br />format as Attachment 3. The formats for both the Budget report and the Progress report <br />are included with this letter. Any questions relating to the reports or to the reporting <br />requirements for SHUP should be directed to Kevin Robertson at 919-807-6900 or <br />kevin.roberison@ricdoi.gov. These required reports must be submitted to the SHIIP <br />Office, Attention: Trista Nance, 11 South Boylan Avenue, Raleigh, NC 27603. Any <br />questions relating to this grant may be directed to Carla Obiol at 919-807-6900 or <br />carla.obiol@ncdoi.eov. The SHIIP office will provide technical assistance, guidance and <br />informational materials to your agency. <br />NC General Statute 143C-6-23 and North Carolina Administrative Code 09 NCAC 03M r <br />require the Grantees to complete specific reports for the Office of State Auditor. The <br />11 S. Boylan Avenue Raleigh, NC 27603 toll free: 800.443.9354 tet 919.807.6900 fax: 919.807.6901 www:ncdoi. co< <br />