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BK:00028 PG:0448 Contract # Fiscal Year Begins October 1, 2016 Ends June 30, 2017 This contract is hereby entered into by and between the Lee County Department of Social Services. Rhe -"County") and Empowering Lives Guardianship Services LLC (the "Contractor") (referred to collectively as the "Pal#ies"). The Contractor's federal tax identification number is 27-3721789 and DUNS Number (required if funding from a federal funding sources;, 1. Contract Documents: This Contract consists of the following documents: (1) This contract (2) The General Terms and Conditions (Attachment A) (3) The Scope of Work, description of services, and rate (Attachment B) (4) Federal Certification Regarding Drug -Free Workplace &Certification Regarding Nondiscrimihaton (Attachment C) (5) Conflict of Interest (Attachment D) (6) No Overdue Taxes (Attachment E) (7) If applicable, HIPAA Business Associate Addendum (checklist and forms) (8) State Certification (Attachment M) (9) Certification of Eligibility Under the Iran Divestment Act (10) Contract Determination Questionnaire (required) These documents constitute the entire agreement between the Parties and supersede all prior oral or written statements or agreements. 2. Precedence among Contract Documents: In the event of a conflict between or among the terms of the Contract Documents, the terms in the Contract Document with the highest relative precedence shall prevail. The order of precedence shall .be the order of documents as listed in Paragraph 1, above, with the first -listed document having the highest precedence and the last -listed document having the lowest precedence. If there are multiple Contract Amendments, the most recent amendment shall have the highest precedence and the oldest amendment shall have the lowest precedence. 3. Effective Period: This contract shall be effective on October 1, 2016 and shall terminate on June 30, 2016. This contract must be twelve months or less. 4. Contractor's Duties: The Contractor shall provide the services and in accordance with the approved rate as described in Attachment B, Scope of Work. 5. County's Duties: The County shall pay the Contractor in the manner and in the amounts specified in the Contract Documents. The total amount paid by the County to the Contractor under this contract shall not exceed $ 30,000.00. This amount consists of $ 0 in Federal funds (CFDA # ), $ 0 in State Funds, $0 in County funds ® a: There are no matching requirements from the Contractor. ❑ b. The Contractor's matching requirement is $ , which shall consist of: ❑ In-kind ❑ Cash ❑ Cash and In-kind ❑ Cash and/or In-kind The contributions from the Contractor shall be sourced from non-federal funds. The total contract amount including any Contractor match shall not exceed $ 6. Reversion of Funds: Any unexpended grant funds shall revert to the County Department of Social Services/Human Services upon termination of this contract. 7. Reporting. Requirements: Contractor shall comply with audit requirements as described in N.C.G.S. § 143C-6-22 & 23 and OMB Circular- CFR Title 2 Grants and Agreements, Part 200, and shall disclose all information required by 42 USC 455.104, or 42 USC 455.105, or 42 USC 455.106. Contract -General (06/15) Page 1 of 3