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0 <br />00~ 15 Pr,~F 195 <br />013 <br />Attachment I <br />PIC RECERTIFICATION REQUEST <br />As authorized representative of the Mid-Carolina Service Delivery Area, I hereby request recertification <br />of the Private Industry Council for the Mid-Carolina Service Delivery Area under the Job Training <br />Partnership Act, P. L. 97-300, as amended. I hereby state that the information provided on this <br />application for PIC recertification and supporting documentation are accurate to the best of my knowledge. <br />I agree to allow the Division of Employment and Training staff or authorized representatives to review <br />additional documentation or other material pertinent to PIC recertification as required by the Job Training <br />Partnership Act and regulations. I further agree to convene the PIC within 30 days of receipt of written <br />notification of certification of the PIC by the Govemor, or his designee, and to fulfill other necessary and <br />appropriate responsibilities as they pertain to the operation of the PIC in the service delivery area as <br />described in the Act and regulations. <br />Name: William C. Stafford, Jr. Title: Chairman, Lee aunty Board of <br />(Chief Elected Official) Commissioners <br />Signature: Date: June 7, 1993 <br />SUBMIT THE COMPLETED RECERTIFICATION PACKAGE TO: <br />DEBORAH VANGORDER <br />MID-CAROLINA SDA ADMINISTRATOR <br />P.O. DRAWER 1510, 130 GDJ ESPIE STREET <br />FAYETTEVILLE, NC 28302 <br />