Laserfiche WebLink
FY 2004 Community Services Performance Contract <br /> <br />Exhibit G: Local Government Acceptance of Funds and Board Approval of <br /> Community Services Performance Contract <br /> <br />1. Name of Board: Piedmont Community Services <br /> <br />2. City or County designated as <br /> as the Board's Fiscal Agent: City of Martinsvill¢ <br /> <br />3. Name of the Fiscal Agent's City Manager or County Administrator or Executive: <br /> <br /> Name: E~rl Reynolds Title: City Manager <br /> <br />4. Name of the Fiscal Agent's County/City Treasurer or Director of Finance: <br /> <br /> Name: Wade Bartlett Title: Fiscal Director <br /> <br />5. Name of the Fiscal Agent official to whom checks should be electronically transmitted: <br /> <br />Name: Wade Bartlett <br /> <br />Title: Fiscal Director <br /> <br />Address: PO Box it12 <br /> <br />Martinsville, VA 24114 <br /> <br />6. The Board's board of directors certifies that, to the best of its knowledge and belief, the data <br /> and information in this performance contract are true and correct and that its entry into this <br /> contract has been duly authorized by a formal vote of the board of directors in an open, public <br /> meeting of the board. This signature affirms the board's approval of this performance contract. <br /> <br />Signature of Board Chairman <br /> <br />Date <br /> <br />7. This signature indicates receipt of a Board-approved copy of this pedormance contract and an <br /> agreement by the Board's Fiscal Agent To accept state and federal funds from the Department <br /> that are included in this contract. <br /> <br />Signature of Fiscal Agent's Administrator or Manager <br /> <br />Date <br /> <br />05-02-03 <br /> <br /> <br />