ࡱ>  eh\]^_`abcd  bjbj΀ m;;;;;///T #$/^/+73:q3q3q3cX a|c@2444444|49;EfP_XEfEf4;;q3q3.mYnYnYnEf|;q3;q32YnEf2YnYnJ&\>q30]//fB0ijz/g4/>>\/; dZ#e@Ynce4eddd44jjdddEfEfEfEf/ddddddddd :  State of North Carolina INCUMBENT WORKFORCE DEVELOPMENT PROGRAM      GUIDELINES and APPLICATION Program Year July 1, 2010 - June 30, 2011  An Equal Opportunity/Affirmative Action Employer/Program. Auxiliary aids and services available upon request to individuals with disabilities. TABLE OF CONTENTS  TOC \o "1-3" \h \z \u HYPERLINK \l "_Toc205021561"Incumbent workforce development pROGRAM (IWDP)  PAGEREF _Toc205021561 \h 4 HYPERLINK \l "_Toc205021562"Guidelines  PAGEREF _Toc205021562 \h 4 KEY POINTS  PAGEREF _Toc205021563 \h 4 HYPERLINK \l "_Toc205021563"What is nORTH CAROLINAS Incumbent WorkFORCE DEVELOpMENT training Program?  PAGEREF _Toc205021563 \h 4 HYPERLINK \l "_Toc205021564"WHAT IS AN INCUMBENT WORKER?  PAGEREF _Toc205021564 \h 4 WHAT IS LAY-OFF AVERSION? 5 WHAT IS SKILL ATTAINMENT?  PAGEREF _Toc205021565 \h 5 HYPERLINK \l "_Toc205021565"Who is eligible TO APPLY?  PAGEREF _Toc205021565 \h 5 HYPERLINK \l "_Toc205021566"WHAT IS A NOT-FOR-PROFIT BUSINESS?  PAGEREF _Toc205021566 \h 5 HYPERLINK \l "_Toc205021567"WHO IS NOT ELIGIBLE TO APPLY? 5 HYPERLINK \l "_Toc205021568"cAN A business APPLY FOR AN iwdp gRANT IF IT IS ELIGIBLE FOR OTHER TYPES OF TRAINING RESOURCES? 5 HYPERLINK \l "_Toc205021569"What kinds of training can be funded by the IWDP?  PAGEREF _Toc205021569 \h 6 HYPERLINK \l "_Toc205021570"WHAT IS THE MAXIMUM AMOUNT FOR WHICH A BUSINESS CAN APPLY?  PAGEREF _Toc205021570 \h 6 HYPERLINK \l "_Toc205021571"WHAT IS THE LIFETIME LIMIT FOR THOSE WHO HAVE RECEIVED AN IWDP GRANT PRIOR TO JULY 1, 2008?  PAGEREF _Toc205021571 \h 6 HYPERLINK \l "_Toc205021572"CAN A BUSINESS APPLY FOR A GRANT THAT WILL SERVE DIFFERENT, MULTIPLE BUSINESSES WITH COMMON TRAINING NEEDS?  PAGEREF _Toc205021572 \h 7 HYPERLINK \l "_Toc205021573"HOW IS A BUSINESS LIFETIME FUNDING LIMIT AFFECTED IF IT IS PART OF A COLLABORATIVE APPLICATION?  PAGEREF _Toc205021573 \h 7 HYPERLINK \l "_Toc205021574"What costs can be reimbursed by the IWDP?  PAGEREF _Toc205021574 \h 8 HYPERLINK \l "_Toc205021575"WHAT OUTCOMES ARE EXPECTED FROM THE IWDP GRANT RECIPIENT?  PAGEREF _Toc205021575 \h 8 HYPERLINK \l "_Toc205021576"HOW IS THE IWDP ADMINISTERED?  PAGEREF _Toc205021576 \h 8 HYPERLINK \l "_Toc205021577"HOW DOES A BUSINESS SUBMIT AN APPLICATION?  PAGEREF _Toc205021577 \h 8 HYPERLINK \l "_Toc205021578"How can a business determine if its parent company and/or subsidiaries have received an iwdp grant?  PAGEREF _Toc205021578 \h 8 HYPERLINK \l "_Toc205021579"IS IT REQUIRED THAT THE APPLICANT USE THE APPLICATION FORM PROVIDED?  PAGEREF _Toc205021579 \h 8 HYPERLINK \l "_Toc205021580"Is an electronic signature acceptable?  PAGEREF _Toc205021580 \h 9 HYPERLINK \l "_Toc205021580"What technical assistance is available to Assist the Business?  PAGEREF _Toc205021580 \h 9 HYPERLINK \l "_Toc205021581"CAN AN ENTITY APPLY FOR TRAINING ON BEHALF OF THE BUSINESS(ES)?  PAGEREF _Toc205021581 \h 9 HYPERLINK \l "_Toc205021582"WHEN CAN A BUSINESS APPLY FOR AN IWDP GRANT?  PAGEREF _Toc205021582 \h 9 HYPERLINK \l "_Toc205021583"WHAT CRITERIA IS USED TO REVIEW AND FUND APPLICATIONS?  PAGEREF _Toc205021583 \h 9 HYPERLINK \l "_Toc205021584"IS A BUSINESS GIVEN ANY SPECIAL CONSIDERATION IF IT IS LOCATED IN A RURAL COUNTY?  PAGEREF _Toc205021584 \h 9 HYPERLINK \l "_Toc205021585"How will I know if my businesss application is approved?  PAGEREF _Toc205021585 \h 10 HYPERLINK \l "_Toc205021586"HOW LONG DOES A BUSINESS HAVE TO CONDUCT THE TRAINING?  PAGEREF _Toc205021586 \h 10 HYPERLINK \l "_Toc205021587"CAN THE CONTRACT BE EXTENDED?  PAGEREF _Toc205021587 \h 10 HYPERLINK \l "_Toc205021588"ONCE THE BUSINESS HAS BEEN AWARDED AN IWDP GRANT, CAN IT CHANGE THE TYPE(S) OF TRAINING OR USE OF FUNDS APPROVED IN THE GRANT?  PAGEREF _Toc205021588 \h 10 HYPERLINK \l "_Toc205021589"WHAT INFORMATION IS A BUSINESS REQUIRED TO SUPPLY TO THE LWDB ON THE EMPLOYEES TO BE TRAINED? 10 HYPERLINK \l "_Toc205021591"ARE ANY REPORTING REQUIREMENTS EXPECTED OF THE BUSINESS?  PAGEREF _Toc205021591 \h 11 HYPERLINK \l "_Toc205021592"APPLICATION  PAGEREF _Toc205021592 \h 12 HYPERLINK \l "_Toc205021593"SECTION I. BUSINESS INFORMATION  PAGEREF _Toc205021593 \h 13 HYPERLINK \l "_Toc205021594"SECTION II. AVAILABILITY AND/OR USE OF OTHER FUNDS  PAGEREF _Toc205021594 \h 14 HYPERLINK \l "_Toc205021595"SECTION III. TRAINING PLAN 16 HYPERLINK \l "_Toc205021596"SECTION IV. BUDGET  PAGEREF _Toc205021596 \h 19 HYPERLINK \l "_Toc205021598"SECTION V. AUTHORIZATION AND CERTIFICATION  PAGEREF _Toc205021598 \h 21 ATTACHMENT A (Project Abstract) 22 HYPERLINK \l "_Toc205021603"ATTACHMENT B (Reimbursable/Non-reimbursable Training Costs)  PAGEREF _Toc205021603 \h 23 HYPERLINK \l "_Toc205021605"ATTACHMENT C (NC Workforce Development Board Listing)  PAGEREF _Toc205021605 \h 24 HYPERLINK \l "_Toc205021606"ATTACHMENT D (2010 County Tier Designations) 29 HYPERLINK \l "_Toc205021607"ATTACHMENT E (Multiple Business Collaboration Form) 30 HYPERLINK \l "_Toc205021607"ATTACHMENT F (Lay-Off Aversion Attestation Form) 33  North Carolina Incumbent workforce development pROGRAM GuidelineS kEY pOINTS: The purpose of the Incumbent Workforce Development Program (IWDP) is to support training that results in either: Lay-off aversion through skill attainment for employees, or Lay-off aversion through process improvement that contributes to the competitiveness and productivity of a business. North Carolina for-profit and not-for-profit businesses that have been in operation for a minimum of one year prior to the application date, are current on all federal and state tax obligations, and are financially viable are eligible to apply. IWDP funds are limited, and are therefore awarded on a competitive basis. Beginning July 1, 2008, the maximum amount is $25,000 per grant, with a lifetime funding limit of $40,000. The IWDP is cooperatively administered through the states Local Workforce Development Boards (LWDB) and the North Carolina Department of Commerces Division of Workforce Development (Division). Applications are submitted directly to a LWDB. A LWDB may request additional information or establish supplemental provisions and requirements for the training projects. State Submission DeadlineGrant Award AnnouncementSeptember 30, 2010November 5, 2010January 31, 2011March 4, 2011May 31, 2011July 6, 2011 For each funding cycle, each LWDB will set its own due date so that the state submission deadline can be met. Only complete IWDP applications will be considered for this competitive grant process. Please see the information below for more details and the grant application. frequently asked questions What is the purpose of the nORTH CAROLINA Incumbent WorkFORCE DEVELOpMENT Program? The purpose of the Incumbent Workforce Development Program (IWDP) is to support training that results in either: Lay-off aversion through skill attainment for employees, or Lay-off aversion through process improvement that contributes to the competitiveness and productivity of a business. WHAT IS AN INCUMBENT WORKER? An incumbent worker is: A paid employee of the applicant business, or a person working for the business as a staffing agency employee; At least 18 years of age; and A citizen of the United States or a non-citizen whose status permits employment in the United States. For the purpose of these funds, any incumbent worker to be trained must be working at a facility located in North Carolina or working for a staffing agency and placed at the North Carolina facility. WHAT IS LAY-OFF AVERSION? A layoff is averted when: 1) a workers job is saved with an existing employer that is at risk of downsizing or closing; or 2) a worker at risk of dislocation transitions to a different job with the same employer or a new job with a different employer and experiences no or a minimal spell of unemployment. WHAT IS SKILL ATTAINMENT? Skill attainment refers to incumbent worker training that develops skills that directly benefit the workers receiving the training and results in: Participants qualifying for a job with changing skill requirements, or for higher paying jobs with their existing employer or other companies in the area; Participants obtaining the skills and knowledge to perform work that is at a higher level than their current positions; and Participants obtaining an industry-recognized certification or credential, or the training provides a significant step towards achieving such credentials that increase the workers' overall employability. Who is eligible TO APPLY? North Carolina for-profit and not-for-profit businesses that have been in operation for a minimum of one year prior to the application date, are current on all federal and state tax obligations, and are financially viable are eligible to apply. WHAT IS A NOT-FOR-PROFIT BUSINESS? A not-for-profit entity is a legally constituted organization whose primary objective is to support or to actively engage in activities of public or private interest without any commercial or monetary profit purposes. For the purpose of this grant, it is further defined as having the following characteristics: 1) has paid employees (Volunteers are not eligible for training under this program.); 2) pays required wage taxes; and 3) generates income through the production of product or the provision of services. WHO IS NOT ELIGIBLE TO APPLY? The following businesses are not eligible to apply for funds under this program: A business currently receiving training funds, either directly or indirectly, from North Carolina state government unless those training funds do not duplicate the training efforts outlined in the project application A business that has received funds either directly or indirectly from North Carolina state government under any previous training initiative, and the terms of the agreement for training have not been met A training provider A Workforce Development Board or its administrative entity A labor union A government entity A company that has already met its lifetime limit ($50,000 for grants awarded prior to July 1, 2008, or $40,000 for grants awarded after July 1, 2008), unless it is part of a collaborative grant application. cAN A business APPLY FOR AN iwdp gRANT IF IT IS ELIGIBLE FOR OTHER TYPES OF TRAINING RESOURCES, SUCH AS CUSTOMIZED TRAINING? In addition to the IWDP, the North Carolina Community College System provides funds through the Customized Training Program. Introduced in 2008, the Customized Training Program is an integration of two prior programs: The New and Expanding Industry Program (NEIT) and the Focused Industrial Training Program (FIT). To maximize resources, the business must demonstrate that it is not eligible for or has exhausted efforts to secure funding through this or other existing programs (examples: agreement on an acceptable training schedule timeline; availability of funds to meet training timeframe). What kinds of training can be funded by the IWDP? The following types of training can be funded: Occupational skills training designed to meet the special requirements of a business or a group of businesses and is conducted with employer commitment to continue to retain all trained individuals upon successful completion of the training Educational training including, but not limited to, workplace literacy, basic skills, soft skills, and English as a second language Training in strategies to improve efficiency of business operations An applicant must demonstrate the effect of the proposed training on business operations and identify the transferable skills to be acquired by the employees. Funds awarded for a project will be expended on training activities that take place only in North Carolina unless the Local Workforce Development Board approves for training outside the state. If consent is given, all other rules and regulations of the IWDP still apply. Costs associated with conferences will not be allowed. WHAT IS THE MAXIMUM AMOUNT FOR WHICH A BUSINESS CAN APPLY? IWDP funds are limited, and are therefore awarded on a competitive basis. For the year beginning July 1, 2008, the maximum amount is $25,000 per grant, with a lifetime funding limit of $40,000. Businesses with locations in multiple areas of the state will be treated as a single company for the purposes of determining when the lifetime maximum has been met. The lifetime limit applies to the company, its parent company and subsidiaries. The business may apply for subsequent grants, based on the difference between the amount of a previous grant award(s) (not total expenditures of previous grants) and the lifetime funding limit of $40,000. WHAT IS THE LIFETIME LIMIT FOR THOSE WHO HAVE RECEIVED AN IWDP GRANT PRIOR TO JULY 1, 2008? Businesses that received IWDP funds prior to July 1, 2008 and have not reached the lifetime funding limit that was set at $50,000 are grandfathered under the $50,000 lifetime limit. Thus, the eligible amount for which they can apply is based on the difference of the prior grant award (not total expenditures of previous grants) and $50,000. If a company is awarded an Incumbent Worker grant but is unable to use any of the funds and forfeits the full grant amount, then that grant amount will not count against the total lifetime limit for that company. CAN A BUSINESS APPLY FOR A GRANT THAT WILL SERVE DIFFERENT, MULTIPLE BUSINESSES WITH COMMON TRAINING NEEDS? Yes, businesses can partner and apply for a collaborative training grant. The businesses pursuing this approach must consult with their Local Workforce Development Boards (LWDB), who will help coordinate this type of application. The proposal for the common training must: Serve employees of at least two (2) different businesses, with one of those businesses designated as the Lead Applicant. A non business entity can apply on behalf of the businesses, but this non-business entity cannot be the training provider. Include information on each business that will be part of the training. The application has a specific section for this information. Include training descriptions and outcomes that address the employees from all businesses impacted by the proposed common training, and Be for a collective group of businesses of which none have ever received a collaborative training grant. Attachment E (Multiple Business Collaborative Form) and Attachment F (Lay-Off Aversion Attestation Form) must be completed for each business that is part of the collaborative training application. An application representing the training needs of two (2) businesses will be subject to the $32,500 per grant funding limits previously set forth. If three (3) or more different businesses apply for a collaborative training grant, then the funding request may be awarded for an amount up to $40,000. HOW IS A BUSINESS LIFETIME FUNDING LIMIT AFFECTED IF IT IS PART OF A COLLABORATIVE APPLICATION? The amount of the award will be equally portioned among the businesses included in the application as follow: For a business that has not received an Incumbent Workforce Development Program (IWDP) grant(s) prior to July 1, 2008, its portion of a collaborative award will apply towards its lifetime funding limit of $40,000. Example: Two businesses receive a collaborative training grant in the amount of $20,000. These businesses have never received an IWDP grant; therefore, their lifetime funding limit is $40,000 each. Each business will have $10,000 credited towards its lifetime funding limit, leaving $30,000 available for future IWDP grant(s) in which each business is the sole applicant. For a business that has received an IWDP award(s) prior to July 1, 2008, its portion of a collaborative grant award will not apply towards its lifetime funding limit of $50,000. The business can still apply for its lifetime funding balance as a sole applicant. Example: Two businesses receive a collaborative training grant in the amount of $20,000. Business A has benefited from the IWDP prior to July 1, 2008. In determining each businesss equal portion of the grant amount, Business A is considered in the denominator, but its portion is not applied towards the amount remaining, if any, in its lifetime funding limit of $50,000. All other rules, regulations and guidelines of the Incumbent Workforce Development Program apply. What costs can be reimbursed by the IWDP? See Attachment B for a list of allowable and non-allowable costs. Costs associated with the training that are not allowable can be included as part of the Employer Contribution column on the budget form. WHAT OUTCOMES ARE EXPECTED FROM THE IWDP GRANT? When workers lack needed training and businesses experience skill gaps, the companys ability to compete, expand, and retain workers can be compromised. North Carolinas IWDP, funded by the federal Workforce Investment Act (WIA), addresses such needs. The specific outcomes of the training through the IWDP will avert lay-offs by providing skill attainment opportunities for employees, or avert lay-offs through contributing to the competitiveness and productivity of the company. HOW IS THE IWDP ADMINISTERED? The IWDP is cooperatively administered through the states Local Workforce Development Boards (LWDB) and the North Carolina Department of Commerces Division of Workforce Development (Division). Within the framework established through the IWDP, a LWDB may request additional information or establish supplemental provisions and requirements for the training projects. HOW DOES A BUSINESS SUBMIT AN APPLICATION? First the business must contact the Local Workforce Development Board (LWDB) that administers the Incumbent Workforce Development Training Program (IWDP) in its geographical area (see Attachment C). This contact allows the business and the LWDB the opportunity to review the guidelines and eligibility requirements, highlight restrictions, discuss training priorities, understand the cost reimbursement procedures and the application time schedule, and other procedures and expectations. Program applications for North Carolinas IWDP are available on the Department of Commerce web-site: HYPERLINK "http://www.nccommerce.com/workforceservices/findinformationforemployers"http://www.nccommerce.com/workforceservices/findinformationforemployers. These documents are also available from LWDB offices. How can a business determine if its parent company and/or subsidiaries have received an iwdp grant? The business should work with its LWDB to determine this information. It may also view the following web site, which has a complete listing of all companies that have received an IWDP grant: HYPERLINK "http://www.nccommerce.com/en/WorkforceServices/FindInformationForEmployers/IncumbentWorkerProgram"http://www.nccommerce.com/en/WorkforceServices/FindInformationForEmployers/IncumbentWorkerProgram The list is updated within forty-five (45) days from the announcement of awards for each round. IS IT REQUIRED THAT THE APPLICANT USE THE APPLICATION FORM PROVIDED? Yes. The application is provided in a Word document. All information is to be provided within the form. The space will expand to accommodate the information. Please do not include trainers resumes or other excess information. Also, a trainers qualifications, course descriptions and objectives should be summarized within the form. Incomplete applications will not be considered for review. All applicants are to complete Attachment A (Project Abstract) and Attachment F (Lay-off Aversion Attestation Form). If the application is for a collaborative grant, the companies included in the grant, but not the lead applicant, are to also complete Attachment E (Multiple Business collaborative Form) and Attachment F (Lay-off Aversion Attestation Form). IS AN ELECTRONIC SIGNATURE ACCEPTABLE? No. Electronic signatures will not be accepted. All sections requiring a signature must be original, handwritten signatures. What technical assistance is available to Assist the Business? The LWDB staff is available to provide technical assistance throughout the process. CAN AN ENTITY APPLY FOR TRAINING ON BEHALF OF THE BUSINESS (ES)? An individual or organization may apply for a grant on behalf of a business or group of businesses; however the individual/organization may not be compensated with grant funds. WHEN CAN A BUSINESS APPLY FOR AN IWDP GRANT? State Submission DeadlineGrant Award AnnouncementSeptember 30, 2010November 5, 2010January 31, 2011March 4, 2011May 31, 2011July 6, 2011 The LWDB will inform the business of its advanced submission date and other requirements necessary in order to meet the States application submission deadlines. WHAT CRITERIA IS USED TO REVIEW AND FUND APPLICATIONS? The application must be reviewed by the Local Workforce Development Board (LWDB) to ensure that: The application is complete, with all information supplied, The proposed training is consistent with local economic and workforce priorities, The primary purpose of lay-off aversion is met, The training is restricted to skill attainment activities (unless the application is for process improvement training), The application clearly describes the training to be delivered, states the training objectives, and describes how the funds will be used to meet the objectives, Support is provided in the application that the training is needed and that other resources are not available to meet the need, and Any additional criteria required by the LWDB are submitted. The LWDB then ranks the applications and submits them to the Division of Workforce Development (Division) for final review and selection. The number of awards approved per round is based on funding availability as determined by the Division. IS A BUSINESS GIVEN ANY SPECIAL CONSIDERATION? Yes. Ten (10) extra points are added to the score if the business is located in a Tier 1 county as specified by the NC Department of Commerces 2010 County Tier Designation (See Attachment D). Ten (10) extra points are added if the applicant (or lead applicant in a collaborative grant) has 100 employees or less. How will I know if my business application is approved? The Local Workforce Development Board (LWDB) will notify the business of action taken on its application. The LWDB will begin the process of developing a contract between it and the business, to be executed within 60 days of the date of the Notice of Funds Availability cover letter from the Division of Workforce Development (Division) to the LWDB. The contract will set forth all processes and expectations for administering, implementing, and completing the training. If the contract is not executed within the aforementioned 60-day time frame, the grant award becomes null and void and the business will have to re-apply in a future round. Each project will be monitored and evaluated by the LWDB, with outcomes reported to the Division. HOW LONG DOES A BUSINESS HAVE TO CONDUCT THE TRAINING? Training must be completed within 12 months from the date of the contract between the business and the LWDB. CAN THE CONTRACT BE EXTENDED? A business is expected to carefully assess its training needs so that it will apply only for the funds needed for training that can be completed in a twelve (12) month time frame. Under extenuating circumstances, a request can be made by the business to the Local Workforce Development Board (LWDB) to extend the date of a contract. The LWDB will evaluate the request and, if favorably reviewed, will submit the request, in writing, to the Division of Workforce Development for final review and decision. Each request is reviewed on a case-by case basis. In any event, no extension will exceed 30 days past the end date of the original contract. ONCE THE BUSINESS HAS BEEN AWARDED AN IWDP GRANT, CAN IT CHANGE THE TYPE(S) OF TRAINING OR USE OF FUNDS APPROVED IN THE GRANT? The Incumbent Workforce Development Training Program (IWDP) is a very competitive program and each application is evaluated and ranked by the Local Workforce Development Board (LWDB). The applications are then reviewed in relation to all applications received within the same round of funding and awarded by the Division of Workforce Development (Division). The business is expected to assess its immediate training needs and apply only for the amount of funds needed to meet those needs within a one-year time frame. The application is approved based on the training outlined in the proposal. If there is a need to request a change to the approved training, in effect the proposal changes. Funds approved for use for Lay-Off Aversion through Skill Attainment cannot be used for funds approved for Lay-Off Aversion through Process Improvement; and, vice versa. For example, a change request for a grant awarded for Lay-Off Aversion through Skill Attainment could only be made for similar training. The funds in this example could not be used for training for process improvement. The business should contact its LWDB to discuss the best alternatives if issues arise that would warrant changes. The LWDB will evaluate the request and, if favorably reviewed, submit the request, in writing, to the Division for final review and decision. WHAT INFORMATION IS A BUSINESS REQUIRED TO SUPPLY TO THE LWDB ON THE EMPLOYEES TO BE TRAINED? The LWDB will discuss with the business the employee information required on the trainees. Federal reporting requirements mandate funded businesses provide the following data for each training participant: Social Security Number Complete Name and Contact Information Gender Date of Birth Citizenship (Right to Work Status) Selective Service Compliance Person with Disability Ethnicity and Race ARE ANY REPORTING REQUIREMENTS EXPECTED OF THE BUSINESS? Yes. The Local Workforce Development Board (LWDB) will advise and discuss the reporting requirements for the grant award, to include content, time frame and other matters. A final report on the training is due no later than forty-five (45) days from the end of the training. It will be forwarded by the LWDB to the Division of Workforce Development. State of North Carolina INCUMBENT WORKFORCE DEVELOPMENT PROGRAM      APPLICATION Program Year July 1, 2010 - June 30, 2011  An Equal Opportunity/Affirmative Action Employer/Program. Auxiliary aids and services available upon request to individuals with disabilities. North Carolina Incumbent Workforce Development Program Application Is process improvement training such as, but not limited to, Lean, Six Sigma, ISO, a part of this application? YES% NO% Note: For an application to be considered, all requested and applicable information must be provided. SECTION I. BUSINESS INFORMATION The sections of the application are to be completed by the Applicant. Please complete within the form, as the space will expand as more information is added. All applicants are to complete Attachment A and Attachment F. If the application is for a collaborative grant, the companies included in the grant, but not the lead applicant, are to also complete Attachment E and Attachment F. A. Applicant Information Company Name: Street/Mailing Address: City/State: Zip: County: Company Contact Person: Title: Phone: Ext: Fax: E-Mail Address: Company Web-site: Description of Business Product(s) or Service(s):Years in business at training location: Total number of paid employees at this location: NAICS Code:Legal Structure of Business: Sole Proprietor Partnership Corporation (Designation) Tax Status of Business: For-profit Not-for-profit (Designation) Other: Employers Federal ID #: Unemployment Comp ID #:  Is your company a subsidiary of another company or affiliated with a parent company? Yes No  If Yes, please provide the following information about the corporate office/parent company, if different from above, or indicate SAME. Parent Company Name: Street/Mailing Address: City/State: Zip: County: Authorized Representative: Title: Phone: Ext: Fax: E-Mail Address: Company Web-site:  C. Business Status Checklist Has the company been in operation in the State of North Carolina during the entire twelve month period immediately preceding the date of application? Yes No  Is your company current on all North Carolina state taxes? Yes No  Is your company current on all federal taxes? Yes No  Is your company current on all county, city and local taxes? Yes No  Is your company subject to a collective bargaining agreement? Yes No (If Yes, please attach a letter of endorsement from the authorized union official) Project Abstract Please provide the following information on Attachment A: Background information on the company; Overview of the training (not to exceed page) and information to support the request and need for training; Description of how the training plan will avert lay-offs of the trainees; and Reason for requesting financial assistance to conduct the training. SECTION II. AVAILABILITY AND/OR USE OF OTHER FUNDS In addition to the IWDP, the North Carolina Community College System provides funds through the Customized Training Program. Introduced in 2008, the Customized Training Program is an integration of two prior programs: The New and Expanding Industry Program (NEIT) and the Focused Industrial Training Program (FIT). To maximize resources, the business must demonstrate that it is not eligible for or has exhausted efforts to secure funding through this or other existing programs (examples: agreement on an acceptable training schedule timeline; availability of funds to meet training timeframe). Please describe the results of your communication with a local community college or publicly funded college or university concerning the availability of resources through: 1) The Customized Training Program 2) other potential training resources that could fund the training described herein. Contact: Institution: Outcome of discussion: NOTE: If more than one contact was made, supply the same information for each contact. Are any of the training components described in this application available from any publicly-funded community college or university? Yes No Has your company previously received any training grants, such as the Customized Training Program, New and Expanding Industry Training or Focused Industrial Training or other training grants from any government sources? Yes No  If Yes, please provide the following information about each grant received: Funding Source: Amount of Award: Dates of Grant Period: Types of training provided: Have the terms and agreements of the training been completed? Yes No (If no, explain.)Summary of the outcome(s) from the training: Explain the relationship, if any, to the training described in this application:  Funding Source:Amount of Award:Dates of Grant Period:Types of training provided: Have the terms and agreements of the training been completed? Yes No (If no, explain.)Summary of the outcome(s) from the training: Explain the relationship, if any, to the training described in this application:  Has your company previously received any Incumbent Workforce Development Training Grants (this includes funds from Local Area Incumbent Workforce Development Training Grants)? Yes No  If Yes, please provide the following information about each grant received: Local Workforce Development Board:Amount of Award: Dates of Grant Period: Types of training provided: Have the terms and agreements of the training been completed? Yes No (If no, explain.)Summary of the outcome(s) from the training: Explain the relationship, if any, to the training described in this application:  Local Workforce Development Board:Amount of Award: Dates of Grant Period: Types of training provided: Have the terms and agreements of the training been completed? Yes No (If no, explain.)Summary of the outcome(s) from the training: Explain the relationship, if any, to the training described in this application:  SECTION III. TRAINING PLAN Training Summary Anticipated Project Start Date: Project Length: (to be no longer than 12 months from date of contract) Amount of Funds Requested: Number of Employees who will attend only an orientation/introduction of the training: (Do not count this number in the Number of Employees to be trained) Number of Employees to be trained (Count each one time): If this is a Collaborative Grant, please provide the following for each company: Company Name: # to be Trained (unique count): Training Components: An application may be for training that: 1) averts lay-offs through employee skill attainment, or 2) averts lay-offs through process improvement. Below is a Training Component Template for each of the types of lay-off aversion strategies. Choose and complete the appropriate template for the application, replicating it as many times as necessary to include all Training Components requested for funding. NOTE: Component Cost Charged to Grant should capture all cost to be charged to the grant. The Component Costs Charged to Grant should include, but is not limited to: training materials, certification costs, software, etc. Lay-Off Aversion through Skill Attainment Template TRAINING COMPONENT #1 Course Title: Course Description and Objectives: Training Schedule (# hours of training):Estimated Training Dates:Number of Trainees for Component: Training Location: Component Cost:Component Cost Charged to Grant:Please provide information for the training provider.Name of Training Provider: Name of Training Provider Contact: Phone: Address: City: State: Zip: E-Mail Address: Provide the following information for each Instructor of this Component.Name of Trainer/Instructor: Qualifications of Trainer/Instructor to Teach Component: Please provide the information requested in questions 1-3. The form will expand as text is inserted.Please provide a list of competencies the trainees will attain: Explain how this training component will lead to or result in a skill certification or other proof of skill attainment that directly benefits the Trainees: How will this training component impact the trainees opportunity for advancement in the company and/or wage increases?  NOTE: This template is to be replicated for each Training Component. Duplicate information in additional components that appears in a prior component may be noted as Same as Component #____ in the appropriate subsection. Lay-Off Aversion through Process Improvement Template TRAINING COMPONENT #1 Course Title: Course Description and Objectives: Training Schedule (# hours of training):Estimated Training Dates::Number of Trainees for Component: Training Location: Component Cost:Component Cost Charged to Grant:Please provide information for the training provider.Name of Training Provider: Name of Training Provider Contact: Phone: Address: City: State: Zip: E-Mail Address: Provide the following information for each Instructor of this Component.Name of Trainer/Instructor: Qualifications of Trainer/Instructor to Teach Component: Please provide the information requested in the questions 1-3 below. The form will expand as text is inserted.Please provide a list of competencies the trainees will attain: How will this training component directly contribute to improving efficiency or quality in a way that makes the company more competitive? How will this training component directly contribute to improving company processes, thereby averting lay-offs?  NOTE: This template is to be replicated for each Training Component. Duplicate information in additional components that appears in a prior component may be noted as Same as Component #____ in the appropriate subsection. SECTION IV. BUDGET The applicant is encouraged to apply only for the amount of funds needed to meet its immediate training needs. The project budget should clearly support and relate to the training plan and itemize how the award will be used. The amount under the Grant Funds Requested column below should equal the total of the amounts shown under Component Cost Charged to Grant for all Components listed in Section III. All proposed expenses must be allowable, reasonable and necessary (See Attachment B). Please provide the required information on this budget form, rather than submitting attachments. The Applicant is encouraged to place a monetary value on the contributions that will be made to this training request, if funded. These contributions may be in-kind, cash, etc. A column has been provided for this information. NOTE: Shaded areas represent expenses not eligible to be funded through the IWDP. See Attachment B for additional information on allowable costs. CategoryGrant Funds RequestedEmployer Contribution (in-kind, cash, etc, expressed in $)Explanation and Detail Please place a G after all explanation of costs to be paid by IWDP funds. Instructor Wages/Tuition(Example: CAD training $300 x 10 employees=$3000) Manuals/Textbooks (itemize)(Example: 10 Microsoft manuals at $30 each=$300) Training Certifications, Certificates, Credentials, Licenses (Specify number and type) Materials/Supplies(Itemize and describe) Software and Technology (limited to 5% of the requested amount) CategoryGrant Funds RequestedEmployer Contribution (in-kind, cash, etc, expressed in $)Explanation and DetailTraining equipment purchase (can be employer contribution)On-site facility usage (can be employer contribution) Trainee travel, food, lodging (can be employer contribution)Trainee wages (can be employer contribution)Total Funds (Both Grant and EC)$$TOTAL TRAINING INVESTMENT (Grant + EC): $ The Local Workforce Development Board and the NC Division of Workforce Development reserve the right to remove or adjust any part of the budget prior to grant approval. SECTION V. AUTHORIZATION AND CERTIFICATION As authorized representative of the Business submitting this application, I hereby certify that: I have read the Incumbent Workforce Development Training Program Guidelines and coordinated this application with the Local Workforce Development Board; The Business meets the requirements and is eligible to submit this application; The information contained in this application is true and accurate and reflects the intentions of the Incumbent Workforce Development Training Program; I am aware that any false information, intentional omissions, or misrepresentations may result in rejection of the application and possible disqualification for future funding; I am aware that any false information, intentional omissions, or misrepresentations may subject the Business to civil or criminal penalties; I understand that training materials purchased or developed with funds awarded under this project will be in the public domain and will be available for use by other eligible entities at no costs; and The Business agrees to adhere to all reporting requirements; and to respond to a Customer Satisfaction Survey(s), if asked. The Business agrees to provide all requested data elements as required for federal reporting. Further, this business shall not discriminate against any employee, applicant for employment, applicant or Workforce Investment Act participant, subcontractor or potential beneficiaries of employment and training programs or projects because of race, color, disability, religion, age, sex, national origin, political affiliation or belief.  Print Name Title  Signature Date ATTACHMENT A PROJECT ABSTRACT SECTION I.D. Please provide the following information, not to exceed three (3) pages: Background information on the company; Overview of the training (not to exceed page) and information to support the request and need for training; Description of how the training plan will avert lay-offs of the trainees; and Reason for requesting financial assistance to conduct the training. ATTACHMENT B Reimbursable/Non-Reimbursable Training Costs The following is a listing of reimbursable and non-reimbursable training costs for NCs IWDP: Allowable Training Costs Instructors/trainers salaries trainers must not be employed by any business whose employees are being trained. Tuition Training materials and training supplies Textbooks/manuals limited to course of study Training that results in participants obtaining an industry-recognized certification or credential, or that provides a significant step towards achieving such credentials that increases the workers' overall employability Training related software -- limited to 5% of the total grant award and must be necessary for the training request Travel for trainers - if the requested training is not available within reasonable proximity to the business On-line training Employee skills assessment that results in primary training funded through the grant Non-Allowable Training Costs Employee wages and fringe benefits Compensation or consultant fees not directly related to the provision of training Costs incurred prior to the approval date of the application Capital improvements and purchase of real estate, to include the construction or renovation of facilities or buildings Business relocation expenses Employment or training in sectarian activities Costs associated with in-house company trainers to include parent company employees Travel outside of contiguous United States or costs associated with bringing a trainer into the country Curriculum design and/or training program development General office supplies and non-personnel service costs, i.e., postage and photocopying Company website design and development, website hosting, and maintenance, software upgrade, advice on computer selection for purchase and upgrade Memberships fees/dues Purchase of employee assessment systems or systems usage licenses (ex. site licenses) Employee travel Basic occupational health and safety training, to include OSHA training Any training that a company is mandated to provide on a regular basis to its employees by federal, state, or local laws. Equipment Food, beverage, entertainment, and/or celebrations Job/position profiling Publicity/public relations costs Costs associated with conferences ATTACHMENT C NC WORKFORCE DEVELOPMENT BOARD LISTING Top of Form Cape Fear Workforce Development Board Director: Margie Parker 1480 Harbour Drive Wilmington, NC 28401 Phone: 910-395-4553 Fax: 910-395-2684 Email: HYPERLINK "mailto:mparker@capefearcog.org"mparker@capefearcog.org Website: Counties Served: Brunswick, Columbus, New Hanover, Pender  Capital Area Workforce Development Board Director: Pat Sturdivant 2321 Crabtree Blvd., Suite 200 Raleigh, NC 27604 Phone: 919-856-6040 Email:  HYPERLINK "mailto:%20pat.sturdivant@co.wake.nc.us" pat.sturdivant@co.wake.nc.us Website:  HYPERLINK "http://www.capitalareawdb.com" www.capitalareawdb.com Counties Served: Johnston, Wake  Centralina Workforce Development Board Director: David Hollars 525 North Tryon Street, 12th Floor Charlotte, NC 28202 Phone: 704-348-2717 Fax: 704-347-4710 Email: HYPERLINK "mailto:dhollars@centralina.org;%20pwhite@centralina.org"dhollars@centralina.org; pwhite@centralina.org Website: HYPERLINK "http://http:/www.centralinaworks.com/index.cfm"http://www.centralinaworks.com/index.cfm Counties Served: Anson, Cabarrus, Iredell, Lincoln, Rowan, Stanly, Union  Charlotte/Mecklenburg Workforce Development Board Director: Deborah Gibson 700 Parkwood Avenue Charlotte, NC 28205 Phone: 704-336-3952 Fax: 704-336-7259 Email: HYPERLINK "mailto:dgibson@ci.charlotte.nc.us"dgibson@ci.charlotte.nc.us Website: HYPERLINK "http://www.charlotteworks.org"www.charlotteworks.org  Counties Served: Mecklenburg  Cumberland County Workforce Development Board  Director: Geneva Mixon 103 Laketree Boulevard Spring Lake, NC 28390 Phone: 910-321-6421 Fax: 910-321-6576 Email:  HYPERLINK "mailto:gmixon@co.cumberland.nc.us" gmixon@co.cumberland.nc.us Website: Counties Served: Cumberland  DavidsonWorks Workforce Development Board Director: Cindy Livengood DavidsonWorks, Inc. P.O. Box 1067 555 West Center Street Extension Lexington, NC 27293-1067 Phone: 336-242-2065 Fax: 336-236-7522 Email:  HYPERLINK "mailto:Cindy.Livengood@DavidsonCountyNC.gov" Cindy.Livengood@DavidsonCountyNC.gov Website: HYPERLINK "http://www.davidsoncountyworks.org"www.davidsoncountyworks.org Counties Served: Davidson  Durham Workforce Development Board  Director: Kevin Dick Office of Economic and Workforce Development 302 E. Pettigrew Street, Suite 190 Durham, NC 27701 Phone: 919-560-4965 Fax: 919-560-4986 Email: HYPERLINK "mailto:kevin.dick@durhamnc.gov"kevin.dick@durhamnc.gov Website: Counties Served: Durham  Eastern Carolina Workforce Development Board Director: Tammy Childers 1341 South Glenburnie Road New Bern, NC 28562 Phone: 252-636-6901 Fax: 252-638-3569 Email: HYPERLINK "mailto:childers@ecwdb.org"childers@ecwdb.org Website: HYPERLINK "http://http:/www.ecwdb.org."http://www.ecwdb.org. Counties Served: Carteret, Craven, Duplin, Lenoir, Onslow, Pamlico, Wayne, Greene, Jones  Gaston County Workforce Development Board  Director: Angela Karchmer 330 N. Marietta Street Gastonia, NC 28052 Phone: 704-862-7930 Fax: 704-862-7939 Email: HYPERLINK "mailto:angela.karchmer@co.gaston.nc.us%20"angela.karchmer@co.gaston.nc.us  Website: Counties Served: Gaston  Greensboro/High Point/Guilford Workforce Development Board  Director: Lillian Plummer 342 North Elm Street Greensboro, NC 27401 Phone: 336-373-8041 Fax: 336-373-8629 Email: HYPERLINK "mailto:lillian.plummer@greensboro-nc.gov"lillian.plummer@greensboro-nc.gov Website: Counties Served: Guilford  High Country Workforce Development Board Director: Carole Coates 468 New Market Boulevard Boone, NC 28607 Phone: 828-265-5434 ext. 130 Fax: 828-265-5439 Email: HYPERLINK "mailto:ccoates@regiond.org"ccoates@regiond.org Website: HYPERLINK "http://www.highcountrywdb.com"www.highcountrywdb.com  Counties Served: Alleghany, Ashe, Avery, Mitchell, Yancey, Watauga, Wilkes  Karr Tar Workforce Development Board  Director: Vincent Gilreath P.O. Box 709 1724 Graham Avenue Henderson, NC 27536 Phone: 252-436-2047 Fax: 252-436-2055 Email:  HYPERLINK "mailto:vgilreath@kerrtarcog.org" vgilreath@kerrtarcog.org  HYPERLINK "mailto:edavis@kerrtarcog.org" edavis@kerrtarcog.org Website: Counties Served: Caswell, Franklin, Granville, Person, Vance, Warren Lumber River Workforce Development Board  Director: Dana Powell ComTech Park 30 CJ Walker Road Pembroke, NC 28372 Phone: 910-618-5533 Fax: 910-521-7576 Email: HYPERLINK "mailto:dana.powell@lrcog.dst.nc.us"dana.powell@lrcog.dst.nc.us Website: Counties Served: Bladen, Robeson, Scotland, Hoke  Triangle South Workforce Development Board (formerly Mid-Carolina WDB)Director: Cindy Casler 1105 Kelly Drive Sanford, NC 27330 Phone: 919-777-7795 Fax: 919-777-7796 Email:  HYPERLINK "mailto:ccasler@cccc.edu" ccasler@cccc.edu Website: Counties Served: Chatham, Harnett, Lee, Sampson  Mountain Area Workforce Development Board  Director: Helen Beck P.O. Box 729 Asheville, NC 28802 Phone: 828-250-4760 or 62 Fax: 828-255-5833 Email: helen.beck@buncombecounty.org Website: Counties Served: Henderson, Madison, Buncombe, Transylvania  Northeastern Workforce Development Board Director: Wendy Jewett P.O. Box 646 512 South Church Street Hertford, NC 27944 Phone: 252-426-5753 ext. 229 Fax: 252-426-8482 Email: wjewett@albemarlecommission.org Website:  Counties Served: Chowan, Gates, Perquimans, Camden, Currituck, Pasquotank, Hyde, Tyrrell, Washington, Dare  Northwest Piedmont Workforce Development Board  Director: Althea Hairston 400 West Fourth Street, Suite 400 Winston-Salem, NC 27101 Phone: 336-761-2111/336-634-5600 Fax: 336-761-2112 Email: HYPERLINK "mailto:ahairston@nwpcog.org"ahairston@nwpcog.org Website:  Counties Served: Davie, Forsyth, Rockingham, Stokes, Surry, Yadkin  Pee Dee Workforce Development Board  Director: Linda Parker P.O. Box 1883 221 South Fayetteville Street Asheboro, NC 27204-1883 Phone: 336-629-5141 Fax: 336-629-1290 Email: HYPERLINK "mailto:lparker@regionalcs.org"lparker@regionalcs.org Website: Counties Served: Montgomery, Moore, Richmond  Region C Workforce Development Board Director: Bill Robertson P.O. Box 841 111 West Court Street Rutherfordton, NC 28139 Phone: 828-287-0262 ext 1245 Fax: 828-287-2735 Email: HYPERLINK "mailto:brobertson@regionc.org"brobertson@regionc.org Website: Counties Served: Cleveland, McDowell, Polk, Rutherford  Region Q Workforce Development Board Director: Walter Dorsey 1385 John Small Avenue Washington, NC 27889 Phone: 252-974-1815 Fax: 252-948-1861 Email: HYPERLINK "mailto:wdorsey@mideastcom.org"wdorsey@mideastcom.org Website: HYPERLINK "http://www.regionqwdb.org"www.regionqwdb.org Counties Served: Beaufort, Bertie, Hertford, Martin, Pitt  Regional Partnership Workforce Development Board Director: Linda Parker P.O. Box 1883 221 South Fayetteville Street Asheboro, NC 27204-1883 Phone: 336-629-5141 Fax: 336-629-1290 Email: HYPERLINK "mailto:lparker@regionalcs.org"lparker@regionalcs.org Website: Counties Served: Alamance, Orange, Randolph  Southwestern Workforce Development Board Director: Vicki Green 125 Bonnie Lane Sylva, NC 28799 Phone: 828-586-1962 x. 210 Fax: 828-586-1968 Email: HYPERLINK "mailto:Vicki@regiona.org;"Vicki@regiona.org Website: HYPERLINK "http://www.regiona.org"www.regiona.org Counties Served: Haywood, Jackson, Macon, Cherokee, Clay, Graham, Swain  Turning Point Workforce Development Board (formerly Region L) Director: Michael Williams 4036 Capital Drive P.O. Box 7516 Rocky Mount, NC 27804 Phone: 252-443-6175 Fax: 252-443-4468 Email:  HYPERLINK "mailto:mwilliams@turningpointwdb.org" mwilliams@turningpointwdb.org Website: HYPERLINK "http://http:/www.turningpointwdb.org/"http://www.turningpointwdb.org/ Counties Served: Edgecombe, Nash, Halifax, Northampton, Wilson  Western Piedmont Workforce Development Board Director: Sheila Dotson P.O. Box 9026 736 Fourth Street, SW Hickory, NC 28603 Phone: 828-485-4218 Fax: 828-322-5991 Email: HYPERLINK "mailto:sheila.dotson@wpcog.org"sheila.dotson@wpcog.org Website:Counties Served: Burke, Caldwell, Alexander, Catawba Top of Form ATTACHMENT D NC DEPARTMENT OF COMMERCE 2010 COUNTY TIER DESIGNATIONS TIER 1TIER 2TIER 3Alexander Alleghany Anson Beaufort Bertie Bladen Burke Caldwell Camden Caswell Chowan Clay Cleveland Columbus Edgecombe Gates Graham Greene Halifax Hertford Hyde Jones Lenoir Martin McDowell Mitchell MontgomeryNorthampton Richmond Robeson Rockingham Rutherford Scotland Surry Tyrrell Vance Warren Washington Wayne Wilkes Alamance Ashe Avery Catawba Cherokee Craven Cumberland Currituck Dare Davidson Davie Duplin Franklin Gaston Granville Harnett Haywood Hoke Jackson Lee Lincoln Macon Madison Nash Pamlico Pasquotank Perquimans PersonPitt Polk Randolph Rowan Sampson Stanly Stokes Swain Transylvania Watauga Wilson Yadkin YanceyBrunswick Buncombe Cabarrus Carteret Chatham Durham Forsyth Guilford Henderson Iredell Johnston Mecklenburg Moore New Hanover Onslow Orange Pender Union WakeATTACHMENT E MULTIPLE BUSINESS COLLABORATIVE FORM Please complete Attachment E for each additional business that is part of a collaborative to provide common training its employees. This attachment(s) is to be included as part of the completed application. A. Applicant Information Company Name: Street/Mailing Address: City/State: Zip: County: Company Contact Person: Title: Phone: Ext: Fax: E-Mail Address: Company Web-site: Description of Business Product(s) or Service(s):Years in business at training location: Total number of paid employees at this location: NAICS Code:Legal Structure of Business: Sole Proprietor Partnership Corporation (Designation) Tax Status of Business: For-profit Not-for-profit (Designation) Other: Employers Federal ID #: Unemployment Comp ID #:  Is your company a subsidiary of another company or affiliated with a parent company? Yes No  If Yes, please provide the following information about the corporate office/parent company, if different from above, or indicate SAME. Parent Company Name: Street/Mailing Address: City/State: Zip: County: Authorized Representative: Title: Phone: Ext: Fax: E-Mail Address: Company Web-site:  C. Business Status Checklist Has the company been in operation in the State of North Carolina during the entire twelve month period immediately preceding the date of application? Yes No  Is your company current on all North Carolina state taxes? Yes No Is your company current on all federal taxes? Yes No Is your company current on all county, city and local taxes? Yes No Is your company subject to a collective bargaining agreement? Yes No (If Yes, please attach a letter of endorsement from the authorized union official) Has your company previously received an Incumbent Workforce Development Training Grant(s)? Yes No  If Yes, please provide the following information about each grant received: Local Workforce Development Board:Amount of Award: Dates of Grant Period: Types of training provided: Have the terms and agreements of the training been completed? Yes No (If no, explain.)Summary of the outcome(s) from the training: Explain the relationship, if any, to the training described in this application:  Local Workforce Development Board:Amount of Award: Dates of Grant Period: Types of training provided: Have the terms and agreements of the training been completed? Yes No (If no, explain.)Summary of the outcome(s) from the training: Explain the relationship, if any, to the training described in this application:  Please provide how participation in this collaborative grant will add value to your company and its employees:  AUTHORIZATION AND CERTIFICATION FOR ATTACHENT E As authorized representative of the Collaborative Business submitting this application, I hereby certify that: I have read the Incumbent Workforce Development Training Program Guidelines and coordinated this application with the Local Workforce Development Board; The Business meets the requirements and is eligible to submit this application; The information contained in this application is true and accurate and reflects the intentions of the Incumbent Workforce Development Training Program; I am aware that any false information, intentional omissions, or misrepresentations may result in rejection of the application and possible disqualification for future funding; I am aware that any false information, intentional omissions, or misrepresentations may subject the Business to civil or criminal penalties; I understand that training materials purchased or developed with funds awarded under this project will be in the public domain and will be available for use by other eligible entities at no costs; and The Business agrees to adhere to all reporting requirements: and to respond to a Customer Satisfaction Survey(s), if asked. The Business agrees to provide all requested data elements as required for federal reporting. Further, this business shall not discriminate against any employee, applicant for employment, applicant or Workforce Investment Act participant, subcontractor or potential beneficiaries of employment and training programs or projects because of race, color, disability, religion, age, sex, national origin, political affiliation or belief.  Print Name Title  Authorized Signature Date (Collaborative Business Representative) ATTACHMENT F LAY-OFF AVERSION ATTESTATION FORM State of North Carolina Incumbent Workforce Development Program This form must be completed and signed by the Owner, President, CEO, or highest ranking local official of each business in North Carolina included in the Incumbent Workforce Development Program application. Lay-off aversion may occur through skill attainment or process improvement. Please review and select the appropriate lay-off aversion criteria. More than one may be chosen. Space will expand as text is entered. 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