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AG 2016 06 20
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AG 2016 06 20
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Last modified
6/22/2016 12:17:16 PM
Creation date
11/27/2017 10:33:31 AM
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Meeting Minutes
Doc Type
Agenda
Meeting Minutes - Date
6/20/2016
Board
Board of Commissioners
Meeting Type
Regular
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Exhibit 14A: List of Subcontractors <br />Provider:Cabarrus County Planning & Development Provider Code: 010 County Cabarrus <br />Region F FY 17 <br />List each subcontractor in the chart below. A subcontractor is defined as an entity that has been contracted to do a job within the scope of the service provider's <br />grant award. The subcontractor is accountable for the same requirements as the service provider, depending on the terms of the subcontract. Subcontractors <br />must adhere to service standard requirements by the Division of Aging and Adult Services. Do not list vendors who provide services through a 'purchase of <br />service'. These are services which do not follow prescribed service standards and are goods or services sold equally to all consumers. <br />Subcontractor <br />Type Agency <br />Subcontracted <br />Subcontractor Contact Name,. <br />Scope of the Subcontract (Briefly describe any service <br />Name <br />Non- Profit <br />For - Profit <br />Service Name <br />Address <br />& Phone Number <br />requirements that will be delegated to the subcontractor, e.g. <br />eligibility determination, service authorization, <br />assessmentslreassessments, preparation and delivery of <br />Government <br />meals, provision of a ride and driver /requirements, tasks on <br />an In -Home Aide plan of care, aide competency testing, aide <br />supervision,etc. ) <br />NIA <br />Attest Statement: Providers utilizing subcontractors must provide assurance that both for profit and non - profit subcontractors are compliant with state and federal regulations. These assurances are <br />the subcontractor: A) has not been suspended or debarred (G.S_ §143C -6-23: 09NCACO3M). B) has not been barred from doing business at the federal level, C) is able to produce a notarized "State <br />Grant Certification of No overdue Tax Debts ", 13) has obtained all licenses, permits, bonds and insurance necessary for carrying out HCCBG Services. In addition, Non -Profit Subcontractors are <br />registered as a charitable (501 c3) organization with the federal government. <br />y Provider Signature: {.. 'Y ' � i t Title: � i I V (f l '( Y "�V� �^- s�'SM! .� � � i e. r <br />m : L-t 4 <br />Version 2016 <br />m <br />D <br />B <br />m <br />Version 2016 <br />Page of _ A <br />F -6 Page 169 <br />
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