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Exhibit 14A: List of Subcontractors <br />Provider: Cabarrus County Department of Human Services <br />Region F FY 17 <br />Provider Code: 042.045, 180, 030, 155 County Cabarrus <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 />Service Name <br />Address <br />requirements that will be delegated to the subcontractor, e.g. <br />For - Prot <br />& Phone Number <br />eligibility determination, service authorization,. <br />assessments /reassessments, preparation and delivery of <br />Government <br />meals, provision of a ride and driver /requiremen tasks on <br />an In -Home Aide plan of care, aide competency testing, aide <br />supervision,etc.) <br />Aaron Jordan <br />Congregrate <br />666 Concord Parkway <br />Preparation & delivery of meals to Congregate <br />PUnChy's Diner <br />For- Profit <br />Nutrition <br />Concord NC 28027 <br />Nutrition sites <br />704 - 786 -2222 <br />Ruby Kumar <br />University Adult <br />Adult Day <br />1324 John Kirk Dr <br />Care., Inc. <br />Non - Profit <br />Care/Health <br />Charlotte, NC 28263 <br />Provision of Adult Day Care/Health Services <br />704 -510 -0030 <br />Susan Caudle <br />Coltrane LIFE <br />Adult Day <br />321 Corban Ave., SW <br />Center, Inc. <br />Non - Profit <br />Care/Health <br />Concord, NC 28025 <br />Provision of Adult Day Care/Health Services <br />704-788 -1215 <br />Attest Statement: Providers utilizing subcontractors must provide assurance that both for profit and non - profit subcontractors are compliant Wth 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 ", D) 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 (501c3) organizationn e federal government. <br />Provider Signature: ' 4 �/,� <br />Al— / c' Title: Z Date: <br />D <br />Version 2016 <br />3 <br />7 <br />7 <br />C <br />Version 2016 <br />Pagel of 2 <br />F -6 Page 142 <br />