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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 -Profit <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 /requirements, tasks on <br />an In -Home Aide plan of care, aide competency testing, aide <br />supervision,etc.) <br />Julie Conrad <br />Interim Healthcare <br />For- Profit <br />In -Home Aide <br />250 Branchview Dr., <br />Provision of In -Home Aide Services Level II & C11 <br />of the Triad, Inc. <br />Services II & III <br />Suite D <br />Concord NC 28025 <br />Sandy Mullins <br />In -Home Aide <br />51 Union St., S <br />Senior Helpers <br />For - Profit <br />Services ll &III <br />Suite on <br />Provision of In -Home Aide Services Level II & III <br />Concord, NC 28025 <br />Dana Ramsey <br />e <br />For- Profit <br />Aide <br />320 Copper Blvd., <br />Provision of In -Home Aide Services Level II & III <br />H omes are <br />amee <br />es II &III <br />Services <br />Services <br />Suite F <br />Attest Statement: Providers utilizing subcontractors must provide assurance that both for proM 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 ", D) has obtained all licenses, permits, bonds and insurance necessary for carrying out HCCBG Services. In addition, Mon - Profit subcontractors are <br />registered as a charitable (501c3) organization with the federal government. <br />3 Provider Signature: A Title: G'I Date: <br />B . <br />m <br />Version 2016 Page 2 of 2 <br />B <br />a <br />m <br />Versgn 2016 <br />F -6 Page 143 <br />