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Exhibit 14A: List of Subcontractors <br />Provider Name: Cabarrus <br />Region F - FY 19 County: Cabarrus <br />Provider Code: F011 <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 scot <br />providers grant award. The subcontractor is accountable for the same requirements as the service provider, depending on the terms <br />Subcontractors must adhere to service standard requirements by the Division of Aging and Adult Services. Do not list vendors who pi <br />.purchase of service'. These are services which do not follow prescribed service standards and are goods or services sold equally to; <br />Subcontractor <br />Name <br />Type Agency <br />Non -Profit <br />For -Profit <br />Government <br />Subcontracted <br />Service Name <br />Subcontractor Contact Name, <br />Address <br />s Phone Number <br />Scope of the Subcontract(Briefly desert <br />requirements that will be delegated to the a� <br />eligibility determination, service authordati< <br />assessments/reassessments, preparation a <br />meals, provision of a ride and driver/require <br />an In -Home Aide plan of care, aide compel <br />supervlsion,etc.) <br />None <br />Attest statement: Providers utilizing Subcontractors must provide assurance that both for profit and non -prom subcontractors are compliant With state and federal reguls <br />the subcontractor A) hes not been suspended or debarred (G.S. §143C-6-23: 09NCAC03M). B) hes not been barred from doing business at the federal level, C) is able <br />Grant Cenlacaaon of No Overdue Tax Debts", D) has obtained all licenses, permits, bonds and insurance necessary for carrying out HCCSG Services. In addition, Non -f <br />registered as a charitable (50101 orgenda0on with Na federal government. <br />Provider Signature: Title: Oita: <br />Version 2016 Page_ fir_ <br />Attach menl number 1 in <br />Version 2016 <br />F-2 <br />