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AG 2018 06 18
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AG 2018 06 18
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Last modified
5/8/2019 5:09:53 PM
Creation date
5/1/2019 6:36:06 PM
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Template:
Meeting Minutes
Doc Type
Agenda
Meeting Minutes - Date
6/18/2018
Board
Board of Commissioners
Meeting Type
Regular
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Exhibit 14A: List of Subcontractors Region F - FV 19 County: Cabarrus <br />Provider Name: Cabarrus County Active Living and Parks Provider Code: F021 <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 />provider's 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 pt <br />'purchase of service'. These are services which do not follow prescribed service standards and are goods or services sold equally to i <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 />& Phone Number <br />Scope of the Subcontract (Briefly describe <br />requirements that will be delegated to the st <br />eligibility determination, service authorizatln <br />asseasmente/reassessments, preparation a <br />meals, provision of a ride and drivedrequere <br />an In -Home Alda plan of care, aide compeb <br />supemision,etc.) <br />Attest Statement: Pari building subcontractors must simple assurance that both for profit ane non-profit subcontractors are compliant with state and federal regula <br />the subcontractor: AI has not been suspended or debarred (G.S. §143C-9-23; 0ONCAC03M), B) has fell been barred from doing business at the federal level, C) Is able I <br />Grant Centra lon of No Overdue Tax Debts'. D) has obtained all licenses, pommels, bonds and Insurance necessary for carrying out HCCBG Services. In addition, d2n_E <br />registered as a charitable (501 c3) organiaation with the federal government. <br />Provider Signature: Title: Director Date: <br />Version 2016 Page of <br />Version 2016 <br />F-2 <br />Attachment number 1 N <br />
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