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Sample lZ2n -ew6 l A5ree.merrt- <br />Contract #68 -2005 <br />Arcadia Health Services, Inc. <br />CONTRACT # _68 -2005 Fiscal Year Begins Jul 1, 2010 Ends June 30. 2011 <br />NORTH CAROLINA <br />ORANGE COUNTY <br />IN -HOME AIDE PROVIDER SERVICES AGREEMENT <br />THIS AGREEMENT, is made and entered into this day of , 2010 by <br />and between Orange County, North Carolina for and on behalf of the Orange County Department <br />of Social Services and the Orange County Department of Aging (the "County "); and Arcadia <br />Health Services, Inc. (the "Contractor ") whose federal tax identification number or Social <br />Security Number is: <br />WITNESSETH: <br />For the purpose and subject to the terms and conditions hereinafter set forth, the County <br />hereby contracts for the services of the Contractor, and the Contractor agrees to provide the <br />services to the County in accordance with the terms of this Agreement. <br />1. Contract Documents: This Agreement consists of this document as well as each of the <br />documents listed below as indicated (collectively referred to as the "Contract Documents "). If <br />the word "Yes" appears beside the title of the contract document at the time both parties execute <br />this Agreement, then that document is included as part of this Agreement. If the word "No" <br />appears beside the title of the contract document at the time both parties execute this Agreement, <br />then that document is not included as part of this Agreement. Each of the Contract Documents <br />made part hereof are attached hereto and incorporated herein by reference to the same: <br />TITLE OF CONTRACT DOCUMENT YES/NO <br />(1) The General Terms and Conditions (Attachment A) YES <br />(2) The Scope of Work, services, and rate (Attachment B) YES <br />(3) Federal Drug Free Workplace Certification (Attachment C) YES <br />(4) Conflict of Interest Policy (Attachment D) YES <br />(5) No Overdue Taxes Certification (Attachment E) YES <br />(6) Certification Regarding Lobbying (Attachment G) YES <br />(7) Certification Regarding Debarment (Attachment H) YES <br />K, <br />