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DocuSign Envelope ID:456CB831-89E2-409B-8715-A71C362353A4 <br /> Florence Gray 5oltys Adult Day Health Program <br /> (Operated,* 5erilor Care of Orange Caufity, /Re) <br /> 105 fileadowland Drive <br /> Hillsborough, North Carolina 2 7278k <br /> Jahn Harnmand, President <br /> Wavy Fspersen Wee President <br /> Dowd aMerssnP, Treasurer <br /> Karen Dania4 Secretary <br /> (9119)2-95-2017 <br /> Fax(919)2q5-207,5' <br /> Date: June 28,2016 <br /> To: Orange County Department of Social Services <br /> r°m: Alvonia.Baldwin, <br /> . , <br /> Executive Director <br /> Re: Overdue Taxes Statement and Conflict of Interest Policy <br /> The Florence Gray Soltys Adult Day Health Program, operated by the Senior Care of Orange <br /> County, Inc., is a non profit agency. Senior Care of Orange County Inc; does not have any overdue tax <br /> debts. We are waiting for Orange County DSS to send their"Overdue Tax Statement"for the new <br /> fiscal year of 2016-2017 no later than July 5, 2016 for the Board Chair and Treasurers signatures and a <br /> notary's stamp as the sworn statement. In the meantime, please accept this letter, last year's copy of <br /> attachment E along with Senior's 990 indicating last year's taxes were filed. <br /> If additional information is needed, please contact me at 919-245-2017 and in my absence, please <br /> contact the Director Substitutes, Kristin Price and or Tamara Griffin. <br /> Thank you. <br /> • Couitlielty tAACtn,c-Q, <br /> •••••• <br /> ConwearaviallhiStaie of <br /> The foregoing ic4ShgricA*IR acknowledged bare <br /> meths 11 ettv 20/c' ' <br /> by, A erc\ cK, <br /> (nirlis of wson seeking ecknowiedgemet) <br /> 6 , <br /> Cc ASHLEYLAYNE H.BELL <br /> Nary <br /> Noteiy <br /> Dave Wilkerson My Commbeen V--1 <br /> Atamanoe Co Public Egibek 0 <br /> North Cantina <br /> Kristin Price My Commission Expires Feb.22,2021 <br /> Tamara Griffin <br />