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Proposal <br /> Part B <br /> YES • NO <br /> 9. The applicant is a Family C:7 tie Home or x <br /> Domiciliary Facility. If "yes", <br /> applicant assures that 75% of the <br /> of service delivered will be probvid in <br /> the clients' homes. <br /> 10. The applicant assures that it i u .:•;•.al x <br /> opportunity employer. <br /> 11. The applicant assures that mont :1; And x <br /> quarterly program and fiscal - <br /> provided by the Area Agency on Aging, <br /> will be submitted in compliance with the <br /> time frame established by the North • <br /> Carolina Division of Aging and/or Area <br /> Agency on Aging. <br /> 12. The applicant hereby assures that it has x <br /> read, fully understands, and will abide <br /> by all the provisions stated in the infor- <br /> mation concerning Respite Care Service. <br /> . OR . <br /> The applicant hereby .assures that it has — <br /> read, fully understands, and will abide <br /> by all provisions stated in the information <br /> • concerning Respite Care Services, except for <br /> the following for which we will seek a waiver(s) . <br /> Item Number: <br /> Reason for seeking waiver: <br /> • <br /> • <br /> • <br /> • <br /> • <br /> • <br /> • <br /> 18 <br />