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2019-668-E DSS - Medisolutions in home aide services
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2019-668-E DSS - Medisolutions in home aide services
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Last modified
10/11/2019 11:45:37 AM
Creation date
10/1/2019 2:48:57 PM
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Template:
Contract
Date
9/30/2019
Contract Starting Date
7/1/2019
Contract Ending Date
6/30/2020
Contract Document Type
Contract
Amount
$13,600.00
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R 2019-668 DSS - Medisolutions in home aide services
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\Board of County Commissioners\Contracts and Agreements\Contract Routing Sheets\Routing Sheets\2019
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DocuSign Envelope ID: 12D946D0-9D14-4754-B762-26F97lE30A53 <br /> ATTACHMENT M <br /> State and Local Certifications <br /> Contractor Certifications Required by North Carolina Law <br /> Orange County Department of Social Services and Department on Aging <br /> Instructions: The person who signs this document should read the text of the statutes and Executive Order listed below and consult <br /> with counsel and other knowledgeable persons before signing.The text of each North Carolina General Statutes and of the Executive <br /> Order can be found online at: <br /> • Article 2 of Chapter 64: hit :Jhvww.ne a.state.nc.us[FnactedLe islation/Statut&PDFB Article/Cho ter 64/Article 2. df <br /> • G.S. 133-32: htlp:/lwww.ncga,state.ne.uslgascripts/statutes/statuteIook up.pl?statute=133-32 <br /> • Executive Order No.24(Perdue,Gov.,Oct. 1,2009): http://www.ethicscommission.nc.p-ovllibrM/pdfs/LawVF024.pdf <br /> • G.S. 105-164.8(b): h€tl2://www.nega.state.nc.us/EnactedI,epis]ation/Statutes/PDFBySection/Cliapter_105JGS_105-16C8.ndf• <br /> • G.S. 143-48.5: http:JJwww.nepa.state.ne,us/EnactedLegislatioa/Statutes/HTML/BySection/Chapter_143JG_S_143-4$.5.html <br /> • G.S. 143-59.1: htt :JJwww.nc a.state.nc.usJEnactedl.e islationJStatutesJPDFB Section/Cha ter 1431GS 143-59.1. df <br /> • G.S. 143-59.2: htto:Jhvww.ncga.state.nc.us/EnactedLegislationJStatutesfPDF/BySection/Chapter 143/GS_143-59.2.pdf <br /> • G.S. 143-133.3: htE :JJwww.ne a.state.nc.us/EnactedLe i slat ion/Statute s/HTM L/By Sect ion/Chapter 14316S 143-133.3.html <br /> • G.S. 143B-139.6C: httn 1Avww.ncga.state.nc.usJEnactcdl.egislationl5tatutes/PDFBySectionJChapter 143B/GS_14313-139.6C.pdf <br /> • The text of Orange County living Wage Contractor Policy which is attached to this document. <br /> Certifications <br /> (1) Pursuant to G.S. 133-32 and Executive Order No. 24 ❑ Neither the Contractor nor any of its affiliates <br /> (Perdue, Gov., Oct. 1, 2009), the undersigned hereby has incorporated or reincorporated in a "tax <br /> certifies that the Contractor named below is in <br /> haven country" as set forth in G.S. 143- <br /> compliance with,and has not violated,the provisions of 59.1(c)(2)after December 31,2001;or <br /> either said statute or Executive Order. <br /> (2) Pursuant to G.S. 143-48.5 and G.S. 143-133.3, the <br /> undersigned hereby certifies that the Contractor named ® The Contractor or one of its affiliates has <br /> below, and the Contractor's subcontractors, complies incorporated or reincorporated in a "tax haven <br /> with the requirements of Article 2 of Chapter 64 of the country" as set forth in G.S. 143-59.1(c)(2} <br /> NC General Statutes, including the requirement for after December 31, 2401 but the United States <br /> each employer with more than 25 employees in North is not the principal market for the public trading <br /> Carolina to verify the work authorization of its of the stock of the corporation incorporated in <br /> employees through the federal E-Verify system." E- the tax haven country. <br /> Verify System Link:www.uscis.gov (4) Pursuant to G.S. 143-59.2(b), the undersigned hereby <br /> certifies that none of the Contractor's officers, <br /> Local government is specifically exempt from Article 2 directors, or owners (if the Contractor is an <br /> of Chapter 64 of the North Carolina General unincorporated business entity) has been convicted of <br /> Statutes. However,local government is subject to and any violation of Chapter 78A of the General Statutes or <br /> must comply with North Carolina General Statute the Securities Act of 1933 or the Securities Exchange <br /> 153A-99.1,which states in part as follows: Act of 1934 within 10 years immediately prior to the <br /> Counties Must Use E-Verify-Each county shall date of the bid solicitation. <br /> register and participate in E-Verify to verify the work (5) Pursuant to G.S. 143B-139.6C, the undersigned <br /> authorization of new employees hired to work in the hereby certifies that the Contractor will not use a <br /> United States. former employee, as defined by G.S. 14313- <br /> (3) Pursuant to G.S. 143-59.1(b), the undersigned hereby 139.6C(d)(2), of the North Carolina Department of <br /> certifies that the Contractor named below is not an Health and Human Services in the administration of a <br /> "ineligible Contractor" as set forth in G.S. 143-59.1(a) contract with the Department in violation of G.S. <br /> because: 143B-139.6C and that a violation of that statute shall <br /> void the Agreement. <br /> (a) Neither the Contractor nor any of its affiliates has (6) The undersigned hereby certifies further that: <br /> refused to collect the use tax levied under Article 5 <br /> of Chapter 105 of the General Statutes on its sales (a) He or she is a duly authorized representative of the <br /> delivered to North Carolina when the sales met <br /> one or more of the conditions of G.S. 105- Contractor named below; <br /> 164.8(b);and (b) He or she is authorized to make, and does hereby <br /> (b) [check one of the following boxes] make, the foregoing certifications on behalf of the <br /> Contractor,and <br /> Contractor Certifications Required by North Carolina Law(Rev.8J2016) Paae I of 3 <br />
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