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0 t t <br /> DocuSign Envelope ID:B92DDOFA-B451-4722-ACC3-D65CAA5BDAEC <br /> Jun 02 2012:01 p Premier Home Health Care 1 p.2 <br /> CONFLICT OF INTEREST ACKNOWLEDOEME14T AMC}MUCY <br /> State of New York <br /> County of Dutch+ess <br /> L Alice Gousbera.Notary Public for said County and State,certify that Gregory Turc#lan <br /> personally appeared before 1ne this day and acknowledged that he/she is President of Premier <br /> Home Health Care Services Inc and by that authority duly given,and as the act of the <br /> Organization,affirmed that the foregoing Conflict of listerest Policy was adopted by the Board of <br /> Oirectom/Trustees or other governing body in a meeting held on the 28 day of <br /> May �y 20 <br /> Sworn to and subscribed before the this :,� � day of I Y7L'L.(4 � °:'•.ice <br /> ALICE J. LOUSMirRG <br /> NOTARY PUBLIC STATE OF NEW YG;tK <br /> (Official Seal) t; Q�1xiUPiEO iNDHOW4aeg39�CKY�tiv7Yl4t2try Public,C <br /> COMMISSION Expirtr5]UNE'1q.ID.,,;;., <br /> My Commission expires .20 <br /> r�rssrs/FxrAis,►sarrrsrsrlttassrs�suarllMssRsrrrr�llrRrYirR��rsrrsllsrreedsll�rssrstt <br /> lnstmCdon for organization: <br /> Sign and attach the following,pagos after adopted by the Board of Directors/Trustees or other <br /> `—governing bodlyt OR replace they foilawing with the vwmnt adopted Conflict of lr emst polfey. <br /> Name of Qrgani n <br /> 519nature r a Offici ' <br /> NCDHHS COI IO15 (Rev.gill 1) <br />