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DocuSign Envelope ID:2D4F9426-4542-4C8B-8119-E035F9A99D35 - — <br /> CONFLICT OF INTEREST ACKNOWLEDGEMENT AND POLICY <br /> State of Kentucky <br /> County Jefferson <br /> l Heather Wilson Notary Public for said County and State, certify that. <br /> Sherry Pemberton personally appeared before me this day and acknowledged <br /> that he/she is VP HomeCare Contracts&Sales of CNC/Access, Inc. dba All Ways Caring HomeCare <br /> [name of Organization] <br /> and by that authority duly given and as the act of the Organization, affirmed that the foregoing Conflict of <br /> Interest Policy was adopted by the Board of Directors/Trustees or other governing body in a meeting held <br /> on the day of <br /> Sworn to and subscribed before me this 11th day of May 2020 <br /> c'T tRY <br /> to <br /> 62ta'311 9 a <br /> --4 I COMAf891OK <br /> ?7M\ EJMIRES J U <br /> fi Eg '% 772>�sa2s J <br /> (Official Sea[) 1'r(� .._. •�� r Notary Public <br /> My Commission expires July 29th 2023 <br /> Instruction for Organization: <br /> Sign and attach the following pages after adopted by the Board of Directors/Trustees or other <br /> governing body OR replace the following with the current adopted conflict of interest policy. <br /> CNC/Access, Inc. dba All Ways Caring HomeCare <br /> Name of Organization <br /> Signature of Organization Official <br /> NCDHHS COI1015 (Rev. 4/11) <br />