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Exhibit 14A: List of Subcontractors Region _J_FY20-21 <br />Provider: Orange County Department on Aging Provider Code: 047 County : Orange <br />Version 2016 Page _______ of _______ <br /> <br />Subcontractor <br />Name <br />Type Agency Subcontracted <br />Service <br />Subcontractor <br />Contact <br />Name, Address <br />& Phone Number <br />Scope of the Subcontract <br />Briefly describe any service requirements that will be delegated to the <br />subcontractor, e.g. eligibility determination, service authorization, client <br />assessments/reassessments, preparation and delivery of meals, provision of a <br />ride and driver/vehicle requirements, tasks on an In-Home Aide plan of care, aide <br />competency testing, aide supervision, etc. <br />Nantucket Café, Inc Non-Profit <br /> For-Profit <br /> Government <br />Congregate Meals Jerry Sullivan <br />PO Box 2655 <br />Chapel Hill, NC 27515 <br />Prepare and deliver noon meals in bulk to the Passmore and <br />Seymour Senior Centers each weekday <br /> Non-Profit <br /> For-Profit <br /> Government <br /> <br /> Non-Profit <br /> For-Profit <br /> Government <br /> <br /> Non-Profit <br /> For-Profit <br /> Government <br /> <br /> <br /> <br /> Non-Profit <br /> For-Profit <br /> Government <br /> <br /> <br /> <br /> Non-Profit <br /> For-Profit <br /> Government <br /> <br />Attest Statement: Providers utilizing subcontractors must provide assurance that both for-profit and non-profit subcontractors are compliant <br />with state and federal regulations. These assurances are that the subcontractor: (A) has not been suspended or debarred (G .S. §143C-6-23; <br />09 NCAC 03M), (B) has not been barred from doing business at the federal level, (C) is able to produce a notarized “State Gra nt Certification <br />of No Overdue Tax Debts”, and (D) has obtained all licenses, permits, bonds and insurance necessar y for carrying out HCCBG Services. In <br />addition, non-profit subcontractors are registered as a charitable (501c3) organization with the federal government. <br />Provider Signature __________________________________________ Title: DIRECTOR, DEPARTMENT ON AGING <br /> Date ______________ <br />DocuSign Envelope ID: 876C92A1-FFCC-4CCE-9133-469A78CE1DCA <br />7/24/2020