Orange County NC Website
9 <br />October 2013 <br />Associate affirms that they are in compliance with Article 3 of Chapter 64 if the North Carolina General <br />Statutes. <br /> <br />IN WITNESS WHEREOF, the Parties have executed this Agreement as of the day and year written <br />above. <br /> <br />COVERED ENTITY: BUSINESS ASSOCIATE: <br /> <br />By:_________________________________ By:___________________________________ <br /> <br />Title:________________________________ Title:__________________________________ <br />DocuSign Envelope ID: C0928E94-13D1-401A-9906-DAA9AF10A142 <br />Clinical Supervisor7/6/2022