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<br /> <br />Transportation Certification (06/16) Page 1 of 1 <br /> <br />ATTACHMENT J <br />CERTIFICATION REGARDING TRANSPORTATION <br /> <br />Orange County Department of Social Services and Orange County Department on Aging <br /> <br />By execution of this Agreement the Contractor certifies that it will provide safe client transportation by: <br /> <br />1. Insuring that all drivers (including employees, contractors, contractor’s employees, and <br />volunteers) shall be at least 18 years of age; <br /> <br />2. Insuring that all drivers (including employees, contractors, contractor’s employees, and <br />volunteers) shall be licensed to operate the specific vehicle used in transporting clients in <br />accordance with Chapter 20-7 of the General Statutes of North Carolina and the Division of <br />Motor Vehicle requirements; <br /> <br />3. Insuring that all vehicles transporting clients shall have at least the minimum level of liability <br />insurance appropriate for the type of vehicle as defined by Article 7, Rule R2-36 of the North <br />Carolina Utilities Commission; <br /> <br />4. Insuring that the contractor shall have written policies and procedures regarding how drivers <br />handle and report client emergencies and/or vehicle crashes involving clients to contractor and <br />how contractor notifies the Orange County Department of Social Services; <br /> <br />5. Insuring that no more than one quarter of one percent of all trips be missed by the contractor <br />during the course of the contract period; (Medicaid only) <br /> <br />6. Insuring that that no more than five percent (5%) of trips should be late for recipient drop off to <br />their appointment per month; (Medicaid only) <br /> <br />7. Contractor will maintain records documenting the following (County may require contractor to <br />provide): <br />a. Valid current copies of Driver’s License for all drivers; <br /> b. Current valid Vehicle Registration, for all vehicles transporting clients; <br /> c. Driving records for all drivers for the past three years and with annual updates; <br /> d. Criminal Background checks through North Carolina Law Enforcement or NCIC <br /> prior to employment and every three years thereafter; <br /> e. Alcohol and Drug Testing policy to meet the Federal Transit Authority guidelines. <br /> <br />8. Disclosing, at the outset of the contract, upon renewal and upon request, any criminal convictions <br />or other reasons for disqualifications from participation in Medicare, Medicaid or Title XX <br />programs (signature on this form confirms this statement). <br /> <br />_________________________________ __________________________________ <br />Signature Title <br /> <br />_________________________________ __________________________________ <br />Agency/Organization Date <br /> <br />(Certification signature should be same as Contract signature.) <br /> <br />DocuSign Envelope ID: 2BDD55A6-AB10-4CEE-BD64-A15242793F1F <br />Charles House Association 8/10/2022 <br />Executive Director