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Aug 18 2023 01 :16PM HP Fax page 5 <br />G.Record of Conflict --The minutes of the governing board and all committees with board delegate,d <br />powers shall contain: <br />1.The names of the persons who disclosed or otherwise were found to have an actual or possible <br />conflict of interest, the nature of the conflict of interest, any action taken to determine whether a <br />conflict of interest was present, and the governing board's or committee's decision as to wheth,�r <br />a conflict of interest in fact existed.2.The names of the persons who were present for dis cussions and votes relating to the transaction <br />or arrangement that presents a possible conflict of interest, the content of the discussion, <br />including any alternatives to the transaction or arrangement. and a record of any votes taken inconnection with the proceedings. <br />Signature of Organization Offlcial <br /><jjj/CJ/ o?.0¢3 Dati NCDHHS COII015 (Rev. 4/l l) DocuSign Envelope ID: 74375224-B7BF-4B07-89E3-8426200297F5