County Contract Information Any organization that receives federal or state financial assistance from a state agency is called a subrecipient. Counties, as subrecipients of the state, must develop monitoring and management procedures to ensure that funds are appropriately spent by any sub-awardee or contractor with whom they may contract to provide services. County Social Services Agencies may use the following template documents and instructions as guidance when entering into any contract. Counties Social Services Agencies are required to follow Uniform Guidance, Electronic Code of Federal Regulations, unless state or local rules are more restrictive. County Social Services Agencies should always consult their local resources to include their attorney when creating and entering into a contract. 1. General Contract 2. Attachment A: General Terms and Conditions 3. Attachment B: Scope of Work 4. Attachment C: Combined Federal Certifications* (Required if any federal funds are involved.) 5. Attachment D: Conflict of Interest Policy (Must be notarized and policy attached.) 6. Attachment E: No Overdue Taxes (Must be notarized.) 7. Attachment I: HIPAA Assessment Form, Business Associates Addendum, Government Associates Addendum* (Required if any health-related information is shared.) 8. Attachment J: Certification Regarding Transportation* (Required if providing transportation services.) 9. Attachment K: IRS Federal Tax Exemption (See 501(c)(3) and Tax-Exempt Status.) 10. Attachment L: Contract Determination Questionnaire (Contract Determination Questionnaire must be completed on all contracts. If the contract is for financial assistance, Attachment L must be provided to the contractor/provider.) 11. Attachment M: State Certification 12. Attachment N: Non-Discrimination, Clean Air, Clean Water 13. Contract Amendment *Forms May Be Required If information on this page needs to be updated please contact Tracie Miller, firstname.lastname@example.org, 919-527-7265.