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6.1.C. - Page 64 <br />PART 3: OWNER/CONTROL RELATIONSHIPS <br />List those persons named in Part 2 that are related to each other (spouse, parent, child, or sibling). You only have to <br />list each relationship pair once. For example, if you've listed John Smith and Mary Smith as owners, just list John <br />Smith related to Mary Smith as husband. You don't need to also list Mary Smith related to John Smith as wife. <br />II Name Related to: Relationship <br />PART4:SUBCONTRACTORS <br />"Subcontractor" means an individual, agency, or organization to which the Entity has contracted or delegated some <br />of its management functions or responsibilities of providing medical care to its patients; <br />For fiscal agents only: A "subcontractor" also means an individual, agency, or organization with which a <br />fiscal agent has entered into a contract, agreement, purchase order, or lease (or leases of real property) to obtain <br />space, supplies, equipment, or services provided under the Medicaid agreement. <br />If the Entity has a 5% or more interest in any Subcontractor, list the information below for each Person with an <br />ownership or controlling interest" (see definition in Part 2) in the Subcontractor <br />Revised 3/9/2015 <br />Page 3 of 5 <br />REV: 01-17-18 RL <br />ATTY/AGR/2018.012/COUNTY OF SAN MATEO <br />