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Contract Number 00029953/Page 33 of 33 <br /> (b) He or she is authorized to make, and does hereby make, the foregoing certifications on behalf of the <br /> Contractor; and <br /> (C) He or she understands that any person who knowingly submits a false certification in response to the <br /> requirements of G.S. 143-59.1and -59.2 shall be guilty of a Class I felony. <br /> ' OYamf- Cajn A rYIf !y)(-A' oc �hcl&j S-eYV14,5S <br /> Contra4of(r'onj e 7 <br /> Signatuactor's Authorized Agent Date <br /> hl( K" (Ad-1*1 b\Yedby- <br /> Printed N me of Contractor's Authorized Agent Title <br /> ` y ,V\`: O M?,� MQt1Ptl�C YV1Et'1 jtl r��C� <br /> Signature of Witness I q Title �— <br /> R-b_ekcJo 2tlo 26 I i -1 13 <br /> Printed Name of Witness Date <br /> The witness should be present when the Contractor's Authorized Agent signs this certification and should sign and date <br /> this document immediately thereafter. <br /> Contractor Certifications Required by North Carolina Law Page 2 of 2 <br />