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34 <br /> G ract Number 00029953/ Page 33 of 33 <br /> (b) He or she is authorized to matte, 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,land -59.2 shall be guilty of a Class I felony. <br /> Contra C oC s B t <br /> � vi-E3 <br /> Signatur of Con actor's Authorized Agent Date <br /> SIMU d Y` 1 2G <br /> Printed N me of Contractor's Authorized Agent Title <br /> C <br /> Signature of Witness A Title <br /> Re,bd&C,..h �YIM26 AHCH3 <br /> Printed Name of Witne s 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 /> I <br /> I <br /> I <br /> I <br /> Comractor Certifications Required by North Carolina Law Page 2 oft <br />