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Appendix D 2010-0499-53 <br /> Page 3 of 18 <br /> IN WITNESS WHEREOF,this Agreement has been executed,in duplicate,the day and year <br /> heretofore set out, on the part of the North Carolina Department of Transportation and the North <br /> Carolina State University by authority duly given. <br /> L.S, ATTEST: NORTH CAROLINA STATE UNIVERSITY <br /> BY: BY: 6�� &M�6� ) <br /> #M 1Q6 a <br /> Assistant Director <br /> TITLE: TITLE: C+ontrad NWtiations <br /> N=Spordwid Programs <br /> DATE: DATE: 10 2P`z <br /> NCGS 133-32 and Executive Order 24 prohibit the offer to,or acceptance by,any State Employee of <br /> any gift from anyone with a contract with the State,or from any person seeking to do business with <br /> the State, By execution of any response in this procurement, you attest,for your entire organization <br /> and its employees or agents, that you are not aware that any such gift has been offered, accepted,or <br /> promised by any employees of your organization. <br /> This instrument has been pre-audited in the manner <br /> required by the Local Government Budget and <br /> Fiscal Control Act. <br /> (SEAL) <br /> (FINANCE OFFICER) <br /> Federal Tax Identification Number EIN: <br /> CAGE:IE7N9 <br /> DUNS:04-209-2122 <br /> Remittance Address: <br /> North Carolina State University <br /> TRACTS/GRANT;, <br /> ,. Lw iX 7214 <br /> II)-SUITE 232-266 <br /> r`, <br /> NO 27695-721 <br /> DEPART OF TRA PORT TIO <br /> BY: <br /> (CHIEF ENGINEER) <br /> DATE: T l J G( 1 J <br /> APPROVED BY BOARD OF TRANSPORTATION ITEM 0: (Date) <br /> i <br /> Agreement ID#5394 3 <br /> s <br />