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Appendix D 2010-0499-53 <br /> Page 16 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 Department and the University by authority duly given. <br /> ATTEST: NORTH CA LIN TATE UNIVERSITY <br /> BY: BY: <br /> Nny G John Chaffee <br /> TITLE: TITLE: AISOC�DkeokW Spa mwe-.md PI rcos <br /> DATE: <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 /> Approved by of the North Carolina State University as attested to by <br /> the signature of Clerk of the on <br /> (Date) <br /> This Agreement has been pre-audited in the manner <br /> required by the Local Government Budget and Fiscal <br /> Control Act. <br /> (SEAL) (FINANCE OFFICER) <br /> Federal Tax Identification Number <br /> North Carolina State University <br /> Remittance Address: <br /> DEPARTMENT OF TRANSPORTATION <br /> (CHIEF ENGIN ) <br /> DATE: <br /> APPROVED BY BOARD OF TRANSPORTATION ITEM 0: A400/44 r o; 1013 (Date) <br /> Agreement ID#3777 13 <br />