Orange County NC Website
Browse       Search
DocuSign Envelope ID:2E5A8509-E4CD-4A45-9241-C69B05F6A27D <br /> ?Contracte!r„ clues car:Bidder B t t i r► This Form With All Others r txcl Bred Document ation,'$'M 4 <br /> IRAN DIVESTMENT NT A t"i' CERTIFICATION?VI'ION RKQt?1141 1J 1I\' N.('.C.S. <br /> 143('4iA>5(n) <br /> Nome or( Vendor or Bidder: /1 . a< J y7 <br /> As of the date listed below. the COi tmCtcjr, vendor or bidder listed above,and all SUhe1)tttrlttaors <br /> utilized by the contractor, vendor or bidder listed above, is not listed on the Final Divestment <br /> I.is1 c-re;ated by the Stale Treasurer to N.i <br /> the utictcrsi ned hereby ceitities that he or she is authorized by the contractor, vendor or bidder <br /> listed aahnvc JO make the foregoing statement. <br /> Signature I)ate <br /> printed Name "Title <br /> Noh,v/o persrur,+,sigillitti this o m: <br /> N.(;.ti.S. 1 13C:-6A-5(.i) requtreN this eciiific ation I'oebidsu contracts with the State of North <br /> Carolina,a Nc'ra'th Carolina local government, or any other political subdivision or the State of <br /> North Carolina, The certification k required ntthe tin s: <br /> .JWhcn i bid is submitted <br /> i <br /> !When is contrite( is entered into(if the eettitic<atiota was not already made when the s endor <br /> made its bid) <br /> U Wiwi) ri cu>m ml k renewed or a Ni ned <br /> N.C.(i,5, 143C-6A-50);eon es that contractors with the Slate, a North Carolina local <br /> t tiucrtntient,or tiny other political subclivisi rn orate State of North Carolina must not utilize <br /> any suIrconuaetirr found on the Slate' teuNtt er'S Final I)ivestnteiii Iast. The State"I`tvasurer's <br /> Final I)i vest mew list can be found on the Suite Treasurer's wchsitc at the address <br /> Y\ti,.[3el t;il',ili t`E.Citila aril is <br /> and will be updated every 1i10 days, <br /> *°*Contrartut,Vendor or Bidder-.Return This form With All Other Required t7ua.ainiont ltlofl' **P <br />