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DocuSign Envelope ID:24E74F61 B98w�9-92A7-r4r76e27ro1e <br /> more of the conditions of G.S. 105-164.8(b); and <br /> (b) [check one of the following boxes] <br /> Neither the Contractor nor any of its affiliates has incorporated or reincorporated in a "tax have <br /> country" as set forth in G.S. 143-59.1(c)(2) after December 31, 2001; or <br /> 1.1 The Contractor or one of its affiliates has incorporated or reincorporated in a"tax haven country <br /> as set forth in G.S. 143-59.1(c)(2) after December 31, 2001 but the United States is not th <br /> principal market for the public trading of the stock of the corporation incorporated in the ta. <br /> haven country. <br /> `'/ Pursuant to G.S. ^~'~.~`~, the undersigned hereby certifies that none of the Contractor's officers, directo . <br /> or owners (if the Contractor s an unincorporated business entity) has been convicted of any violation of Chapt-I, <br /> 7--- -' the General Statutes _ the Securities Act of 1933 or the Securities Exchange year: <br /> immediately prior to the date of the bid solicitation. <br /> (4) The undersigned hereby certifies further that: <br /> (a) He or she is a duly authorized representative of the Contractor named below; <br /> (b) He or she is authorized to make, and does hereby make, the foregoing certifications on behalf of th <br /> Contractor; and <br /> (c) He or she understands that any person who knowingly submits a false certification in response to th <br /> requirements of G.S. 143-59.1and-59.2 shall be guilty of a Class I felony. <br /> (5) Pursuant to the Orange County Living Wage Contractor's Policy: <br /> (a) The undersigned certifies that the Contractor pays the employees who perform services under this contract 1 <br /> performing under this contract a living wage. If Contractor does not pay employees a living wage, what is th <br /> wage that employees performing services under this contract paid <br /> Contractor's <br /> ridym <br /> 8/4/2016 <br /> Signature of Contractor's Authorized Agent Date <br /> mark Pi etrow Presi dent <br /> DocuSig[led by: <br /> Printed Natrhtt&vntractor's Authorized Agent Title <br /> ritAl4t-VrOIA, National sales & contracts Di rector <br /> Signature of Witness Title <br /> living wage (in Orange County currently $13.15 per/hr.) Check here 1 if contractor pays employe-rs <br /> sherry Pemberton 8"15/201" <br /> Printed Name of W s [)ate <br /> The witness should be present when the Contractor's Authorized Agent signs this certification and should sign and da e <br /> this document immediately thereafter. <br /> Contractor Certifications Required by North Carolina Law Page 2 ot 2 <br />