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DocuSign Envelope ID:A9CF8A9E-4CDB-4BB9-A678-D4AD80CD1393 <br /> Attach to Bid Attach to Bid Attach to Bid Attach to Bid Attach to Bid Attach to Bid Attach to Bid Attach to Bid <br /> State of North Carolina --AFFIDAVIT -- Intent to Perform Contract <br /> with Own Workforce. <br /> County of <br /> Affidavit of <br /> (Name of Bidder) <br /> I hereby certify that it is our intent to perform 100% of the work required for the <br /> contract. <br /> (Name of Project) <br /> In making this certification, the Bidder states that the Bidder does not customarily subcontract elements <br /> of this type project, and normally performs and has the capability to perform and will perform all <br /> elements of the work on this project with his/her own current work forces; and <br /> The Bidder agrees to provide any additional information or documentation requested by the owner in <br /> support of the above statement. The Bidder agrees to make a Good Faith Effort to utilize minority <br /> suppliers where possible. <br /> The undersigned hereby certifies that he or she has read this certification and is authorized to bind the <br /> Bidder to the commitments herein contained. <br /> Date: Name of Authorized Officer: <br /> Signature: <br /> Title: <br /> SEAL <br /> State of , County of <br /> Subscribed and sworn to before me this day of 20_ <br /> Notary Public <br /> My commission expires <br /> MBForms 2002-Revised July 2010 <br />