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DocuSign Envelope ID: ACF53DOB- DE31- 493C- AC79- 4B38761278A7 <br />* * ** *Contractor Vendor or Bidder — Return This Form With All Other Required Documentation * * * ** <br />IRAN DIVESTMENT ACT CERTIFICATION REQUIRED BY N.C.G.S. <br />143C- 6A -5(a) <br />Name of Contractor, Vendor or Bidder: WP1-Ctj 44�Nr M AW i t.0r'-- <br />INC- <br />o 1L 4;1cl� N/C <br />As of the date listed below, the contractor, vendor or bidder listed above, and al I subcontractors <br />utilized by the contractor, vendor or bidder listed above, is not listed on the Final Divestment <br />List created by the State Treasurer pursuant to N.C.G.S. 143 -6A -4. <br />The undersigned hereby certifies that he or she is authorized by the contractor, vendor or bidder <br />listed above to make the foregoing statement. <br />9-- 4, 2)-0) CA/ <br />Signaturei Date <br />--)�jj Lim "-,-j S�v ri <br />Printed Name Title <br />Notes to persons signing this form: <br />N.C.G.S. 1430- 6A -5(a) requires this certification for bids or contracts with the State of North <br />Carolina, a North Carolina local government, or any other political subdivision of the State of <br />North Carolina_ The certification is required at the following times: <br />F]When a bid is submitted <br />❑W hen a contract is entered into (if the certification was not already made when the vendor <br />trade its bid) <br />❑When a contract is renewed or assigned <br />N.C.G.S. 1430- 6A -5(b) requires that contractors with the State, a North Carolina local <br />government, or any other political subdivision of the State of North Carolina must not utilize <br />any subcontractor found on the State Treasurer's Final Divestment List. The State Treasurer's <br />Final Divestment List can be found on the State Treasurer's website at the address <br />www.nctreasurer.comllran and will be updated every 180 days. <br />*" "Contractor, Vendor or Bidder— Return This Form With All Other Required Documentation * * * ** <br />