2018-138 DSS - NCDSS training contract amendment

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State Ch$4111Rfi'1"ther 00036254, Amendment Number 11 Page 15 of 16 Contractor Certifications Required by North Carolina few Instructors: The person who signs this document should mid the text orlhe slamles and Execidwe Order had below and consult with camel and other knowledgeable persons before signing. The text of can North Carelia General Statutes and or the Excativc Omer an be road online al: • Aniek2ol'Chan"64: hap /Iwww.n gnnak. nc. uJ[ noa< EL< 6iabtianl5mtmevl 'DFIOYAnid<MM1Vq <r 6llAnkle 2.pdf • G.S. 13342: htryl/ www. ncgaaak. nnu9ausmiPWamm <YSamehwkupDHaaute 133 -32 • Execan Order No. 24 O calm, Gov., Oct 1, 2009): mtp: /l www. ethicxommiuian .nc.govll3wy/pdmAg E024.pdf • GS. 105- 164.8(6): M1npdM+vw.nzp.sum.nmu EnxtvdlsglslOLi d mlote DFMySccti MPlm_IOS/GS_ 105.164. h.pdr • G.S. 14348.5: hupd/ wwwn< gutv¢. nc. orlEnuncdL< PislvtiWSlvmkeM1rfM1J9y5eNON CM1Vptcr NLGS 1434&51ml • G.S. 14339.1: M1np// mnv. maomPle. rc. uyEnvnmL< eialmivNSlam¢ vPDFl0y8mioNChopler .,HLG514L59.I4Mf • G.S. 143 -59.2: Mtp!/ www. mgoeom. nc. uslEnn ct< JL< glslotioMauteslpDF /OYSeaION[hvPtv_L43MS 14349.2pdr • G.S. 143- 1333: http /Iwww.n<6asvt<. noes/[ nvaedLglsldioNStwuksli11M1 /BySmicNChgaer_ 1431GS 143-133.3.himl • G.S. 1438.139.6C: hupl/ www. ncgnuvk. n<. uf/[ nu¢ dLegislvtivNSmmuxtPDplpyScnivNCNp <r 1430PoS_I4ID.II9.bC.pdf Certifications (1) Pungent to G.S. 13342 and Executive Order No. 24 after December 31, 2001 but the United States (Pardon, Gov., Ocl. 1, 2009), the undersigned hereby is not the principal market for the public trading certifies that the Contractor named below is in of the stack of the corporation incorporated in compliance with, mid has not violated, the previsions of the tax haven country. either said statute or Executive Order. (4) pursuant to G.S. 143.59.2(b), the undersigned hereby (2) Personal to G.S. 14349.5 and G.S. 143 - 133.3, the artiftes that Atone of the COn[nLlor's officers, undersigned hereby certifies that the Connscor named directors, or owners (if the Contractor is an below, and the Contractor's subcontractors, complies unincorporated business entity) has been convicted of with the requirements of Article 2 of Chapter 64 of the any violation of Chapter 79A of the Gem ml Statutes or NC General Sautes, including the requirement for the Securities Act of 1933 or the Securities Exchange such employer with more than 25 employ=$ in North Act of 1934 within 10 years immediately prior to the Carolina to verify the work authorimtian of its date of the bid solicitation. employees through the federal E- Verify system." E- (5) Pursuant to C.S. 1430- 139AC, the undersigned Verity System Link: www lscis eov hereby certifies that the Contractor will not use o (3) Pursuant to G.S. 143 - 59.1(6), the undersigned hereby former employee, as defined by G.S. 1430 - certifies that the Contractor named below is not an 139.6C(d)(2), of the North Carolina Department of 'ineligible Contractor' m set forth in G.S. 143 - 59.1(x) Health and Human Services in the administration era because: contract with the Department in violation of G.S. (a) Neither the Contractor nor any of its affiliates has 1430- 139.6C and that a violation of that statute shall refused ID collect the use tax levied under Article 5 void the Agreement. of Chapter 105 of the General Statutes on its aim (6) The undersigned hereby certifies further dint: delivemd to North Carolina when the sales met (a) He or she is a duly authorized representative of the one or more of the conditions of G.S. 105- Conereclor named below, 164.8(6); and (b) He or she is authorized to make, and does hereby (b) [check one of the following boxes] make, the foregoing certifications on behalf of the ® Neither the Counselor nor any of its affiliates Contractor, and has incorporated or reincorporated in a Wax (c) He or she understands that any person who haven country" as at forth in G.S. 143- knowingly submits o false ariffcation in responom 59.1(c)(2) after December 31, 2001; or to the requirements of G.S. 143- 59.1and .59.2 O The Contractor at one of its affiliates has shall be guilty era Class l felony. incorporated or reincorporated in a "lax haven country" as set forth in G.S. 143-59.1(c)(2) contmchors Nmm: Oran oLou" Ou cntofAntes, Services Omanoes Authodud Agent: sipatum NintNNOme C Goal ran Director Winners shunt, -I Dw nimmNUne Serena McPherson mar Administrative Assisunt ill CunlxiorCmifmlimrReuuircJ hr NaMCUmlim luwlRn Must Pace I air