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(b) He or she is authorized to make, and does hereby make, the foregoing certifications on behalf of the <br /> Contractor; and <br /> (c) He or she understands that any person who knowingly submits a false certification in response to the <br /> requirements of G.S. 143-59.1 and -59.2 shall be guilty of a Class I felony. <br /> Contractor's Name <br /> Signature of Contractor's Authorized Agent Date <br /> Printed Name of Contractor's Authorized Agent Title <br /> Signature of Witness Title <br /> Printed Name of Witness Date <br /> The witness should be present when the Contractor's Authorized Agent signs this certification and should sign and date <br /> this document immediately thereafter. <br /> Contractor Certifications Required by North Carolina Law Page 2 of 2 <br />