Orange County NC Website
DocuSign Envelope ID:CC57DE94-E4EF-4D65-8035-F4F6E42CB4CC <br /> ATTACHMENT M <br /> State and Local Certifications <br /> Contractor Certifications Required by North Carolina Law <br /> Orange County Department of Social Services <br /> Instructions:The person who signs this document should read the text of the statutes and Executive Order listed below and consult <br /> with counsel and other knowledgeable persons before signing.The text of each North Carolina General Statutes and of the Executive <br /> Order can be found online at: <br /> ■ Article 2 of Chapter 64: ho://www.ncga.state.nc.us/EnactedLc&its[atiort/Statutes/PDFIByArticle/Chapter 6_4/Article_2.pdf <br /> • G.S. 133-32: htt ://w►yw.nc a.state.nc.usl ascTi ts/statutes/statute[ooku I?statute=133-32 <br /> • Executive Order No.24(Perdue,Gov.,Oct. 1,2009): http:llwww.ethiescommission.nc.pov/iibrm pdfs/l.aws/EO24.Vdf <br /> • G.S. 105-164.8(b): http:I ivww.ncea.state.nc.uslEnactedLep-islation/Statutes/PDF/BySection/Chapter_105/GS_105-164.8.pdf <br /> • G.S. 143-48.5: http:lwwwmcga.state.nc.usJEnactedI-egis[ation/Statutes/l-ITML/ByScction/Chapter_143/GS_143-48.5.html <br /> ■ G.S. 143-59.1: http:llwww.ncU.state.nc.usll nactedLegislation/Statutes/PDF/BvSection/ChaRter_143/GS 143-59.1.pdf <br /> ■ G.S. 143-59.2: http:llwww.ncga.state.nc.us/EnactedLep-is[ation/Statutes/PDF/BySeelion/ChVier_1431GS_143-59.2.pdf <br /> ■ G.S. 143-133.3: htW://www.ncp-a.state.nc.ugl,,nactedi,egistation/Statutes/l-ITML/13ySection/ChaWer_143/GS_143-133.3.html <br /> • G.S. 143B-139.6C: hup:Ilwww.ne a.state.nc.u s/F nac ted Leg isIationlStatutes/Pl]FIB y SectionlCha ter 143BIGS 143B-139.E{'. df <br /> • The text of Orange County Living Wage Contractor Policy which is attached to this document. <br /> Certifications <br /> (1) Pursuant to G.S. 133-32 and Executive Order No.24 ❑Neither the Contractor nor any of its affiliates <br /> (Perdue, Gov., Oct. 1, 2009), the undersigned hereby has incorporated or reincorporated in a "tax <br /> certifies that the Contractor named below is in <br /> haven country" as set forth in G.S. 143- <br /> compliance with,and has not violated,the provisions of 59.1(c)(2)after December 31,2001;or <br /> either said statute or Executive Order. <br /> (2) Pursuant to G.S. 143-48.5 and G.S. 143-133.3, the <br /> undersigned hereby certifies that the Contractor named ® The Contractor or one of its affiliates has <br /> below, and the Contractor's subcontractors, complies incorporated or reincorporated in a "tax haven <br /> with the requirements of Article 2 of Chapter 64 of the country" as set forth in G.S. 143-59.1(c)(2) <br /> NC General Statutes, including the requirement for after December 31, 2001 but the United States <br /> each employer with more than 25 employees in North is not the principal market for the public trading <br /> Carolina to verify the work authorization of its of the stack of the corporation incorporated in <br /> employees through the federal E-Verify system." E- the tax haven country. <br /> Verify System Link: www.uscis.gov (4) Pursuant to G.S. 143-59.2(b), the undersigned hereby <br /> certifies that none of the Contractor's officers, <br /> Local government is specifically exempt from Article 2 directors, or owners (if the Contractor is an <br /> of Chapter 64 of the North Carolina General unincorporated business entity) has been convicted of <br /> Statutes. However, local government is subject to and any violation of Chapter 78A of the General Statutes or <br /> must comply with North Carolina General Statute the Securities Act of 1933 or the Securities Exchange <br /> 153A-99.1, which states in part as follows: Act of 1934 within 10 years immediately prior to the <br /> Counties Must Use E-Verify-Each county shall date of the bid solicitation. <br /> register and participate in E-Verify to verify the work (5) Pursuant to G.S. 143B-139.6C, the undersigned <br /> authorization of new employees hired to work in the hereby certifies that the Contractor will not use a <br /> United States. former employee, as defined by G.S. 14313- <br /> (3) Pursuant to G.S. 143-59.1(b), the undersigned hereby 139.6C(d)(2), of the North Carolina Department of <br /> certifies that the Contractor named below is not an Health and Human Services in the administration of a <br /> "ineligible Contractor" as set forth in G.S. 143-59.1(a) . contract with the Department in violation of G.S. <br /> because: 143B-139.6C and that a violation of that statute shall <br /> void the Agreement. <br /> (a) Neither the Contractor nor any of its affiliates has (6) The undersigned hereby certifies further that: <br /> refused to collect the use tax levied under Article 5 <br /> of Chapter 105 of the General Statutes on its sales (a) He or she is a duly authorized representative of The <br /> delivered to North Carolina when the sales met one or more of the conditions of G.S. 105- <br /> Contractor named below; <br /> 164.8(b); and <br /> (b) He or she is authorized to make, and does hereby <br /> (b) [check one of the following boxes] make,the foregoing certifications on behalf of the <br /> Contractor;and <br /> Contractor Certifications Required bvNorth Carolina Law(Rev.8/2016) Page I of 3 <br />