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DocuSign Envelope ID: 12D946D0-9D14-4754- 7762-26F971 E30A53 <br /> OA6"Q-VAA V- I I S( A U d()1.1 S <br /> August 7tn 2019 <br /> To: County Department of Social Services/Human Services <br /> Certification: <br /> We certify that the Medisolutions, Inc does not have any overdue tax debts, as defined <br /> by N.C.G.S. 105-243.1, at the federal, State, or local level. We further understand that <br /> any person who makes a false statement in violation of N.C.G.S. 143C-6-23(c) is guilty <br /> of a criminal offense punishable as provided by N.C.G.S.) 143C-10-1 b. <br /> Sworn Statement: <br /> John ❑kafor and Oswald Nwogbo being duly sworn, say that we are the Board Chair <br /> and CEO, respectively, of Medisolutions, Inc of Burlington in the State of North Carolina; <br /> and that the foregoing certification is true, accurate and complete to the best of our <br /> knowledge and was made and subscribed by us. We also acknowledge and understand <br /> that any misuse of State funds will be reported to the appropriate authorities for further <br /> action. <br /> Boar hair <br /> C <br /> Sworn to and subscribed before me on the day of the date of said certification. <br /> L fISKA D,ptwRT-GREEN <br /> Qom=.. t r Pu , No, h Car01i�t1 <br /> My Commission V <br /> Sion Expires <br /> Notary Signature and S a <br /> G.S. 105-243.1 defines: Overdue tax debt.—Any part of a tax debt that remains unpaid 90 days <br /> or more after the notice of final assessment was mailed to the taxpayer.The term does not <br /> include a tax debt, however, if the taxpayer entered into an installment agreement for the tax debt <br /> under G.S. 105-237 within 90 days after the notice of final assessment was mailed and has not <br /> failed to make any payments due under the installment agreement." <br /> Page 1 of 1 <br /> Rev.6-7-2015 <br />