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5 <br /> favors to any State employee of the Governor's Cabinet Agencies (i.e., Administration, <br /> Commerce, Correction, Crime Control and Public Safety, Cultural Resources, Environment and <br /> Natural Resources, Health and Human Services, Juvenile Justice and Delinquency Prevention, <br /> Revenue, Transportation, and the Office of the Governor). <br /> IN WITNESS WHEREOF, this Agreement has been executed, in duplicate, the day and year <br /> heretofore set out, on the part of the Department and the Municipality by authority duly given. <br /> L.S. ATTEST: <br /> BY: BY: <br /> TITLE: TITLE: <br /> DATE: <br /> N.C.G.S. § 133-32 and Executive Order 24 prohibit the offer to, or acceptance by, any State <br /> Employee of any gift from anyone with a contract with the State, or from any person seeking to do <br /> business with the State. By execution of any response in this procurement, you attest, for your entire <br /> organization and its employees or agents, that you are not aware that any such gift has been offered, <br /> accepted, or promised by any employees of your organization. <br /> Approved by the -as attested to by the signature of <br /> Clerk of the (governing body) on <br /> This instrument has been pre-audited in the manner <br /> required by the Local Government Budget and <br /> Fiscal Control Act. <br /> (SEAL) <br /> (FINANCE OFFICER) <br /> Federal Tax Identification Number <br /> Remittance Address: <br /> DEPARTMENT OF TRANSPORTATION <br /> BY: <br /> (CHIEF ENGINEER) <br /> Agreement ID# 3 <br />