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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 : Arv► PW ILLV00* TITLE : <br /> DATE : q /`! <br /> L,) <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 /> �- <br /> Clerk of the ity � ( governing body ) on e 0 <br /> This instr ent has been pre -audited in the manner <br /> required ocal Government Budget and <br /> Fiscal o A t . <br /> ( SEAL ) <br /> I NCE OFFICER) <br /> Federa Tax Identification Number <br /> m <br /> Remittance Address : <br /> DEPARTMENT OF TRANSPORTATION <br /> BY : <br /> ( CHIEF ENGINEER) <br /> Agreement ID # 3 <br />