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Orange County, North Carolina <br />Lake Orange (ORANG-005) Auxiliary Spillway Concrete Repairs Project <br />Bid Proposal Form 004000-4 <br /> <br /> <br />The undersigned further agrees that in the case of failure on his part to execute the said <br />Contract and the Bond within ten (10) consecutive calendar days after written notice being given of <br />the award of the Contract, the check, cash or Bid Bond accompanying this Bid shall be paid into the <br />funds of Owner's Account set aside for this Project, as liquidated damages for such failure; <br />otherwise, the check, cash or Bid Bond accompanying this Bid Proposal shall be returned to the <br />undersigned. <br />By acceptance of this contract/purchase order or by submission of any Bid Proposal, etc, <br />vendors, contractors, and/or subcontractors affirm they are not listed on the Final Divestment List <br />created by the State Treasurer pursuant to N.C.G.S. 143-6A-4, Iran Divestment Act Certification. <br />Contractor/vendor shall not utilize any subcontractor that is identified on the list. <br /> <br />Respectfully submitted this <br />day of , 2023 <br /> <br /> <br /> <br />(Name of Firm or Corporation making Bid) <br /> <br /> <br />By: <br />WITNESS: <br /> <br /> <br /> <br /> <br />(Proprietorship or Partnership) <br />Title: (Owner, Partner, or Corporation <br />President or Vice President Only) <br /> <br />Address: <br /> <br /> <br /> <br /> <br />Affix Corporate Seal Above License Number: <br /> <br />ATTEST: <br /> <br />By: <br /> <br />Title: <br />(Corporation Secretary or Assistant Secretary Only) <br />CORP <br />SEAL <br />DocuSign Envelope ID: D39D2B13-B093-4F9F-81A1-A5F3A0FBF1AE