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DocuSign Envelope ID:07A4359F-6D47-4987-B1F1-BF667ACBB3BA <br /> IRAN DIVESTMENT ACT CERTIFICATION REQUIRED BY N.C.G.S.143C-6A-5(a) <br /> As of the date listed below,the vendor or bidder listed above is not listed on the Final Divestment List created by <br /> the State Treasurer pursuant to N.C.G.S. 143-GA-4. <br /> The undersigned hereby certifies that he or she is authorized by the vendor or bidder listed above to make the <br /> foregoing statement. <br /> Signature Date <br /> Printed Name Title <br /> Notes to persons signing this form: <br /> N.C.G.S. 143C-6A-5(a) requires this certification for bids or contracts with the State of North <br /> Carolina, a North Carolina local government, or any other political subdivision of the State of <br /> North Carolina. The certification is required at the following times: <br /> • When a bid is submitted <br /> • When a contract is entered into (if the certification was not already made when the vendor <br /> made its bid) <br /> • When a contract is renewed or assigned <br /> N.C.G.S. 143C-6A-5(b) requires that contractors with the State, a North Carolina local government, <br /> or any other political subdivision of the State of North Carolina must not utilize any subcontractor <br /> found on the State Treasurer's Final Divestment List. <br /> The State Treasurer's Final Divestment List can be found on the State Treasurer's website at <br /> the address www.nctreasurer.com/lran and will be updated every 180 days. <br /> 15 <br />