Agenda 05-06-25; 8-j - Acceptance of the Sobriety Treatment and Recovery Teams (START) Grant with the NCDHHS and Approval of Related Budget Amendment #8-B

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Docusign Envelope ID:50585F21-A73&4303-BD3F-60841076ED5E 32 State Certifications Contract Number 000481451 Page 30 of 30 GranteelCoutractor Certifications Required by North Carolina Law Instructions:The person who signs this document should read the text of the statutes and Executive Order listed below and consult with counsel and other knowledgeable persons before signing.The text of each North Carolina General Statutes and of the Executive Order can be found online at: • Article 2 of Chapter 64: httn:/Avww.nega.state.nc.us/EnactedLe2islation/Statutes/PDF,'ByArticle/Chapter 64/Article 2.1)df • G.S. 133-32: h=://-Aww.nciza.state.nc.us/gascrir)ts/statutes/statLitelook • Executive Order No.24(Perdue,Gov.,Oct. 1,2009):httus://ethics.nc.gov,'media/242/download?attachment • G.S. 105-164.8(b): hU://wa-w.ncga.state.nc.us/EnactedLe2islationfStatutes,'PDF/B3Sectian/Cliapter 105/GS 105-164.8.pdf • G.S. 143-48.5: httu://w%-w..iic2a.state.nc.ris/EnactedLegislationfStatutes/HTNELBySectio.U/Chuter 143/GS 143-48.5.htnA • G.S. 143-59.1: http://www.ncga.state.ne.us/EnactedLepislation/Statutes/PDF/BySection/Chapter 143/GS 143-59.1.pdf • G.S. 143-59.2: http://ww^w.ncga.state.nc.isslEnactedLepislation/Statutes/PDFBySection/Chapter 143/GS 143-59.2.pdf • G.S. 143-133.3: http://www.nega.state.nc.us/EnactedLepislation/Statiites/HTMLIBySection/Chapter 143/GS 143-133.3.hturl • G.S. 143B-139.6C: http://v�,ww.ncga.state.nc.us/EnactedLe#dslation/Statutes/PDFBySection/Chapter 143B/GS 143B-139,6C.pdf Certifications (1) Pursuant to G.S. 133-32 and Executive Order No. 24 country" as set forth in G.S. 143-59.1(c)(2) after (Perdue,Gov.,Oct.1,2009),the undersigned hereby certifies December 31, 2001 but the United States is not the that the Grantee/Contractor named below is in compliance principal market for the public trading of the stock of with,and has not violated,the provisions of either said statute the corporation incorporated in the tax haven country. or Executive Order. (4) Pursuant to G.S. 143-59.2(b), the undersigned hereby (2) Pursuant to G.S. 14348.5 and G.S. 143-133.3, the certifies that none of the Grantee/Contractor's officers, luldersi,ned hereby certifies that the Grantee/Contractor directors, or owners (if the Grantee/Contractor is an named below, and the Grantee/Contractor's subcontractors, unincorporated business entity) has been convicted of any complies with the requirements of Article 2 of Chapter 64 of violation of Chapter 78A of the General Statutes or the the NC General Statutes, including the requirement for each Securities Act of 1933 or the Securities Exchange Act of 1934 employer with more than 25 employees in North Carolina to within 10 years immediately prior to the date of the bid verify the work authorization of its employees through the solicitation. federal E-Verify system." E-Verify System Link: (5) Pursuant to G.S. 143B-139.60, the undersigned hereby www.uscis.gov certifies that the Grantee/Contractor will not use a former (3) Pursuant to G.S. 143-59.1(b), the undersigned hereby employee,as defined by G.S. 143B-139.6C(d)(2),of the North certifies that the Grantee/Contractor named below is not an Carolina Department of Health and Human Services in the "ineligible Grantee/Contractor" as set forth in G.S. 143- administration of a contract with the Department in violation 59.1(a)because: of G.S. 14313-139.60 and that a violation of that statute shall (a) Neither the Grantee/Contractor nor any of its affiliates void the Agreement. has refused to collect the use tax levied under Article 5 (6) The undersigned hereby certifies further that: of Chapter 105 of the General Statutes on its sales (a) He or she is a drily authorized representative of the delivered to North Carolina when the sales met one or Grantee/Contractor named below, more of the conditions of G.S. 105-164.8(b);and (b) He or she is authorized to make,and does hereby make, (b) [check one of the following boxes] the foregoing certifications on behalf of the Z Neither the Grantee/Contractor nor any of its Grantee/Contractor.,and affiliates has incorporated or reincorporated in a"tax (C) He or she understands that any person who knowingly haven country" as set forth in G.S. 143-59.1(c)(2) submits a false certification in response to the after December 31,2001; or requirements of G.S. 143-59.1and -59.2 shall be guilty ❑ The Grantee/Contractor or one of its affiliates has of a Class l felony. incorporated or reincorporated in a "tax haven Grantee/Contractor's Name: Oran e , , Grantee/Contractor's L±rs MAI 1/16/2025 Authorized Agent: Signature Date Printed Nis Title County Manager SSri. � Sbin. 1/17/202 5 Witness: Signature Date Printed Name Melissa Allison Title Business Officer The witness should be present when the Grantee/Contractor's Authorized Agent signs this certification and should sign and date this doclunent immediately thereafter. Contractor Certifications Required by North Carolina Law(Rev_8116;3/22;8124) Page 1 of 1