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aouF 23 t; .9:3:3 <br />RELATED MEMBER CEIRTIFICATION <br />FOR COiNIPANY DISBURSEMENT REQUEST <br />If any part ofjob creation or retention requirements are performed by a related <br />member, that entity should complete this form. Multiple forms should be submitted if <br />there are multiple Related Members. <br />The undersigned Related Member hcrcbv certifies that: <br />(i) Attached hereto is a true and correct copy of the Company's and Related <br />Member's latest ]DIG Grantee Annual Report and Findings; <br />it has created and retained New Jobs, representing % of the <br />total required New Jobs, these jobs are net new positions for the Company's <br />and Related Member's operations in the state, and no Ne"' Job (or employee) <br />has been transferred from any existing North Carolina operations of the <br />Company or Related Member or their affiliates: <br />(iii) it has retained Current Jobs, representing at least _% of the total <br />required Current .lobs (if Company /Related Member is espandtm, frmn <br />existing employee base); <br />(iv) it, or the Company, has obtained all required environmental permits for the <br />Project; <br />(�) it makes available health insurance to all permanent lull -time employees <br />employed by it at the Facility in the amount required for eligibility for tax <br />credits under the Article 3.1 (] Bill 2170 § 105 129.83(d)); <br />(vi) Attached hereto is a true and correct copy oCthe Related Member's lixed asset <br />report showing a description, acquisition date and cost for each asset acquired, <br />disposed of, or transferred from the date of the grant (if Related Member is <br />responsible for making some of the Required Investment); <br />(vii) it has made Required Investment in the amount of <br />(viii) the average weekly wage it pays employees in all permanent full -time jobs at <br />the Facility, including the New Jobs, is S <br />(is) it is in compliance with all of the terms and conditions of the CPA and affirms <br />the representations, warranties and covenants contained therein; <br />(x) by not later than \March I ofeach vear following Closeout. for so long as the <br />Related Member is required to retainjobs under the terms of the CPA, it shall <br />submit to the DOC an annual report detailing permanent full -time jobs <br />