2011 - 01-31-2011 Reg. Adj. Meeting

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E BouK 23 PAL - 917 E EXHIBIT A TO LOCAL GOVERNMENT GRANT AGREEMENT ONE NORTH CAROLINA FUND LOCAL GOVERNMENT CERTIFICATION Project No 0- 2010 -6194 County of Lee (the "Local Government ") hereby requests a disbursement in the amount of [spell out dollar amount] ($ ) from the North Carolina Department of Commerce (the "DOC "), pursuant to that certain Company Performance Agreement between the Local Government and Caterpillar Inc., dated as of August 5, 2010 (the "CPA "), and that certain Local Government Grant Agreement between the Local Government and the DOC, dated as of August 5, 2010 (the "LGGA," and, together with the CPA, the "Agreements "). All capitalized terms not otherwise defined herein have the meaning ascribed to them in the Agreements. The Local Government hereby certifies to the DOC that it: (i) has provided funds and/or resources for the Project pursuant to the Local Government application to the DOC and the terns of the LGGA, in the amount of ($ ), an amount that is at least equal to the amount of the disbursements that have been requested under the LGGA); (ii) has provided such funds and /or resources in the following form: (iii) has attached true and correct copy of documents evidencing its expenditure of the amount specified in (ii) above for the purposes specified above; (iv) will submit proof of receipt, deposit, and proper disbursement of the disbursed DOC funds, to the DOC, within thirty (30) days; and (v) it is in compliance with all of the terms and conditions of the LGGA, and affirms the representations, warranties, and covenants contained therein.