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The County of Lee North Carolina <br />Vendor/Contractor Name Dominion Energy <br />IRAN DIVESTMENT ACT CERTIFICATION <br />REQUIRED BY k.C.G.S. i47-86.59 <br />As of the date listed below, the Vendor/Contractor listed above certifies that they are not on the Iran Final <br />Divestment List ("List") created by the North Carolina State Treasurer persuant to N.C.G.S. 147-86.58. <br />ContractorNendor shall not utilize any subcontractor that is identified on the list <br />E -VERIFY CERTIFICATION <br />REQUIRED BY 1.C.C.S. 143-46.5 &:147-33.95(0 <br />As of the date listed below, the Vendor/Contractor listed above and all Vendor/Contractor's subcontractors <br />certify that they are in compliance with the requirements of Article 2 of Chapter 64 of the North Carolina <br />General Statutes, including the requirement for each employer with more than 25 employees in North <br />Carolina to verify the work authorization of its employees through the federal E -Verify system. <br />The undersigned hereby certifies that he/she is authorized by the entity listed above to make the foregoing <br />statement <br />Signature <br />,A6 <br />/1-1' `S'`�.a a 4 c.c. <br />Printed Name <br />Date <br />y%2.3 Aj aJ <br />s oPct,es ►o,u.s <br />Printed Title <br />