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G44 <br />L.S. ATTEST: <br />BY: <br />TITLE: <br />DEEP RIVER VOLUNTEER FIRE DEPARTMENT <br />TITLE: <br />DATE: <br />"N.C.G.S. § 133 -32 and Executive Order 24 prohibit the offer to, or acceptance by, any State <br />Employee of any gift from anyone with a contract With the State, or from any person seeking to do <br />business with the State. By execution of any response in this procurement, you attest, for your entire <br />organization and its employees or agents, that you are not aware that any such gift has been offered, <br />accepted, or promised by any employees of your organization." <br />This Agreement has been pre- audited in the manner <br />required by the Local Government Budget and Fiscal <br />Control Act. <br />(SEAL) (FINANCE OFFICER) <br />Federal Tax Identification Number <br />Remittance Address: <br />Deep River Volunteer Fire Department <br />Larry Kelly, Fire Chief <br />5107 Deep River Road <br />Sanford, NC 27330 <br />DEPARTMENT OF TRANSPORTATION <br />AVA <br />(STATE HIGHWAY ADMINISTRATOR) <br />Ht \9:i <br />PRESENTED TO THE BOARD OF TRANSPORTATION ITEM O: <br />Agreement ID # 2904 13 <br />