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The County of Lee North Carolina <br /> Vendor/Contractor Name: (' Ir;SS},41..1 14kaI fkCgr-e— du I' ' AcuteGNruz- <br /> eLdd R m ltrs <br /> IRAN DIVESTMENT ACT CERTIFICATION <br /> REQUIRED BY N.C.G.S. 147-86.59 <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 N.C.G.S. 143-48.5 & 147-33.95(g) <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 Date <br /> Nci f-l- rn -ir"b\11 X e_Gct" i t/-e. Q i rte+ <br /> Printed Name Printed Title <br />