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RFP Number(if applicable): <br /> Name of Vendor or Bidder: Zacchaeus Legal Services <br /> IRAN DIVESTMENT ACT CERTIFICATION <br /> REQUIRED BY N.C.G.S. 143C-6A-S(a) <br /> As of the date listed below,the vendor or bidder listed above is not listed on the Final Divestment List created <br /> by the State Treasurer pursuant to N.C.G.S. 143-6A-4. In addition,no parent entity owning more than 20;% <br /> nor any majority-owned subunit or subsidiary of the vendor or bidder listed above is listed on the said Final <br /> Divestment List. <br /> The undersigned hereby certifies that he or she is authorized by the vendor or bidder listed above <br /> to make the foregoing statement. <br /> \ 3 / r <br /> S i g/n��a/t/u�►re //� , / Aate.8 Printed Nam-e Title <br /> Notes to persons signing this form: <br /> N.C.G.S. 143C-6A-5(a) requires this certification for bids or contracts with the <br /> State of North Carolina, a North Carolina local government, or any other political <br /> subdivision of the State of North Carolina. The certification is required at the <br /> following times: <br /> • When a bid is submitted <br /> • When a contract is entered into (if the certification was not already made <br /> when the vendor made its bid) <br /> • When a contract is renewed or assigned <br /> N.C.G.S. 143C-6A-5(b) requires that contractors with the State, a North Carolina <br /> local government, or any other political subdivision of the State of North Carolina <br /> must not utilize any subcontractor found on the State Treasurer's Final <br /> Divestment List. <br /> The State Treasurer's Final Divestment List can be found on the State Treasurer's <br /> website at the address wwNv.nctreastu•er.com%Iran and will be updated every 180 days. <br /> i <br /> G-4 Page 151 <br />