00 0015 EX E _ Contractor Affidavit.pdf
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- Solicitation number
- PE-72600-NONST-2026-000000029
- Issued by
- Spalding County, Georgia
About this file
This document is a Contractor Affidavit and Agreement from the State of Georgia involving the Spalding County Board of Commissioners and the Spalding County Water & Sewerage Facilities Authority for Project No. 18121.00. The affidavit verifies the contractor's compliance with Georgia state law O.C.G.A. § 13-10-91 and Georgia Department of Labor Rule 300-10-1-.02, specifically regarding participation in a federal work authorization program. The contractor agrees to ensure that any subcontractors also comply with these regulations and will maintain records of such compliance.
The affidavit requires the contractor to use the "EEV / Basic Pilot Program" operated by the U.S. Citizenship and Immigration Services Bureau of the U.S. Department of Homeland Security, in conjunction with the Social Security Administration, to verify the work authorization of newly hired employees. This is in accordance with the Immigration Reform and Control Act of 1986 (IRCA). The document provides space for the contractor's authorized officer or agent to sign, date, and have the affidavit notarized, confirming their commitment to these legal requirements.
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Text version
Exhibit E - 1 Project No. 18121.00
STATE OF GEORGIA
______________ COUNTY
CONTRACTOR AFFIDAVIT AND AGREEMENT
COMES NOW before me, the undersigned officer duly authorized to administer oaths, the undersigned contractor, who, after being duly sworn, states as follows:
1.
By executing this affidavit, the undersigned contractor verifies its compliance with
O.C.G.A. § 13-10-91 and Georgia Department of Labor Rule 300-10-1-.02, stating affirmatively that the individual, firm, or corporation which is contracting with SPALDING COUNTY BOARD OF COMMISSIONERS has registered with and is participating in a federal work authorization program* in accordance with the applicability provisions and deadlines established in O.C.G.A. § 13-10-91 and Georgia Department of Labor Rule 300-10-1-.02.
2.
The undersigned contractor further agrees that, should it employ or contract with any subcontractor(s) in connection with the physical performance of services pursuant to the contract with SPALDING COUNTY BOARD OF COMMISSIONERS, of which this affidavit is a part, the undersigned contractor will secure from such subcontractor(s) similar verification of compliance with O.C.G.A. § 13-10-91 and Georgia Department of Labor Rule 300-10-1-.02 through the subcontractor’s execution of the subcontractor affidavit required by Georgia Department of Labor Rule 300-10-1-.08 or a substantially similar subcontractor affidavit. The undersigned contractor further agrees to maintain records of such compliance and provide a copy of each such verification to THE SPALDING COUNTY WATER & SEWERAGE FACILITIES AUTHORITY at the time the subcontractor(s) is retained to perform such service.
EEV / Basic Pilot Program User Identification Number
Exhibit E - 2 Project No. 18121.00
FURTHER AFFIANT SAYETH NOT.
BY: Authorized Officer or Agent Date
Contractor Name
Title of Authorized Officer or Agent of Contractor
Printed Name of Authorized Officer or Agent
Sworn to and subscribed before me This ____ day of ___________, 2020
Notary Public
My commission expires: ___________
* Any of the electronic verification of work authorization programs operated by the United States Department of Homeland Security or any equivalent federal work authorization program operated by the United States Department of Homeland Security to verify information of newly hired employees, pursuant to the Immigration Reform and Control Act of 1986 (IRCA), P.L. 99-603. As of the effective date of O.C.G.A. § 13-10-91, the applicable federal work authorization program is the “EEV / Basic Pilot Program” operated by the U.S. Citizenship and Immigration Services Bureau of the U.S. Department of Homeland Security, in conjunction with the Social Security Administration (SSA).
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