018_47 Exhibit E _ E_Verify Affidavit.pdf

Hall County Government

FINANCIAL SERVICES

PURCHASING DIVISION

POST OFFICE DRAWER 1435

GAINESVILLE, GA 30503

t: 770.535.8270 | f: 770.531.6711

FINANCIAL SERVICES DIRECTOR

Taylor Samples, CPA

ASSISTANT FINANCE DIRECTOR

Elizabeth White

PURCHASING MANAGER

Andy Youngblood

EXHIBIT E – MANDATORY E-VERIFY AFFIDAVIT

The undersigned contractor ("Contractor") executes this Affidavit to comply with O.C.G.A § 13-10-91 related to any contract to which Contractor is a party that is subject to O.C.G.A. § 13-10-91 and hereby verifies its compliance with O.C.G.A. § 13-10-91, attesting as follows:

A. The Contractor has registered with, is authorized to use and uses the federal work authorization program commonly known as E-Verify, or any subsequent replacement program; and, B. The Contractor will continue to use the federal work authorization program throughout the contract period, including any renewal or extension thereof; and, C. The Contractor will notify the public employer in the event the Contractor ceases to utilize the federal work authorization program during the contract period, including renewals or extensions thereof;

and, D. The Contractor understands that ceasing to utilize the federal work authorization program constitutes a material breach of contract; and, E. The Contractor will contract for the performance of services in satisfaction of such contract only with subcontractors who present an affidavit to the Contractor with the information required by O.C.G.A. § 13-10-91(a), (b), and (c); and, F. The Contractor acknowledges and agrees that this Affidavit shall be incorporated into any contract(s) subject to the provisions of O.C.G.A.

§ 13-10-91 for the project listed below to which Contractor is a party after the date hereof without further action or consent by Contractor;

and, G. Contractor acknowledges its responsibility to submit copies of any affidavits, drivers' licenses, and identification cards required pursuant to O.C.G.A. § 13-10-91 to the public employer within five (5) business days of receipt.

Federal Work Authorization User ID Number Date of Authorization

Name of Contractor

Name of Project

Name of Public Employer: Hall County, Georgia

I hereby declare under penalty of perjury that the foregoing is true and correct.

Executed on ___________________, 202___ in ________________________ (city), ______ (state).

Signature of Authorized Officer or Agent

Printed Name and Title of Authorized Officer or Agent

Subscribed and sworn before me on this the ______ day of ________________, 202___.

Notary Public: ______________________________

Print Name: ________________________________

My Commission Expires: ______________________