1-Contractor Affidavit - O.C.G.A. 13-10-91(b)(1) - One Page.pdf
PDF 3 KB Posted
- Solicitation number
- 4821-808549
- Issued by
- Kentucky
About this file
This is a Contractor Affidavit document required by the City of Hazlehurst, Georgia, pursuant to O.C.G.A. 13-10-91(b)(1), for the Southside Baptist Culvert Replacement project. The project involves the removal and replacement of a 36" RCP culvert, concrete pad, and headwalls at Southside Baptist Church Lot, 35 Alma Highway, Hazlehurst, Georgia 31539. Sealed bids must be submitted through the DFS Procurement Portal no later than Thursday, November 12, 2026 at 2:00 P.M. EST, with public opening and reading scheduled for 3:00 P.M. the same day at Hazlehurst City Hall, 86 S Cromartie Street. Contract award is scheduled for the City Council meeting on Thursday, November 19, 2026 at 5:00 P.M. EST. Work is expected to be completed within 60 days of contract award, and bids remain valid for 60 calendar days after the deadline.
The affidavit requires all contractors to register with and use E-Verify or any subsequent federal work authorization program throughout the contract period and to notify the City if utilization ceases, which constitutes a material breach. Contractors must ensure all subcontractors provide compliant affidavits and must submit copies of affidavits, driver's licenses, and identification cards to the public employer within five business days of receipt. Bidders must submit a 5% bid guarantee (bid bond, postal money order, certified check, cashier's check, or irrevocable letter of credit) and proof of general and professional liability insurance with their bids. The project is partially funded through FEMA's Public Assistance Program. Questions must be submitted through the Portal, with questions submitted within 48 hours of the deadline not answered.
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Other files
| File | Type | Posted |
|---|---|---|
| 2-City of Hazlehurst - 808549 Southside Baptist Culvert Replacement RFB.pdf |
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Text version
Contractor Affidavit under O.C.G.A. § 13-10-91(b)(l)
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;
b) The Contractor will continue to use the federal work authorization program throughout the contract period, including any renewal or extension thereof;
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;
d) The Contractor understands that ceasing to utilize the federal work authorization program constitutes a material breach of Contract;
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);
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 business days of receipt.
Federal Work Authorization User Identification Number Date of Authorization
Name of Contractor Name of Project
Name of Public Employer
I hereby declare under penalty of perjury that the foregoing is true and correct.
Executed on _________, _____, 20_____ 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 _____________, 20______.
NOTARY PUBLIC
My Commission Expires: _____________________________
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