1-Contractor Affidavit under O.C.G.A. § 13-10-91(b)(l) - Blank.pdf
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- Solicitation number
- 4830 - 796113 - R2
- Issued by
- Allensville CDP, Kentucky
About this file
This is a Contractor Affidavit form required under O.C.G.A. § 13-10-91(b)(1) for the City of Alamo's Parade Fire Truck Building and City Hall Repairs construction project in Georgia. Contractors bidding on this FEMA-funded repair project must submit sealed bids online through the DFS Procurement Portal at dfs.bonfirehub.com no later than Friday, May 15, 2026 at 9:00 A.M. EST. Questions regarding the Request for Bids must be submitted through the Portal by May 11, 2026 at 5:00 P.M. Bid opening and award will occur at the Alamo City Council meeting on Monday, May 18, 2026 at 6:00 P.M. at Alamo City Hall, located at 7 West Main Street, Alamo, GA 30411. The project scope includes repairs to restore both structures to pre-disaster design, function, and capacity within their existing footprints, with partial funding provided through FEMA's Public Assistance Program.
The affidavit requires all contractors to register with and actively use E-Verify throughout the entire contract period, including any renewals or extensions, and to notify the City if they cease using the program, which constitutes material breach of contract. Contractors must ensure all subcontractors also provide compliant affidavits under O.C.G.A. § 13-10-91(a), (b), and (c). Contractors are responsible for submitting copies of required affidavits, drivers' licenses, and identification cards to the public employer within five business days of receipt. The affidavit must be executed before a notary public and incorporated into any resulting contract without further action or consent from the contractor.
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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: _____________________________
File details come from the government source that posted it. Updated .