2-E Verify affadavit - fillable.pdf
PDF 102 KB Posted
- Solicitation number
- RFP 101-2026
- Issued by
- St. Louis City, Missouri
About this file
This is a Federal Work Authorization Program Affidavit form related to the St. Louis Public Schools' "STOWE" Demolition Existing Structures and Site Restoration contract opportunity in Missouri. The affidavit serves as a compliance document requiring contractors to certify their participation in the E-Verify federal work authorization program and confirm that they do not knowingly employ unauthorized aliens in connection with services provided to the district. The form is designed to be completed by an authorized representative of the bidding company, who must provide their signature, title, and company name, along with notarization by a Missouri notary public to authenticate the affiant's sworn statement regarding employment authorization compliance.
The affidavit contains standard certification language requiring the signatory to attest to being over twenty-one years of age, having direct knowledge of the company's E-Verify enrollment status, and confirming the company's commitment to federal work authorization requirements. The document includes designated spaces for completion of the notarization process, including the notary's signature, commission expiration date, and the specific county and date of notarization. This form represents a mandatory submission requirement for contractors bidding on the St. Louis Public Schools demolition and site restoration project and serves as verification of the contractor's compliance with federal employment authorization standards.
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Other files
| File | Type | Posted |
|---|---|---|
| 4-No Boycot Israel Certification - fillable form.pdf | ||
| 6-A 04 BID SUMMARY 101.docx | DOCX document | |
| 7-A01 Demolition RFP.docx | DOCX document | |
| 1-E Verify agreement - fillable.pdf | ||
| 3-W9 and Registration Process.pdf | ||
| 5-A02 STOWEScope of Work and Hazardous Material Identification for.pdf |
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Text version
FEDERAL WORK AUTHORIZATION PROGRAM AFFIDAVIT
I, __________________________________________, being of legal age and having been duly sworn upon my oath, state the following facts are true:
1. I am more than twenty-one years of age; and have first-hand knowledge of the matters set forth herein.
2. I am employed by ____________________________________ (hereinafter “Company”) and have authority to issue this affidavit on its behalf.
3. Company is enrolled in and participating in the United States E-Verify (formerly known as “Basic Pilot”) federal work authorization program with respect to Company’s employees working in connection with the services Company is providing to, or will provide to, the district, to the extent allowed by E-Verify.
4. Company does not knowingly employ any person who is an unauthorized alien in connection with the services Company is providing to, or will provide to, the district.
FURTHER AFFIANT SAYETH NOT.
By: _________________________________________________ (individual signature)
For: ________________________________________________ (company name)
Title: _______________________________________________
STATE OF MISSOURI)
) ss.
COUNTY OF __________________________)
On this _______ day of ______________, 20____, before me, _______________________, a Notary Public in and for such County and State, personally appeared _______________________________________ of
___________________________________________, known to me to be the person who executed the affidavit on behalf of said ________________________ and acknowledged to me that he or she executed the same for the purposes therein stated. Subscribed and affirmed before me this _______ day of
_________________, 20______.
Notary Public My commission expires on: _________________________
| I: |
| 2 I am employed by: |
| By: |
| For: |
| Title: |
| COUNTY OF: |
| On this: |
| day of: |
| 20: |
| before me: |
| and for such County and State personally appeared: |
| known to me to be the person who executed the: |
| affidavit on behalf of said: |
| same for the purposes therein stated Subscribed and affirmed before me this 1: |
| same for the purposes therein stated Subscribed and affirmed before me this 2: |
| 20_2: |
| Notary Public: |
| My commission expires on: |
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