3-Contractor Affidavit.pdf
PDF 193 KB Posted
- Attached to
- P26-04 Fire Services
- Solicitation number
- P26-04
- Issued by
- Fayette County, Georgia
About this file
This is a Contractor Affidavit document executed by Forsyth County Schools, located in Cumming, Georgia, under the supervision of Superintendent Dr. Mitch Young. The affidavit pertains to the P26-04 Fire Services contract solicitation, in which Forsyth County Schools seeks qualified vendors to provide Fire Inspection Services. The document establishes compliance requirements for contractors participating in this procurement opportunity in accordance with Georgia state law O.C.G.A. 13-10-91. The affidavit must be completed and submitted by all contractors as a mandatory condition of contract award and performance.
The affidavit requires contractors to certify their registration with and authorized use of the E-Verify federal work authorization program, maintain such participation throughout the contract period including any renewals or extensions, and notify the public employer immediately if E-Verify usage ceases, with such cessation constituting material breach. Contractors must ensure all subcontractors provide comparable affidavits and comply with the same requirements. The document must be notarized and signed by an authorized officer or agent of the contractor. Contractors without employees may satisfy requirements through Section B by providing a copy of a driver's license or state-issued identification card. Contractors are responsible for submitting all required documentation and identification to Forsyth County Schools within five business days of receipt.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 4-P26-04 Scope of Work.pdf | ||
| 2-P26-04 Equipment Matrix.pdf | ||
| 6-Contract Agreement P26-04.pdf | ||
| 5-P26-04 FCS General Terms Conditions.pdf | ||
| 1-P26-04 Fire Services.pdf |
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Text version
Forsyth County Schools Dr. Mitch Young, Superintendent. 1120 Dahlonega Hwy. Cumming, GA 30040. Telephone 770-887-2461
Section A 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.
Date of E-Verify Authorization
Name of Project/Contract Number/ Purchase Order Number
Federal Work Authorization User Identification Number
(4-7 Digits, No Letters)
Name of Contractor
Forsyth County Schools Name of Public Employer
I hereby declare under penalty of perjury that the foregoing is true and correct.
Executed on ______________, _____, 20_____ in ______________________________ (city), __________ (state).
Printed Name and Title of Authorized Officer or Agent Signature of Authorized Officer or Agent
SUBSCRIBED AND SWORN BEFORE ME
ON THIS THE _______ DAY OF _________________, 20______.
__________________________________________________ My Commission Expires: ___________________
NOTARY PUBLIC
Section B
I hereby certify that I do not have and do not intend to hire any employees. Therefore, I am attaching a copy of my driver’s license or an alternative ID card issued by the State.
Name of Contractor Signature of Contractor Date
Exempt; licensed under Title 26, Title 43 or by State Bar of Georgia tridings Underline
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