6-E-Verify Affidavit-Contractor.pdf
PDF 88 KB Posted
- Attached to
- MID BROADWELL CULVERT & SIDEWALK CONSTRUCTION
- Solicitation number
- 26-111
- Issued by
- Fulton County, Georgia
About this file
This is an E-Verify Affidavit document required by the City of Alpharetta, Georgia for contractor participation in the MID BROADWELL CULVERT & SIDEWALK CONSTRUCTION project (Event ID: PE-66085-NONST-2026-000000080). The project involves construction of a culvert and sidewalk along Mid Broadwell Road between Jennifer Oaks Drive and Bethany Road within the City of Alpharetta. The contractor must provide all materials, labor, and equipment necessary for the complete construction work. The affidavit serves as verification of the contractor's compliance with O.C.G.A. § 13-10-91 regarding federal work authorization requirements.
The affidavit requires the contractor to confirm registration with and ongoing use of the E-Verify federal work authorization program throughout the contract period, including any renewals or extensions. The contractor must notify the City if E-Verify usage ceases, understanding that such cessation constitutes material breach of contract. Additionally, the contractor must ensure all subcontractors provide similar affidavits meeting O.C.G.A. § 13-10-91 requirements and must submit copies of all required affidavits, drivers' licenses, and identification cards to the City within five business days of receipt. The affidavit must be executed before a notary public and incorporated into the contract without further action or consent from the contractor.
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Text version
City of Alpharetta, GA Procurement Required Document Affidavit Verifying Contractor Participation in Federal Work Authorization Program (E-Verify)
AFFIDAVIT VERIFYING CONTRACTOR PARTICIPATION IN
FEDERAL WORK AUTHORIZATION PROGRAM (E-Verify)
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 City of Alpharetta 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) The 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 City of Alpharetta within five business days of receipt.
Federal Work Authorization User Identification Number Date of Authorization
Name of Contractor Name of Project
I hereby declare under penalty of perjury that the foregoing is true and correct.
Executed date ___________________ 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: _____________________________
(Notary Stamp)
AFFIDAVIT VERIFYING CONTRACTOR PARTICIPATION IN FEDERAL WORK AUTHORIZATION PROGRAM (E-Verify)
| Federal Work Authorization User Identification Number: |
| Date of Authorization: |
| Name of Contractor: |
| Name of Project: 26-111, MID BROADWELL CULVERT & SIDEWALK CONSTRUCTION |
| Executed date: |
| in: |
| state: |
| Printed Name and Title of Authorized Officer or Agent: |
| My Commission Expires: |
| Year: |
| Month: |
| Day: |
File details come from the government source that posted it. Updated .