60550_2026_0006 Chemicals Specs.pdf

CITY OF MILLEDGEVILLE, GEORGIA

INVITATION FOR BID

BID #60550-2026-0006

For

CHEMICALS

FOR WATER & WASTEWATER TREATMENT PLANTS

For all questions about this Bid contact:

Jacque Huley, CPPB, Procurement Coordinator

(478) 414-4009 phone

(478) 414-4418 fax jhuley@milledgevillega.us

Deadline:

Wednesday, June 24, 2026 at 3:00 pm mailto:jhuley@milledgevillega.us

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INVITATION FOR BID

60550-2026-0006

CHEMICALS FOR WATER & WASTEWATER TREATMENT PLANTS

CITY OF MILLEDGEVILLE, GA

SECTION I – INVITATION FOR BID OVERVIEW AND PROCEDURES

1. PURPOSE

The City of Milledgeville is soliciting Bids from qualified chemical vendors to provide chemicals for the City of Milledgeville Lamar Hamm Water Treatment Plant #1, James E. Baugh Water Plant #2, and Wastewater Treatment Plant.

2. SCHEDULE

This Invitation for Bid will be governed by the following schedule:

DATES

Release of Bid Saturday, May 23, 2026 Deadline for written questions Friday, June 12, 2026 Answers to written questions Tuesday, June 16, 2026 Proposals due Wednesday, June 24, 2026 at 3:00 PM

3. RESTRICTIONS ON COMMUNICATIONS WITH STAFF

All questions about this bid must be submitted in the following format:

Company Name

1. Question Citation of relevant section of the bid

All questions must be in writing to the Purchasing Manager/Deputy Clerk:

Address: Jacque Huley, CPPB

Procurement Manager/Deputy Clerk City of Milledgeville P. O. Box 1900, Milledgeville, GA 31059 127 E. Hancock Street, Milledgeville, GA 31061

Email: jhuley@milledgevillega.us Fax: 478.414.4418

No questions other than written will be accepted. No response other than written will be binding upon the City of Milledgeville. Questions will be combined into one list of questions and responses and will be sent to all vendors who have received the bid document.

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4. COMPANY BACKGROUND & EXPERIENCE

4.1 EXPERIENCE

The vendor will provide a list of all clients for whom similar services, as detailed in this bid, have been provided during the past 5 years. The list must include:

Dates of service Name of contact person Title of contact person Phone number of contact person

The vendor will also disclose any services terminated by the client(s) and the reason(s) for termination.

Failure to provide this information will disqualify the bid submission.

5. BID

5.1 PACKAGING OF BID

Submissions must be by the following method:

Hard copies in a sealed package containing two (2) signed copies. The sealed package must be labeled as follows:

(Vendor Name)

BID #60550-2026-0006

Chemicals Water & Wastewater Treatment Plants

Vendor response to this bid must consist of the following documents:

• Schedule of delivery.

• General Requirements.

• Letters from three (3) references or list of three references.

5.2 SUBMISSION OF BID

The original and three (3) copies of the bid response must be delivered no later than 3:00 PM on Wednesday, June 24, 2026.

Proposals must be submitted to:

City of Milledgeville 127 E. Hancock Street

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Milledgeville, GA 31061 Attention: Mrs. Jacque Huley, CPPB, Procurement Manager/Deputy Clerk

Any proposal received after the due date and time will not be evaluated.

5.3 ADDITIONAL INFORMATION/ADDENDA

The City of Milledgeville will issue responses to inquiries and any other corrections or amendments it deems necessary in written addenda issued prior to the bid opening date. Bidders should not rely on any representations, statements, or explanations other than those made in this Invitation for Bid or in any addendum to this Invitation for Bid.

Where there appears to be a conflict between the Invitation for Bid and any addenda issued, the last addendum issued will prevail.

Bidders must acknowledge any issued addenda. Bids which fail to acknowledge the bidder’s receipt of any addendum will result in the rejection of the bid if the addendum contains information, which substantively changes the Owner’s requirements

5.4 WITHDRAWAL OF BID

A bidder may withdraw his bid before the expiration of the time during which bids may be submitted without prejudice to the bidder, by submitting a written request of withdrawal to the Purchasing Coordinator.

5.5 LATE SUBMITTAL, LATE MODIFICATIONS & LATE WITHDRAWALS

Bid submittals received after the bid opening date and time will not be considered.

Modifications received after the bid opening date will not be considered. The City of Milledgeville assumes no responsibility for the premature opening of a bid not properly addressed and identified, and/or delivered to the proper designation.

5.6 REJECTION OF BIDS

The City of Milledgeville may reject any and all bids and reserves the right to waive any irregularities or informalities in any bid or in the bid submittal procedure. Bid submittals received after said time or at any place other than the time and place as stated in the notice will not be considered.

5.7 BID OPENING

All bids will be opened in public and read aloud at the time and place of the bid opening.

5.8 MIMINUM BID ACCEPTANCE PERIOD

Bids shall be valid and may not be withdrawn for a period of 60 days from the date specified for receipt of bids.

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5.9 MULTIPLE AWARDS

Where applicable, the City of Milledgeville reserves the right to make multiple awards or to award a contract by individual line items or alternatives, by group of line items or alternatives, or to make an aggregate award, whichever is deemed most advantageous to the City of Milledgeville. If the City of Milledgeville determines that an aggregate award to one offeror is not in the City’s best interest, "all or none" offers will be rejected.

5.10 AWARD OF CONTRACT

Award will be made to the responsible bidder whose bid is responsive to the terms of the Invitation for Bid and is most advantageous to City of Milledgeville.

5.11 STATEMENT OF EXPERIENCE AND QUALIFICATIONS

The bidder may be required, upon request, to prove to the satisfaction of the City of Milledgeville that he/she has the skill and experience and the necessary facilities and ample financial resources to perform the contract(s) in a satisfactory manner and within the required time. If the available evidence of competency of any bidder is not satisfactory, the proposal of such bidder may be rejected.

5.12 NON-COLLUSION AFFIDAVIT

By submitting a bid, the bidder represents and warrants that such bid is genuine and not a sham or collusive or made in the interest or on behalf of any person not therein named and that the bidder has not directly or indirectly induced or solicited any other bidder to put in a sham bid, or any other person, firm or corporation to refrain from submitting and that the bidder has not in any manner sought by collusion to secure to that bidder any advantage over any other bidder.

By submitting a bid, the bidder represents and warrants that no official or employee of City of Milledgeville has, in any manner, an interest, directly or indirectly in the bid or in the contract which may be made under it, or in any expected profits to arise therefrom.

5.13 COST INCURRED BY BIDDERS

All expenses involved with the preparation and submission of the bid to the City of Milledgeville, or any work performed in connection therewith is the responsibility of the bidder(s).

5.14 HOLD HARMLESS AND INDEMNIFICATION

The Offeror agrees, insofar as it legally may, to indemnify and hold harmless the Government, its officers, employees and agents from and against all loss, costs, expenses, including attorneys' fees, claims, suits and judgments, whatsoever in connection with injury to or death of any person or persons or loss of or damage to property resulting from any and all operations performed by Offeror, its officers, employees, and agents under any of the terms of this contract.

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5.15 ALTERNATE BIDS

Alternate proposals or proposals that deviate from the requirements of this solicitation will not be considered. Offerors shall not insert in their proposal any written statement which will have the effect of making any material change or changes in the Scope of Services or in any contract between the parties covering subject matter thereof.

SECTION II - GENERAL CONDITIONS AND SPECIFICATIONS

A. CONTRACT PERIOD

Contract performance period shall be for the period July 1, 2026 or date of award if later, through June 30, 2027, with the option for one (1) extension of one-year if agreeable with all involved parties.

B. DELIVERY REQUIREMENTS

Unless otherwise stated in the Specifications, delivery shall be during the hours 8:00 a.m. to 2:00 p.m. Monday through Friday only. Technical questions regarding deliveries may be directed to Michael Burch, Superintendent of the Water Treatment Plants, and Superintendent of Wastewater Treatment Plant.

Delivery means actual placement of containers onto unloading docks of the Water Treatment (Lamar Hamm Water Plant #1 and James E. Baugh Water Plant #2) or Wastewater Treatment facilities.

Delivery means actual placement and stacking of bags in Water Treatment’s storage room.

The City of Milledgeville has the right to refuse any damaged or leaking containers.

For liquid alum delivery means actual placement for material into storage tank.

Trucks must have own air for unloading and hoses for chemical unloading.

All chemicals to be shipped on suitable pallets for unloading by forklift.

Delivery to James E. Baugh Water Treatment Plant #1 requires a short-bed truck due to limited space at this facility.

Chemical delivery personnel are required to stay with and personally monitor their chemicals until unloading has been completed.

Chemical delivery personnel are responsible for the cleanup of any chemical spills, except spills that may be the fault of the receiver.

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Chemical companies shall provide chemical company’s contact fax #, truck #, trailer #, driver’s name, and picture ID within 24 hours prior to chemical company delivery.

C. OPTION TO EXTEND THE CONTRACT

The City of Milledgeville may extend this contract upon agreement of the parties for up to one additional one-year period only under the terms and conditions of the original contract except as stated herein. In the event the City of Milledgeville desires to extend this contract, the City of Milledgeville will provide a written notice at least 60 days prior to the expiration date of the extension period affording the contractor an opportunity to submit a request for price increase for the option period. If the parties agree to increase the price of the items for the option period, the contract will be extended for one additional year at the agreed upon price(s).

D. ORDERING

The City of Milledgeville may issue annual, monthly or periodical purchase orders under this contract or as needed. All purchase orders are subject to the terms and conditions of this contract. In the event of conflict between a purchase order and this contract, the contract shall control.

E. AVAILABILITY OF FUNDS FOR THE NEXT FISCAL YEAR

Funds are not presently available for performance under this contract beyond June 30, 2027. The City of Milledgeville’s obligation for performance of this contract beyond that date is contingent upon the availability of funds from which payment for contract purposes can be made. No legal liability on the part of the City for any payment may arise for performance under this contract beyond June 30, 2027, until funds are made available for performance and until the Contractor receives a purchase order committing funds for the next fiscal year.

F. CONTRACTOR'S INVOICE

a. The Contractor shall prepare and submit invoices to the Finance Office address specified on individual orders. If the invoice does not comply with these requirements, the Finance Office will return it with the reasons why it is not a proper invoice. A proper invoice must include the items listed below.

(i) Name and address of the Contractor.

(ii) Invoice date and invoice number. (The Contractor should date invoices as close as possible to the date of the mailing or transmission.)

(iii) Purchase order number for supplies delivered.

(iv) Description, quantity, unit of measure, unit price, and extended price of supplies delivered.

(v) Shipping and payment terms (e.g., shipment number and date of shipment, discount for prompt payment terms).

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(vi) Name and address to whom payment is to be sent.

(vii) Name (where practicable), title, phone number, and mailing address of person to notify in the event of a defective invoice.

(viii) Any other information or documentation required by the contract (e.g., evidence of shipment).

b. Contractor may provide a summary invoice for all deliveries made during a billing period, identifying the delivery tickets covered therein, stating their total dollar value. A summary invoice shall be supported by receipt copies of the delivery tickets. Delivery tickets or sales slips shall contain:

(i) Name of supplier

(ii) Purchase Order number (iii)Ship to Department and Address (iv)Description, Quantity, unit price, and extension of each item.

(v) Date of delivery or shipment.

G. PAYMENT

Payment will be made for items accepted by the City of Milledgeville.

H. ESTIMATED QUANTITIES

The quantities of items specified in the Bid Schedule are estimates only and are not purchased by this contract. Except as this contract may otherwise provide, if the City of Milledgeville requirements do not result in orders in the quantities described as "estimated", that fact shall not constitute the basis for an equitable price adjustment. Delivery shall be made only as authorized by orders issued in accordance with the Ordering clause. Subject to any limitations in the Order clause or elsewhere in this contract, the Contractor shall furnish to the City of Milledgeville all items specified in the Bid Schedule and called for by orders issued in accordance with the Ordering clause.

I. TAXES

Contractor will be provided with the City of Milledgeville’s Sales and Use Tax Certificate of Exemption number upon request.

J. CERTIFICATION STANDARDS

All items are to be certified to meet American Waterworks Association (AWWA) standards for use in waterworks Rule ANSI/NSF Standard 60/61, latest editions.

K. INSPECTION/ACCEPTANCE

The Contractor shall only tender for acceptance those items that conform to the requirements of this contract. The City of Milledgeville reserves the right to inspect or test any items that have been tendered for acceptance. The City of Milledgeville may require replacement of nonconforming items at no increase in

IFB #60550-2026-0006 Chemicals Page 9 of 17 contract price. The City of Milledgeville must exercise its post-acceptance rights—

1) within a reasonable time after the defect was discovered or should have been discovered; and 2) before any substantial change occurs in the condition of the item, unless the change is due to the defect in the item. Unless specified elsewhere in this contract, title to items furnished under this contract shall pass to the City of Milledgeville upon acceptance, regardless of when or where the City takes physical possession.

The City of Milledgeville will not accept ton cylinders with header valves that have not been rebuilt after each return or shows signs of corrosion or damage, valves that are frozen, and cylinders that do not have the tare weight displayed.

L. ASSIGNMENT OR NOVATION OF CONTRACT

The Contractor shall not assign or transfer, whether by Assignment or Novation, any of its rights, duties, benefits, obligations, liabilities, or responsibilities under the Contract without the written consent of the City of Milledgeville; provided, however, that assignments to banks, trust companies or other financial institutions for the purpose of securing a bond may be made without the consent of the City of Milledgeville.

M. TERMINATION FOR CAUSE

The City of Milledgeville reserves the right to terminate the resulting contract, in whole or in part, for failure to comply with any provisions of the contract as outlined by providing a written notice to the contractor at least thirty (30) days before the effective date of termination. The contractor will not be relieved of any outstanding responsibilities or unfinished obligations under this contract.

Receipt of items by the delivery date is critical to the terms of this contract. The City of Milledgeville considers late delivery of contract items as reasonable cause to terminate the contract.

The contractor also has a right to terminate this contract for cause by providing a written notice of intent to terminate at least thirty (30) days prior to the effective date of the contract termination.

N. CHANGES

Changes in the terms and conditions of this contract may be made only by written agreement of the parties.

O. REPORTING DISPUTES

The contractor shall report any contract disputes and/or problems to the purchasing coordinator, both verbally and in writing, within 48 hours of their occurrence.

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SPECIFICATIONS FOR SODIUM CHLORITE &

CHLORINE DIOXIDE GENERATOR

Sodium Chlorite - The material must be a 25% solution both EPA and ANSI/NSF 60 approved. It must be a pale green, clear liquid with a specific gravity of 1.23+ 0.02@ 20C.

Chlorine Dioxide Generator – The contractor shall provide two (2) chlorine dioxide generators capable of meeting the following minimum performance criteria:

• The Chlorine Dioxide Generator system shall be the vacuum operated, solution feed type; not requiring any chemical feed pumps; with an in-line pH meter to monitor performance and yield; and a visual control panel to monitor system and automatically shutdown if any of the following occur:

o Low pressure o Low sodium chlorite o Low chlorine o pH out of range (optional) o Loss of power

• The generator system shall have a chlorine dioxide yield of 95% or better, with 150 pounds per day capacity of chlorine dioxide productions. The system shall be a sealed unit where no chlorine, sodium chlorite, or chlorine dioxide can escape into the atmosphere. The contractor is responsible for providing all generator system components for a complete working system.

• Rotameters shall be changed by contractor if required for proper treatment capacity.

• Separate unit shutdown capability.

• The chlorine dioxide generator shall be able to effectively inject chlorine dioxide into water in a flow range of one (1) million gallons per day to twenty-four (24) million gallons per day.

• Chlorine dioxide residuals at the raw water mixing chamber are anticipated to be in a range of 0.3 to 0.6 mg/L during the months of October through March and

0.5 to 1.0 mg/L during the months of April through September. The chlorine dioxide generator shall be capable of maintaining these concentration ranges.

Maintenance and Repair – The contractor shall provide all scheduled maintenance and repair of contractor owned equipment. A service representative shall be on call and shall respond within twenty-four (24) hours after notification of an emergency breakdown, repair, or required service. The contractor shall ensure equipment is not down for more than twenty-four (24) hours.

Site Visits – The contractor shall conduct a monthly site visit to provide the following as a minimum:

• Check operational modes of chlorine dioxide generator.

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• Check chlorine dioxide residuals at the raw water mixing chamber, water over filter beds, and water leaving filter beds.

• Check pH of chlorine dioxide mixture to insure it is within a 2.8 and 4.0 range.

(Optional)

• Review operations and logs, as it pertains to chlorine dioxide, with plant operators, supervisors and laboratory personnel.

• Provide an oral or written service report of chemical status on each site visit.

This report shall include volume on hand, equipment verification, operational controls and recommendations or adjustments made. Report shall be provided to the Chief Operator.

• Provide technical assistance, maintenance and calibration of component rotometers, pumps, solenoids, values, etc.

Testing – In addition to any quality control testing required, the contractor shall provide the following tests:

• pH test of chlorine dioxide. (Optional)

• The contractor shall provide testing to verify that the chlorine dioxide generator yield meets the 95% efficiency requirement.

• Part per million (ppm) test of chlorine dioxide residuals at the raw water mixing chamber, water over the filter beds and water leaving the filter beds.

• Quarterly test for trihalomethenes (THM) concentration of finished water taken from three (3) random sample points designed by the Chief Operator throughout the distribution system. The THM testing will be done by the lab that is approved and accepted by the Georgia Department of Health and Natural Resources.

• Chlorite DBP testing as requested by Chief Operator not to exceed once per quarter.

• All testing shall be performed by qualified laboratory technicians in accordance with Standard Methods of Examinations of Wastewater, 14th Edition.

Training – The contractor shall provide a technical representative for initial startup, adjustment, calibration of equipment and issuance of safety instructions to Plant Operators and Supervisory Personnel. Contractor shall train any newly designated Government Personnel, when requested, concerning operational controls of startup, shutdown and safety.

Determination of Chlorine Dioxide Needs – The determination of when to use chlorine dioxide and the feed rates to be utilized shall be the responsibility of the Chief Operator.

Shipments: Lamar Hamm Plant orders Sodium Chlorite in bulk, James Baugh Plant orders in totes.

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SPECIFICATIONS FOR ALUMINUM SULFATE, LIQUID

1. SCOPE:

This standard covers purified aluminum sulfate in liquid form for use in the treatment of municipal and industrial water supplies.

2. CHARACTERISTICS:

• Liquid aluminum sulfate (liquid alum) is a clear, light green to light yellow aqueous solution. Iron-free and food-grade liquid alums are clear and colorless.

• Molecular weight of dry alum 594.

• Approximately 48.5% dry aluminum sulfate.

3. CHEMICAL REQUIREMENTS:

• Liquid Alum must meet or exceed ANSI/NFS Standard 60 requirements for drinking water chemicals – health effect;

• Liquid Alum shall contain water-soluble aluminum for not less that 4.23% as AL.

or 8.0% as AL2O3. pH of 1% Solution shall equal 3.5 Specific gravity at 60°F 1.335 lb/gal 11.1

• Liquid Alum insoluble matter shall not exceed 0.2 percent;

• Liquid Alum shall not contain a measurable amount of zinc and arsenic.

4. IMPURITIES:

• Liquid Alum shall contain no soluble material or organic substance in quantities capable of producing deleterious or injurious effect on the health of those consuming the water product;

• Liquid Alum shall be of such clarity as to permit the reading of flow-measuring device without difficulty;

• Liquid Alum shall be filtered and free of suspended solids;

5. VERIFICATION:

• Sampling;

• Sampling Point: sample point shall be taken at the point of destination;

• Liquid Alum delivery temperature shall be 60 F or above;

• Liquid Alum shall have a Baume reading that measures between 35.5 to 36.5. No less than 34.0

6. MATERIAL SAFETY DATA SHEET (MSDS):

Bidders shall provide a current material safety data sheet (MSDS) with each product.

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SECTION III – BID SUBMITTAL REQUIREMENTS

A. BID SUBMITTAL FORMAT

The bid submittal shall include two separate, sealed envelopes containing the number of copies specified, which shall be marked as follows:

1) Bid Schedule #60550-2026-0006, “Chemicals”

2) References #60550-2026-0006, “Chemicals”

1. The bid package, in the number of copies specified, shall include the information outlined below and in the following order:

1) Bid Schedule Envelope

a. Bidder shall itemize environmental charges, superfund charges or environmental liability charges. These superfund charges are supposed to be the same nationwide.

b. Bidder shall itemize container deposit or environmental cleaning charges.

c. Bidder shall list pallet charges.

d. Bidder shall include all extra charges for bulk deliveries: examples of these are pump charge, fuel surcharge, cleaning charge, stop charge or on-site hourly charge.

e. Bidder must provide the CAS Registry Number (Chemical Compliance Number).

2) References Envelope

a. Cover Letter: A brief cover letter of introduction and interest

b. Descriptive literature, illustrations, drawings, brochures, if submitted, shall be enclosed in the number of copies specified for the bid.

c. References: The bidder should provide a list of references (minimum of three (3) currently utilizing the item(s) bid. The reference list shall include name, address, phone number, date of purchase, and contact person. The bidder shall indicate which references, if any, have an operating environment similar to the City of Milledgeville.

d. Acknowledgement of Addenda: The bidder shall provide the attached acknowledgement of any addenda issued.

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IV – BID SCHEDULE

PRICE BID FOR CHEMICALS

IFB #60550-2026-0006

DUE WEDNESDAY, JUNE 24, 2026 AT 3:00 P.M.

1. Price Proposed on Specifications as Outlined: YES NO

2. Price Bid Expires on: __________day of __________________ ,_______ (year) (prices must be held firm for a minimum of 60 days after submittal)

3. Vendor must provide the CAS Registry Number (Chemical Compliance Number).

4. Vendor must provide the Brand Name where indicated.

Item

Estimated Quantity

Unit of Measure

Item Description

Chemical Compliance

Unit Price

Total Price

59,000

7,000

28,000

Pounds

Chlorine Gas (Delivery in 1-ton cylinders) Lamar Hamm Water Treatment Plant #1

James E. Baugh Water Treatment Plant #2 (1,000 lb cylinders Wastewater Treatment Plant

12,000

Sulfur Dioxide (Delivery in 1-ton cylinders.)

Wastewater Treatment Plant

80,000 20,000

Sodium Chlorite – 25% Solution (per attached specifications).

Delivery in bulk with 5000 gallon tanker Lamar Hamm Water Treatment Plant #1 James E. Baugh Water Treatment Plant #2 delivery on short-bed truck

51,000 17,000

Gallons Gallons

Aluminum sulfate (per attached specifications) Lamar Hamm Water Treatment Plant #1 James E. Baugh Water Treatment Plant #2

5 Environmental, Superfund, Environmental Liability Charges 6 Container Deposit 7 Environmental Cleaning Charles 8 Pallet and/or single stringer Charges 9 Charges for Bulk Deliveries

PLEASE TYPE OR PRINT THE BELOW INFORMATION:

COMPANY NAME : _____________________________________________________________

MAILING ADDRESS:____________________________________________________________

TELEPHONE # :______________________________ FAX # :___________________________

EMAIL : ___________________________________________________________________

SIGNATURE PRINT NAME/TITLE

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ATTACHMENT (1)

ADDENDA ACKNOWLEDGEMENT

The Bidder has examined and carefully studied the Specifications and the following Addenda, receipt of all of which is hereby acknowledged:

Addendum No. _____ dated _________ Acknowledgement _______________

Bidders must acknowledge any issued addenda. Bids which fail to acknowledge the bidder’s receipt of any addendum will result in the rejection of the bid if the addendum contained information which substantively changes the Owner’s requirements.

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BID RESPONSE SIGNATURE PAGE

If the Vendor is : A SOLE OWNER OR PARTNERSHIP (Please Indicate Which):

Execute this part of the Bid:

DATE: __________________________

(Signature of Owner or Partner)

(Business Name or Bidder) (Print Name and Title)

(Address) (City) (State) (Zip) (Telephone Number)

If the Vendor is: A CORPORATION execute this part of the Bid. If not executed by the Corporation (i.e., required signatures as seen below and Corporate Seal affixed), a certified Corporate Resolution authorizing the form of execution used must be attached to and made part of this Bid Response.

DATE: _____________________________

(Corporate or Business Name of Bidder)

(Address) (City) (State) (Zip) (Telephone Number)

(Signature of President or Vice-Pres.) (Signature of Secretary, Asst. Sec., Treasurer or Asst. Treasurer)

(Print Name and Title) (Print Name and Title)

CORPORATE SEAL

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Georgia Security & Immigration Compliance (GSIC) Act

CONTRACTOR AFFIDAVIT AND AGREEMENT

The City of Milledgeville and Contractor agree that compliance with the requirements of O.C.G.A. §13-10-91 and

Rule 300-10-1-.02 of the Rules of the Georgia Department of Labor are conditions of this Agreement for the physical performance of services.

By executing this affidavit, the undersigned contractor verifies its compliance with O.C.G.A. §13-10-91, stating affirmatively that the individual, firm, or corporation which is contracting with the City of Milledgeville has registered with and is participating the federal work authorization program known as “E-Verify”, web address https://e-verify.uscis.gov/enroll/ operated by the United States Citizenship and Immigration Services Bureau of the

United States Department of Homeland Security to verify information of newly hired employees, pursuant to the

Immigration Reform and Control Act of 1986 (IRCA), P.L. 99-603], in accordance with the applicability provisions and deadlines established in O.C.G.A. §13-10-91. The undersigned Contractor also verifies that he/she/it is using and will continue to use the federal work authorization program throughout the contract period.

The undersigned Contractor agrees that, should it employ or contract with any subcontractor(s) in connection with the physical performance of services pursuant to the contract with the City of Milledgeville, Contractor will secure from such subcontractor(s) similar verification of compliance with O.C.G.A. §13-10-91 on the Subcontractor

Affidavit provided in Rule 300-10-01-.08 or a substantially similar form. Contractor further agrees the Contractor will advise the City of Milledgeville of the hiring a new subcontractor and will provide the City of Milledgeville with a Subcontractor Affidavit attesting to the Subcontractor’s name, address, user identification number, and date of authorization to use the Federal Work Authorization Program within five (5) days of the hiring before the

Subcontractor begins working on the Project. Contractor also agrees to maintain all records of such compliance for inspection by the City of Milledgeville at any time and to provide a copy of each such verification to the City of

Milledgeville at the time the subcontractor(s) is retained to perform such services.

E-Verify Employment Eligibility Verification User Identification Number

Date of Authorization to Use Federal Work Authorization Program

NAME OF CONTRACTOR

Title of Authorized Officer or Agent of Contractor

Signature and Printed Name of Authorized Officer or Agent

SUBSCRIBED AND SWORN BEFORE ME ON THIS THE _____ DAY OF______________, 20____

Notary Public

My Commission Expires: __________________________________________________

* As of the effective date of O.C.G.A. §13-10-91, the applicable federal work authorization program is the “EEV / Basic Pilot Program” operated by the U. S. Citizenship and Immigration Services Bureau of the U.S. Department of Homeland Security, in conjunction with the Social

Security Administration (SSA).

Authority O.C.G.A. Sec. §13-10-91. History. Original Rule entitled “Contractor Affidavit and Agreement” adopted. F. May 25, 2007; eff. June

18, 2007, as specified by the Agency.