7-E-Verify Affidavit-Contractor.pdf

94 KB Posted

Attached to
ON-CALL STORM PIPE CLEANING
Solicitation number
26-117
Issued by
Fulton County, Georgia

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This is an E-Verify Affidavit document required by the City of Alpharetta, Georgia, for contractors participating in the ON-CALL STORM PIPE CLEANING contract opportunity (Event ID: PE-66085-NONST-2026-000000089). The City of Alpharetta is soliciting proposals from qualified companies to provide on-call stormwater pipe and proprietary water quality device cleaning services on a task order basis. Services include pumping, removal, and disposal of all materials associated with cleaning partially and fully clogged storm structures and pipes, as well as inspection and maintenance of proprietary water quality devices such as stormceptors and crystal streams. These services are required to maintain compliance with National Pollution Discharge Elimination System (NPDES) regulations and support the City's proactive stormwater inspection and maintenance program, which has experienced significantly increased demand for unclogging services.

The affidavit document verifies that contractors are registered with and actively use the federal E-Verify work authorization program, as mandated by O.C.G.A. § 13-10-91. Contractors must attest that they will continue using E-Verify throughout the contract period and any renewals or extensions, and must notify the City of Alpharetta if they cease participation. Contractors are required to ensure all subcontractors also provide compliant E-Verify affidavits and must submit copies of required documentation within five business days of receipt. Failure to maintain E-Verify participation constitutes a material breach of contract. The affidavit must be notarized and executed by an authorized officer or agent of the contractor.

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Other files

File Type Posted
2-IRS Form W-9 March 2024.pdf PDF
4-26-117 RFP Information and Contract TC.pdf PDF
8-Stormceptor and other Proprietary Device map.pdf PDF
1-Alpharetta LVP Form.pdf PDF
6-Disclosure-Debarment Form.pdf PDF
5-26-117 Scope of Work-Submittal Info.pdf PDF
3-26-117 Cost Proposal.xlsx XLSX spreadsheet
9-RFP 25-112 SCORING SUMMARY.pdf PDF

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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:

26-117 ON-CALL STORM PIPE CLEANING

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 .