7-Sub-Contractor Affidavit and Agreement Form - v09182026.pdf
PDF 473 KB Posted
- Solicitation number
- 2026-GS-14
- Issued by
- Clayton County, Georgia
About this file
This is a Sub-Contractor Affidavit and Agreement Form issued by the Clayton County Water Authority (CCWA) in Morrow, Georgia. The form is required for subcontractors performing work on CCWA projects and ensures compliance with O.C.G.A. § 13-10-91, Georgia's federal work authorization verification statute. The affidavit applies to any contract or purchase order involving the physical performance of services exceeding $2,499.99, including routine operation and maintenance of facilities, services necessary for normal business operations, and professional consulting services. Subcontractors must submit a signed and notarized affidavit before contract award or purchase order issuance, with a separate affidavit required for each contract or purchase order within a calendar year if the contractor enters into multiple contracts with CCWA.
The form requires subcontractors to attest to their registration with and participation in the federal E-Verify work authorization program. Subcontractors with employees must provide their E-Verify identification number and date of authorization and commit to maintaining E-Verify compliance throughout the contract period, including any renewals or extensions. Subcontractors with no employees are exempt from E-Verify requirements and must instead submit a copy of a state-issued driver's license or identification card to document authorization to work in the United States. Foreign companies without E-Verify numbers are not required to submit E-Verify information but must provide proof of authorization to enter the United States. The form is executed under penalty of perjury, and knowingly providing false information constitutes a violation of O.C.G.A. § 16-10-20 and may result in criminal prosecution, contract termination, or both. The affidavit is incorporated into any resulting contract and survives any renewal or extension thereof.
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Other files
| File | Type | Posted |
|---|---|---|
| 6-Vendor Information Form.docx | DOCX document | |
| 9-2026-GS-14 ADD 1.pdf | ||
| 8-Contractor Affidavit and Agreement Form FINAL - v09182026.pdf | ||
| 2-References.docx | DOCX document | |
| 3-Non-Collusion Certificate.docx | DOCX document | |
| 1-Georgia Security and Immgradtion Complaince Act.docx | DOCX document | |
| 5-2024-W9.docx | DOCX document | |
| 4-Certification of Absence of Conflict of Interest .docx | DOCX document |
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Text version
v09182026
CLAYTON COUNTY WATER AUTHORITY
1600 Battle Creek Road | Morrow, Georgia 30260
Phone: (770) 960-5880 | Web Site: www.ccwa.us
SUB-CONTRACTOR AFFIDAVIT AND AGREEMENT FORM
SECTION A – Project Information / Sub-Contractor’s Employee Status / General Attestations
*Legal Name of Sub-Contractor *Street Address, City, State, Zip Code
Check one: ☐ Sub-Contractor currently employs one or more employees Name of Project ☐ Sub-Contractor has no employees
The undersigned Sub-Contractor (“Sub-Contractor”) executes this Affidavit and Agreement Form (“Affidavit”) to comply with O.C.G.A § 13-10-91 related to any contract to which Sub-Contractor is a party with Clayton County Water Authority 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 Sub-Contractor acknowledges and agrees that Sub-Contractor will contract for the performance of services in satisfaction of the Project only with sub-Contractors who present an affidavit to the Sub-Contractor with the information required by O.C.G.A.
§ 13-10-91. Sub-Contractor agrees to maintain such affidavits for inspection upon request of Clayton County Water Authority.
b) The Sub-Contractor acknowledges and agrees that this Affidavit is incorporated into any contract or purchase order for the Project and shall survive any renewal or extension thereof.
SECTION B – Sub-Contractor With Employees (E-Verify Required) (Complete Only If Applicable) By completing the information in this Section, the Sub-Contractor further attests as follows:
a) The Sub-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 Sub-Contractor will continue to use the federal work authorization program throughout the contract period, including any renewal or extension thereof;
c) The Sub-Contractor will notify the public employer in the event the Sub-Contractor ceases to utilize the federal work authorization program during the contract period, including renewals or extensions thereof;
d) The Sub-Contractor understands that ceasing to utilize the federal work authorization program constitutes a material breach of Contract;
*Enter Identification Number as Checked Above *Date of Authorization/Issuance *Required Entries
SECTION C – Sub-Contractor With No Employees (Complete Only If Applicable) ☐ By checking this box, Sub-Contractor certifies that Sub-Contractor has no employees and does not hire or intend to hire employees for purposes of satisfying or completing the terms and conditions of any part of the above-referenced Project.
☐ By checking this box, Sub-Contractor acknowledges that Sub-Contractor must attach a copy of the front and back of their state issued driver’s license or state issued identification card to this submission of this affidavit.
SECTION D – Execution (Completion Required by All) I hereby declare under penalty of perjury that the foregoing is true, correct, and complete. I understand and acknowledge that knowingly and willfully making a false, fictitious, or fraudulent statement or representation in this Affidavit constitutes a violation of O.C.G.A. § 16-10-20 and may subject the Sub-Contractor to criminal prosecution, termination of any Contract or Purchase Order, or both.
Executed this of , (month) 20 , 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 v09182026
GUIDELINES & GENERAL INFORMATION
SUB-CONTRACTOR AFFIDAVIT AND AGREEMENT FORM
The following guidance is provided for informational purposes only and does not supersede, modify, or constitute a legal interpretation of Official Code of Georgia Annotated (O.C.G.A.) § 13-10-91. Contractors remain solely responsible for ensuring compliance with applicable law when completing the Affidavit and Agreement Form. In the event of any conflict between this guidance and the statute, the statute shall control.
Pursuant to O.C.G.A. § 13-10-91(b), a public employer (Clayton County Water Authority) shall not enter into a contract for the physical “performance of services” unless the contractor is registered with and participates in the federal work authorization program (E-Verify). Before any Solicitation, Purchase Order or Contract for such services is considered, the contractor must submit a signed and notarized affidavit. NOTE: A Purchase Order (PO) is considered a contract pursuant to O.C.G.A. § 13-10-91.
TOPIC 1: APPLICABILITY
These requirements apply to any contract or purchase order involving the physical performance of services exceeding $2,499.99.
“Physical performance of services” means any performance of labor or services for a public employer using a bidding process or by contract or purchase order and includes, but is not limited to:
Routine operation, repair, and maintenance of facilities or office space;
Services necessary for normal business operations (e.g., IT support, janitorial services, equipment repair);
and Professional and consulting services.
TOPIC 2: CONTRACTOR AFFIDAVIT REQUIREMENT
Contractors must submit a signed and notarized Contractor Affidavit and Agreement Form (“Affidavit”) confirming registration and participation in the federal work authorization program before contract award or purchase order issuance.
If a contractor enters into multiple contracts with the public employer within a calendar year, a separate affidavit is required for each Contract and/or Purchase Order.
TOPIC 3: SUBCONTRACTORS
If the contractor intends to use subcontractors, the contractor is responsible for obtaining a signed and notarized affidavit from each subcontractor and ensuring compliance with O.C.G.A. § 13-10-91.
TOPIC 4: STATEWIDE CONTRACT VENDORS
If the vendor is on a statewide contract, E-Verify information may be obtained from the supplier records maintained by the Georgia Department of Administrative Services (DOAS).
In such cases, a separate affidavit is not required.
TOPIC 5: GENERAL COMPLIANCE GUIDANCE
Public employers and contractors are encouraged to err on the side of caution.
If there is uncertainty as to whether an affidavit is required, requesting one is acceptable and recommended to ensure compliance.
TOPIC 6: EXEMPTIONS
Contractors With No Employees
Contractors with no employees are not eligible to obtain an E-Verify number.
In lieu of an affidavit, the Clayton County Water Authority must document the contractor’s authorization to be in the United States by verifying acceptable identification, such as:
o A state-issued driver’s license from a state that verifies immigration status through its licensing or renewal process; or o Other acceptable identification, including a U.S. passport or military ID.
Foreign Companies Foreign companies that do not have an E-Verify number are not required to submit information related to Title 13 of the O.C.G.A.
If the foreign company or its personnel will enter the United States, the public employer must verify that the required authorization to enter the U.S. has been obtained.
| Legal Name of SubContractor: |
| Name of Project: |
| SubContractor currently employs one or more empl: Off |
| SubContractor has no employees: Off |
| Enter Identification Number as Checked Above: |
| Date of AuthorizationIssuance: |
| of: |
| State: |
| Printed Name and Title of Authorized Officer or Agent: |
| SUBSCRIBED AND SWORN BEFORE ME: |
| 20: |
| My Commission Expires: |
| Check Box3: Off |
| Check Box4: Off |
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