Appendix C .docx
DOCX document 21 KB Posted
- Attached to
- 6130-EGBA- SUNLIGHT / LeVITA: RN-15-0114
- Solicitation number
- RFP EGBA 2015000114 4
- Issued by
- Garfield County, Denver City, Colorado
About this file
This is a certification and affidavit form issued by the State of Colorado Office of the State Architect for State Buildings Programs. The document establishes compliance requirements for vendors entering into contracts with the State of Colorado. Vendors must certify that they will not knowingly employ or contract with unauthorized immigrants and must participate in either the E-Verify Program administered by the U.S. Department of Homeland Security and Social Security Administration, or the Department Program administered by the Colorado Department of Labor and Employment to confirm employment eligibility of all newly hired employees performing work under the contract. Vendors are also required to comply with all reasonable investigative requests made by the Colorado Department of Labor and Employment.
The affidavit section requires sole proprietors to swear under penalty of perjury that they are either a United States citizen, a Permanent Resident of the United States, or lawfully present in the United States pursuant to Federal law. Sole proprietors must provide proof of lawful presence prior to starting work and must comply with CRS 24-76.5-101 et seq. False statements in the affidavit constitute perjury in the second degree under Colorado law and are punishable as criminal offenses. The form must be certified and signed by an authorized vendor representative with the date of execution. Failure to comply with the certification or affidavit provisions may result in contract termination for breach, and the vendor may be held liable for damages to the State.
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| Bid Alternates.doc | DOC document | |
| PerfBond.docx | DOCX document | |
| APPENDIX F- Budget Sunlite.doc | DOC document | |
| Questions & Responses .docx | DOCX document | |
| Appendix B (1).docx | DOCX document | |
| BuildingCodeCompliancePolicy.pdf | ||
| MBond.docx | DOCX document | |
| Appendix D- Specifications.docx | DOCX document | |
| Appendix B (2).docx | DOCX document | |
| RFP-2015000114 Sunlight.docx | DOCX document | |
| Attachment B-SitePlan.pdf | ||
| Attachment C-GroundPlanDet.pdf | ||
| RFP-2015000114 Sunlight MOD1.docx | DOCX document | |
| Bid Bond.docx | DOCX document | |
| Bid Form.docx | DOCX document | |
| Attachment D-GeotechReport.pdf | ||
| Attachment A-approvedstatebldgcode.pdf |
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Text version
STATE OF COLORADO
OFFICE OF THE STATE ARCHITECT
STATE BUILDINGS PROGRAMS
CERTIFICATION AND AFFIDAVIT REGARDING UNAUTHORIZED IMMIGRANTS
| Institution/Agency: |
| Project No./Name: |
A. CERTIFICATION STATEMENT CRS 8-17.5-101 & 102 (HB 06-1343, SB 08-193)
The Vendor, whose name and signature appear below, certifies and agrees as follows:
1. The Vendor shall comply with the provisions of CRS 8-17.5-101 et seq. The Vendor shall not knowingly employ or contract with an unauthorized immigrant to perform work for the State or enter into a contract with a subcontractor that knowingly employs or contracts with an unauthorized immigrant.
2. The Vendor certifies that it does not now knowing employ or contract with and unauthorized immigrant who will perform work under this contract, and that it will participate in either (i) the “E-Verify Program”, jointly administered by the United States Department of Homeland Security and the Social Security Administration, or (ii) the “Department Program” administered by the Colorado Department of Labor and Employment in order to confirm the employment eligibility of all employees who are newly hired to perform work under this contract.
3. The Vendor shall comply with all reasonable requests made in the course of an investigation under CRS 8-17.5-102 by the Colorado Department of Labor and Employment. If the Vendor fails to comply with any requirement of this provision or CRS 8-17.5-101 et seq., the State may terminate work for breach and the Vendor shall be liable for damages to the State.
B. AFFIDAVIT CRS 24-76.5-101 (HB 06S-1023)
1. If the Vendor is a sole proprietor, the undersigned hereby swears or affirms under penalty of perjury under the laws of the State of Colorado that (check one):
|_| I am a United States citizen, or
|_| I am a Permanent Resident of the United States, or
|_| I am lawfully present in the United States pursuant to Federal law.
I understand that this sworn statement is required by law because I am a sole proprietor entering into a contract to perform work for the State of Colorado. I understand that state law requires me to provide proof that I am lawfully present in the United States prior to starting work for the State. I further acknowledge that I will comply with the requirements of CRS 24-76.5-101 et seq. and will produce the required form of identification prior to starting work. I acknowledge that making a false, fictitious, or fraudulent statement or representation in this sworn affidavit is punishable under the criminal laws of Colorado as perjury in the second degree under CRS 18-8-503 and it shall constitute a separate criminal offense each time a public benefit is fraudulently received.
CERTIFIED and AGREED to this _ ____ day of ___ ___, _20 __.
VENDOR:
Vendor Full Legal Name
BY:
Signature of Authorized Representative
Title
State Form UI-1 Page 1 of 1 Issued 7/2008 image1.png
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