ATT D3 CONTRACTOR CERTIFICATION IMM.docx

DOCX document 17 KB Posted

Attached to
AM 4- Q201--Kosciusko CBOC Services (new Long Term) 586
Solicitation number
36C25625R0028
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About this file

This is a contractor certification form (Attachment D3) requiring contractors to comply with immigration laws and regulations when providing services to Department of Veterans Affairs (VA) patient referrals. The certification mandates that contractors cannot knowingly employ or subcontract with illegal aliens or foreign nationals who violate their immigration status. Contractors must comply with E-Verify requirements per Executive Order 12989 and applicable Federal Acquisition Regulations.

The document specifies that failure to comply may result in prohibiting non-compliant foreign nationals from working at contractor facilities serving VA patient referrals and could lead to contract termination. The form requires the contractor's signature, date, typed name and title, and company name. It also requires contractors to obtain similar certifications from their subcontractors. This certification is related to a VA solicitation for Kosciusko CBOC Services under solicitation number 36C25625R0028.

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ATTACHMENT D3

CONTRACTOR CERTIFICATION

The Contractor certifies that the Contractor shall comply with any and all legal provisions contained in the Immigration and Nationality Act of 1952, As Amended; its related laws and regulations that are enforced by Homeland Security, Immigration and Customs Enforcement and the U.S Department of Labor as these may relate to non-immigrant foreign nationals working under contract or subcontract for the Contractor while providing services to Department of Veterans Affairs patient referrals; While performing services for the Department of Veterans Affairs, the Contractor shall not knowingly employ, contract or subcontract with an illegal alien; foreign national non-immigrant who is in violation their status, as a result of their failure to maintain or comply with the terms and conditions of their admission into the United States. Additionally, the Contractor is required to comply with all “E-Verify” requirements consistent with “Executive Order 12989” and any related pertinent Amendments, as well as applicable Federal Acquisition Regulations. https://www.uscis.gov/e-verify/federal-contractors/e-verify-federal-contractors-questions-and-answers While performing services for the Department of Veterans Affairs, the Contractor shall not knowingly employ, contract or subcontract with an illegal alien; foreign national non-immigrant who is in violation their status, as a result of their failure to maintain or comply with the terms and conditions of their admission into the United States.

If the Contractor fails to comply with any requirements outlined in the preceding paragraphs or its Agency regulations, the Department of Veterans Affairs may, at its discretion, require that the foreign national who failed to maintain their legal status in the United States or otherwise failed to comply with the requirements of the laws administered by Homeland Security, Immigration and Customs Enforcement and the U.S Department of Labor, shall be prohibited from working at the Contractor’s place of business that services Department of Veterans Affairs patient referrals; or other place where the Contractor provides services to veterans who have been referred by the Department of Veterans Affairs; and shall form the basis for termination of this contract for breach.

The Contractor agrees to obtain a similar certification from its subcontractors.

Signature:____________________________________________
Date:____________________________________________

Typed Name and Title: ___________________________________ Company Name: ______________________________________ This certification concerns a matter within the jurisdiction of an agency of the United States and the making of a false, fictitious, or fraudulent certification may render the maker subject to prosecution under 18 U.S.C. 1001.

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