Attachment 3 - Immigration and Nationality Act Certification.pdf

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NWI Offsite Pathology Services
Solicitation number
36C26326R0063
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This is a certification form required for federal contracts with the Department of Veterans Affairs (VA). The contractor must certify compliance with the Immigration and Nationality Act of 1952, as amended, and related laws enforced by Homeland Security, Immigration and Customs Enforcement, and the U.S. Department of Labor. The contractor is prohibited from knowingly employing, contracting, or subcontracting with illegal aliens or foreign nationals in violation of their immigration status while providing services to the VA.

The certification requires the contractor to comply with all E-Verify requirements consistent with Executive Order 12989 and related amendments, as well as applicable Federal Acquisition Regulations. Non-compliance provides grounds for contract termination, and the VA may prohibit any foreign national who fails to maintain legal status from working at the contractor's place of business providing VA services or any other location where the contractor provides services to VA-referred veterans. Contractors must obtain similar certifications from their subcontractors. The form includes signature blocks for the contractor representative, with a warning that false or fraudulent certification may result in prosecution under 18 U.S.C. 1001.

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Immigration and Nationality Act Certification

The Contractor certifies that they shall comply with 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 (VA). While performing services for the Department of Veterans Affairs, the Contractor shall not knowingly employ, contract, or subcontract with an illegal alien or any foreign national non-immigrant who is in violation their status for any reason.

Additionally, the Contractor is required to comply with all “E-Verify” requirements consistent with “Executive Order 12989” and any related Amendments, as well as applicable Federal Acquisition Regulations.

Any failure by the Contractor to comply with any requirements outlined above will provide the VA with grounds for termination for breach of the contract and the VA 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, or the U.S Department of Labor, shall be prohibited from working at the Contractor’s place of business that provides the VA services as well as from any other place where the Contractor provides services to Veterans who have been referred by the VA.

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.”

Attachment 3: Immigration and Nationality Act Certification

Name and Title:
Company Name:
Date_af_date:

File details come from the government source that posted it. Updated .