Attachment D.3 - Contractor Certification of Immigration.pdf
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- Solicitation number
- 36C24923R0047
About this file
This document is a contractor certification form regarding immigration and nationality act requirements for a federal contract opportunity with the Department of Veterans Affairs. The contractor must certify that all contract employees working on services referred by the VA are United States citizens, nationals, or lawful permanent residents. The contractor agrees not to knowingly employ any foreign nationals who are in violation of their immigration status or failed to comply with admission requirements. Failure to comply with immigration laws administered by Homeland Security, Immigration and Customs Enforcement, or the Department of Labor could result in prohibiting non-compliant foreign nationals from working on the contract or forming the basis for termination. The solicitation is for community based outpatient clinic services in Helena, Arkansas under solicitation number 36C24923R0047.
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Attachment D.3 Contractor Certification
CONTRACTOR CERTIFICATION: IMMIGRATION AND NATIONALITY ACT OF 1952, AS
AMENDED
1. The Contractor must certify 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;
1.1. Citizenship-related requirements. Each affected contractor employee as described in paragraph shall be:
A United States (U.S.) citizen; or A national of the United States (see 8 U.S.C. 1408); or An alien lawfully admitted into the United States for permanent residence as evidenced by an Alien Registration Receipt Card Form I–151.
2. 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.
3. 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.
4. The Contractor must obtain a similar certification from its sub Contractors.
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.
36C24923R0047 - Helena CBOC
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