Attachment D _ Illegal Immigration Affidavit .pdf
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- Attached to
- Energy Service Provider RFP
- Solicitation number
- PE-64458-NONST-2025-000000018
- Issued by
- Dekalb County, Georgia
About this file
This is a compliance affidavit attachment related to the City of Decatur's implementation of Georgia's Illegal Immigration Reform and Enforcement Act of 2011. The document establishes mandatory requirements for contractors, subcontractors, and sub-subcontractors performing services on behalf of the City of Decatur. All parties involved in the physical performance of services must register with the United States Department of Homeland Security's E-Verify program and maintain documentation of their federal work authorization user identification number and authorization date. Contractors are required to provide affidavits certifying compliance with O.C.G.A. 13-10-91 and to continue using the E-Verify program throughout the entire contract period. Additionally, contractors must ensure that any subcontractors engaged for the physical performance of services also provide affidavits demonstrating their E-Verify registration and authorization.
The affidavit form requires contractors to submit their federal work authorization user identification number, authorization date, project name, and the executed affidavit must be notarized and sworn under penalty of perjury. The document includes fields for the contractor's name, signature of an authorized officer or agent, and notary public certification. No specific pricing, funding amounts, or contract term details are addressed in this compliance attachment, as its sole purpose is to establish and document adherence to federal work authorization requirements for all contract participants.
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Text version
ATTACHEDMENT D: Georgia’s Illegal Immigration Reform and
Enforcement Act of 2011
Contractor, Subcontractor and Sub-subcontractor
Evidence of Compliance
Contractor, all Subcontractors, and all Sub-subcontractors shall comply with
Georgia’s Illegal Immigration Reform and Enforcement Act of 2011.
Contractor, Subcontractors and Sub- subcontractors, must provide Evidence of Compliance with these requirements, by:
1. Registering with the United States Department of Homeland
Security federal work authorization E-Verify program.
2. Providing the Employment Eligibility Verification Program (EEV)
Basic Pilot Program User Identification Number.
3. Providing Affidavits using the attached forms, maintaining records and affidavits for inspection by Owner at any time, and incorporating and attaching affidavits to contracts for construction.
Note: Below is a link to the U.S. Department of Homeland Security E-Verify site where a Contractor, Subcontractor, and/or Sub-subcontractor can register for the program. http://www.dhs.gov/e-verify http://www.dhs.gov/e-verify
Contractor Affidavit under O.C.G.A. § 13-10-91(b)(1)
By executing this affidavit, the undersigned consultant verifies its compliance with O.C.G.A.
§ 1310-91, stating affirmatively that the individual, firm or corporation which is engaged in the physical performance of services on behalf of the City of Decatur has registered with, is authorized to use and uses the federal work authorization program commonly known as E-
Verify, or any subsequent replacement program, in accordance with the applicable provisions and deadlines established in O.C.G.A. § 13-10-91.
Furthermore, the undersigned consultant will continue to use the federal work authorization program throughout the contract period and the undersigned consultant will contract for the physical performance of services in satisfaction of such contract only with subconsultants who present an affidavit to the consultant with the information required by O.C.G.A. § 13-10-
91(b). Consultant hereby attests that its federal work authorization user identification number and date of authorization are as follows:
Federal Work Authorization User Identification Number: _____________________________
Date of Authorization: ________________________________________________________
Name of Contractor: _________________________________________________________
Name of Project: ___________________________________________________________
I hereby declare under penalty of perjury that the foregoing is true and correct.
Executed on ______________ , 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: _______________________
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