Bid Document - Exhibit 1 BLANK.pdf
PDF 82 KB Posted
- Attached to
- ECONOLITE PRODUCTS
- Solicitation number
- 300000237993928
- Issued by
- Missouri
About this file
This is an Annual Worker Eligibility Verification Affidavit required by the Missouri Department of Transportation (MHTC) for contractors seeking to enter into state contracts. The affidavit applies to all business entities, including joint ventures which must submit separate affidavits for each entity. The document requires authorized representatives of bidding companies to affirm under oath that their business entity is enrolled in a federal work authorization program operated by the United States Department of Homeland Security and will verify employment eligibility of all newly hired employees working on MHTC-contracted services. The affidavit must be notarized and submitted with documentation evidencing enrollment and participation in the federal work authorization program. The contract opportunity referenced is for Econolite-specific products, warranty services, and repairs for existing Econolite traffic control systems in the Kansas City District, with Traffic Control Corporation identified as the sole regional authorized distributor. The contract period runs from April 30, 2026, through May 1, 2027, with up to two optional one-year renewal periods.
Contractors must affirm that their business entity does not and will not knowingly employ any unauthorized aliens in connection with MHTC services, as defined under 8 U.S.C. 1324a(h)(3). Business entities are held liable under Missouri Revised Statutes Sections 285.525 through 285.550 for subcontractors that knowingly employ unauthorized workers. This affidavit represents a compliance requirement under Section 285.530, RSMo, and serves as a prerequisite for contract eligibility rather than a pricing or funding document. No specific pricing terms, set-asides, or funding amounts are outlined in this eligibility verification form.
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Text version
Exhibit 1
ANNUAL WORKER ELIGIBILITY VERIFICATION AFFIDAVIT
(for joint ventures, a separate affidavit is required for each business entity)
) STATE OF -------
) ss
COUNTY OF ______ )
On the __ day of ______ � 20 __ , before me appeared ______________ � Affiant name personally known to me or proved to me on the basis of satisfactory evidence to be a person whose name is subscribed to this affidavit, who being by me duly sworn, stated as follows:
• I, the Affiant, am of sound mind, capable of making this affidavit, and personally certify the facts herein stated, as required by Section 285.530, RSMo, to enter into any contract agreement with the state to perform any job, task, employment, labor, personal services, or any other activity for which compensation is provided, expected, or due, including but not limited to all activities conducted by business entities.
• I, the Affiant, am the --�ti�tl�e--- of -----�b-u-sm_e_
_n_am_e ___ �, and I am duly authorized, directed, and/or empowered to act officially and properly on behalf of this business entity.
• I, the Affiant, hereby affirm and warrant that the aforementioned business entity is enrolled in a federal work authorization program operated by the United States Department of Homeland Security, and the aforementioned business entity shall participate in said program to verify the employment eligibility of newly hired employees working in connection with any services contracted by the Missouri Highways and Transportation
Commission (MHTC). I have attached documentation to this affidavit to evidence enrollment/participation by the aforementioned business entity in a federal work authorization program, as required by Section 285.530, RSMo.
• I, the Affiant, also hereby affirm and warrant that the aforementioned business entity does not and shall not knowingly employ, in connection with any services contracted by MHTC, any alien who does not have the legal right or authorization under federal law to work in the United States, as defined in 8 U.S.C. § 1324a(h)(3).
• I, the Affiant, am aware and recognize that, unless certain contract and affidavit conditions are satisfied pursuant to Section 285.530, RSMo, the aforementioned business entity may be held liable under Sections
285.525 though 285.550, RSMo, for subcontractors that knowingly employ or continue to employ any unauthorized alien to work within the state of Missouri.
• I, the Affiant, acknowledge that I am signing this affidavit as a free act and deed of the aforementioned business entity and not under duress.
Affiant Signature
Subscribed and sworn to before me in __________ , __ , the day and year first above-written.
city ( or county) state
Notary Public My commission expires:
[documentation of enrollment/participation in a federal work authorization program attached]
File details come from the government source that posted it. Updated .