Contract Affidavit A.pdf
PDF 7 KB Posted
- Solicitation number
- PE-55462-NONST-2024-000000008
- Issued by
- Georgia
About this file
This document is a Contractor Affidavit required by the Walker County Board of Education under Georgia state law O.C.G.A. 13-10-91. It verifies that the contractor is registered with and uses the federal E-Verify program to confirm the employment eligibility of its personnel performing physical services on behalf of the Walker County Board of Education. The contractor must also ensure that any subcontractors it uses provide a similar affidavit. The contractor must provide its federal work authorization user identification number and date of authorization.
The affidavit requires the contractor to attest under penalty of perjury that the information provided is true and correct. It must be signed by an authorized officer or agent of the contractor and notarized.
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Text version
Walker County Board of Education - Immigration and Security Form A
Contractor Affidavit under O.C.G.A. § 13-10-91(b)(1)
By executing this affidavit, the undersigned contractor verifies its compliance with O.C.G.A. § 13-10-91, stating affirmatively that the individual, firm or corporation which is engaged in the physical performance of services on behalf of Walker County
Board of Education 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 contractor will continue to use the federal work authorization program throughout the contract period and the undersigned contractor will contract for the physical performance of services in satisfaction of such contract only with subcontractors who present an affidavit to the contractor with the information required by O.C.G.A. § 13-10-91(b). Contractor 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 of Contractor
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:
File details come from the government source that posted it. Updated .