Contractor Affidavit (13).pdf
PDF 105 KB Posted
- Attached to
- I-20 Landscape Maintenance Bid
- Solicitation number
- PE-64800-NONST-2025-000000048
- Issued by
- Douglas County, Georgia
About this file
This document is a Contractor Affidavit under O.C.G.A. § 13-10-91(b)(1) for Douglas County, Georgia, related to compliance with state work authorization requirements. The affidavit requires the contractor to verify their use of the federal E-Verify work authorization program, commit to continued use throughout the contract period, and acknowledge that ceasing to use the program constitutes a material breach of contract. The contractor must also ensure that subcontractors provide similar affidavits and submit required documentation to the public employer within five business days of receipt.
The affidavit is a mandatory compliance document that outlines the contractor's responsibilities regarding employment verification and work authorization. It specifically requires the contractor to register with and use the E-Verify program, notify the public employer if they cease using the program, and incorporate this affidavit into any contracts subject to the specified Georgia state law provisions. The document provides space for the contractor to enter their Federal Work Authorization User Identification Number, project details, and execution information, and must be signed, dated, and notarized to be considered valid.
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Text version
Contractor Affidavit under O.C.G.A. § 13-I0-9l(b)(I)
The undersigned contractor ("Contractor") executes this Affidavit to comply with O.C.G.A § 13-10-91 related to any contract to which Contractor is a party that is subject to O.C.G.A. § 13-10-91 and hereby verifies its compliance with O.C.G.A. § 13-10-91, attesting as follows:
a) The Contractor has registered with, is authorized to use and uses the federal work authorization program commonly known as E-Verify, or any subsequent replacement program.
b) The Contractor will continue to use the federal work authorization program throughout the contract period, including any renewal or extension thereof.
c) The Contractor will notify the public employer in the event the Contractor ceases to utilize the federal work authorization program during the contract period, including renewals or extensions thereof.
d) The Contractor understands that ceasing to utilize the federal work authorization program constitutes a material breach of Contract.
e) The Contractor will contract for the 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(a), (b), and (c).
f) The Contractor acknowledges and agrees that this Affidavit shall be incorporated into any contract(s) subject to the provisions of O.C.G.A. § 13-10- 91 for the project listed below to which Contractor is a party after the date hereof without further action or consent by Contractor; and
g) Contractor acknowledges its responsibility to submit copies of any affidavits, drivers' licenses, and identification cards required pursuant to O.C.G.A. § 13-10-91 to the public employer within five business days of receipt.
Federal Work Authorization User Identification Number
Name of Contractor:
Date of Authorization
Name of Project
Douglas County, Georgia Name of Public Employer
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: _ _ _ _ _ _ _ _ _ _ _ _ lammons Cross-Out
Contractor Affidavit under O.C.G.A. § 13-I0-9l(b)(I)
File details come from the government source that posted it. Updated .