Contractor Affidavit (23).pdf
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- Attached to
- 3rd Party Transportation Operator
- Solicitation number
- PE-64800-NONST-2025-000000058
- Issued by
- Douglas County, Georgia
About this file
This is a Contractor Affidavit document required under O.C.G.A. § 13-10-91(b)(1) for contracts with Douglas County, Georgia. The affidavit establishes compliance requirements for contractors performing work on county projects. Contractors must register with and actively use the federal E-Verify work authorization program throughout the entire contract period, including any renewals or extensions. Contractors are required to notify the public employer if they cease using E-Verify at any point during contract performance, and failure to maintain E-Verify participation constitutes a material breach of contract. Additionally, contractors must ensure that all subcontractors used for contract performance also submit compliant affidavits with required documentation including E-Verify authorization information, drivers' licenses, and identification cards to the public employer within five business days of receipt.
The affidavit incorporates specific operational requirements regarding work authorization verification and subcontractor compliance. Contractors must provide their Federal Work Authorization User Identification Number, the date of E-Verify authorization, and execute the affidavit before a notary public under penalty of perjury. The document is automatically incorporated into any subsequent contracts for Douglas County projects without requiring further action or consent from the contractor. This requirement applies to all contracts subject to O.C.G.A. § 13-10-91, establishing mandatory participation in federal work authorization verification as a condition of doing business with Douglas County.
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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 .