Contractor Affidavit (31).pdf
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- Solicitation number
- PE-64800-NONST-2026-000000065
- Issued by
- Georgia
About this file
This is a Contractor Affidavit document required by the State of Georgia under O.C.G.A. 13-10-91(b)(1) for Douglas County's Transportation Special Purpose Local Option Sales Tax (T-SPLOST) project. The affidavit certifies that contractors comply with Georgia's federal work authorization requirements and must be executed by any contractor entering into a contract subject to this statute. The document requires contractors to register with and use the E-Verify federal work authorization program throughout the entire contract period, including any renewals or extensions, and mandates notification to the public employer if the contractor ceases using E-Verify at any time during contract performance, with such cessation constituting a material breach of contract.
The affidavit further obligates contractors to ensure that all subcontractors also provide compliant affidavits containing the information required under O.C.G.A. 13-10-91(a), (b), and (c). Contractors must submit copies of all required affidavits, driver's licenses, and identification cards to Douglas County within five business days of receipt. The document requires notarization and must be signed by an authorized officer or agent under penalty of perjury, with the affidavit automatically incorporated into any resulting contracts without further action or consent required from the contractor.
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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 .