Contractor Affidavit (40).pdf
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- Attached to
- Pavement Markings
- Solicitation number
- PE-64800-NONST-2026-000000074
- 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 contractors entering into agreements with Douglas County, Georgia. The affidavit establishes compliance requirements for federal work authorization verification throughout the contract period, including any renewals or extensions. Contractors must register with and actively use E-Verify or any subsequent federal work authorization replacement program. The contractor is required to maintain this authorization status continuously and notify the public employer if the program usage ceases at any point during contract performance. The affidavit must be executed before a notary public and submitted with the contractor's Federal Work Authorization User Identification Number and date of authorization.
The affidavit establishes that cessation of E-Verify usage constitutes material breach of contract. Contractors are further obligated to ensure all subcontractors provide comparable affidavits with required information under O.C.G.A. § 13-10-91(a), (b), and (c). The contractor assumes responsibility for submitting copies of all affidavits, drivers' licenses, and identification cards required by statute to the public employer within five business days of receipt. The affidavit is incorporated automatically into any subject contracts without additional action or consent from the contractor. This document serves as a prerequisite compliance requirement for contract award and performance with Douglas County, Georgia.
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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 .