Contractor Affidavit (46).pdf
PDF 105 KB Posted
- Solicitation number
- PE-64800-NONST-2026-000000079
- Issued by
- Douglas County, Georgia
About this file
This Contractor Affidavit is related to Douglas County, Georgia's Fleet Maintenance Generator Project, a turnkey installation of a 100kW Diesel Standby Generator at the Fleet Maintenance Building. The project aims to ensure Douglas County can maintain normal operations and continue serving citizens during power outages, with the generator serving a facility that houses numerous county employees and supports all county departments daily. The affidavit serves as a formal attestation document required as part of the procurement process for this FEMA Hazard Mitigation Grant Program-funded project.
The selected contractor must comply with all federal requirements under 2 C.F.R. Part 200 and FEMA-specific mitigation policies governing the use of grant funds. The project is partially funded through the FEMA Hazard Mitigation Grant Program, establishing federal compliance obligations and oversight requirements. As a contractor affidavit, this document represents the contractor's sworn certification of qualifications, legal status, and commitment to meet project requirements and contractual obligations under state and federal law.
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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 .