Contractor Affidavit (48).pdf
PDF 105 KB Posted
- Attached to
- I-20 LANDSCAPE MAINTENANCE BID
- Solicitation number
- PE-64800-NONST-2026-000000081
- Issued by
- Douglas County, Georgia
About this file
This is a Contractor Affidavit form required by the Douglas County Board of Commissioners in Georgia for the I-20 Landscape Maintenance Bid project. The affidavit ensures compliance with O.C.G.A. 13-10-91, which mandates federal work authorization verification for all contractors and subcontractors on public projects. Contractors must be registered with and actively use E-Verify or any subsequent replacement federal work authorization program throughout the entire contract period, including any renewals or extensions. Contractors are required to maintain their E-Verify authorization status and notify the public employer immediately if they cease using the program at any point during contract performance, which constitutes a material breach. All subcontractors must provide similar affidavits demonstrating compliance with the same work authorization requirements prior to contract execution.
The affidavit must be executed before a notary public and includes fields for the contractor's Federal Work Authorization User Identification Number, date of authorization, authorized officer signature, and notarization. Contractors bear responsibility for submitting copies of all required affidavits, driver's licenses, and identification cards to the public employer within five business days of receipt. The form becomes automatically incorporated into any resulting contract 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 .