Contractor Affidavit.pdf
PDF 105 KB Posted
- Attached to
- 2026 Mowing and Litter Bid
- Solicitation number
- 25-029
- Issued by
- Douglas County, Georgia
About this file
This document is a Contractor Affidavit form for Douglas County, Georgia, related to compliance with Georgia State Law O.C.G.A. § 13-10-91. The affidavit requires contractors to verify their participation in the federal E-Verify work authorization program, confirming that they have registered with and will continue to use the program throughout the contract period. Contractors must also agree to notify the public employer if they cease using E-Verify, understand that stopping use constitutes a material breach of contract, and commit to using only subcontractors who can provide similar verification.
The affidavit is a legal document that mandates contractors attest to their compliance with employment verification requirements, with specific obligations including submitting copies of required documentation within five business days of receipt. The form is designed to ensure that contractors working with Douglas County are utilizing federally approved systems to verify the employment eligibility of their workforce, with provisions for ongoing compliance and potential consequences for non-adherence to the established requirements.
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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 .