Contractor_Affidavit Updated.doc
DOC document 54 KB Posted
- Attached to
- 26-60 DW Servers
- Solicitation number
- PE-55267-NONST-2026-000000040
- Issued by
- Jefferson County, Georgia
About this file
This is a Contractor Affidavit document required under O.C.G.A. 13-10-91(b)(1) for state and local contracts in Georgia. The affidavit establishes compliance requirements for contractors working on Georgia public projects. Contractors must certify that they have registered with and are authorized to use the federal E-Verify work authorization program, or any subsequent replacement program. Contractors commit to maintaining E-Verify usage throughout the entire contract period, including any renewals or extensions, and must notify the public employer if they cease participation in the program. The document specifies that discontinuation of E-Verify participation constitutes a material breach of contract. Additionally, contractors must ensure that all subcontractors performing work under the contract submit similar affidavits with required documentation.
The affidavit must be executed before a notary public and incorporated into all resulting contracts without further action or consent from the contractor. Contractors bear responsibility for submitting copies of all required affidavits, drivers' licenses, and identification cards to the public employer within five business days of receipt. The document requires the contractor to provide their Federal Work Authorization User Identification Number, the date of authorization, the project name, the name of the public employer, and signature and notarization by an authorized officer or agent.
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Other files
| File | Type | Posted |
|---|---|---|
| Certificate of NonCollusion.pdf | ||
| DW Servers Specifications.pdf | ||
| 26_60 DW Servers General Information Sheet.doc | DOC document | |
| 26_60 DW Servers eRFP.pdf | ||
| W_9 (1).pdf | ||
| JCSS STANDARD TERMS AND CONDITIONS (1).pdf | ||
| DEPARTMENT OF AUDITS IMMIGRATION AND SECURITY.pdf | ||
| District Certifications Form.pdf | ||
| Tax Compliance Form.doc | DOC document |
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Text version
Contractor Affidavit under O.C.G.A. § 13-10-91(b)(l) 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
Date of Authorization
Name of Contractor
Name of Project
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: _____________________________
File details come from the government source that posted it. Updated .