Contractor Everify Affidavit
37 KB Posted
- Attached to
- Definium Tempo Pro & OTS System
- Solicitation number
- 82000-ATC0000055
- Issued by
- Douglas County, Georgia
About this file
This is a Contractor E-Verify Affidavit associated with an electronic Request for Quotes (eRFQ) issued by the Technical College System of Georgia on behalf of Albany Technical College for the purchase of a Definium Tempo Pro and OTS System. The eRFQ seeks to establish a one-time purchase agreement with a single authorized supplier to provide one new Definium Tempo Pro and OTS System for the Radiologic Technology Program's laboratory, to be used for medical imaging education purposes. The procurement is conducted pursuant to the State Purchasing Act (Official Code of Georgia Annotated 50-5-50 et seq.) through the Team Georgia Marketplace Bid Event. Suppliers must be authorized by the manufacturer to sell the requested equipment.
The affidavit document functions as a compliance verification requirement for contractors bidding on this opportunity. Interested suppliers should contact the Department of Administrative Services (DOAS) Customer Service Help Desk at 404-657-6000 or ProcurementHelp@doas.ga.gov for technical assistance with system registration, bid event access, or bid document retrieval during business hours (Monday through Friday, 8:00 AM to 5:00 PM, excluding state holidays and office closures). Additional details regarding specifications, project scope, and bidding requirements are available in the documents attached to the Comments and Attachments section of the Team Georgia Marketplace Bid Event.
Text of this file
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: _____________________________
Other files
| File | Type | Posted |
|---|---|---|
| NOIA & Bid Tabulation | — | |
| Tax Compliance Form | — | |
| Notice of Award | — |
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