Contractor's E-Verify Registration Waiver.pdf
PDF 123 KB Posted
- Attached to
- 5th District Court of Appeal Security Upgrades
- Solicitation number
- ITN-14562
- Issued by
- Leon County, Florida
About this file
This is a Contractor's E-Verify Registration Waiver Certification form applicable to contractors engaged with the 5th District Court of Appeal in Florida. The certification document requires the owner or authorized representative of a business entity to acknowledge Florida Statutes sections 448.09 and 448.095, which mandate that public employers, contractors, and subcontractors register with and utilize the E-Verify system to verify work authorization status of newly hired employees. The form includes fields for the business entity's legal name, address, and taxpayer identification number, and must be completed and signed by the sole proprietor or authorized representative prior to contract execution.
The certification provides three exemption pathways for contractors: businesses not engaged as employers who do not hire employees, pay wages, collect federal withholding taxes, or supervise subcontractor employees; businesses organized outside the United States with no domestic physical locations; or businesses with five or fewer employees at any given time and hiring no more than five employees annually. Contractors claiming exemption must agree not to hire unauthorized workers and must notify the Contract Manager within ten calendar days of any change in employer status or if employees are hired, with failure to provide notification resulting in immediate contract termination. The form is version 1.00 revised June 2024 and is designated as SCS-E-Verify Registration Waiver Certification.
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Text version
CONTRACTOR’S E-VERIFY REGISTRATION CERTIFICATION
I, _____________________________________, am the owner or authorized representative of the business entity shown below. I hereby acknowledge on behalf of my business or business entity that I am aware of the requirement in sections 448.09 and 448.095, Florida Statutes, that every public employer, contractor, and subcontractor shall register with and use the E-Verify system to verify the work authorization status of all newly hired employees.
Business or Business Entity Legal Name:
Business or Business Entity Legal Address:
Business or Business Entity Taxpayer Identification Number:
I hereby certify that my business:
Is not engaged as an “employer” who hires individuals as an “employee” to perform labor or services in exchange for a salary, wages or other renumeration requiring the completion and submission of the U.S. Citizenship and Immigration Services Form I-9, “Employment Eligibility Verification”, does not pay employee salaries or wages, does not collect federal withholding taxes from any salaries or wages and submit them to the Internal Revenue Service, has no power to dictate or control an individual’s work duties and obligations, and does not supervise employees of subcontractors.
Is organized outside the United States and its territories and does not have any physical locations within the United States, and is not considered an “employer”, as described in the paragraph above.
Does not have more than five (5) employees at any given time and does not hire more than five
(5) employees in a calendar year.
For the reasons stated above, my business or business entity is not eligible to register with and cannot use the Department of Homeland Security E-Verify System.
By signing this certification, I agree not to hire employees who are not authorized to be employed in the United States pursuant to 8 U.S.C. s. 1324a(h)(3) at the time of employment or at any time throughout the term of the employment. I further acknowledge that I will notify the Contract Manager within ten
(10) calendar days of any change in the business entity status as an employer or if any employees are hired. I further acknowledge that the failure to make the appropriate notifications will result in the immediate termination of my contract.
I HEREBY CERTIFY THAT THE FOREGOING IS TRUE AND CORRECT.
Sole Proprietor/Authorized Representative
Printed Name
SCS-E-Verify Registration Waiver Certification v.1.00 rev 6/2024
| am the owner or authorized representative of the business: |
| Business or Business Entity Legal Name: |
| Business or Business Entity Legal Address: |
| Business or Business Entity Legal Address_2: |
| Business or Business Entity Legal Address_3: |
| Business or Business Entity Taxpayer Identification Number: |
| Check Box1: Off |
| Check Box2: Off |
| Check Box3: Off |
| Text4: |
File details come from the government source that posted it. Updated .