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 an E-Verify Registration Waiver Certification form for the 5th District Court of Appeal Security Upgrades contract opportunity managed by the Office of the State Courts Administrator (OSCA) in Florida. The form allows contractors to certify exemption from E-Verify registration requirements under Florida Statutes sections 448.09 and 448.095. Contractors may qualify for waiver eligibility if they are not engaged as employers hiring employees for labor or services requiring I-9 verification, do not pay employee salaries or withhold federal taxes, have no control over individual work duties, do not supervise subcontractor employees, are organized outside the United States with no domestic physical locations, or employ five or fewer employees. Contractors electing to use this waiver must certify their exemption status and agree not to hire unauthorized workers. They are required to notify the Contract Manager within ten calendar days of any change in employer status or if employees are hired; failure to provide appropriate notification results in immediate contract termination.
The waiver form requires certification by the sole proprietor or authorized representative and includes fields for the business entity legal name, address, and taxpayer identification number. Contractors must select the applicable exemption category by checkbox. The certification confirms that the provided information is true and correct under penalty of law. This document serves as documentation of compliance with Florida's E-Verify requirements for the architectural and engineering firm selected to conduct security assessments and recommend upgrades at the 5th District Court of Appeal facility in Daytona Beach.
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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 .