D.1 Attachment Contractor Certification IMMI.pdf

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Q504--Onsite Dermatologist Physician 36C25626Q1162_1
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36C25626Q1162_1
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This is a Contractor Certification form (Attachment D.1) required for a Department of Veterans Affairs (VA) contract (36C25626Q1162_1). The certification obligates the contractor to comply with all provisions of the Immigration and Nationality Act of 1952, as amended, and related laws and regulations enforced by Homeland Security, Immigration and Customs Enforcement, and the U.S. Department of Labor concerning non-immigrant foreign nationals working on the contract.

The contractor certifies that it shall not knowingly employ, contract, or subcontract with illegal aliens or foreign national non-immigrants whose immigration status is in violation of U.S. admission terms and conditions. The contractor must comply with all E-Verify requirements consistent with Executive Order 12989 and applicable Federal Acquisition Regulations. Should the contractor fail to comply with these requirements, the VA may prohibit the non-compliant foreign national from working at any location where services are provided to VA patient referrals, and such failure shall constitute grounds for contract termination for breach. The contractor is also required to obtain similar certifications from all subcontractors. The form includes signature blocks for the contractor's authorized representative, including date, typed name and title, and company name. The certification includes a warning that false, fictitious, or fraudulent certification may result in prosecution under 18 U.S.C. 1001.

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Other files

File Type Posted
D.4 Attachment Rules of Behavior.pdf PDF
D.3 Attachment QASP.pdf PDF
36C25626Q1162_1.pdf PDF
D.2 Attachment Contractor Key Personnel.pdf PDF

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Attachment D.1 36C25626Q1162_1

CONTRACTOR CERTIFICATION

The Contractor certifies that the Contractor shall comply with any and all legal provisions contained in the Immigration and Nationality Act of 1952, As Amended; its related laws and regulations that are enforced by Homeland Security, Immigration and Customs Enforcement and the U.S Department of Labor as these may relate to non-immigrant foreign nationals working under contract or subcontract for the Contractor while providing services to Department of

Veterans Affairs patient referrals; While performing services for the Department of Veterans

Affairs, the Contractor shall not knowingly employ, contract or subcontract with an illegal alien;

foreign national non-immigrant who is in violation their status, as a result of their failure to maintain or comply with the terms and conditions of their admission into the United States.

Additionally, the Contractor is required to comply with all “E-Verify” requirements consistent with “Executive Order 12989” and any related pertinent Amendments, as well as applicable

Federal Acquisition Regulations. https://www.uscis.gov/e-verify/federal-contractors/e-verify-federal-contractors-questions-and-answers

While performing services for the Department of Veterans Affairs, the Contractor shall not knowingly employ, contract or subcontract with an illegal alien; foreign national non-immigrant who is in violation their status, as a result of their failure to maintain or comply with the terms and conditions of their admission into the United States.

If the Contractor fails to comply with any requirements outlined in the preceding paragraphs or its Agency regulations, the Department of Veterans Affairs may, at its discretion, require that the foreign national who failed to maintain their legal status in the United States or otherwise failed to comply with the requirements of the laws administered by Homeland Security, Immigration and Customs Enforcement and the U.S Department of Labor, shall be prohibited from working at the Contractor’s place of business that services Department of Veterans Affairs patient referrals;

or other place where the Contractor provides services to veterans who have been referred by the

Department of Veterans Affairs; and shall form the basis for termination of this contract for breach.

The Contractor agrees to obtain a similar certification from its subcontractors.

Signature: ____________________________________________

Date: ____________________________________________

Typed Name and Title: ___________________________________

Company Name: ______________________________________

This certification concerns a matter within the jurisdiction of an agency of the United States and the making of a false, fictitious, or fraudulent certification may render the maker subject to prosecution under 18 U.S.C. 1001.

https://www.uscis.gov/e-verify/federal-contractors/e-verify-federal-contractors-questions-and-answers https://www.uscis.gov/e-verify/federal-contractors/e-verify-federal-contractors-questions-and-answers

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