D.2 36C26126R0014 Immigration Certification.pdf
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- Attached to
- Community Based Outpatient Clinic - Yreka, CA
- Solicitation number
- 36c26126r0014
About this file
This is a contractor certification form required by the Department of Veterans Affairs that addresses compliance with immigration and employment verification requirements.
The contractor must certify compliance with 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. The contractor is prohibited from knowingly employing, contracting, or subcontracting with illegal aliens or foreign nationals whose non-immigrant status is in violation of their admission terms and conditions. All workers providing services related to Department of Veterans Affairs patient referrals must comply with E-Verify requirements consistent with Executive Order 12989 and applicable Federal Acquisition Regulations. If the contractor fails to comply with these requirements, the Department of Veterans Affairs may prohibit the non-compliant foreign national from working at any location servicing VA patient referrals, and such failure shall constitute grounds for contract termination for breach. The contractor must obtain similar certifications from all subcontractors. The certification carries legal weight under 18 U.S.C. Section 1001, as false or fraudulent certifications may subject the signatory to federal prosecution.
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Text version
CONTRACTOR CERTIFICATION: IMMIGRATION AND NATIONALITY ACT OF 1952, AS
AMENDED
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.
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.
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