D.4 IMMIGRAT CERT.pdf
PDF 93 KB Posted
- Attached to
- G004--Evansville Heath Care for Homeless MC Veterans (HCHV) (VA-25-00078129) (VA-26-00041379)
- Solicitation number
- 36C25526R0077
About this file
This is a contractor certification form required by the Department of Veterans Affairs for compliance with the Immigration and Nationality Act of 1952, as amended. The certification requires contractors to comply with all legal provisions under the Immigration and Nationality Act and related laws enforced by Homeland Security, Immigration and Customs Enforcement, and the U.S. Department of Labor as they pertain to non-immigrant foreign nationals working on Department of Veterans Affairs contracts or subcontracts while providing services to VA patient referrals.
The contractor must certify that it will not knowingly employ, contract, or subcontract with illegal aliens or foreign nationals who are in violation of their immigration status or who have failed to maintain compliance with the terms and conditions of their U.S. admission. Contractors are required to comply with all E-Verify requirements consistent with Executive Order 12989 and applicable Federal Acquisition Regulations. Non-compliance may result in the Department of Veterans Affairs prohibiting non-compliant foreign nationals from working at the contractor's place of business servicing VA patient referrals and may form the basis for contract termination for breach. The contractor must obtain similar certifications from subcontractors. The form includes signature lines for the contractor's authorized representative, date, typed name and title, and company name. False certification is subject to prosecution under 18 U.S.C. Section 1001.
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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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