[E]_E-Verify_Affidavit.pdf

Notarized Affidavit

EMPLOYMENT ELIGIBILITY VERIFICATION SYSTEM (E-VERIFY) AFFIDAVIT

BY REGISTERING AS A VENDOR, SUBMITTING A RESPONSE TO A SOLICITATION, OR ENTERING INTO A CONTRACT, YOU ARE OBLIGATED TO COMPLY WITH THE PROVISIONS OF SECTION 448.095, FLA. STAT., "EMPLOYMENT ELIGIBILITY."

FURTHER, BY YOUR REGISTRATION AS A VENDOR, RESPONSE TO A SOLICITATION, ENTERING INTO A CONTRACT, YOU AFFIRM AND REPRESENT THAT YOU ARE REGISTERED WITH THE E-VERIFY SYSTEM AND ARE USING SAME, AND WILL CONTINUE TO USE SAME AS REQUIRED BY SECTION 448.095, F.S. COMPLIANCE WITH SECTION 448.095 INCLUDES, BUT IS NOT LIMITED TO, UTILIZATION OF THE E-VERIFY SYSTEM TO VERIFY THE WORK AUTHORIZATION STATUS OF ALL NEWLY HIRED EMPLOYEES, AND REQUIRING ALL SUBCONTRACTORS TO PROVIDE AN AFFIDAVIT ATTESTING THAT THE SUBCONTRACTOR DOES NOT EMPLOY, CONTRACT WITH, OR SUBCONTRACT WITH, AN UNAUTHORIZED ALIEN. FAILURE TO COMPLY WILL LEAD TO TERMINATION AS A VENDOR, DISQUALIFYING YOU FOR AWARD OF A SOLICITATION, DENIAL OF ENTERING INTO A CONTRACT AND/OR, CANCELLATION OF AN ACTIVE CONTRACT, OR IF YOUR SUBCONTRACTOR KNOWINGLY VIOLATES THE STATUTE, THE SUBCONTRACT MUST BE TERMINATED IMMEDIATELY. ANY CHALLENGE TO TERMINATION UNDER THIS PROVISION MUST BE FILED NO LATER THAN 20 CALENDAR DAYS AFTER THE DATE OF

TERMINATION.

STATE OF FLORIDA

COUNTY OF LEE

This ____________ day of ____________ 20___, _______________________, being first duly sworn, deposes and says that he or she is the authorized representative of ________________________ (Name of the contractor, firm or individual), maker of the attached request for bid, proposals, qualifications and/or any other solicitation released by the City of Fort Myers and that the bidder and any of its agents agree to abide by the City of Fort Myers Employment Eligibility Verification System requirements in regards to this solicitation.

AFFIANT

The foregoing instrument was acknowledged before me this ___ day of ___________, 20__ by (name of person, officer, or agent, title of officer or agent), of

(state of incorporation or (corporation or partnership, if as

(corporation or partnership, if applicable), a partnership, if applicable), on behalf of the applicable). He/She is personally known to me or has produced identification.

Name of Notary typed, printed or stamped

Name typed, printed or stamped

(Title or Rank)

City of Fort Myers reserves the right to request supporting documentation at any time.

(Seal)

Signature of person taking acknowledgment

Notary Public Signature