E_Verify Affidavit_Contractor.pdf

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Attached to
PAVEMENT ANALYSIS
Solicitation number
PE-66085-NONST-2025-000000041
Issued by
Fulton County, Georgia

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This document is an Affidavit Verifying Contractor Participation in the Federal Work Authorization Program (E-Verify) required by the City of Alpharetta, Georgia for any contractor participating in a contract subject to O.C.G.A. § 13-10-91. The affidavit requires the contractor to register with and utilize the E-Verify program throughout the contract period, including any renewals or extensions. The contractor must notify the City of Alpharetta if it ceases using E-Verify, which would constitute a material breach of the contract. The contractor must also obtain affidavits from any subcontractors attesting to their participation in E-Verify.

The affidavit must be executed and submitted for the project titled "RFP25-103 PAVEMENT ANALYSIS". The affidavit includes the Federal Work Authorization User Identification Number, the date of authorization, the name of the contractor, and the name of the project. It must be signed by an authorized officer or agent of the contractor and notarized.

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City of Alpharetta, GA Procurement Required Document Affidavit Verifying Contractor Participation in Federal Work Authorization Program (E-Verify)

AFFIDAVIT VERIFYING CONTRACTOR PARTICIPATION IN

FEDERAL WORK AUTHORIZATION PROGRAM (E-Verify)

The undersigned contractor ("Contractor") executes this Affidavit to comply with O.C.G.A § 13-10-91 related to any contract to which Contractor is a party that is subject to O.C.G.A. § 13-10-91 and hereby verifies its compliance with O.C.G.A. § 13-10-91, attesting as follows:

a) The Contractor has registered with, is authorized to use and uses the federal work authorization program commonly known as E-Verify, or any subsequent replacement program;

b) The Contractor will continue to use the federal work authorization program throughout the contract period, including any renewal or extension thereof;

c) The Contractor will notify the City of Alpharetta in the event the Contractor ceases to utilize the federal work authorization program during the contract period, including renewals or extensions thereof;

d) The Contractor understands that ceasing to utilize the federal work authorization program constitutes a material breach of Contract;

e) The Contractor will contract for the performance of services in satisfaction of such contract only with subcontractors who present an affidavit to the Contractor with the information required by O.C.G.A. § 13-10-91(a), (b), and (c);

f) The Contractor acknowledges and agrees that this Affidavit shall be incorporated into any contract(s) subject to the provisions of O.C.G.A. § 13-10- 91 for the project listed below to which Contractor is a party after the date hereof without further action or consent by Contractor; and

g) The Contractor acknowledges its responsibility to submit copies of any affidavits, drivers' licenses, and identification cards required pursuant to O.C.G.A. § 13-10-91 to the City of Alpharetta within five business days of receipt.

Federal Work Authorization User Identification Number Date of Authorization

Name of Contractor Name of Project

I hereby declare under penalty of perjury that the foregoing is true and correct.

Executed date ___________________ in _______________ (city), __________ (state).

Signature of Authorized Officer or Agent

Printed Name and Title of Authorized Officer or Agent

SUBSCRIBED AND SWORN BEFORE ME

ON THIS THE _______ DAY OF _____________, 20______.

NOTARY PUBLIC

My Commission Expires: _____________________________

(Notary Stamp)

AFFIDAVIT VERIFYING CONTRACTOR PARTICIPATION IN FEDERAL WORK AUTHORIZATION PROGRAM (E-Verify)

Federal Work Authorization User Identification Number:
Date of Authorization:
Name of Contractor:
Name of Project:

RFP25-103 PAVEMENT ANALYSIS

Executed date:
in:
state:
Printed Name and Title of Authorized Officer or Agent:
My Commission Expires:
Year:
Month:
Day:

File details come from the government source that posted it. Updated .