E_Verify Affidavit_Contractor.pdf
PDF 88 KB Posted
- Attached to
- 26-011 STREET & PARKING DECK SWEEPING
- Solicitation number
- PE-66085-NONST-2026-000000084
- Issued by
- Fulton County, Georgia
About this file
This is an E-Verify Affidavit document required by the City of Alpharetta, Georgia for contractor participation in the Federal Work Authorization Program. The affidavit pertains to ITB 26-011 for Street & Parking Deck Sweeping services. Contractors executing this document must verify their registration with and authorization to use E-Verify, the federal work authorization program, and commit to continued participation throughout the contract period and any renewals or extensions. Contractors are required to notify the City of Alpharetta if they cease using E-Verify during the contract term, as discontinuation constitutes a material breach of contract. Additionally, contractors must ensure that all subcontractors engaged to perform services under the contract provide comparable affidavits demonstrating their own E-Verify compliance.
The affidavit must be executed before a notary public and submitted to the City of Alpharetta within five business days of receipt. The document requires the contractor to provide their Federal Work Authorization User Identification Number, date of authorization, authorized officer signature, and notarization. By executing this affidavit, contractors acknowledge that the document will be incorporated into any resulting contracts subject to O.C.G.A. 13-10-91 without further action or consent required. This compliance requirement applies to all contractors and subcontractors participating in this City of Alpharetta procurement.
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Other files
| File | Type | Posted |
|---|---|---|
| 26_011 Specifications_Instructions.pdf | ||
| 26_011 Information and Contract.pdf | ||
| Disclosure_Debarment.pdf | ||
| Alpharetta LVP Form.pdf | ||
| IRS Form W_9 March 2024.pdf | ||
| 26_011 SOI.xlsx | XLSX spreadsheet | |
| MAP.pdf |
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Text version
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: |
ITB 26-011 STREET & PARKING DECK SWEEPING
| Executed date: |
| in: |
| state: |
| Printed Name and Title of Authorized Officer or Agent: |
| My Commission Expires: |
| Year: |
| Month: |
| Day: |
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