E_Verify Affidavit_Contractor.pdf
PDF 94 KB Posted
- Attached to
- ON-CALL STORM PIPE CLEANING
- Solicitation number
- PE-66085-NONST-2026-000000089
- Issued by
- Fulton County, Georgia
About this file
This is an E-Verify Affidavit required by the City of Alpharetta, Georgia for contractor participation in the federal work authorization program. The document pertains to the 26-117 On-Call Storm Pipe Cleaning project. Contractors executing this affidavit must verify compliance with O.C.G.A. § 13-10-91 and confirm their registration with and authorization to use E-Verify. Contractors are required to maintain continuous E-Verify participation throughout the contract period, including any renewals or extensions, and must notify the City of Alpharetta if they cease utilizing the program at any point during contract performance. The affidavit must be executed before a notary public and incorporates the requirements into any resulting contract without further action by the contractor.
The affidavit establishes material breach provisions for failure to maintain E-Verify participation and requires contractors to ensure all subcontractors submit compliant affidavits as well. Contractors must submit copies of any required affidavits, drivers' licenses, and identification cards to the City of Alpharetta within five business days of receipt. The document includes spaces for the contractor's E-Verify User Identification Number, date of authorization, authorized officer signature, notary acknowledgment, and contract-specific information. This document serves as a compliance verification mechanism rather than establishing pricing, award dates, or performance terms, which would be detailed in the separate contract documents.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Disclosure_Debarment Form.pdf | ||
| 26_117 RFP Information and Contract T_C.pdf | ||
| 26_117 Scope of Work_Submittal Info.pdf | ||
| Stormceptor and other Proprietary Device map.pdf | ||
| 26_117 Cost Proposal.xlsx | XLSX spreadsheet |
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
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: |
26-117 ON-CALL STORM PIPE CLEANING
| 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 .