E-Verify_Affidavit.pdf
PDF 69 KB Posted
- Solicitation number
- 25-0770-ITB-C
- Issued by
- Pinellas County, Florida
About this file
This document is an E-Verify Affidavit for a Pinellas County contract related to Drawbridge Services for Bridge Preventative Maintenance and Emergency Repair Services. The affidavit requires the contractor to certify compliance with Section 448.095 of Florida Statutes, specifically confirming that the company does not employ unauthorized aliens and has verified work authorization through the E-Verify system for all employees hired on or after January 1, 2021. The document includes spaces for the contractor to provide company details, signature, date, and Federal Work Authorization User Identification Number, along with a notary acknowledgment section.
The affidavit is a standard compliance document that ensures the contractor meets legal requirements for workforce authorization in Florida, particularly for government contracts. It requires the contractor to attach proof of registration in the E-Verify system and allows for either physical presence or online notarization of the document. While directly tied to the Drawbridge Services contract for Pinellas County Public Works Department, this form serves as a critical validation of the contractor's legal employment practices and commitment to employing authorized workers.
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Other files
| File | Type | Posted |
|---|---|---|
| Drawbridge_Services_-_Bridge_-_Preventative_Maintenance_&_Emergency_Repair_Services.pdf | ||
| Affidavit.docx | DOCX document | |
| Attestation.docx | DOCX document | |
| Sample_Agreement-25-0770.pdf | ||
| Attachments_A-C.pdf | ||
| Affdavit_of_Release_and_Guarantee_0770.pdf | ||
| SBE_Compliance_Form.pdf | ||
| Specifications_.pdf | ||
| Affdavit_of_Release_and_Guarantee.pdf | ||
| QUALIFICATION_SUBMITTAL_FORM.pdf | ||
| OpenGov_Fillable-_Final.pdf | ||
| Bid_Submittal_Form-JOC.pdf | ||
| Performance_and_Payment_Bonds.pdf | ||
| Florida_Trench_Safety_Form.pdf | ||
| Sample_Application_for_Payment.pdf | ||
| Budget_Estimate_(For_Review_Only).xlsx | XLSX spreadsheet | |
| Airport_Security_Program.pdf | ||
| Sample_Change_Order.pdf | ||
| Non-Competitive_Oversight_Committee_Justification_Form.docx | DOCX document |
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Text version
E-VERIFY AFFIDAVIT
E-VERIFY AFFIDAVIT
I hereby certify that ___________________________ [insert contractor company name] does not employ, contract with, or subcontract with an unauthorized alien, and is otherwise in full compliance with Section 448.095, Florida Statutes.
All employees hired on or after January 1, 2021 have had their work authorization status verified through the E-Verify system.
A true and correct copy of _______________________________ [insert contractor company name] proof of registration in the E-Verify system is attached to this Affidavit.
Signature:______________________________
Print Name:______________________________
Date:______________________________
Federal Work Authorization User Identification No.:_____________________________
Name of Pinellas County Contract and Contract No.:____________________________
STATE OF FLORIDA COUNTY OF ________________
The foregoing instrument was acknowledged before me by means of 1) physical presence __ or 2) online notarization ___, this __________________________ (date) by ____________________________ (name of officer or agent, title of officer or agent) of _____________________________________ (name of contractor company acknowledging), a __________________________________ (state or place of incorporation) corporation, on behalf of the corporation.
He/she is personally known to me or has produced __________________________________ (type of identification) as identification.
[Notary Seal]
Notary Public:_________________________________________
Name typed, printed, or stamped:_________________________________________
My Commission Expires:_________________________________________
File details come from the government source that posted it. Updated .