E-Verify_Affidavit.pdf
PDF 69 KB Posted
- Attached to
- FY 2026 Pavement Preservation Package 1-STEP 2
- Solicitation number
- 25-0070-ITB-C STEP 2
- Issued by
- Pinellas County, Clewiston City, Florida
About this file
This document is an E-Verify Affidavit for a Pinellas County contract, which requires a contractor to certify compliance with Section 448.095 of Florida Statutes regarding employment authorization. The affidavit mandates that all employees hired on or after January 1, 2021, have had their work authorization status verified through the E-Verify system. The form requires the contractor to attach proof of registration in the E-Verify system and provides space for the contractor's signature, printed name, date, and Federal Work Authorization User Identification Number.
The document is a standard legal form designed to ensure that contractors are not employing unauthorized aliens and are using the E-Verify system to confirm employee work authorization. It includes a notarization section where a notary public can acknowledge the document, with options for physical presence or online notarization. The form is to be completed by the contractor, signed, and notarized, serving as a formal declaration of compliance with Florida's employment verification requirements for government contracts.
View the file
Other files
Show all 26
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
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 .