E-Verify_Affidavit.pdf
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- Attached to
- South Cross Bayou Replacement of Generator Controls and Switchgear (GEN2) (PID 004906A) - STEP 1
- Solicitation number
- 26-0256-ITB-C
- Issued by
- Pinellas County, Clewiston City, Florida
About this file
This is an E-Verify Affidavit required by Pinellas County, Florida for contractors bidding on or performing work related to the South Cross Bayou Replacement of Generator Controls and Switchgear project. The affidavit serves as a compliance document certifying that the contractor company does not employ, contract with, or subcontract with unauthorized aliens and maintains full compliance with Section 448.095, Florida Statutes. The contractor must verify that all employees hired on or after January 1, 2021 have had their work authorization status verified through the E-Verify system and must provide a true and correct copy of their proof of registration in the E-Verify system along with the signed affidavit.
The affidavit requires completion by an authorized representative of the contractor company, including signature, printed name, date, and the Federal Work Authorization User Identification Number. The document must be notarized before a Florida notary public, who will acknowledge the contractor's representative either through physical presence or online notarization. The notary must document the date, the officer or agent's name and title, the contractor company name, state or place of incorporation, type of identification produced, and provide their notary seal, signature, printed or stamped name, and commission expiration date. This affidavit is a mandatory compliance requirement for participation in Pinellas County contracts.
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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 .