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 form required by Pinellas County, Florida, for the South Cross Bayou Replacement of Generator Controls and Switchgear (GEN2) project. The affidavit certifies that the contractor company does not employ, contract with, or subcontract with unauthorized aliens and is in full compliance with Section 448.095, Florida Statutes. All employees hired on or after January 1, 2021, must have their work authorization status verified through the E-Verify system, with proof of registration attached to the affidavit. The form requires the contractor's signature, printed name, date, Federal Work Authorization User Identification Number, Pinellas County contract name and number, and must be notarized before a notary public who will certify acknowledgment through either physical presence or online notarization, including the notary's seal, signature, typed name, and commission expiration date.
This document serves as a compliance verification tool ensuring that all contractors and subcontractors meet federal work authorization requirements mandated by Florida state law for public works projects. Submission of the completed and notarized E-Verify Affidavit is a mandatory requirement for bid eligibility in the Pinellas County procurement process. Contractors must maintain current E-Verify registration throughout contract performance and provide documentation of compliance as part of their qualification and bidding submissions.
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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 .