E_verify affidavit.pdf

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Attached to
RESURFACING OF LAKEVIEW DR, BROAD ST, CEDAR DR, BLUE JAY CT, QUAIL RIDGE DR, WOODPECKER LN, STAPLER
Solicitation number
PE-66298-NONST-2026-000000002
Issued by
Barrow County, Georgia

About this file

This is an E-Verify Affidavit Form B issued by the City of Nicholson, Georgia, in compliance with O.C.G.A. 36-60-6(d). The affidavit is related to a sealed bid invitation for resurfacing approximately 3.14 miles of roadway across multiple streets including Lakeview Drive, Broad Street, Cedar Drive, Blue Jay Court, Quail Ridge Drive, Woodpecker Lane, Stapler Drive, New Hope Drive, Peach Street, and James Maxwell Road. Sealed bids for furnishing all materials, labor, tools, equipment, and appurtenances necessary for patching, OGI, recycled asphaltic concrete resurfacing, striping, and shoulder filling will be received at the City of Nicholson Office, 5488 US Hwy 441 S., Nicholson, Georgia 30565, until 9:00 a.m. on April 23rd, 2026. The work shall be completed in accordance with Plans, Special Provisions, GDOT Standard Specifications, applicable Supplemental Specifications, and the Manual on Uniform Traffic Control Devices. The project schedule includes a March 25th, 2026 release date, April 15th, 2026 at 3:00 p.m. deadline for bidder questions, April 20th, 2026 at 5:00 p.m. for answers to questions and addenda, and April 23rd, 2026 at 9:00 a.m. for bid submission. The work will be awarded as one contract.

The E-Verify affidavit form requires the executing private employer to declare under penalty of perjury that it employs fewer than 100 employees and is therefore exempt from O.C.G.A. 36-60-6 E-Verify registration requirements. The affidavit must be executed by an authorized officer or agent and notarized before a notary public. This form represents compliance verification documentation that potential bidders or contractors may need to submit as part of the bid package for this Georgia roadway resurfacing project.

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E-VERIFY AFFIDAVIT

FORM B

Private Employer of Compliance Pursuant to O.C.G.A. § 36-60-6(d)

By executing this affidavit, the undersigned private employer verifies that it is exempt from compliance with O.C.G.A. § 36-60-6, stating affirmatively that the individual, firm or corporation employs fewer than 100 employees and therefore, is not required to register with/or utilize the federal work authorization program commonly known as E-Verify, or any subsequent replacement program, in accordance with the applicable provisions and deadlines established in O.C.G.A. § 13-10-90.

Signature of Exempt Private Employer

Printed Name of Exempt Private Employer

I hereby declare under penalty of perjury that the foregoing is true and correct.

Executed on ________, _______, 202___ 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 ______________, 202_____.

NOTARY PUBLIC

My Commission Expires: (SEAL)

File details come from the government source that posted it. Updated .