E_verify affidavit.pdf
PDF 48 KB Posted
- 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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Other files
| File | Type | Posted |
|---|---|---|
| 5 ROADWAY TYPICAL ASPH _STAPLER_PEACH.docx | DOCX document | |
| 6 SEC 415_ogi.pdf | ||
| 6 SEC 652.pdf | ||
| 5 ROADWAY TYPICAL ASPH_JAMES MAXWELL_NEW HOPE.docx | DOCX document | |
| 6 SEC 162_165.pdf | ||
| 1COVER SHEET.doc | DOC document | |
| 5_F 150.pdf | ||
| AGREEMENT.doc | DOC document | |
| 5 ROADWAY TYPICAL ASPH_BROAD ST.docx | DOCX document | |
| 5_B ss105.pdf | ||
| 5_A104.pdf | ||
| 6 SEC 400.pdf | ||
| 5 BID FORM.doc | DOC document | |
| i_9 2027.pdf | ||
| 5 Nicholson Roads PAVING MAP.pdf | ||
| BID BOND.doc | DOC document | |
| 5_E ss109.pdf | ||
| Security and Immigration AFfidavit.doc | DOC document | |
| 5_D ss108.pdf | ||
| 5 ROADWAY TYPICAL ASPH.docx | DOCX document | |
| 4 Instruction to Bidder.doc | DOC document | |
| 5 SPECIAL PROVISION.docx | DOCX document | |
| CITY OF NICHOLSON.docx | DOCX document | |
| Corporate Certification.doc | DOC document | |
| 5_C ss107.pdf |
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Text version
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 .