E-Verify_Affidavit.pdf

PDF 69 KB Posted

Attached to
SOLID WASTE ADMINISTRATION BUILDING HVAC RENOVATION
Solicitation number
26-0394-ITB-C
Issued by
Pinellas County, Clewiston City, Florida

About this file

This is an E-Verify Affidavit document required by Pinellas County, Florida for the Solid Waste Administration Building HVAC Renovation project (ITB-C #26-0394-ITB-C). The affidavit certifies that the contractor company does not employ, contract with, or subcontract with unauthorized aliens and maintains full compliance with Florida Statute Section 448.095. All employees hired on or after January 1, 2021 must have their work authorization status verified through the E-Verify system, and contractors must provide proof of registration in the E-Verify system. The document requires the contractor's signature, printed name, date, and Federal Work Authorization User Identification Number, along with the name and number of the Pinellas County contract. The affidavit must be notarized before a notary public, with the notary acknowledging the instrument either through physical presence or online notarization and providing their commission expiration date.

This mandatory compliance document establishes a binding certification of the contractor's adherence to federal work authorization requirements. The affidavit serves as a prerequisite submission for all bidders on the HVAC renovation project and must be executed by an authorized officer or agent of the contractor company. Failure to comply with E-Verify registration and the submission of a properly notarized affidavit will result in the contractor being deemed non-responsive to the solicitation. The document is part of a comprehensive compliance package that includes Foreign Country of Concern affidavits, Common Carrier attestations, and Human Trafficking affidavits, all of which must be notarized and submitted with bid packages.

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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 .