E-Verify_Affidavit.pdf
PDF 69 KB Posted
- Attached to
- HVAC PM, Repairs and Replacement
- Solicitation number
- 24-0365-ITB-C
- Issued by
- Pinellas County, Florida
About this file
The document is an E-Verify Affidavit for a Pinellas County contract related to HVAC preventative maintenance, repairs, and replacement services. The affidavit certifies that the contractor does not employ unauthorized aliens and is in compliance with Section 448.095 of Florida Statutes. Specifically, the contractor affirms that all employees hired on or after January 1, 2021, have had their work authorization status verified through the E-Verify system, and a copy of the company's E-Verify registration proof will be attached to the document.
The affidavit requires the contractor to provide key identifying information, including a signature, printed name, date, Federal Work Authorization User Identification Number, and the specific Pinellas County contract details. The document includes a notary section for official acknowledgment, which can be completed through physical presence or online notarization, and requires the contractor's representative to be identified and potentially provide additional identification. This E-Verify Affidavit is a standard compliance document for the HVAC services contract with Pinellas County, ensuring legal workforce verification for the project.
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Other files
| File | Type | Posted |
|---|---|---|
| HVAC_PM,_Repairs_and_Replacement_(Addendum_#2_Revision).pdf | ||
| HVAC_PriceSheet_5.3.xlsx | XLSX spreadsheet | |
| 24-0365-ITB-C_SAMPLE_SIMPLIFIED_CONSTRUCTION_AGREEMENT.docx | DOCX document | |
| OpenGov_Fillable-_Final.pdf | ||
| HVAC.PriceSheet_(004)_(9).xlsx | XLSX spreadsheet | |
| QUALIFICATION_SUBMITTAL_FORM.pdf | ||
| Airport_Security_Program.pdf | ||
| Sample_Change_Order.pdf | ||
| Bid_Submittal_Form-JOC.pdf | ||
| SBE_Compliance_Form.pdf | ||
| Non-Competitive_Oversight_Committee_Justification_Form.docx | DOCX document | |
| Sample_Application_for_Payment.pdf | ||
| Florida_Trench_Safety_Form.pdf |
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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 .