E-Verify_Affidavit.pdf
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- Solicitation number
- 24-0301-ITB-C
- Issued by
- Pinellas County, Florida
About this file
The document is an E-Verify Affidavit for a Pinellas County contract related to the Jail Elevator Modernization project at the Central Intake Detention Building. The affidavit certifies that the contractor does not employ unauthorized aliens and is in full compliance with Section 448.095 of Florida Statutes. Specifically, the document confirms that all employees hired on or after January 1, 2021, have had their work authorization status verified through the E-Verify system, and requires an attached proof of registration in the E-Verify system.
The affidavit is a standard compliance document that must be completed and notarized by the contractor before participating in the Pinellas County Jail Elevator Modernization project. The document requires the contractor to provide their Federal Work Authorization User Identification Number and details about the specific Pinellas County contract. The form includes spaces for signature, printed name, date, and notarization, ensuring legal verification of the contractor's employment authorization compliance. While the affidavit itself does not specify pricing or funding details, it is a crucial component of the bidding process for the elevator modernization project involving three elevators in a seven-story building.
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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 .