E-Verify_Affidavit.pdf
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- Solicitation number
- 24-0309-ITB-C
- Issued by
- Pinellas County, Florida
About this file
This document is an E-Verify Affidavit for a Pinellas County contract related to Aboveground Fuel Site Closures, which will be funded through ARPA and other grant sources. The affidavit certifies that the contractor does not employ unauthorized aliens and is in full compliance with Section 448.095 of Florida Statutes, with all employees hired after January 1, 2021 having their work authorization verified through the E-Verify system. The project involves closing aboveground storage tank (AST) fueling systems at two locations: Walsingham Park in Largo and Mosquito Control in Clearwater, each site featuring a 6,000-gallon UL 2085 Fireguard double-walled dual section tank with 4,000 gallons for unleaded gasoline and 2,000 gallons for low sulfur diesel fuel.
The affidavit requires the contractor to attach proof of E-Verify system registration and includes spaces for signature, date, Federal Work Authorization User Identification Number, and notarization. While specific pricing details are not included in this document, the affidavit is a mandatory compliance document for the contractor to participate in the Pinellas County contract, demonstrating legal authorization to work and verification of employee eligibility. The document serves as a critical administrative requirement to ensure labor law compliance for this fuel site closure project.
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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 .