E-Verify_Affidavit.pdf

69 KB Posted

Attached to
Sanitary Sewer CIPP Rehabilitation – Various Locations (PID 001933DEF)
Solicitation number
24-0206-ITB-C
Issued by
Pinellas County, Clewiston City, Florida

About this file

Written by GovTribe AI ·

This document is an E-Verify Affidavit related to a Pinellas County contract for sanitary sewer rehabilitation. The affidavit certifies that the contractor does not employ unauthorized aliens and is in full compliance with Section 448.095 of Florida Statutes. All employees hired on or after January 1, 2021, have had their work authorization status verified through the E-Verify system. The document requires the contractor to attach proof of E-Verify system registration and includes spaces for signatures, notarization, and contract details.

The affidavit is specifically associated with a sanitary sewer CIPP (Cured-In-Place Pipe) rehabilitation project involving small to medium diameter gravity sewer mains (8" - 18"). The project aims to clean, video, and rehabilitate existing sewer lines to reduce infiltration and extend the pipe system's life by at least 50 years. The form provides a template for contractors to demonstrate legal compliance with work authorization requirements, which is a standard prerequisite for participating in local government contracts in Florida.

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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 .