E-Verify_Affidavit.pdf
PDF 69 KB Posted
- Attached to
- Pave Strawberry Parking Lot (PID 004570A)
- Solicitation number
- 24-0116-ITB-C
- Issued by
- Pinellas County, Clewiston City, Florida
About this file
The document is an E-Verify Affidavit for a Pinellas County contract related to the Strawberry Parking Lot project at St. Pete-Clearwater International Airport. 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 project involves reconstructing and expanding the Strawberry Parking Lot, transforming it from a temporary to a permanent facility. Construction will include reworking existing asphalt millings, paving, stormwater improvements, new light poles, fencing modifications, parking lot entrance/exit changes, and bus shelters. An additive alternate is included for a south overflow parking lot on Roosevelt Blvd. The project is funded equally by the Airport CIP budget and an FDOT Grant, with the contractor required to provide proof of E-Verify system registration as part of the contract requirements.
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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 .