E-Verify.pdf
PDF 476 KB Posted
- Attached to
- Invitation to Bid Parking Lot Rehabilitation (3)
- Solicitation number
- 2025-PWP-014
- Issued by
- Marion County, Indiana
About this file
This is an E-Verify Affidavit form required by the City of Bloomington, Indiana, for contractors and subcontractors seeking to provide services to the municipality. The affidavit requires the signatory, under oath before a notary public, to confirm their job title and company name, certify that their company either has contracted or is seeking to contract with the City of Bloomington to provide services, and affirm that the company does not knowingly employ unauthorized aliens as defined under 8 United States Code 1324a(h)(3). Additionally, the signatory must attest that the company is enrolled in and participates in the E-Verify program. The document must be notarized with the notary public's signature, printed name, commission expiration date, and county of residence included.
This E-Verify Affidavit is a compliance requirement for the Parking Lot Rehabilitation project, which involves three distinct parking lots in Bloomington. Sealed bids for the project must be submitted electronically through the OpenGov e-Procurement Portal by December 15, 2025, at 12:00 p.m., with a public bid opening scheduled for the same date. The project is set to commence on June 1, 2026, with a 45-calendar-day completion timeline, weather permitting. Bidders must comply with the City of Bloomington's Living Wage Ordinance requiring a minimum wage of $16.66 per hour in 2026, and for contracts exceeding $150,000, contractors must submit a written employee drug testing program plan. Performance and payment bonds equal to 100 percent of the contract price are mandatory for contracts of $200,000 or more, with a one-year maintenance period following final acceptance.
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Text version
“AFFIDAVIT”
STATE OF _______________ )
) SS:
COUNTY OF _____________ )
E-VERIFY AFFIDAVIT
The undersigned, being duly sworn, hereby affirms and says that:
1. The undersigned is the ___________________ of _______________________________.
(job title) (company name)
2. The company named herein that employs the undersigned:
i. has contracted with or seeking to contract with the City of Bloomington to provide services; OR
ii. is a subcontractor on a contract to provide services to the City of Bloomington.
3. The undersigned hereby states that, to the best of his/her knowledge and belief, the company named herein does not knowingly employ an “unauthorized alien,” as defined at 8 United States Code
1324a(h)(3).
4. The undersigned herby states that, to the best of his/her belief, the company named herein is enrolled in and participates in the E-verify program.
Signature Printed Name
STATE OF _______________ )
) SS:
COUNTY OF _____________ )
Before me, a Notary Public in and for said County and State, personally appeared ___________________ and acknowledged the execution of the foregoing this _____ day of _____________________, 20____.
Notary Public’s Signature
Printed Name of Notary Public
My Commission Expires: __________________
County of Residence: _____________________
File details come from the government source that posted it. Updated .