E-Verify Registration Waiver Certificationt.pdf

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Attached to
5th District Court of Appeal Parking Garage Corrosion Remediation and Repairs
Solicitation number
ITN-11251
Issued by
Volusia County, Florida

About this file

This document is a Contractor's E-Verify Registration Certification form required by the State of Florida under sections 448.09 and 448.095 of the Florida Statutes, related to a parking garage corrosion remediation project at the 5th District Court of Appeal. The form serves as a waiver certification for contractors who are not required to register with the Department of Homeland Security's E-Verify system based on specific business circumstances.

The form provides three qualifying conditions for waiver: 1) The business is not engaged as an employer who hires employees and does not handle employee-related documentation and supervision, 2) The business is organized outside the United States with no physical U.S. locations, or 3) The business does not have more than five employees at any time and does not hire more than five employees in a calendar year. The form requires business identification details including legal name, address, and taxpayer identification number, and must be signed by the sole proprietor or authorized representative, with a revision date of 6/2024.

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Text version

CONTRACTOR’S E-VERIFY REGISTRATION CERTIFICATION

I, _____________________________________, am the owner or authorized representative of the business entity shown below. I hereby acknowledge on behalf of my business or business entity that I am aware of the requirement in sections 448.09 and 448.095, Florida Statutes, that every public employer, contractor, and subcontractor shall register with and use the E-Verify system to verify the work authorization status of all newly hired employees.

Business or Business Entity Legal Name:

Business or Business Entity Legal Address:

Business or Business Entity Taxpayer Identification Number:

I hereby certify that my business:

Is not engaged as an “employer” who hires individuals as an “employee” to perform labor or services in exchange for a salary, wages or other renumeration requiring the completion and submission of the U.S. Citizenship and Immigration Services Form I-9, “Employment Eligibility Verification”, does not pay employee salaries or wages, does not collect federal withholding taxes from any salaries or wages and submit them to the Internal Revenue Service, has no power to dictate or control an individual’s work duties and obligations, and does not supervise employees of subcontractors.

Is organized outside the United States and its territories and does not have any physical locations within the United States, and is not considered an “employer”, as described in the paragraph above.

Does not have more than five (5) employees at any given time and does not hire more than five

(5) employees in a calendar year.

For the reasons stated above, my business or business entity is not eligible to register with and cannot use the Department of Homeland Security E-Verify System.

By signing this certification, I agree not to hire employees who are not authorized to be employed in the United States pursuant to 8 U.S.C. s. 1324a(h)(3) at the time of employment or at any time throughout the term of the employment. I further acknowledge that I will notify the Contract Manager within ten

(10) calendar days of any change in the business entity status as an employer or if any employees are hired. I further acknowledge that the failure to make the appropriate notifications will result in the immediate termination of my contract.

I HEREBY CERTIFY THAT THE FOREGOING IS TRUE AND CORRECT.

Sole Proprietor/Authorized Representative

Printed Name

SCS-E-Verify Registration Waiver Certification v.1.00 rev 6/2024

am the owner or authorized representative of the business:
Business or Business Entity Legal Name:
Business or Business Entity Legal Address:
Business or Business Entity Legal Address_2:
Business or Business Entity Legal Address_3:
Business or Business Entity Taxpayer Identification Number:
Check Box1: Off
Check Box2: Off
Check Box3: Off
Text4:

File details come from the government source that posted it. Updated .