Exhibit 1 - AnnualWorkerEligibility.pdf
PDF 136 KB Posted
- Attached to
- SE Poplar Bluff Building Rehabilitation
- Solicitation number
- 300000170707393
- Issued by
- Missouri
About this file
This document is an Annual Worker Eligibility Verification Affidavit required by the Missouri Highways and Transportation Commission (MHTC) for contractors seeking to enter into service agreements with the state. The affidavit applies to all business entities, including joint ventures, which must each submit separate documentation. The affiant must certify under oath that they are duly authorized to act on behalf of the business entity and possess sound mind and capability to execute the affidavit. The document requires verification of enrollment and participation in a federal work authorization program operated by the United States Department of Homeland Security prior to contract execution with MHTC.
The affidavit mandates that the contracting business entity commit to verifying employment eligibility of all newly hired employees working on MHTC-contracted services and affirm that it shall not knowingly employ any alien lacking legal authorization to work in the United States as defined under 8 U.S.C. 1324a(h)(3). Contractors acknowledge potential liability under Missouri Sections 285.525 through 285.550 for subcontractors that knowingly employ unauthorized aliens. The affidavit must be notarized and accompanied by documentation evidencing enrollment in an approved federal work authorization program. This verification requirement applies to all activities conducted by the business entity in connection with state contracts.
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Text version
EXHIBIT 1
ANNUAL WORKER ELIGIBILITY VERIFICATION AFFIDAVIT
(for joint ventures, a separate affidavit is required for each business entity)
STATE OF )
) ss
COUNTY OF )
On the day of , 20 , before me appeared , Affiant name personally known to me or proved to me on the basis of satisfactory evidence to be a person whose name is subscribed to this affidavit, who being by me duly sworn, stated as follows:
• I, the Affiant, am of sound mind, capable of making this affidavit, and personally certify the facts herein stated, as required by Section 285.530, RSMo, to enter into any contract agreement with the state to perform any job, task, employment, labor, personal services, or any other activity for which compensation is provided, expected, or due, including but not limited to all activities conducted by business entities.
• I, the Affiant, am the of , and I am duly title business name authorized, directed, and/or empowered to act officially and properly on behalf of this business entity.
• I, the Affiant, hereby affirm and warrant that the aforementioned business entity is enrolled in a federal work authorization program operated by the United States Department of Homeland Security, and the aforementioned business entity shall participate in said program to verify the employment eligibility of newly hired employees working in connection with any services contracted by the Missouri Highways and Transportation Commission (MHTC). I have attached documentation to this affidavit to evidence enrollment/participation by the aforementioned business entity in a federal work authorization program, as required by Section 285.530, RSMo.
• I, the Affiant, also hereby affirm and warrant that the aforementioned business entity does not and shall not knowingly employ, in connection with any services contracted by MHTC, any alien who does not have the legal right or authorization under federal law to work in the United States, as defined in 8 U.S.C. § 1324a(h)(3).
• I, the Affiant, am aware and recognize that, unless certain contract and affidavit conditions are satisfied pursuant to Section 285.530, RSMo, the aforementioned business entity may be held liable under Sections
285.525 though 285.550, RSMo, for subcontractors that knowingly employ or continue to employ any unauthorized alien to work within the state of Missouri.
• I, the Affiant, acknowledge that I am signing this affidavit as a free act and deed of the aforementioned business entity and not under duress.
Affiant Signature
Subscribed and sworn to before me in , , the day and year first above-written.
city (or county) state
Notary Public My commission expires:
[documentation of enrollment/participation in a federal work authorization program attached]
File details come from the government source that posted it. Updated .