Exhibit B

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Attached to
Campus Infrastructure, Phase II
Solicitation number
J-396-DB
Issued by
Clayton County, Georgia

About this file

Exhibit B is a Contractor Affidavit required under O.C.G.A. 13-10-91(b)(1) for the Board of Regents of the University System of Georgia related to the Campus Infrastructure, Phase II project at Clayton State University in Morrow, Georgia. This affidavit serves as verification that contractors comply with federal work authorization requirements and will utilize the E-Verify program or any subsequent replacement program throughout the contract period in accordance with applicable Georgia state law provisions and deadlines. The document establishes that contractors must maintain federal work authorization compliance and engage only subcontractors who similarly present required affidavits demonstrating their compliance with the state's work authorization mandates.

The affidavit requires the contractor to provide their federal work authorization user identification number and date of authorization. The document must be executed by an authorized officer or agent of the contractor and notarized, with the contractor declaring under penalty of perjury that the information provided is true and correct. This affidavit is a mandatory compliance document for the Design-Build Services contract (Project No. J-396-DB) and represents Georgia's requirement that all contractors and subcontractors verify their eligibility to work in the United States before engaging in performance of services on public projects.

Text of this file

Exhibit B Contractor Affidavit under O.C.G.A. § 13-10-91(b)(1)

By executing this affidavit, the undersigned contractor verifies its compliance with O.C.G.A. § 13-10-91, stating affirmatively that the individual, firm or corporation which is engaged in the physical performance of services on behalf of Board of Regents of the University System of Georgia for the use and benefit of Clayton State University the federal work authorization program commonly known as E-Verify, or any subsequent replacement program, in accordance with the applicable provisions and deadlines established in O.C.G.A. § 13-10-91. Furthermore, the undersigned contractor will continue to use the federal work authorization program throughout the contract period and the undersigned contractor will contract for the physical performance of services in satisfaction of such contract only with subcontractors who present an affidavit to the contractor with the information required by O.C.G.A. § 13-10-91(b). Contractor hereby attests that its federal work authorization user identification number and date of authorization are as follows:

Federal Work Authorization User Identification Number

Date of Authorization

Name of Contractor

J-396, Campus Infrastructure, Phase II Name of Project

Board of Regents of the University System of Georgia For the use and benefit of Clayton State University Name of Public Employer I hereby declare under penalty of perjury that the foregoing is true and correct.

Executed on ______, ___, 20__ in _____(city), ______(state).

Signature of Authorized Officer or Agent

Printed Name and Title of Authorized Officer or Agent

SUBSCRIBED AND SWORN BEFORE ME

ON THIS THE ______ DAY OF ______________,20__.

NOTARY PUBLIC

My Commission Expires:

Other files

File Type Posted
CLSU J-396 Utility Masterplan —
CLSU J-396 DB Addendum No. 1 —
Exhibit D —
Exhibit A —
Award Information —
CLSU J-396-DB RFQ-RFP —
Exhibit G —
Exhibit F —
Exhibit C —
Egnyte Upload Instructions —
Exhibit E —
Show all 11

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