Exhibit B _ Contractor Affidavit.docx
DOCX document 14 KB Posted
- Solicitation number
- PE-47200-RFQ-2026-000000120
- Issued by
- Fulton County, Georgia
About this file
This is a Contractor Affidavit form executed under O.C.G.A. 13-10-91(b)(1) by the Board of Regents of the University System of Georgia for the benefit of Georgia State University regarding the Peachtree Center Parking Deck and Retail project (BR-50-2603). The affidavit serves as a compliance verification document wherein the contractor affirms its registration with and authorization to use E-Verify, the federal work authorization program, and commits to continued use throughout the contract period. The contractor must also ensure that all subcontractors engaged in the physical performance of services present similar affidavits demonstrating their E-Verify compliance in accordance with applicable provisions and deadlines established by state law.
The affidavit requires the contractor to provide its federal work authorization user identification number and date of authorization, and must be executed by an authorized officer or agent under penalty of perjury. The document requires notarization and includes signature blocks for the contractor's authorized representative and a notary public. This affidavit is a mandatory compliance requirement for contract award and performance, ensuring that all parties performing work under this contract maintain active E-Verify enrollment throughout the contract term.
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Other files
| File | Type | Posted |
|---|---|---|
| Exhibit G _ Proposer_s Disclosure Statement.doc | DOC document | |
| _GSU BR_50_2603 DB RFQ_RFP.pdf | ||
| Exhibit F _ Project Cost Matrix.xlsx | XLSX spreadsheet | |
| Egnyte Upload Instructions.pdf | ||
| Exhibit D _ Precon Cost and Expenses.xlsx | XLSX spreadsheet | |
| Exhibit E _ General Conditions Breakdown.xlsx | XLSX spreadsheet | |
| Exhibit C _ DB Fee Proposal.docx | DOCX document | |
| Exhibit A _ Certification Form.docx | DOCX document |
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Text version
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 Georgia State University, Using Agency (public employer) has registered with, is authorized to use and uses 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
BR-50-2603 Peachtree Center Parking Deck and Retail Name of Project
Board of Regents of the University System of Georgia For the use and benefit of Georgia 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:
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