Exhibit B _ Contractor Affidavit.docx
DOCX document 16 KB Posted
- Attached to
- CLSU J-475-DB Campus Infrastructure Phase III
- Solicitation number
- PE-47200-RFQ-2027-000000153
- Issued by
- Clayton County, Georgia
About this file
This is a Contractor Affidavit form required by the Board of Regents of the University System of Georgia for Project No. J-475, Campus Infrastructure Phase III at Clayton State University in Morrow, Georgia. The affidavit serves as verification of the contractor's compliance with O.C.G.A. § 13-10-91(b)(1), which mandates federal work authorization verification. Any contractor engaged in physical performance of services for this project must register with, be authorized to use, and actively use the E-Verify program or any subsequent replacement system throughout the entire contract period. The contractor must provide their federal work authorization user identification number and the date of authorization on the affidavit.
The affidavit further requires contractors to attest that all subcontractors performing physical services under this contract will also present compliant affidavits demonstrating their own E-Verify authorization. The document must be executed by an authorized officer or agent of the contracting firm and notarized before a notary public. This form represents a mandatory compliance document rather than a pricing or service specification document, establishing the work authorization requirements that all contractors and subcontractors must meet to participate in the Campus Infrastructure Phase III Design-Build project.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Exhibit A _ Certification Form.docx | DOCX document | |
| Exhibit C _ DB Fee Proposal.docx | DOCX document | |
| Exhibit E _ General Conditions Breakdown.xlsx | XLSX spreadsheet | |
| Egnyte Upload Instructions.pdf | ||
| _CLSU J_475 DB RFQ_RFP.pdf | ||
| Exhibit F _ Project Cost Matrix.xlsx | XLSX spreadsheet | |
| Exhibit D _ Precon Cost and Expenses.xlsx | XLSX spreadsheet | |
| Exhibit G _ Proposer_s Disclosure Statement.doc | DOC document |
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Text version
Exhibit B Project No. J-475, Campus Infrastructure Phase III Clayton State University
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, 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
J-475 Campus Infrastructure Phase III Project No. and Name
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:
File details come from the government source that posted it. Updated .