Exhibit B.docx

EXHIBIT B

CONTRACTOR AFFIDAVIT AND CERTIFICATE OF COMPLIANCE

GEORGIA SECURITY AND IMMIGRATION CERTIFICATION

(FEDERAL AND STATE WORK AUTHORIZATION PROGRAMS)

STATE OF GEORGIA; COUNTY OF FULTON:

PROJECT NAME: “Insert Project Name/Description”

CONTRACTOR AFFIDAVIT, CERTIFICATE AND AGREEMENT

COMES NOW before me, the undersigned officer duly authorized to administer oaths, the undersigned contractor (“Contractor”), who, after being duly sworn, states, warrants, agrees and certifies as follows to Georgia Tech Facilities, Inc., as a cooperative organization of the Georgia Institute of Technology, a unit of the Board of Regents of the University System of Georgia.

1.

By executing this affidavit, Contractor verifies and warrants its compliance with O.C.G.A. §13-10-90 et seq. and Georgia Department of Labor Rule 300-10-1-.01, and the U.S. Immigration Reform and Control Act of 1986 (IRCA), P.L. 99-603. Contractor must register and verify information of all new employees at https://www.vis-dhs.com/EmployerRegistration (the E Verify program) or any of the electronic verification of work authorization programs operated by the United States Department of Homeland Security or any equivalent federal work authorization program to verify information of newly hired employees, pursuant to the IRCA. Contractor affirmatively certifies that it has registered with and is participating in a federal work authorization program in accordance with the applicability provisions and deadlines established in O.C.G.A. § 13-10-91 and Georgia Department of Labor Rule 300-10-1-.02, as initialed below.

2.

Contractor verifies and warrants it employs the following employees as of this date and meets or shall meet the requirements set forth above by the deadline for the category initialed below:

Contractor utilized the following federal verification program:

https://www.vis-dhs.com/EmployerRegistration (E Verify program) Other:

Verification Program User ID or Registration No.:

3.

The Contractor further warrants and agrees that all subcontractors, suppliers and consultants contracted in connection with the provision of materials and equipment or performance of services or work for the Project described above shall be required prior to the commencement of any work on the project to supply the Subcontractor Certification verifying compliance with O.C.G.A. §13-10-90 et seq. and Georgia Department of Labor Rule 300-10-1-.01, and the U.S. Immigration Reform and Control Act of 1986 (IRCA), P.L. 99-603 and paragraph 5 below. Subcontractor must register and verify information of all new employees at https://www.vis- dhs.com/EmployerRegistration (the E Verify program) or other federal verification program. The affidavit must contain the certifications required by Georgia Department of Labor Rule 300-10-1-.08 and the requirements set forth herein. The Contractor shall maintain records of compliance and provide a copy of each such certification to the Owner and Using Agency as set forth in paragraph 5 below. Contractor warrants that Contractor has S

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included this requirement in all written agreements with any subcontractors engaged to perform services for this Project.

4.

The Contractor further warrants and agrees to comply with the President’s Executive Order 13224, which mandates that no U.S. company shall do business with any person (Prohibited Person) who has been determined to have committed, or pose a risk of committing or supporting terrorist acts, and those identified on the list of Specially Designated Nationals and Blocked Persons, generated by the Office of Foreign Assets Control (“OFAC”). The OFAC list is updated regularly, and an up-to-date OFAC list can be obtained from the U.S. Department of the Treasury website at http://www.ustreas.gov/ofac. This Executive order extends to “Affiliates,” which includes any other person or entity who, directly or indirectly, is in control of, is controlled by or is under common control with any Prohibited Person. A copy of the Executive Order can be obtained at http://www.ustreas.gov/offices/enforcement/ofac/sanctions/terrorism.html and the USA Patriot Act of 2001, restricting terrorist groups’ access to financial resources in the United States can be obtained at http://www.fincen.gov/pa_main.html for review. The Contractor agrees to review its subcontracts and other agreements annually with the Treasury website for compliance, and maintain a record of its reviews.

5.

Contractor warrants and agrees that it shall submit, and shall ensure all its subcontractors and suppliers submit, the required certifications and verifications (i) at contract execution prior to commencing work or services; (ii) upon the completion or termination of the contract; and (iii) and recertified as of July 15 of each year during the term of the Project. The required certificates must be filed with the Owner and Using Agency and copies maintained by the Contractor in its Project files and retained for audit as specified in the Project contract. State officials, including officials of the Georgia Department of Labor, officials of the Owner, retain the right to inspect and audit the Project Site and employment records of the Contractor, subcontractors, suppliers and consultants without notice during normal working hours until Final Completion, and as otherwise specified by law and by Rules and Regulations of the Georgia Department of Labor.

Contractor Name: Street/Mailing Address: City, State, Zip: Telephone Number: Facsimile Number: Email Address:

FURTHER AFFIANT SAYETH NOT.

Company Name

By: Name - Title

Sworn to and subscribed before me by the affiant named above as of this day of , 20

Notary Public

My commission expires:_