Exhibit E _ Contractor Affidavit.docx
DOCX document 14 KB Posted
- Solicitation number
- PE-50300-RFP-2025-000000172
- Issued by
- Fulton County, Georgia
About this file
This is a Contractor Affidavit (Exhibit E) required by the Board of Regents of the University System of Georgia for the use and benefit of Georgia Tech Facilities, Inc. (GTFI) related to Project #0251-2025 GT Zelnak Basketball Headquarters Renovation & Expansion. The affidavit requires contractors to verify compliance with O.C.G.A. 13-10-91 regarding the use of E-Verify, the federal work authorization program, for all physical services performed under the contract.
The document requires contractors to provide their federal work authorization user identification number and authorization date, maintain E-Verify compliance throughout the contract period, and ensure all subcontractors provide similar affidavits. The affidavit must be signed by an authorized officer or agent, notarized, and includes penalties of perjury for false statements.
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Other files
| File | Type | Posted |
|---|---|---|
| Addendum__1 for release 01_06_2025.pdf | ||
| Exhibit D _ DP Fee Proposal.doc | DOC document | |
| 0251_2025 RFQP_DP_Final.pdf | ||
| Exhibit A _ Certification Form.docx | DOCX document | |
| Exhibit H _ Sample Form of AIA Contract.pdf | ||
| Exhibit B _ Certificate of Insurance _ Minori.docx | DOCX document | |
| Exhibit C _ Team Composition.docx | DOCX document | |
| Exhibit F _ Proposer_s Disclosure Statement.doc | DOC document | |
| Exhibit G _ Project Schedule.pdf |
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Text version
Exhibit E 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 Tech Facilities, Inc., Using Agency (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). The 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
Project #0251-2025 GT Zelnak Basketball Headquarters Renovation & Expansion Name of Project
Board of Regents of the University System of Georgia For the use and benefit of GTFI (Institution) Name of Employer I hereby declare under penalty of perjury that the foregoing is true and correct.
Executed on ___(day), ______________ (month), 20____ (year) 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 .