Exhibit E _ Contractor Affidavit.docx
DOCX document 15 KB Posted
- Attached to
- CSU, J-445-DP, Space Science / Robotics Facility
- Solicitation number
- PE-47200-RFQ-2025-000000097
- Issued by
- Muscogee County, Georgia
About this file
This document is a Contractor Affidavit under O.C.G.A. 13-10-91(b)(1) involving the Board of Regents of the University System of Georgia for Columbus State University, specifically related to the J-445 - Space Science Robotics Facility project. The affidavit verifies the contractor's compliance with state work authorization requirements, specifically confirming registration and use of the federal E-Verify program for employment eligibility verification.
The affidavit requires the contractor to affirm ongoing compliance with E-Verify throughout the contract period and mandates that subcontractors also provide similar affidavits. The document provides space for the contractor to record their federal work authorization user identification number and date of authorization, and includes a declaration to be signed and notarized, confirming the accuracy of the information provided. This legal document ensures that the contractor is legally authorized to work and employs workers who are eligible to work in the United States.
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Other files
| File | Type | Posted |
|---|---|---|
| Exhibit A _ Certification Form.docx | DOCX document | |
| Exhibit D _ DP Fee Proposal.doc | DOC document | |
| Exhibit C _ Project Team Composition Form.docx | DOCX document | |
| Exhibit F _ Proposers Disclosure Statement.doc | DOC document | |
| _J_445 CSU Space Science Robotics Facility DP.pdf | ||
| Egnyte Upload Instructions.pdf | ||
| Exhibit G _ 179D Allocation Agreement.doc | DOC document | |
| Exhibit B _ Certificate of Minority Form.docx | DOCX document |
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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 Columbus 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-445 – Space Science Robotics Facility__ Name of Project
Board of Regents of the University System of Georgia For the use and benefit of the Columbus 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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