Exhibit_E___Contractor_Affidavit.docx
DOCX document 14 KB Posted
- Solicitation number
- PE-54300-RFQC-2026-000000114
- Issued by
- Cobb 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. 999-26-341, the Utilities, Stormwater and Landscape Campuswide Study at Kennesaw State University in Kennesaw and Marietta, Georgia. The affidavit verifies contractor compliance with O.C.G.A. 13-10-91(b)(1), which mandates federal work authorization verification. The document requires the contractor performing physical services to register with, be authorized to use, and actively utilize the E-Verify federal work authorization program or any subsequent replacement program in accordance with applicable provisions and deadlines. The contractor must maintain E-Verify compliance throughout the entire contract period and ensure that all subcontractors engaged for physical performance of services also submit compliant affidavits containing required information under O.C.G.A. 13-10-91(b).
The affidavit requires the contractor to provide its federal work authorization user identification number and date of authorization, along with project identification details and the institution name. The form must be executed under penalty of perjury by an authorized officer or agent of the contractor and notarized before a notary public. This document serves as a contractual prerequisite and compliance verification instrument, ensuring that all contractors and subcontractors meet Georgia's mandatory federal work authorization requirements prior to commencing work on the project.
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Other files
| File | Type | Posted |
|---|---|---|
| Exhibit_B___Certificate_of_Minority_Form.docx | DOCX document | |
| Exhibit G_KSU_campus maps.pdf | ||
| Exhibit H_KSU Transportation Study_2025_10.pdf | ||
| 999_26_187_Utility SW Landscape MP_PC RFQ_RFP.pdf | ||
| Exhibit_F___Proposers_Disclosure_Statement.doc | DOC document | |
| Exhibit I_KSU_SWMP Update_Final.pdf | ||
| Exhibit_C___Project_Team_Composition_Form.docx | DOCX document | |
| Exhibit_D___DP_Fee_Proposal.doc | DOC document | |
| Exhibit_A___Certification_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 (Institution Name), 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
Project No., and Project Name Name of Project
Board of Regents of the University System of Georgia For the use and benefit of (Institution Name)
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 .