Exhibit E _ Contractor Affidavit.docx
DOCX document 14 KB Posted
- Attached to
- UGA, J-459-DP School of Nursing Building
- Solicitation number
- PE-47200-RFQ-2026-000000117
- Issued by
- Clayton County, Georgia
About this file
This is a Contractor Affidavit document for the Board of Regents of the University System of Georgia related to Project J-459, the School of Nursing Building at the University of Georgia in Athens, Georgia. The affidavit serves as verification of the contractor's compliance with O.C.G.A. 13-10-91(B)(1), which requires contractors performing services for public employers to register with and use the federal E-Verify work authorization program. The contractor must provide its federal work authorization user identification number and date of authorization on the form. Additionally, the contractor commits to maintaining E-Verify compliance throughout the contract period and to contract only with subcontractors who similarly demonstrate E-Verify compliance through their own affidavits.
The affidavit requires execution by an authorized officer or agent of the contractor and must be notarized, with the notary public attesting to the oath taken before them. The document functions as a binding declaration under penalty of perjury, establishing the contractor's commitment to federal work authorization compliance as a condition of performing work on the University of Georgia project.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Exhibit A _ Certification Form.docx | DOCX document | |
| Exhibit C _ Project Team Composition Form.docx | DOCX document | |
| J_459 UGA School of Nursing DP RFQ.pdf | ||
| Exhibit G _ 179D Allocation Agreement.doc | DOC document | |
| Exhibit F _ Proposers Disclosure Statement.doc | DOC document | |
| Exhibit D _ DP Fee Proposal.doc | DOC document | |
| Egnyte Upload Instructions.pdf | ||
| Exhibit B _ Certificate of Minority Form.docx | DOCX document |
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Text version
Exhibit E J-459 School of Nursing Building University of Georgia, Athens, Georgia
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 University of Georgia, 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-459 School of Nursing Building Name of Project
Board of Regents of the University System of Georgia For the use and benefit of University of Georgia
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 .