Exhibit E _ Contractor Affidavit.docx
DOCX document 17 KB Posted
- Attached to
- UNG, J-466-PM Strickland Hall Renovation
- Solicitation number
- PE-47200-RFQ-2026-000000135
- Issued by
- Hall County, Georgia
About this file
This is a Contractor Affidavit document executed under O.C.G.A. 13-10-91(b)(1) for the J-466 Strickland Hall Renovation project at the University of North Georgia in Oakwood, Georgia. The affidavit is submitted to the Board of Regents of the University System of Georgia and confirms the contractor's compliance with Georgia state law regarding work authorization verification. The document requires the executing contractor to verify that it is registered with and actively uses the federal E-Verify work authorization program throughout the contract period and to ensure that all subcontractors similarly present required affidavits demonstrating their own E-Verify compliance.
The affidavit template contains designated spaces for the contractor to insert its federal work authorization user identification number and date of authorization. The document must be executed under penalty of perjury and notarized, with the contractor's authorized officer or agent providing a signature, printed name, and title. The affidavit serves as a mandatory compliance verification mechanism and must be completed prior to contract award. No pricing terms, set asides, or funding amounts are specified in this document, as it functions solely as a work authorization compliance instrument rather than a substantive contract terms document.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Exhibit D _ PM Fee Proposal Form.xlsx | XLSX spreadsheet | |
| Exhibit C _ Project Team Composition Form.docx | DOCX document | |
| Exhibit B _ Certificate of Minority Form.docx | DOCX document | |
| Exhibit F _ Proposer_s Disclosure Statement.doc | DOC document | |
| Egnyte Upload Instructions.pdf | ||
| _J_466 UNG PM RFQ_RFP.pdf | ||
| Exhibit A _ RFQ Certification Form.docx | DOCX document |
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Text version
Exhibit A J-466 Strickland Hall Renovation University of North Georgia, Oakwood, 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 University of North 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-466, Strickland Hall Renovation Name of Project
Board of Regents of the University System of Georgia For the use and benefit of University of North 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: _________________________________
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