Exhibit E _ Contractor Affidavit.docx
DOCX document 14 KB Posted
- Solicitation number
- PE-47200-RFQ-2027-000000146
- Issued by
- Tattnall County, Georgia
About this file
This is a Contractor Affidavit document for the J-477 Renovations for Student Success and Career Services project involving the Board of Regents of the University System of Georgia on behalf of Abraham Baldwin Agricultural College in Tifton, Georgia. The affidavit serves as verification of contractor compliance with O.C.G.A. 13-10-91(b)(1), requiring the contractor to confirm registration with and authorized use of the E-Verify federal work authorization program. The contractor executing this document attests that it uses E-Verify or any subsequent replacement program in accordance with applicable provisions and deadlines established under Georgia law and commits to continued use of the program throughout the contract period.
The affidavit requires the contractor to provide its federal work authorization user identification number and date of authorization, and obligates the contractor to engage only subcontractors who have submitted compliant affidavits containing the information required by O.C.G.A. 13-10-91(b). The document must be executed under penalty of perjury by an authorized officer or agent of the contractor and notarized. This affidavit is a standard compliance requirement for all contractors performing services on state of Georgia projects and does not address pricing, contract term, or project scope details, as those elements are contained in separate contract documents.
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Other files
| File | Type | Posted |
|---|---|---|
| Exhibit B _ Certificate of Minority Form.docx | DOCX document | |
| _J_477 ABAC RSSCS DP RFQ_RFP.pdf | ||
| Exhibit F _ Proposers Disclosure Statement.doc | DOC document | |
| Exhibit D _ DP Fee Proposal.doc | DOC document | |
| Exhibit C _ Project Team Composition Form.docx | DOCX document | |
| Exhibit G _ 179D Allocation Agreement.doc | DOC document | |
| Exhibit A _ Certification Form.docx | DOCX document | |
| Egnyte Upload Instructions.pdf |
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Text version
Exhibit E J-477 Renovations for Student Success and Career Services Abraham Baldwin Agricultural College, Tifton, 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 Abraham Baldwin Agricultural College, 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-477 Renovations for Student Success and Career Services Name of Project
Board of Regents of the University System of Georgia For the use and benefit of Abraham Baldwin Agricultural College
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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