Exhibit_E___Contractor_Affidavit.docx
DOCX document 22 KB Posted
- Attached to
- KSU - Project No. 555-27-058 ¿Design, Construction Standards, and Technical Specifications Update¿
- Solicitation number
- PE-54300-RFQC-2027-000000132
- Issued by
- Cobb County, Georgia
About this file
This is a Contractor Affidavit document required by the Board of Regents of the University System of Georgia for contractors performing services on behalf of Kennesaw State University. The affidavit certifies contractor compliance with O.C.G.A. 13-10-91, confirming that the contractor has registered with and is authorized to use the federal E-Verify work authorization program or any subsequent replacement program. The contractor must provide its federal work authorization user identification number and date of authorization and commit to using E-Verify throughout the entire contract period. Additionally, the contractor must ensure that all subcontractors engaged for physical performance of services under the contract submit affidavits containing the information required by O.C.G.A. 13-10-91(b).
The affidavit requires execution by an authorized officer or agent of the contractor under penalty of perjury and must be notarized. The document includes fields for the contractor's name, project number, project name, the institution benefiting from the services, the public employer, execution date and location, signature, printed name and title of the authorized signatory, and notary public certification with commission expiration date. This documentation is a mandatory compliance requirement for all contractors and subcontractors performing work on state contracts within the University System of Georgia.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Exhibit_C___Project_Team_Composition_Form.docx | DOCX document | |
| Exhibit G KSU USG Building and Room Summary.pdf | ||
| Exhibit H Current KSU Design and Construction.pdf | ||
| Exhibit_D___DP_Fee_Proposal.doc | DOC document | |
| Exhibit_F___Proposers_Disclosure_Statement.doc | DOC document | |
| KSU DCS and Technical_Specs_Update RFQ_RFP_26.pdf | ||
| Exhibit_B___Certificate_of_Minority_Form.docx | DOCX 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 .