Form_3_Immigration_Certification.pdf
PDF 172 KB Posted
- Attached to
- Wellness Engagement Platform
- Solicitation number
- 26-8653
- Issued by
- Collier County, Florida
About this file
This is an Immigration Certification form required by Collier County, Florida's Procurement Services Division for vendor participation in county contracts. The form mandates that all vendors must be enrolled in the E-Verify program operated by the Department of Homeland Security in partnership with the Social Security Administration at the time of proposal submission. Acceptable proof of enrollment includes either a copy of the completed E-Verify Company Profile page or a fully executed E-Verify Memorandum of Understanding. Failure to provide this documentation will result in the vendor's submission being deemed non-responsive and ineligible for consideration.
The county explicitly prohibits awarding contracts to vendors who knowingly employ unauthorized alien workers, as this constitutes a violation of 8 U.S.C. Section 1324a(e), Section 274A(e) of the Immigration and Nationality Act. Vendors must attest under penalties of perjury that they are fully compliant with all applicable immigration laws, including the 1986 Immigration Act and subsequent amendments, and are aware of and in compliance with Florida Statutes 448.095. Employment of unauthorized aliens by a contract recipient may serve as grounds for unilateral contract termination by Collier County. The form requires execution by a duly authorized corporate representative with signature authority, including the company name, date, signature, and title.
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Text version
Version 2 9.2.25
Procurement Services Division
Form 3: Immigration Certification
Vendors are required to be enrolled in the E-Verify program (https://www.e-verify.gov/), at the time of the submission of the Vendor’s proposal/bid. Acceptable evidence of your enrollment consists of a copy of the properly completed E-Verify Company Profile page or a copy of the fully executed E-Verify Memorandum of Understanding for the company which will be produced at the time of the submission of the Vendor’s proposal/bid. Failure to do so will result in the vendor’s submission being deemed non-responsive.
Collier County will not intentionally award County contracts to any Vendor who knowingly employs unauthorized alien workers, constituting a violation of the employment provision contained in 8 U.S.C. Section 1324 a(e) Section 274A(e) of the Immigration and Nationality Act (“INA”).
Collier County may consider the employment by any Vendor of unauthorized aliens a violation of Section 274A (e) of the INA. Such Violation by the recipient of the Employment Provisions contained in Section 274A (e) of the INA shall be grounds for unilateral termination of the contract by Collier County.
Vendor attests that they are fully compliant with all applicable immigration laws (specifically to the 1986 Immigration Act and subsequent Amendment(s), that it is aware of and in compliance with the requirements set forth in Florida Statutes §448.095, and agrees to comply with the provisions of the Memorandum of Understanding with E-Verify and to provide proof of enrollment in The Employment Eligibility Verification System (E-Verify), operated by the Department of Homeland Security in partnership with the Social Security Administration at the time of submission of the Vendor’s proposal/bid.
Under penalties of perjury, I certify that the information shown on this form is correct to my knowledge and a duly corporate authorized representative with signature authority.
Company Name: _________________________________________
Date: _____________________________
Signature: ____________________________________________ Title: _____________________________ https://www.e-verify.gov/
| Company Name_3: |
| Date21_af_date: |
| Title_3: |
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