Form_9.11_-_E-Verify_Affidavit.pdf
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- Solicitation number
- RFP-26-24-CW
- Issued by
- Volusia County, Florida
About this file
This is an E-Verify Affidavit form required by the State of Florida for the RFP 26-24-CW Re-Advertisement for the Elevation of Flood Prone Homes project. The affidavit is a compliance document that contractors must complete and submit as part of their bid response. The project involves the elevation of eleven single-family structures located in Florida, with respondents permitted to bid on any number of properties from one to all eleven structures based on their capacity and timeline capabilities. The form serves as the contractor's sworn statement confirming their participation in the federal E-Verify program, which is mandatory for contractors working on state and local government contracts in Florida.
The E-Verify Affidavit is a standard eligibility and compliance requirement rather than a pricing or service specification document. Contractors must certify under penalty of perjury that they are registered with and utilize the E-Verify system for employment eligibility verification. This documentation is typically required before contract award and is a condition of eligibility to compete for the elevation project work. The affidavit ensures that all contractor employees will undergo federal employment verification procedures as mandated by Florida law for public construction projects.
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Text version
FORM 9.11 - E-VERIFY AFFIDAVIT
CITY OF PORT ORANGE
CONTRACTOR E-VERIFY AFFIDAVIT
IN ACCORDANCE WITH SECTION 448.095, FLORIDA STATUTES
Project Name: _________________________________________________________________________________________
Solicitation Number: _______________________________________
I, the undersigned hereby certify that _______________________________________________ (insert contractor company name) does not employ, contract with or subcontract with an unauthorized alien, and is otherwise in full compliance with Section 448.095, Florida Statutes.
I acknowledge that it is my responsibility to ensure full compliance with Section 448.095, Florida Statutes. I am aware enrollment in the E-Verify system for employers can be done at www.e-verify.gov.
A true and correct copy of ___________________________________________________ (insert contractor company name) proof of registration in the E-Verify system is attached to this Affidavit.
By affixing my signature below, I hereby affirm that I am duly authorized to bind the company reference herein and I will comply with all applicable E-Verify requirements.
Print or Type Name, Title Signature of Affiant
Federal Employer ID Number (FEIN) E-Verify Number
STATE OF FLORIDA
COUNTY OF: _______________________
The foregoing instrument was acknowledged before me by means of ☐physical presence or ☐online notarization, this _________ day of _______________________, 2025, by____________________________________________________________ and who:
☐Is personally known to me; or ☐ has produced __________________ as identification.
________________________________________________________ Notary Public, State of ______________________________________ Printed, typed or stamped name, commission and expiration:
This document to be completed and returned with your Submittal http://www.e-verify.gov/
File details come from the government source that posted it. Updated .