Form A. Georgia Security and Immigration.pdf
PDF 139 KB Posted
- Solicitation number
- 25ITB1482633A-JWT
- Issued by
- Georgia
About this file
This document is a Georgia Security and Immigration Contractor Affidavit and Agreement for Fulton County Government. The form requires contractors performing physical services valued over $2,499.99 to verify their participation in a federal work authorization program in compliance with O.C.G.A. 13-10-91. Contractors must affirm their registration and ongoing participation in an electronic verification of work authorization program operated by the U.S. Department of Homeland Security.
The affidavit further obligates contractors to secure similar verification from any subcontractors they employ, maintain compliance records, and provide copies of these verifications to Fulton County Government when subcontractors are retained. The document includes spaces for the contractor's identification number, authorized officer's signature, title, printed name, and notarization details. This form ensures that contractors and subcontractors are legally compliant with immigration work authorization requirements when performing services for Fulton County.
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Other files
| File | Type | Posted |
|---|---|---|
| Form B. GA. Security and Immigration Subcontractor.pdf | ||
| REQSL1500166.pdf |
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Text version
STATE OF GEORGIA
COUNTY OF FULTON
FORM A: GEORGIA SECURITY AND IMMIGRATION CONTRACTOR AFFIDAVIT
AND AGREEMENT
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 services1 under a contract with _______________________________________________ on behalf of Fulton County Government has registered with and is participating in a federal work authorization program*,2 in accordance with the applicability provisions and deadlines established in O.C.G.A. 13-10-91.
The undersigned further agrees that, should it employ or contract with any subcontractor(s) in connection with the physical performance of services to this contract with Fulton County Government, contractor will secure from such subcontractor(s) similar verification of compliance with O.C.G.A. 13-10-91 on the Subcontractor Affidavit provided in Rule 300-10-01-.08 or a substantially similar form. Contractor further agrees to maintain records of such compliance and provide a copy of each such verification to the Fulton County Government at the time the subcontractor(s) is retained to perform such service.
EEV/Basic Pilot Program* User Identification Number
BY: Authorized Officer of Agent (Insert Contractor Name)
Title of Authorized Officer or Agent of Contractor
Printed Name of Authorized Officer or Agent
Sworn to and subscribed before me this ______ day of _________________, 20__.
Notary Public: ________________________________
County: _____________________________________
Commission Expires: __________________________________
1O.C.G.A.§ 13-10-90(4), as amended by Senate Bill 160, provides that “physical performance of services” means any performance of labor or services for a public employer (e.g., Fulton County) using a bidding process (e.g., ITB, RFQ, RFP, etc.) or contract wherein the labor or services exceed $2,499.99, except for those individuals licensed pursuant to title 26 or Title 43 or by the State Bar of Georgia and is in good standing when such contract is for service to be rendered by such individual.
2*[Any of the electronic verification of work authorization programs operated by the United States Department of Homeland Security or any equivalent federal work authorization program operated by the United States Department of Homeland Security to verify information of newly hired employees, pursuant to the Immigration Reform and Control Act of 1986 (IRCA), P.L. 99-603].
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