Immigration and Security Form revised.pdf

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Attached to
Chattanooga Valley Elem School Reroof Project 2nd Bid
Solicitation number
PE-55462-NONST-2024-000000008
Issued by
Georgia

About this file

This document is an Immigration and Security Form from the Walker County Board of Education. It outlines the requirements for contractors and individuals performing services in excess of $2,499.99 for the Walker County Board of Education. Contractors must comply with the Federal work authorization program by signing and submitting an E-Verify Contractor Affidavit, unless the contractor has no employees and provides an approved state-issued identification card or driver's license, or the contract is with an individual licensed under Title 26, Title 43 or the State Bar of Georgia who is in good standing. Subcontractors are held to the same requirement, and a copy of the Georgia License must be submitted with the form.

The form also requires the contractor to certify compliance with the Immigration Reform and Control Act of 1986 (IRCA) and the Georgia Security and Immigration Compliance Act by initialing one of three provided sections. A W-9 Request for Taxpayer Identification Number is also required to be submitted with the form.

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IMMIGRATION AND SECURITY FORM

Contractors and Individuals Performing Services for

Walker County Board of Education

Any contractor who contracts with Walker County Board of Education for the performance of services in which the fee for services or labor exceeds $2,499.99 must comply with the Federal work authorization program by signing and submitting an E-Verify Contractor Affidavit to Walker County Board of

Education unless:

1. the contractor has no employees and no intent to hire employees in which case the contractor must present an approved state-issued identification card or driver’s license. The driver’s license or identification card is acceptable only if it is issued by a state that verifies lawful immigration status prior to issuance; or

2. the contract is with an individual licensed under Title 26, Title 43 or the State Bar of Georgia who is in good standing and is performing the service. Subcontractors are held to the same requirement. A copy of the Georgia License issued under Title 26, Title 43 or the State Bar of

Georgia must be submitted with this form.

In order to insure compliance with the Immigration Reform and Control Act of 1986 (IRCA), Pub.L. 99-

603 and the Georgia Security and Immigration Compliance Act O.C.G.A. § 13-10-90 et. seq., Contractor must certify compliance by initialing one of the sections below:

_____The Contractor has employees and has attached completed Contractor Affidavit (Form A).

Subcontractor Affidavit (Form B) and Sub-subcontractor Affidavit (Form C) are also attached if applicable. W-9 Request for Taxpayer Identification Number is also attached.

_____The Contractor has no employees and has attached a copy of a valid driver’s license or other approved state-issued identification card. W-9 Request for Taxpayer Identification Number is also attached.

_____The Contractor is an individual licensed under Title 26, Title 43 or the State Bar of Georgia who is in good standing and is performing the service. Copy of Georgia license is attached. W-9 Request for

Taxpayer Identification Number is also attached.

Signature Title

By signing above, you are certifying that the representations made herein are true and correct.

Firm Name:___________________________________________________________________________

Street/Mailing Address: _________________________________________________________________

City, State, Zip Code: _________________________________________________________________

Telephone Number: _________________________________________________________________

Email Address: _________________________________________________________________

Sworn to and subscribed before me

This ____ day of _________________, 20____.

Notary Public

File details come from the government source that posted it. Updated .