Immigration and Security Form revised.pdf
PDF 82 KB Posted
- Solicitation number
- PE-55462-NONST-2025-000000010
- Issued by
- Wilcox County, Georgia
About this file
This is an Immigration and Security Form required by the Walker County Board of Education for contractors performing services valued over $2,499.99. The form outlines compliance requirements with the Federal work authorization program through E-Verify and the Georgia Security and Immigration Compliance Act O.C.G.A. § 13-10-90.
The form provides three compliance options: 1) Contractors with employees must submit a completed Contractor Affidavit (Form A), Subcontractor Affidavit (Form B), and Sub-subcontractor Affidavit (Form C) if applicable, along with a W-9 form; 2) Contractors with no employees must provide a valid state-issued driver's license or identification card from a state that verifies lawful immigration status, plus a W-9 form; or 3) Individual contractors licensed under Title 26, Title 43 or the State Bar of Georgia must provide their Georgia license and W-9 form. The document requires notarization and includes spaces for the contractor's business information, signature, and title.
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Text version
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 .