NORCROSS E_Verify Contractor Affidavit_1.pdf
PDF 895 KB Posted
- Solicitation number
- PE-66780-NONST-2026-000000045
- Issued by
- Gwinnett County, Georgia
About this file
This is an E-Verify Contractor Affidavit required by the City of Norcross, Georgia for contractors performing physical labor or services valued over $2,499.99. The affidavit mandates contractor compliance with O.C.G.A. 13-10-91, requiring all contractors and subcontractors to register with and utilize the E-Verify federal work authorization program throughout the contract period. Contractors must provide their federal work authorization user identification number and date of authorization, or alternatively, submit a state driver's license or state identification number if they have no employees and do not intend to hire staff. The affidavit must be completed and notarized, with the contractor's authorized officer or agent declaring under penalty of perjury that the information provided is accurate and complete.
The affidavit applies to the City of Norcross's Cybersecurity Assessment, Compliance, & Governance Services contract opportunity and serves as a prerequisite compliance document rather than a pricing or funding instrument. Contractors must submit this form as part of their proposal requirements, and the contractor bears full responsibility for ensuring all subcontractors also submit compliant E-Verify Affidavits before engaging in contract work. The document explicitly references the statutory requirement that contractors maintain E-Verify authorization status for the duration of the contract and establishes that exemption from this requirement is limited to specific circumstances noted on the form.
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Text version
Physical performance of services: Contracts with the City involving both physical labor and any services over $2499.99 in value.
Contractors must be registered with and use the E-Verify program. If you have not registered, you can find the information at www.uscis.gov(click on E-verify Homepage, see start here directions.)
It is the responsibility of the Contractor to submit additional E-Verify Affidavits on every Sub-Contractor for this project.
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 services on behalf of the City of Norcross has registered with, is authorized to use and uses the federal work authorization program commonly known as E-Verify, or any subsequent replacement program, in accordance with the applicable provisions and deadlines established in O.C.G.A. § 13-10-91. Furthermore, the undersigned contractor will continue to use the federal work authorization program throughout the contract period and the undersigned contractor will contract for the physical performance of services in satisfaction of such contract only with subcontractors who present an affidavit to the contractor with the information required by O.C.G.A. § 13-10-91(b).
Contractor hereby attests that its federal work authorization user identification number and date of authorization are as follows:
Project Name: Date of Project: _
Legal Name of Contractor:
Address: City: _________________ State: _____ Zip Code: _________________
Federal Work Authorization User Identification Number (E-Verify Number): __________(4-6 digit numeric #)
Date of Authorization:
*If a contractor has no employees and does not hire or intend to hire they may satisfy the law by submission of (State DL or State ID) Drivers’ License Number: _____________________________________
I hereby declare under penalty of perjury that the foregoing is true and correct
Signature of Authorized Officer/Agent Date Printed Name and Title of Authorized Officer/Agent
MUST BE COMPLETED BY NOTARY
SUBSCRIBED AND SWORN BEFORE ME ON THIS THE DAY OF ,20
Executed in (City), (State)
NOTARY PUBLIC Signature My Commission Expires
65 Lawrenceville St. Norcross, GA 30071 [P] 770.448.2122 [F] 770.448.5945 www.norcrossga.net
E-Verify Contractor Affidavit O.C.G.A. § 13-10-91 (b)(1)
EXEMPT: YES OR NO
http://www.uscis.gov/
File details come from the government source that posted it. Updated .