NORCROSS E_Verify Contractor Affidavit.pdf
PDF 895 KB Posted
- Attached to
- WEST PEACHTREE STREET DEVELOPMENT
- Solicitation number
- PE-66780-NONST-2024-000000020
- Issued by
- Gwinnett County, Georgia
About this file
This document is an E-Verify Contractor Affidavit for the City of Norcross, Georgia. It outlines the requirements for contractors and subcontractors performing physical labor or services over $2,499.99 for the City of Norcross. Contractors must register with and use the federal E-Verify program to verify the work authorization of their employees. The affidavit requires contractors to provide their federal work authorization user ID number and date of authorization, and to contractually obligate any subcontractors to also provide affidavits with the required E-Verify information. The affidavit must be executed by an authorized officer or agent of the contractor and notarized.
The document does not provide details on any specific contract opportunity, but rather outlines the City of Norcross' standard requirements for contractors performing physical services. There is no information provided on pricing terms, funding sources, or other typical contract details. The document focuses solely on the E-Verify employment verification requirements for contractors and subcontractors doing business with the City of Norcross.
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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 .