NORCROSS E_Verify Subcontractor Affidavit.pdf
PDF 780 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 Subcontractor Affidavit required by the City of Norcross, Georgia. The affidavit verifies that the subcontractor is registered with and uses the federal E-Verify program in accordance with O.C.G.A. § 13-10-91. The subcontractor must also ensure that any sub-subcontractors it engages also comply with E-Verify requirements and provide the necessary affidavits. The affidavit requires the subcontractor to provide its federal work authorization user identification number and date of authorization. The affidavit must be executed before a notary public.
The document does not contain any information about specific contract opportunities, pricing, funding, or other salient details beyond the E-Verify compliance requirements.
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Text version
By executing this affidavit, the undersigned subcontractor 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 under a contract with___________________________________on behalf of 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 subcontractor will continue to use the federal work authorization program throughout the contract period and the undersigned subcontractor will contract for the physical performance of services in satisfaction of such contract only with sub-subcontractors who present an affidavit to the subcontractor with the information required by O.C.G.A. § 13-10-91(b).
Additionally, the undersigned subcontractor will forward notice of the receipt of an affidavit from a sub-subcontractor to the contractor within five business days of receipt. If the undersigned subcontractor receives notice that a sub-subcontractor has received an affidavit from any other contracted sub-subcontractor, the undersigned subcontractor must forward, within five business days of receipt, a copy of the notice to the contractor. Subcontractor hereby attests that its federal work authorization user identification number and date of authorization are as follows:
Federal Work Authorization User Identification Number
Date of Authorization
Name of Subcontractor
Name of Project
Name of Public Employer
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 Subcontractor Affidavit O.C.G.A. § 13-10-91 (b)(3)
File details come from the government source that posted it. Updated .