NORCROSS E_Verify Subcontractor Affidavit.pdf
PDF 780 KB Posted
- Attached to
- On-Call CIPP Relining Services (RFQ PW 26-05)
- Solicitation number
- PE-66780-NONST-2026-000000037
- Issued by
- Gwinnett County, Georgia
About this file
This is an E-Verify Subcontractor Affidavit form required by the City of Norcross, Georgia for the On-Call CIPP Relining Services contract (RFQ PW 26-05). The affidavit serves as verification of compliance with O.C.G.A. 13-10-91, confirming that subcontractors engaged in the physical performance of services have registered with and are authorized to use the E-Verify federal work authorization program. The contract term is one year with renewal options up to three years total. Subcontractors must provide their federal work authorization user identification number and date of authorization, along with the project name and public employer information. The affidavit requires certification under penalty of perjury from an authorized officer or agent and must be notarized before execution.
Subcontractors are obligated to maintain E-Verify authorization throughout the entire contract period and must ensure all sub-subcontractors also comply with the same E-Verify requirements by obtaining and reviewing affidavits from them. Any affidavits received from sub-subcontractors must be forwarded to the prime contractor within five business days, along with any notices regarding affidavits received by sub-subcontractors from other contracted parties within the same timeframe. This document establishes the work authorization compliance framework required for participation in City of Norcross public works contracts.
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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 .