Parks and Recreation.docx
DOCX document 174 KB Posted
- Attached to
- PLL 2024-002 Gymnasium Addition & Rehab
- Solicitation number
- PE-77801-NONST-2024-000000007
- Issued by
- Greene County, Georgia
About this file
This document is a Request for Proposals (RFP) issued by the Greene County Board of Commissioners for design-build services for the construction of a second recreational gymnasium and rehabilitation services for the existing gymnasium, including replacement of the gymnasium floor, for the Greene County Recreation Department. The project scopes include the turnkey construction of an approximately 10,000 SF addition of a second gymnasium, as well as specified rehabilitation to the existing gymnasium facility. Proposals are due by August 8, 2024, at 10:00 a.m. EST. On-site visits can be scheduled by emailing the project manager. The selection process will be a competitive proposal evaluation, with pricing being one of the most important but not the only criteria. The successful bidder will be required to perform at least 50% of the work with their own organization and will need to provide a performance bond.
The RFP outlines the required bid documents, including a completed bid proposal form, bid bond or certified check, certifications, and a schedule of items. Pricing will be evaluated based on the unit prices provided in the schedule of items. The contract will be governed by the laws of the State of Georgia, and the successful bidder will be required to comply with all applicable federal, state, and local laws, as well as Greene County's insurance and indemnification requirements.
View the file
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
REQUEST FOR PROPOSALS
DESIGN-BUILD SERVICES FOR A
GYMNASIUM ADDITION AND
ADDITIONAL SPECIFIED REHABILITATION OF THE EXISTING GYMNASIUM AT
THE GREENE COUNTY RECREATION COMPLEX
GREENE COUNTY BOARD OF COMMISSIONERS
| ISSUED BY: | Greene County Board of Commissioners | |
| 1034 Silver Drive | ||
| Suite 201 | ||
| Greensboro, GA 30642 | ||
| Attention: Chuck Wooley, Project Manager | ||
| 706-453-3333 | ||
| cwooley@greenecountyga.gov |
PROPOSAL DUE BY: August 8, 2024, at 10:00 a.m.
Project Number: PLL 2024-002 – 2024-002 Page | 1 of 18
NOTICE TO CONTRACTORS
Proposals must be hand delivered in a sealed envelope to Chuck Wooley, located in the Greene County Building and Zoning office, Suite 103, or mailed to the below address:
U. S. Mail:
Greene County Board of Commissioners Attn: Chuck Wooley, Project Manager 1034 Silver Drive Suite 103 Greensboro, GA 30642
All proposals must be received by 10:00 a.m. EST, on Thursday August 8, 2024. Requests for an extension of time to submit will not be granted. Late proposals will be rejected. Requests to modify or withdraw a proposal after its submission will not be considered.
It is the sole responsibility of the firm to ensure that the proposal arrives on time. The name, address, email address, and telephone number of the person to contact must be clearly identified. All preparation costs are the responsibility of the firm.
Any questions about the RFP should be directed in writing to:
Chuck Wooley, Project Manager cwooley@greenecountyga.gov
To schedule an onsite visit please email:
poneal@greenecountyga.gov
The work to be performed consists of design-build services for the following scopes of work:
· Turnkey construction of an approximately 10,000 SF addition of a second recreational gymnasium area with site work included (includes Arch, Structural, and MEP design): The existing gym is 96’x80’ and is striped for a high school regulation full court (actually, it is 3’ short of regulation size), 2 half basketball courts with practice goals on the sides, 3 pickleball courts and 2 volleyball courts. There are bleachers along one side. The project is to duplicate this gym along the south side of the existing facility, albeit slightly larger to accommodate telescoping bleachers on both sides of the court. The new gymnasium is to have windows along the south wall along the upper portion of the wall, six (6) retractable basketball goals, and two (2) scoreboards. Interior metal wall panels to protect insulation. R-30 insulation in the roofline, R-19 in the walls. Painting of exposed metal building system and fire sprinkler piping. Electrical to include new exterior wall packs, AVG of 30-foot candles in gymnasium, emergency exit lights, lighting control devices, power to scoreboard, power to two (2) interior ceiling hung speakers, power to location to control scoreboard and speakers, duplex outlets per code, power to HVAC equipment, fire alarm. HVAC system to include two (2) 20-ton units and duct sock for air distribution. Access to the new gym will be through the current exterior wall on the south side of the building. Relocation of the gravel access road to the rear of the existing building will be required by moving it south.
· Specified rehabilitation to the existing gymnasium facility: Water intrusion issues into the existing facility must be addressed:
· Remove blue decorative trim along the exterior building walls and caulk the fastener holes.
· Caulk all fascia trim lap joints at the roof.
· Caulk all metal siding termination trim lap joints (bottom of metal wall panels and above masonry veneer).
· Repaint and seal masonry veneer.
· Replace gutter on north side of roof with larger/appropriately sized gutter.
· Repair all instances/locations where interior masonry walls are damaged due to water intrusion (repair/retool mortar joints, scrape and repaint walls).
· Install weep holes in bottom course of all exterior block façade as needed.
· Remove exterior column on left side of building.
· Sealing the bottom of exterior south facing wall on the interior side of the wall.
· Repoint exterior south facing wall on the interior side of the wall.
· Scrape and paint exterior walls throughout the existing gymnasium on the interior side of the wall with a minimum of 2 coats of paint.
· Replace exterior Exit door on the end of the south side of existing building.
· Replace the existing gymnasium floor: Scope includes:
· Labor and materials to remove and dispose of existing gym floor.
· Furnish and install ELASTIPLUS Seamless Multisport Gym Surface.
· Labor will include removal and put back of existing bleachers which must be moved to install new floor.
The Bidder is required to submit only the Bid Proposal, which includes:
1. Completed Bid Proposal Form Page
2. Bid Bond or Certified Check
3. Certification of Contractor re: Non-Segregated Facilities
4. Non collusion Affidavit of Prime Bidder
5. Certifications
6. Completed Schedule of Items… (Sign Each Page)
Bidding Documents are open to the public at the Greene County Building and Zoning Office.
All work performed for this project will be in accordance with the 2018 International Building Code, 2018 International Fire Code, 2020 National Electrical Code, Life Safety Code, 2015 International Energy Conservation Code, and the 2018 International Fire Code, all addenda issued to the Specifications of the published codes and any modifications identified in the bid documents.
The Bidder shall be responsible for performing with his/her own organization at least fifty percent (50%) of the work in this contract. The Bidder shall not subcontract, transfer, assign, or otherwise dispose of the contract or any portion thereof, without the written consent of the County.
The successful bidder shall secure and pay for necessary approvals, assessments, and changes required for construction and installation of this project as required by local, state, and federal regulations.
The successful Bidder will be required to post a performance bond in the amount of the Contract.
Bidders must comply with Title VI of the Civil Rights Act of 1964, the Anti-Kickback Act, the Contract Work Hour Standard Act, and the National Occupational Safety and Health Act of 1970.
Bidders must certify that they do not and will not maintain or provide for their employees any facilities which are segregated on a basis of race, color, creed, or national origin.
Bidders must comply with the Georgia Security and Immigration Compliance Act
The County will evaluate all proposals during which time they may ask questions of a clarifying nature from the firm(s) and/or contact any references provided. The Project Manager will award the bid and all proposers will be notified of the results via email.
The County reserves the right to reject any or all proposals, to waive any informality in a proposal and/or to accept that proposal which is in the best interest of the County.
The selection process used for determining the most successful proposal is best described as a “Competitive Proposal” process in which pricing is one of the most important criteria but not the only criteria. The factors in the evaluation process include:
A. Experience of the firm. Number of years and type of experience will be considered.
B. Organization, size, and structure of the firm.
C. Qualifications of the staff to be assigned.
D. Location and accessibility of the firm and of the staff to be assigned.
E. Responsiveness of the written proposal to the scope of services outlined in the County’s request and adherence to the proposal format.
F. Proposed project cost.
TERMS AND CONDITIONS
1. The County reserves the right to reject any or all proposals, or to award the contract to the next most qualified firm if the selected firm does not draw up a contract within thirty (30) days after the award of the proposal.
2. The County reserves the right to request clarification of information submitted and to request additional information from firms submitting proposals.
3. Any agreement or contract resulting from the acceptance of a proposal shall be on forms either supplied by or approved by the County and shall contain, at a minimum, applicable provisions of the RFP. The County reserves the right to reject any agreement that does not conform to the RFP and to any County requirements for agreements and contracts.
ADDITIONAL ITEMS
Independent Contractor It is understood, agreed, and recognized, the successful vendor awarded the contract will be an independent contractor and not an employee of Greene County. The successful vendor will be required to comply with such terms and conditions established by the Greene County Board of Commissioners with regards to clearances, confidentiality, indemnification and termination of services.
Governing Law and Venue Awarded vendor and its subcontractors if applicable agree that any agreement shall be governed and construed in accordance with the laws of the State of Georgia, including all matters of construction, validity, enforcement and performance, without regard to its conflict of law provisions. Such agreements shall be deemed to have been drafted by each party hereto, and neither party may argue otherwise. Venue of jurisdiction of any claim or dispute arising out of, related to, or implicating the terms of this Agreement shall exist exclusively in the Court of Greene County, Georgia.
Collusion Any agreement or collusion among vendors or perspective vendors in restraint of freedom of competition, by agreement, to submit a proposal at a fixed price or to refrain from submitting a proposal or otherwise shall render proposals of such vendor void and shall cause such vendors to be disqualified from submitting proposals to the Greene County Board of Commissioners.
Insurance Throughout the term of an awarded contract and for applicable statutes of limitation periods, vendor shall maintain in full force and affect the insurance coverage set forth herein.
All insurance policies shall be issued by companies authorized to do business in the State of Georgia.
Certificate of insurance shall be required prior to contract signing. Awarded vendor must provide proof of insurance and carry minimum types of insurance to include, but not limited to, the following:
Workers Compensation: workers compensation insurance, with statutory limits, shall apply to all employees in compliance with “Workers Compensation Law” of the State of Georgia and all applicable Federal Laws.
Excess Liability: vendor shall carry Excess Liability Insurance with minimum limits of $1,000,000 per occurrence.
References: Bidder shall provide the names of three (3) commercial accounts for similar work performed. References are also required for any subcontractors.
Evaluation and Award: Bids/proposals shall be evaluated and awarded by the County as soon as possible. Award of the bid will be based on quality, service, completion date, experience and price. Information on each of these categories shall be included in bid responses.
Compliance with the Law: Contractor shall comply with all applicable federal, State and local laws and ordinances, rules and regulations, as well as any applicable County policies.
BID PROPOSAL
Proposal of __________________________________________________ (hereinafter called “Bidder”) a contractor organized and existing under the laws of the State of Georgia, *an individual, a corporation, or partnership doing business as __
| TO: | Greene County |
| (Hereinafter called “County”) |
The Bidder in compliance with your Notice to Contractors and all Bidding Documents for the construction of:
Turnkey construction of an approximately 10,000 SF addition of a second recreational gymnasium area with site work included (includes Arch, Structural, and MEP design), specified rehabilitation to the existing gymnasium facility, and to replace the existing gymnasium floor
Having examined the specifications with related documents and the site of the proposed work, and being familiar with all of the conditions surrounding the construction of the proposed project, including the availability of materials and supplies to construct the project in accordance with the contract documents, within the time set forth herein, and at the prices stated below, proposes to enter into a Contract with Greene County to provide the necessary machinery, tools, apparatus, all materials and labor, and other means of construction necessary to complete the work. The undersigned proposes to furnish and construct the items listed in the attached Schedule of Items for the unit prices stated.
Bidder agrees that the cost of any work performed, materials furnished, services provided, or expenses incurred, which are not specifically delineated in the Contract Documents, but which are incidental to the scope, intent, and completion of the Contract, shall be deemed to have been included in the prices bid for the various items scheduled.
Bidder further proposes and agrees hereby to promptly commence the Work with adequate force and equipment within ten (10) calendar days from receipt of Notice to Proceed, or as may be specified by Special Provision, and to complete the work as may be specified by Special Provision.
*Strike Out Inapplicable Terms.
Bidder acknowledges receipt of the following addenda:
The undersigned further agrees that in case of failure on his part to execute said contract and bond, or provide satisfactory proof of carriage of the insurance required, within fourteen (14) calendar days after the award thereof, the Bid Bond or certified check accompanying his bid and the money payable thereon shall be forfeited to the County as liquidated damages; otherwise, the check or Bond accompanying this proposal shall be returned to the Bidder.
The Bidder declares that he/she understands that the quantities shown on the proposal are subject to adjustment by either increase or decrease, and that should the quantities of any of the items of work be increased, the undersigned proposes to do the additional work at the unit prices stated herein; and should the quantities be decreased, he also understands that payment will be made on actual quantities at the unit price bid and will make no claim for anticipated profits for any decrease in the quantities, and that actual quantities will be determined upon completion of work, at which time adjustment will be made to the Contract amount by direct increase or decrease.
Attached hereto is a bid bond or certified check on the (Bank) ______________________ in the amount of _______________________________________, (Five percent of Total Amount Bid).
The full name and residence of persons or parties interested in the foregoing bid as contractors, are named as follows:
Greene County, Georgia
Signed, sealed, and dated this _______ day of _______________________, _________.
Bidder: __________________________________________ (Company Name)
By: __________________________________________
Title: __________________________________________
Mailing Address:
| ________________________________________________ |
| ________________________________________________ |
CERTIFICATION BY CONTRACTOR
Regarding
NON-SEGREGATED FACILITIES
The Bidder certifies that he/she does not, and will not, provide and maintain segregated facilities for his employees at his establishments and, further that he does not, and will not, permit his employees to perform their services at those locations, under his control, where segregated facilities are provided and maintained. Segregated facilities include, but are not necessarily limited, drinking fountains, transportation, parking, entertainment, recreation, and housing facilities; waiting, rest, wash, dressing, and locker rooms, and time clock, work, storage, restaurant, and other eating areas which are set apart in fact, or by explicit directive, habit, local custom, or otherwise, on the basis of color, creed, national origin, and race. The Bidder agrees that, except where he has obtained identical certifications from proposed subcontractors for specific time periods, he will obtain identical certifications from proposed subcontractors prior to the award of subcontracts exceeding $10,000.00 which are not exempt from the provisions of the Equal Opportunity clause, and that he will retain such certifications in his files.
The Bidder agrees that a breach of this certification is a violation of the Equal Opportunity clause in this Contract. The penalty for making false statements is described in 18 U.S.C. 1001.
| ____________________________________ |
| Bidder |
| ____________________________________ |
| (Signature) |
| ____________________________________ |
| Name of Signer |
| ____________________________________ |
| Title of Signer |
| ____________________________________ |
| Date |
NONCOLLUSION AFFIDAVIT OF PRIME BIDDER
State of ______________________, County of _____________________. .
________________________________________________, being first duly sworn, deposes and says that:
1. He/she is __________________________________ (owner, partner, officer, representative, or agent) of the Bidder that has submitted the attached Bid;
2. He/she is fully informed respecting the preparation and contents of the attached Bid and of all pertinent circumstances respecting such Bid;
3. Such Bid is genuine and is not a collusive or sham Bid;
4. Neither the said Bidder nor any of its officers, partners, owners, agents, representatives, employees, or parties of interest, including this affiant, has in any way colluded, conspired, connived, or agreed, directly or indirectly, with any other Bidder, firm or person to submit a collusive or sham Bid in connection with the Contract for which the attached Bid has been submitted to or refrain from bidding in connection with such Contract, or has in any collusion or communication or conference with any other Bidder, or to fix any overhead, profit or cost element of the Bid price or the Bid price of any other Bidder, or to secure through any collusion, conspiracy, connivance or unlawful agreement any advantage against Greene County or any person interested in the proposed Contract; and,
5. The price or prices quoted in the attached Bid are fair and proper and are not tainted by any collusion, conspiracy, connivance, or unlawful agreement on the part of the Bidder or any of its agents, representatives, owners, employees, or parties of interests, including this affiant.
Signed: _____________________________
Name: _____________________________
Title: _____________________________
Subscribed and Sworn to before me this _______ day of ______________________________, _________.
(SEAL)
___________________________________ Title
CERTIFICATIONS
Failure to complete appropriate certification requirements identified below or submission of a false certification shall render the bid non-responsive.
EXAMINATION OF SPECIFICATIONS
I certify that I have carefully examined the Standard Specifications for this project, the 2018 International Building Code, 2018 International Fire Code, 2020 National Electrical Code, Life Safety Code, 2015 International Energy Conservation Code, and the Supplemental Specifications and Special Provisions included in and made a part of this Proposal and have also personally examined the site of work. Based on the said Specifications, I proposed to furnish all necessary machinery, tools, apparatus and other means of construction, and do all the work and furnish all the materials in the manner specified.
I understand the quantities mentioned are approximate only and are subject to either increase or decrease and hereby propose to perform any increased or decreased quantities of work or extra work on the basis provided for in the specifications.
I also hereby agree that Greene County would suffer damages in a sum equal to at least the amount of the enclosed Proposal Guaranty, in the event my Proposal should be accepted and a Contract tendered me thereunder and I should refuse to execute same and furnish bond as herein required, in consideration of which I hereby agree that in the event of such failure on my part to execute said Contract and furnish bond within fifteen (15) days after the date of the letter transmitting the Contract to me, the amount of said Proposal Guaranty shall be and is hereby, forfeited to Greene County as liquidated damages as the result of such failure on my part.
I further propose to execute the Contract agreement described in the Specifications as soon as the work is awarded to me, and to begin and complete the work within the time limit provided. I also propose to furnish a Contract Bond, approved by the Greene County Board of Commissioners as required by the laws of the State of Georgia. This bond shall not only service to guarantee the excellence of both workmanship and materials until the work is finally accepted, as well as to fully comply with all the laws of the State of Georgia.
CERTIFICATIONS
CONFLICT OF INTEREST
By signing and submitting this Contract I hereby certify that employees of this company or employees of any company supplying material or subcontracting to do work on this Contract will not engage in business ventures with employees of Greene County nor shall they provide gifts, gratuities, favors, entertainment, loans, or other items of value to employees of this Department.
Also, by signing and submitting this Contract, I hereby certify that I will notify Greene County of any business ventures entered into between employees of this company or employees of any company supplying material or subcontracting to do work on this Contract with a family member of Greene County employees.
| __________________________________________ |
| Contractor |
| __________________________________________ |
| Signature |
__________________________________________ Name of Signer
| __________________________________________ |
| Title of Signer |
GREENE COUNTY BOARD OF COMMISSIONERS
1034 SILVER DRIVE
GREENSBORO GA. 30642
PROJECT: Turnkey construction of an approximately 10,000 SF addition of a second recreational gymnasium area with site work included (includes Arch, Structural, and MEP design), specified rehabilitation to the existing gymnasium facility, and to replace the existing gymnasium floor
001: Greene County Parks and Recreation.
· Turnkey construction of an approximately 10,000 SF addition of a second recreational gymnasium area with site work included (includes Arch, Structural, and MEP design): The existing gym is 96’x80’ and is striped for a high school regulation full court (actually, it is 3’ short of regulation size), 2 half basketball courts with practice goals on the sides, 3 pickleball courts and 2 volleyball courts. There are bleachers along one side. The project is to duplicate this gym along the south side of the existing facility, albeit slightly larger to accommodate telescoping bleachers on both sides of the court. The new gymnasium is to have windows along the south wall along the upper portion of the wall, six (6) retractable basketball goals, and two (2) scoreboards. Interior metal wall panels to protect insulation. R-30 insulation in the roofline, R-19 in the walls. Painting of exposed metal building system and fire sprinkler piping. Electrical to include new exterior wall packs, AVG of 30-foot candles in gymnasium, emergency exit lights, lighting control devices, power to scoreboard, power to two (2) interior ceiling hung speakers, power to location to control scoreboard and speakers, duplex outlets per code, power to HVAC equipment, fire alarm. HVAC system to include two (2) 20-ton units and duct sock for air distribution. Access to the new gym will be through the current exterior wall on the south side of the building. Relocation of the gravel access road to the rear of the existing building will be required by moving it south.
· Specified rehabilitation to the existing gymnasium facility: Water intrusion issues into the existing facility must be addressed:
· Remove blue decorative trim along the exterior building walls and caulk the fastener holes.
· Caulk all fascia trim lap joints at the roof.
· Caulk all metal siding termination trim lap joints (bottom of metal wall panels and above masonry veneer).
· Repaint and seal masonry veneer.
· Replace gutter on north side of roof with larger/appropriately sized gutter.
· Repair all instances/locations where interior masonry walls are damaged due to water intrusion (repair/retool mortar joints, scrape and repaint walls).
· Install weep holes in bottom course of all exterior block façade as needed.
· Remove exterior column on left side of building.
· Sealing the bottom of exterior south facing wall on the interior side of the wall.
· Repoint exterior south facing wall on the interior side of the wall.
· Scrape and paint exterior walls throughout the existing gymnasium on the interior side of the wall with a minimum of 2 coats of paint.
· Replace exterior Exit door on the end of the south side of existing building.
· Replace the existing gymnasium floor: Scope includes:
· Labor and materials to remove and dispose of existing gym floor.
· Furnish and install ELASTIPLUS Seamless Multisport Gym Surface.
· Labor will include removal and put back of existing bleachers which must be moved to install new floor.
Any soil required for sub-grade work is to be obtained or disposed of at the contractor’s expense.
GREENE COUNTY Parks and Recreation
| LINE NUMBER |
| ITEM DESCRIPTION |
| APPROXIMATE QUANTITY AND UNITS |
| UNIT PRICE |
| BID AMOUNT |
| DOLLARS |
| CTS |
| DOLLARS |
| CTS |
TOTAL BID: $
Company Name
By
Title
I certify that I personally examined the work sites and I understand that the above quantities are approximate and subject to increase or decrease.
Signature Title Date
The Bidder whose signature appears on this document, having personally appeared before me, duly sworn, deposes and says the above statements are true and correct.
SUBSCRIBED AND SWORN
BEFORE ME ON THIS THE
______ DAY OF , 20 .
Notary Public
My Commission Expires:
CONTRACTOR/SUBCONTRACTOR EXEMPTION
Is this contract for the physical performance of services*?
Yes________ No_________
Does this vendor have one or more employees (excluding self)?
Yes________ No_________
Will any additional people not classified as employees provide these services?
Yes________ No_________
If the contractor answers yes to both of the first two questions, the contractor is required by law to fill out the contractor affidavit prior to contract being accepted. If additional persons not classified as employees provide the services, a subcontractor affidavit is required for all individuals/companies not considered employees of the contractor. Otherwise, the contractor is exempt from signing the contractor affidavit.
Company Name
| ________________________________________ | ____________________________________ | |
| Authorized Officer or Agent | Date |
(Contractor Signature)
| ________________________________________ | ____________________________________ | |
| Printed Name of Authorized Officer or Agent | Title of Authorized Officer or Agent of Contractor |
SUBSCRIBED AND SWORN
______ DAY OF , 20 .
CONTRACTOR AFFIDAVIT AND AGREEMENT
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 contracting with the Greene County Board of Commissioners has registered with and is participating in a federal work authorization program* [any of the electronic verification of work authorization programs operated by the United States Department of Homeland Security or any equivalent federal work authorization program operated by the United States Department of Homeland Security to verify information of newly hired employees, pursuant to the Immigration Reform and Control Act of 1986 (IRCA), P.L. 99-603], in accordance with the applicability provisions and deadlines established in O.C.G.A. 13-10-91.
The undersigned further agrees that, should it employ or contract with any subcontractor(s) in connection with the physical performance of services pursuant to this contract with the Greene County Board of Commissioners, contractor will secure from such subcontractor(s) similar verification of compliance with O.C.G.A. 13-10-91 on the Subcontractor Affidavit provided in Rule 300-10-01-.08 or a substantially similar form and provide copies to the Greene County Board of Commissioners within five (5) business days of entering into a contract with such subcontractor.
| ________________________________________ | ____________________________________ | |
| E-Verify * Company Identification Number | Date Authorized to Use e-Verify |
| ________________________________________ | ____________________________________ | |||
| Company Name | Authorized Officer/Agent | Date | ||
| (Contractor Signature) |
| ________________________________________ | ____________________________________ | |
| Printed Name of Authorized Officer/Agent | Title of Authorized Officer/Agent of Contractor |
______ DAY OF ______________, 20
SUBCONTRACTOR AFFIDAVIT AND AGREEMENT
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 _________________________________________________ (Name of Contractor) on behalf of the Greene County Board of Commissioners has registered with and is participating in a federal work authorization program* [any of the electronic verification of work authorization programs operated by the United States Department of Homeland Security or any equivalent federal work authorization program operated by the United States Department of Homeland Security to verify information of newly hired employees, pursuant to the Immigration Reform and Control Act of 1986 (IRCA), P.L. 99-603], in accordance with the applicability provisions and deadlines established in O.C.G.A. 13-10-91.
| ________________________________________ | ____________________________________ | |
| E-Verify * Company Identification Number | Date Authorized to Use e-Verify |
| ________________________________________ | ____________________________________ | ||
| Company Name | Authorized Officer/Agent | Date |
(Contractor Signature)
| ________________________________________ | ____________________________________ | |
| Printed Name of Authorized Officer/Agent | Title of Authorized Officer/Agent of Contractor |
______ DAY OF ______________, 20__.
image1.png image2.jpeg
File details come from the government source that posted it. Updated .