RFP City of Douglas Downtown Historic Resourc.docx

CITY OF DOUGLAS

REQUEST FOR PROPOSALS

DOWNTOWN HISTORIC DISTRICT

RESOURCES SURVEY

Bid# 66812-25-0009 PROPOSALS DUE: No later than October 10, 2024 11:00 AM EST.

Late proposals will not be accepted.

September 9, 2024

INVITATION TO BID

Sealed bids will be received at City Hall, 302 South Madison Ave., Douglas, Georgia, up to October 10, 2024 @ 11:00 A.M., at which time the bids will be publicly opened and read in the Council Chambers for the purchase of the following:

“Bid# 66812-25-0009 FY25 Douglas Downtown District Historic Resource Survey”

The City of Douglas reserves the right to accept the lowest, most acceptable bid and reserves the right to accept or reject any or all bids. No late bids, proposals, etc. will be accepted or opened. Email is not an acceptable form of delivery.

The City of Douglas reserves the right to waive any technicalities or irregularities so that an award can be made in the best interest of the city.

Bids are to be F.O.B. Destination 302 South Madison Ave., Douglas, Ga. 31533

The City of Douglas is an equal opportunity employer, including nondiscrimination in employment of the disabled.

For further information concerning this bid contact Nikki Thompson, at the City of Douglas Purchasing Agent at (912) 389-3463. Any technical questions concerning this bid should be directed to Georgia Henderson, at 912-3893-0277.

To obtain the complete Invitation to Bid, please go to our web-site, www.cityofdouglas.com. Click on “Bids and Contracts” in the middle of screen. Once this opens, click on “Bid # 66812-25-0009 FY25 Douglas Downtown District Historic Resource Survey” located under “Douglas Bid Opportunities”. This will open to a page which gives an overview of this Bid request. Scroll down and click on the “Related Document”, “Bid # 66812-25-0009 FY25 Douglas Downtown District Historic Resource Survey” located near the bottom of this screen. This will open the complete Invitation to Bid. Print, complete and submit as directed. Should you have any problems opening the attachment, please contact Payton Wilkerson at 912-389-3453.

NOTE: Please include five (5) copies of your bid in package and (1) USB.

GENERAL CONDITIONS OF BID

BID OPENING: October 10, 2024 @ 11:00 a.M.

LOCATION: City of Douglas, City Hall 302 S. Madison Ave.

Douglas, Ga. 31533

SEALED BID: All bids shall be sealed in an Envelope and plainly marked:

Bid # 66812-25-0009 FY25 Douglas Downtown District Historic Resource Survey

MAIL BID TO: City of Douglas Attn: City Clerk 302 S. Madison Ave.

Douglas, Ga. 31533

BID FORMS: All bids shall be submitted upon forms provided by the City of Douglas.

RIGHT OF REFUSAL: The City of Douglas reserves the right to accept or reject any or all bids submitted at its discretion.

ADDITIONAL INFORMATION: May be obtained by writing to:

Nikki Thompson, Purchasing Agent, @ (912) 389-3463

Bid Award Letter and a Tabulation will be sent to all responding Bidders after Mayor and Board of Commissioners approval of low bidder is approved by way of e-mail, so please make sure that your E-mail address is included in your Bid Packet.

FAILURE TO RESPOND WILL BE GROUNDS OF REMOVAL FROM BID LIST

REQUEST FOR PROPOSALS

Downtown Historic Resources Survey City of Douglas, Georgia Bid # 66812-25-0009

I. INTRODUCTION

The City of Douglas, Georgia is requesting proposals from consultants to conduct an intensive historic resources survey of approximately 78 parcels (or as many as funds will allow, up to 500) in the city limits of Douglas. The project will be financed in part with funds from the National Park Service, through a 2024 Historic Preservation Fund Grant, administered by the Georgia Historic Preservation Division.

The survey project will bring the past-surveyed area up to date with current standards, making sure all resources within the project area will be documented for future consideration in National Register Nominations.

II. PROJECT OVERVIEW

The City of Douglas (hereafter referred to as the city) is seeking proposals for the completion of a comprehensive historic resources survey of an estimated 78 historic parcels, which will include buildings, structures, sites, and objects constructed before 1984, and located within the Survey Area of the City of Douglas Downtown Historic District Resources Survey Area Map. The survey area is generally bounded by West Cherry Street, S Pearl Avenue, West Peachtree Street, and North Manilla Avenue.

Funding for this project shall be in part through a grant received from the Department of Community Affairs Historic Preservation Division (hereafter referred to as HPD), which will require the consequent final product to be in compliance with the Secretary of the Interior's Standards for Archaeology and Historic Preservation, which include the Standards for Evaluation, Identification, and Registration.

III. SURVEY AREA

Below is the Survey Area for the Downtown Historic Resource Survey identified as area within black boundary lines. The survey area is generally bounded by West Cherry Street, S Pearl Avenue, West Peachtree Street, and North Manilla Avenue.

If funds allow for the survey of additional resources outside of these boundaries, the consultant and the CITY should work with DCA to define additional survey area boundaries in a systematic manner.

IV. SCOPE OF WORK

The CITY will conduct a comprehensive historic resources survey of an estimated 78 parcels (or as many as funds will allow, up to 500), which will include buildings, structures, sites, and objects, constructed before 1984, and located within the city limits of City of Douglas, Georgia. The survey area will include the 78 parcels within the survey boundary, which is defined on the map above.

All project work shall conform to the Secretary of the Interior's Standards for Archaeology and Historic Preservation, which include the Standards for Evaluation, Identification, and Registration. The project work will be prepared in accordance to (a) National Register Bulletin: Guidelines for Local Surveys: A Basis for Preservation Planning; (b) the Historic Preservation Division’s guidance materials for identifying and documenting Georgia’s historic resources, including the most recent versions of “Georgia Historic Resources Manual,” and “Tips for Using GNAHRGIS as part of a Georgia Historic Resources Survey,” available online; and (c) the DEPARTMENT’S Georgia’s Natural, Archaeological, and Historic Resources Geographic Information System (GNAHRGIS) web-based GIS database.

The CITY will ensure that the consultant(s) meets professional requirements according to the Secretary of the Interior’s Professional Qualification Standards (36 CFR Part 61) and possesses the following:

1. A thorough knowledge of and familiarity with American architectural history;

1. Demonstrated experience in researching and describing historic resources, conducting architectural surveys, and writing historic contexts;

1. A thorough knowledge of and familiarity with identifying and evaluating Georgia’s historic resources including architectural styles and types, the GNAHRGIS database, and survey procedures;

1. Demonstrated writing skills; and

1. Experience with digital photography.

The CITY will ensure that consultant(s) is familiar with data categories and procedures for the GNAHRGIS system and is aware of the information contained in Item V.

The CITY will ensure that all survey data and digital photographs are entered in the GNAHRGIS online database within the contract period. All data groups in GNAHRGIS will be completed for each resource surveyed and a minimum of two (2) digital photographs, dating to within six (6) months of the survey date, per surveyed resource will be uploaded. Resource information is entered and stored via the GNAHRGIS website. Printed (hard copy) resource “forms” are not required and are not reimbursable as part of this grant.

The CITY will provide a survey area map delineating surveyed parcels. The map will indicate the survey area boundary, any relevant local or National Register of Historic Places-listed historic district boundaries, ALL addresses, legal parcels, and ALL street names, and be at a scale of 1” = 200’. The map will include a key explaining boundaries.

The CONSULTANT will provide two (2) electronic copies of the survey report, and the survey map, to the CITY within the contract period. The CITY will then provide the final copies to DCA.

The survey report is to include at a minimum:

· Executive summary, which includes the total number of surveyed resources;

· Project description, including how the survey was funded, who sponsored the survey, the name of the surveyor, and a general description of the survey area, including a clear statement and justification of the boundaries of the Phase One area surveyed, and the total number of surveyed resources for Phase One;

· In describing the survey’s funding, include the following disclaimer:

“This (material or preservation project) has been financed with assistance from the Historic Preservation Fund, administered by the National Park Service, U. S. Department of Interior, through the Historic Preservation Division of the Georgia Department of Community Affairs. Any opinions, findings, conclusions or recommendations expressed in this [project/product] are those of the author(s) and do not necessarily reflect the views or policies of the Department of the Interior or the Georgia Department of Community Affairs, nor does the mention of trade names, commercial products or consultants constitute endorsement or recommendation by these agencies. This program receives Federal financial assistance for identification and protection of historic properties. Under Title VI of the Civil Rights Act of 1964 and Section 504 of the Rehabilitation Act of 1973, and the Age Discrimination Act of 1975, as amended, the U.S. Department of the Interior prohibits discrimination on the basis of race, color, national origin, age, gender or disability in its federally-assisted programs. If you believe you have been discriminated against in any program, activity, or facility as described above, or if you desire further information, please write to: Office for Equal Opportunity, National Park Service, 1849 C Street, N. W., Washington, D.C. 20240.”

· Summary of previous preservation projects, including previous survey efforts, local designations, National Register listings, and other historic preservation planning efforts;

· Developmental history, a brief written account of how the area developed over time and how it reflects distinctive aspects of Georgia’s history. Special attention should be paid on African American history and contributions to Winterville.

· Survey methodology, including the fieldwork techniques and research methods employed while conducting the survey references to previous surveys and any re-survey completed as part of this project;

· Recommendations for future preservation activities, including: potential National Register nominations for individual resources and/or historic districts with basic boundary justification(s) for any proposed historic districts, including additional character areas, as applicable; potential updates and/or amendments to existing National Register historic district listings, as applicable; designation recommendations for potential local historic districts, as applicable; and potential economic development, heritage tourism, and other preservation planning activities;

· The following disclaimer must be included in this section:

“This survey does not change the existing National Register nomination or listing in any way, including but not limited to: contributing/noncontributing status of properties, period of significance, boundaries, and/or additional documentation. Any amendments, additional information, increase or decrease of boundaries must be made through the formal National Register process outlined in 36 CFR 60, as amended.”

· Survey results and architectural analysis, including the total number of surveyed resources divided into appropriate categories; a table listing all building types and main architectural styles as identified in GNAHRGIS, as well as narrative defining these; local architectural character; general observations (such as integrity and condition of resources, character-defining features, and apparent developmental trends), and local landmarks and eccentricities;

· Appendix 1: table listing all GNAHRGIS ID numbers associated with the survey paired with the address of the resource that each GNHARGIS ID number represents.

· Appendix 2: A survey map that delineates the survey area; existing local historic district and National Register-listed district boundaries and potential updates and/or amendments to these existing district boundaries; and the boundaries of identified potential new historic districts (this map will be in addition to the separate 1”=200’ map discussed above).

The above criteria are the minimum standards. For more detailed guidance on the survey report, please refer to the Georgia Historic Resources Survey Manual.

All project development by the CITY shall be reviewed by the DCA. The review process includes reviewing and approving consultant selection, the consultant contract, GNAHRGIS data, first draft of the survey report and map, subsequent drafts of the survey report and map, final draft of the survey report and map, and other materials determined necessary during project development.

Prior to review by the DCA, the CITY shall review drafts of the survey report and map. The CITY shall ensure that the consultant provides GNAHRGIS survey data point documentation at the 25% and 75% data entry due dates for review and comment. Monthly progress reports will be due to the city on the 1st of every month explaining activities completed in the prior month.

The consultant will complete project work by the following due dates.

January 15, 2025 Approximately 25% of surveyed resource data entered into GNAHRGIS. Documentation spreadsheet submitted with First Activity Report.

May 15, 2025 Approximately 75% of surveyed resource data entered into GNAHRGIS. Documentation spreadsheet submitted with Third Activity Report.

August 15, 2025 First Draft of Survey Report submitted in hard copy (1 unbound copy) or electronic format (MS Word) and map to the DCA for review and comment

November 1, 2025 Second Draft of Survey Report submitted in hard copy format to the CITY for review and comment, before sending to DCA as necessary Final version of one (1) set of survey map(s) submitted for approval by DCA

V. In 1988-1990, Coffee County was surveyed, and resources documented through this survey were later entered into GNAHRGIS with varying degrees of accuracy. Therefore, this survey will likely have a high number of resurveyed resources. The below image of GNAHRGIS shows resources located within and around the proposed survey area. This means the surveyor will need to identify previously-surveyed points in GNAHRGIS and link new survey data (or resurveyed resources) to the previous entry to avoid duplicate entries for the same resource.

The surveyor will need to find the previous point or GNAHRGIS ID number via an address search, by locating the resource geographically using the GNAHRGIS map, or by exporting survey data from the GNAHRGIS Public website and filtering the points to identify those within the current survey area boundary. The address search method for locating previously surveyed resources will likely be the most helpful within municipalities or when a resource’s address is clearly defined. In more rural areas of the county, where an exact address may not be immediately apparent, the method of geographically locating the resources using the GNAHRGIS map will likely be more effective.

These processes are discussed in detail in the GNAHRGIS help guides located within the web site.

Account for this process in determining time and budget allowances for this survey.

Figure 1 Screenshot of GNAHRGIS database of survey area, 7/9/2024

VI. COMMUNITY INVOLVEMENT

The City of Douglas staff and members of the Historic Preservation Commission will participate in the Historic Resource Survey Project by providing historic context, information on previous and current preservation projects, and will provide physical support for the survey on an as needed basis when available. Progress meetings with members of the community and the project administrator will be required on a regular basis.

VII. SCREENING PROCESS

A Selection Committee will be responsible for recommending a consultant to provide the services related to the Downtown Historic District Resource Survey. The Selection Committee will evaluate the qualifications received, interview the consultants it determines (if necessary), and make a recommendation to the Mayor and City Council as to the consultant it determines is best suited to perform the services. The Selection Committee will consist of representatives from the City of Douglas Historic Preservation Commission and the City Administration. Following interviews and reference checks, the Selection Committee will forward a recommendation to the City of Douglas City Commission, who will approve the recommendation and authorize negotiation of scope of work and contract.

VIII. CRITERIA FOR SELECTION

The successful entity will have the educational background to complete the project as well as related experience on similar types of projects. Professional qualifications will be required as established by the National Park Service in the fields of Architectural History, Historic Architecture, or History. In addition, the consultant must demonstrate an interest in the project, convey an understanding of the requirements of the effort, provide references and examples from other similar projects, and show an ability to work within the schedule and budget and to provide the deliverables noted herein.

Key points the Committee will consider in selecting the successful firm include:

1. Professional Qualifications. The education, training, registration, and amount of relevant experience of the proposed key project personnel.

2. Specialized Experience and Technical Competence. The submitting entity’s specialized experience and technical competence on similar projects should be detailed. The effectiveness of the proposed project team (management structure and coordination of disciplines, offices and/or subcontractors) will also be considered.

3. Capacity of the Entity to Accomplish the Required Services on Schedule and within Budget. The submitting entity must demonstrate and ability to complete projects within the specified completion dates and budget.

4. Past Performance. Past performance of work on similar or comparable projects should be demonstrated.

5. Understanding of Project. A clear understanding of the type of project work to be performed, and appreciation for the importance of the project, and a plan to complete the work should be clearly demonstrated.

6. Quality Assurance. The consultant’s quality control processes and management approach that will be used on the project. The submitting entity must demonstrate an ability to produce high quality work, including written work, photography, printed material, and presenting at public meetings.

IX. SUBMISSION REQUIREMENTS

All submissions must include the following information:

1. Project Director with a list of team members (as applicable):

a. Must include principal participant(s)

b. Contact information for the Project Director, including phone and email

2. Response to the six key points mention in Section VII. Criteria For Selection:

a. Resumes of all principals and professional staff involved, demonstrating qualifications and related experience and expertise.

b. Descriptions or examples of similar projects completed by those involved in the team.

3. Proposed Budget:

a. A proposed budget to demonstrate the project can be completed with the allotted maximum of $ 20,015.00

4. References:

a. List of references, including brief description of projects and contact name and telephone number.

5. Maximum Page Limit:

a. Thirty-five (35) numbered, 8.5 x 11 pages, excluding cover, table of contents, cover letter, and dividers.

X. DIRECTIONS FOR SUBMISSION

The guidelines for submission of the RFP package should be as follows:

· The RFP package should be delivered in a completely sealed envelope or package no later than: Thursday, October 10, 2024 at 11:00 am (EST).

· The outside of the package should be clearly marked “Bid # 66812-25-0009 FY25 Douglas Historic Resource Survey”.

· Please submit any questions regarding this RFP to Georgia Henderson, Community Development Director via email at ghenderson@cityofdouglasga.gov no later than: Friday, September 27, 2024 at 2:00 pm (EST).

· The RFP may be submitted in person or by mail to the following address:

City of Douglas Attn: Wynetta Bolder 302 S. Madison Avenue Douglas, GA 31533 P: 912-383-0277 E: wbolder@cityofdouglasga.gov

· All packages should contain five (5) printed copies and one (1) digital copy (USB) of the submitted Proposal.

All submitted RFPs should follow instructions and be complete in scope as requested by the city. Late submissions will not be accepted.

All persons awarded an/or entering into contracts with the City of Douglas shall be subject to and required to comply with all applicable City, State, and Federal provisions pertaining to non-discrimination, Equal Employment Opportunity, Affirmative Action, and the Americans with Disabilities Act (ADA).

The Downtown Historic District Resource Survey, which is the subject of a Historic Preservation Fund Grant, is being financed with assistance from the Historic Preservation Fund, administered by the National Park Service, U. S. Department of Interior, through the Historic Preservation Division of the Georgia Department of Community Affairs. Any opinions, findings, conclusions or recommendations expressed in this [project/product] are those of the author(s) and do not necessarily reflect the views or policies of the Department of the Interior or the Georgia Department of Community Affairs, nor does the mention of trade names, commercial products or consultants constitute endorsement or recommendation by these agencies. This program receives Federal financial assistance for identification and protection of historic properties. Under Title VI of the Civil Rights Act of 1964 and Section 504 of the Rehabilitation Act of 1973, and the Age Discrimination Act of 1975, as amended, the U.S. Department of the Interior prohibits discrimination on the basis of race, color, national origin, age, gender or disability in its federally assisted programs. If you believe you have been discriminated against in any program, activity, or facility as described above, or if you desire further information, please write to: Office for Equal Opportunity, National Park Service, 1849 C Street, N. W., Washington, D.C. 20240.

VENDOR INFORMATION

Company Name: ___________________________________________________

Address: __________________________________________________________

City, State, Zip: ____________________________________________________

Phone: ____________________________________________________________

Fax: ______________________________________________________________

Email Address: _____________________________________________________

Rep. Printed Name: _________________________________________________ (Type or Print Legibly)

Rep. Signature Name: ______________________________________________

Tax ID: ______________________________________

REFERENCES

Name: __________________ Phone: __________________

Name: __________________ Phone: __________________

Name: __________________ Phone: __________________

INSURANCE SPECIFICATIONS PAGE:

Insurance is required on projects being done on City property as specified on the Request for Quote unless waived by City of Douglas. A Certificate of Insurance made out to City of Douglas must be furnished before any work can begin.

Please provide the following information.

Liability Insurance coverage*:

· Bodily injury $_____________________________________________________ (Minimum $500,000. required)

· Property damage $__________________________________________________ (Minimum $500,000. required)

· Workman’s Compensation $___________________________________________ (Statutory coverage as required by the State of Georgia.)

*Liability coverage must be provided to include premises, operations, products and completed operations.

GEORGIA SECURITY AND IMMIGRATION COMPLIANCE ACT OCGA 13-10-90

TO ALL PROSPECTIVE VENDORS:

If you are providing service, or performing work for The City of Douglas, Georgia, the applicable Georgia Security and Immigration Compliance documents found here must be completed, signed, notarized and submitted with your bid/proposal.

1) The City of Douglas Georgia shall comply with the Georgia Security and Immigration Compliance Act OCGA 13-10-90 et. seq.,

2) In order to insure compliance CONTRACTOR agrees to comply with all of the contractor requirements of the “Georgia Security and Immigration Compliance Act” of 2006 as codified in O.C.G.A. Sections 13-10-90 and 13-10-91 and regulated in Chapter 300-10-1 of the Rules and Regulations of the State of Georgia, "Public Employers, Their Contractors and Subcontractors Required to Verify New Employee Work Eligibility Through a Federal Work Authorization Program," accessed at http://www.dol.state.ga.us, as further set forth below.

A. Contractor Agreement to Verify the Work Eligibility of its New Hires through the U.S Department of Homeland Security’s “Employment Eligibility Verification (EEV) / Basic Pilot Program.” CONTRACTOR agrees to verify the work eligibility of all of CONTRACTOR’S newly hired employees through the U.S. Department of Homeland Security’s Employment Eligibility Verification (EEV) / Basic Pilot Program, accessed through the Internet at https://www.vis-dhs.com/EmployerRegistration, in accordance with the provisions and timeline found in O.C.G.A. 13-10-91 and Rule 300-10-1-.02 of the Rules and Regulations of the State of Georgia. As of July 1, 2007, the verification requirement applies to contractors and subcontractors with five-hundred (500) or more employees.

B. Contracts Affected by the “Georgia Security and Immigration Compliance Act.” CONTRACTOR agrees that the contractor and subcontractor requirements of the “Georgia Security and Immigration Compliance Act” of 2006 apply to contracts for, or in connection with, the physical performance of services within the State of Georgia.

C. Timeline for Application of the Worker Eligibility Verification Requirements to Contractors and Subcontractors. CONTRACTOR agrees that the following Georgia Security and Immigration Compliance Act contract compliance dates apply to this contract, pursuant to O.C.G.A. 13-10-91:

On or after July 1, 2007, to public employers, contractors, or subcontractors of 500 or more employees;

On or after July 1, 2008, to public employers, contractors, or subcontractors of 100 or more employees; and On or after July 1, 2009, to all other public employers, their contractors, and subcontractors.

The prospective CONTRACTOR must initial one of the sections below:

Contractor has 500 or more employees [CONTRACTOR must register with the Employment Eligibility Verification/Basic Pilot Program and begin work eligibility verification on July 1, 2007, and execute and send to DEPARTMENT a “Contractor Affidavit and Agreement” attesting to registration with the EEV / Basic Pilot Program];

Contractor has 100-499 employees [CONTRACTOR must register with the Employment Eligibility Verification/Basic Pilot Program and begin work eligibility verification by July 1, 2008];

or Contractor has 99 or fewer employees [CONTRACTOR must begin work eligibility verification by July 1, 2009].

3) In the event that the contractor employs or contracts with any subcontractor in connection with a covered contract the contractor will secure from the subcontractor attestation of the subcontractor’s compliance with O.C.G.A. § 13-10-90 et seq. and Georgia Department of Labor Rule 300-10-1-.02 by the subcontractor’s execution of the subcontractor affidavit shown in Georgia Department of Labor Rule 300-10-1-.02 or a substantially similar affidavit.

4) Contractor agrees that, in the event the (insert your company’s name) ________________ ____________________________________________ employs or contracts with any sub-contractor in connection with the covered contract to Require “Georgia Security and Immigration Compliance Act” Compliance of its Subcontractors Connected with this Contract. CONTRACTOR agrees to require O.C.G.A. Sections 13-10-90 and 13-10-91 compliance in all written agreements with any subcontractor employed by CONTRACTOR to provide services connected with this contract, as required pursuant to O.C.G.A. 13-10-91., that the (insert company’s name) ____________________________ ________________________________will secure from each sub-contractor the employee-number applicable to the sub-contractor.

CONTRACTOR agrees to obtain from any subcontractor that is employed by CONTRACTOR to provide services connected with this contract, the subcontractor’s indication of the employee-number category applicable to the subcontractor.

5) Contractor agrees to provide the City of Douglas with and secure all affidavits from any subcontractor engaged to perform services under this Contract an executed the “Subcontractor Affidavit,” as required pursuant to O.C.G.A. 13-10-91 and Rule 300-10-1-.08 of the Rules and Regulations of the State of Georgia, which rule can be accessed at http://www.dol.state.ga.us.

CONTRACTOR agrees to maintain all records of the subcontractor’s compliance with O.C.G.A. Sections 13-10-90 and 13-10-91 and Chapter 300-10-1 of the Rules and Regulations of the State of Georgia.

CONTRACTOR AFFIDAVIT AND AGREEMENT

By executing this affidavit, the undersigned contractor verifies its compliance with O.C.G.A. 13 1 0-91, stating affirmatively that the individual, firm, or corporation which is contracting with The City of Douglas, 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. 99-6031], 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 City of Douglas, 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. Contractor further agrees to maintain records of such compliance and provide a copy of each such verification to the (name of the public employer) at the time the subcontractor(s) is retained to perform such service.

EEV / Basic Pilot Program* User Identification Number

(Contractor Name)

Title of Authorized Officer or Agent of Contractor

Printed Name of Authorized Officer or Agent

SUBSCRIBED AND SWORN BEFORE ME ON THIS

THE __________DAY OF, 20____

Notary Public My Commission Expires: _____________

*As of the effective date of O.C.G.A. 13-10-91, the applicable federal work authorization program is the "EEV / Basic Pilot Program" operated by the U. S. Citizenship and Immigration Services Bureau of the U.S. Department of Homeland Security, in conjunction with the Social Security Administration (SSA).

Authority O.C.G.A. 13-10-91

SUBCONTRACTOR AFFIDAVIT

Contractors shall use the following affidavit form, or an affidavit form that is substantially similar to that provided below, to document a subcontractor's compliance with the requirements of O.C.G.A. 13-10-91:

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 City of Douglas 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. 99-6031], in accordance with the applicability provisions and deadlines established in O.C.G.A. 13-10-91.

EEV / Basic Pilot Program* User Identification Number

(Contractor Name)

Title of Authorized Officer or Agent of Contractor

Printed Name of Authorized Officer or Agent

SUBSCRIBED AND SWORN BEFORE ME ON THIS

THE __________DAY OF, 20____

Notary Public My Commission Expires: _____________

*As of the effective date of O.C.G.A. 13-10-91, the applicable federal work authorization program is the "EEV / Basic Pilot Program" operated by the U. S. Citizenship and Immigration Services Bureau of the U.S. Department of Homeland Security, in conjunction with the Social Security Administration (SSA).

Authority O.C.G.A. 13-10-9 2 | Page image3.png image1.png image2.jpg