Sub Contractor Affidavit
31 KB Posted
- Attached to
- CLAY NGC Advanced Metering (Phase I)
- Solicitation number
- 41100-DOD0000041
- Issued by
- Cobb County, Georgia
About this file
This is a Subcontractor Affidavit document required under O.C.G.A. 13-10-91(b)(3) for subcontractors working on contracts with the Georgia Department of Defense, specifically for the CLAY NGC Advanced Metering (Phase I) project serving the Georgia Army National Guard. The project involves the installation of electrical conduits, wiring, CAT6 cables for network communications, split core style current transformers (CTs), and preparation for commissioning of fifty electrical meters across two sites: Clay National Guard Center (47 meters) in Marietta, Georgia and Dobbins Air Force Base (3 meters). The contractor must provide all labor, supervision, tools, lifts, scaffolding, elevated platforms, and ladders necessary for the installation work. A mandatory pre-bid meeting is required at Clay National Guard Center, Building 77 Maintenance Break Room, 1000 Halsey Ave., Marietta, GA 30060. Questions should be directed to Contracting Officer Viki S. Moolman at viki.s.moolman@us.army.mil or 678-569-6718.
The affidavit requires all subcontractors to register with and actively use E-Verify or any successor federal work authorization program throughout the contract period in accordance with O.C.G.A. 13-10-91. Subcontractors must provide their federal work authorization user identification number and date of authorization, maintain compliance with all applicable provisions and deadlines, and ensure that any sub-subcontractors engaged for physical performance of services also submit required affidavits. Subcontractors must forward notice of sub-subcontractor affidavit receipt to the prime contractor within five business days, and forward any subsequent notices within the same timeframe. The affidavit must be executed under penalty of perjury and notarized before a notary public.
Text of this file
Subcontractor Affidavit under O.C.G.A. § 13-10-91(b)(3)
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 Georgia Department of Defense 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 of receipt of an affidavit from any sub-subcontractor that has contracted with a sub-subcontractor to forward, within five business days of receipt, a copy of such notice to the contractor. Subcontractor hereby attests that its federal work authorization user identification number and date of authorization are as follows:
_________________________________(E-Verify Company ID or Individual’s User ID) Federal Work Authorization User Identification Number
Date of Authorization
Legal Name of Subcontractor
Legal Address of Subcontractor
Name of Project
Georgia Department of Defense
DOD PO #
DOD PO Date____________ Name of Public Employer
(For DOD use only)
(For DOD use only) I hereby declare under penalty of perjury that the foregoing is true and correct.
Executed on ______, ___, 201__ in _____(city), ______(state).
Signature of Authorized Officer or Agent
Printed Name and Title of Authorized Officer or Agent
SUBSCRIBED AND SWORN BEFORE ME
ON THIS THE ______ DAY OF ______________,201__.
NOTARY PUBLIC
My Commission Expires:
Other files
| File | Type | Posted |
|---|---|---|
| Amendment 1 Revised Pre-Bid | — | |
| Contractor Affidavit | — | |
| SPD Template | — | |
| Scope of Work | — | |
| Bonding Required | — | |
| Liquidated Damages | — | |
| Sub-Subcontractor Affidavit | — | |
| Insurance Requirements | — | |
| Mandatory Pre-Bid | — |
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