Subcontractor affidavit (23).pdf
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- Attached to
- 3rd Party Transportation Operator
- Solicitation number
- PE-64800-NONST-2025-000000058
- Issued by
- Douglas County, Georgia
About this file
This is a Subcontractor Affidavit form required by the Douglas County Board of Commissioners in compliance with O.C.G.A. § 13-10-91(b)(3). The document establishes that subcontractors performing services under a contract with Douglas County have registered with and are authorized to use the federal E-Verify work authorization program or its successor program in accordance with applicable provisions and deadlines. Subcontractors executing this affidavit commit to maintaining E-Verify compliance throughout the entire contract period and agree to contract only with sub-subcontractors who similarly present compliant affidavits. The affidavit requires subcontractors to forward notice of receipt of sub-subcontractor affidavits to the prime contractor within five business days and to provide copies of any further affidavit notices received from additional tiers of subcontractors within the same timeframe.
The form requires subcontractors to provide their federal work authorization user identification number, date of authorization, subcontractor name, project name, and public employer identification. The affidavit must be executed under penalty of perjury by an authorized officer or agent of the subcontracting entity and notarized before a notary public. This documentation requirement applies to all individuals, firms, or corporations engaged in the physical performance of services under Douglas County contracts and serves as a condition of contract compliance and authorization to perform work.
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Text version
Subcontractor Affidavit
O.C.G.A. § 13‐10‐91(b)(3)
By executing this Subcontractor 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 Douglas County Board of Commissioners 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, subcontractor shall 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:
Federal Work Authorization User Identification Number Date of Authorization
Name of Subcontractor: ____________________________________________________
Name of Project: ____________________________________________________
Name of Public Employer: Douglas County Board of Commissioners
I hereby declare under penalty of perjury that the forgoing is true and correct.
Executed on _____________, 20__ 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:
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