Subcontractor affidavit (42).pdf

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Attached to
Pavement Markings
Solicitation number
PE-64800-NONST-2026-000000074
Issued by
Douglas County, Georgia

About this file

This is a Subcontractor Affidavit form required by the Douglas County Board of Commissioners under Georgia Code O.C.G.A. § 13-10-91(b)(3). The document serves as verification that subcontractors engaged in the physical performance of services under county contracts are compliant with state work authorization requirements. Subcontractors must affirm that they have registered with, are authorized to use, and actively use the federal E-Verify program or any subsequent replacement program in accordance with applicable provisions and deadlines established under O.C.G.A. § 13-10-91. Subcontractors are required to provide their federal work authorization user identification number and date of authorization on the form and must continue E-Verify usage throughout the contract period.

The affidavit requires subcontractors to contract only with sub-subcontractors who also submit compliant affidavits and establish a notification chain whereby sub-subcontractor affidavits must be forwarded to the prime contractor within five business days of receipt. The form must be executed under penalty of perjury by an authorized officer or agent of the subcontracting firm and notarized. No pricing terms, bid amounts, or project-specific deliverables are included in this compliance document, as it functions solely as a work authorization verification requirement applicable to all contractors and subcontractors performing work for the Douglas County Board of Commissioners.

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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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