Subcontractor affidavit (47).pdf
PDF 139 KB Posted
- Solicitation number
- PE-64800-NONST-2026-000000079
- Issued by
- Douglas County, Georgia
About this file
This is a Subcontractor Affidavit form required by the Douglas County Board of Commissioners in Georgia for the Fleet Maintenance Generator Project, a turnkey installation of a 100kW Diesel Standby Generator. The affidavit serves as a compliance verification document mandated under O.C.G.A. § 13-10-91(b)(3), requiring all subcontractors engaged in the physical performance of services to confirm registration with and authorization to use the federal E-Verify work authorization program. Subcontractors must provide their federal work authorization user identification number and date of authorization, maintain E-Verify usage throughout the contract period, and ensure any sub-subcontractors also comply with the same requirements. Additionally, subcontractors are obligated to forward notice of receipt of affidavits from sub-subcontractors to the primary contractor within five business days of receipt.
The affidavit must be executed under penalty of perjury and notarized by a qualified notary public. This compliance requirement applies to all contracted parties involved in the project, which is partially funded through the FEMA Hazard Mitigation Grant Program (HMGP) and subject to federal requirements under 2 C.F.R. Part 200 and FEMA-specific mitigation policies. The project aims to ensure the Douglas County Fleet Maintenance Building can maintain operational continuity during utility outages, protecting essential county services and personnel.
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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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