Subcontractor affidavit (51).pdf
PDF 139 KB Posted
- Attached to
- Public Health Building Renovation
- Solicitation number
- PE-64800-NONST-2026-000000083
- Issued by
- Douglas County, Georgia
About this file
This is a Subcontractor Affidavit required by the Douglas County Board of Commissioners in Georgia for the Public Health Building Renovation project located at 6770 Selman Drive, Douglasville, Georgia. The affidavit form documents a subcontractor's compliance with O.C.G.A. § 13-10-91, which mandates the use of the E-Verify federal work authorization program. Subcontractors must verify that they are registered with and actively use E-Verify or any successor program throughout the contract period. The form requires the subcontractor to provide their federal work authorization user identification number and date of authorization, along with the names of the subcontractor, project, and public employer.
The affidavit carries significant compliance obligations beyond the subcontractor's direct responsibilities. Subcontractors must ensure that any sub-subcontractors engaged for physical performance of services also submit compliant affidavits and must forward notice of receipt of such affidavits to the primary contractor within five business days. Should a sub-subcontractor engage further sub-subcontractors, the subcontractor must forward copies of those notices to the contractor within five business days as well. The document requires execution under penalty of perjury and must be notarized before a notary public, establishing a formal legal attestation of compliance with Georgia's work authorization verification requirements.
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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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