Subcontractor affidavit (53).pdf
PDF 139 KB Posted
- Attached to
- Basketball Court Flooring Restoration
- Solicitation number
- PE-64800-NONST-2027-000000085
- Issued by
- Georgia
About this file
This is a Subcontractor Affidavit form required by the Douglas County Board of Commissioners in Georgia for the Basketball Court Flooring Restoration project. The affidavit verifies that subcontractors comply with O.C.G.A. § 13-10-91, which mandates federal work authorization verification through the E-Verify program. Subcontractors must register with and actively use E-Verify throughout the contract performance period and ensure compliance from any sub-subcontractors. The form requires the subcontractor to provide their federal work authorization user identification number and authorization date, along with project and public employer information. Additionally, subcontractors are required to forward notice of sub-subcontractor affidavits to the prime contractor within five business days of receipt, creating a chain of compliance verification down through all contract tiers.
The affidavit must be executed by an authorized officer or agent of the subcontracting firm and notarized before a notary public, with the affiant declaring under penalty of perjury that all information provided is true and correct. This requirement functions as a compliance and eligibility verification mechanism rather than establishing pricing terms, set-asides, or funding sources. The form serves to document that all entities performing work under the Douglas County contract have met Georgia's mandatory E-Verify requirements prior to contract execution.
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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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