Subcontractor's E-Verify Affidavit.pdf
PDF 177 KB Posted
- Attached to
- 5th District Court of Appeal Security Upgrades
- Solicitation number
- ITN-14562
- Issued by
- Leon County, Florida
About this file
This is a Subcontractor's E-Verify Registration Affidavit for the Florida State Courts System, specifically required for the 5th District Court of Appeal Security Upgrades project (ITN #2025-002). The affidavit documents a subcontractor's compliance with Florida Statute section 448.095(2)(a), which mandates that all private employers with more than 25 employees and all public employers, contractors, and subcontractors register with and utilize the Department of Homeland Security's E-Verify system to verify employment authorization status of newly hired employees. Subcontractors must certify one of three conditions: current registration with the DHS E-Verify system with verification of new employees within three business days of hire; exemption from registration due to having five or fewer employees and not hiring more than five employees annually; or agreement not to hire unauthorized workers. The affidavit requires the subcontractor's legal business name, address, and taxpayer identification number, along with the signature of the sole proprietor or authorized representative and notarization.
The affidavit establishes compliance obligations with specific consequences for non-compliance, including daily fines of $1,000, prohibition from entering into any contracts with Florida government entities for one year, suspension or revocation of business or professional licenses, and immediate contract termination. Subcontractors must maintain active E-Verify registration throughout the contract period and notify the Contract Manager within ten calendar days of any changes in employer status. Compliance must be certified on the first unemployment tax return submitted to the Department of Commerce. This document serves as a mandatory prerequisite requirement for all subcontractors bidding on the 5th District Court of Appeal Security Upgrades project, ensuring alignment with Florida's employment eligibility verification requirements.
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Text version
SCS-E-Verify Registration Affidavit v.8.0 Page | 1 rev 4/16/2024
FLORIDA STATE COURTS SYSTEM
SUBCONTRACTOR’S E-VERIFY REGISTRATION AFFIDAVIT
I, _____________________________________, am the owner or authorized representative of the business entity shown below. I hereby acknowledge on behalf of my business or business entity that I am aware of the requirement in section 448.095(2)(a), Florida Statutes, that every private employer with more than 25 employees and every public employer, contractor, and subcontractor must be registered with and use the Department of Homeland Security’s (DHS) E-Verify system to verify the work authorization status of all newly hired employees.
Business or Business Entity Legal Name:
Business or Business Entity Legal Address:
Business or Business Entity Taxpayer Identification Number (TIN):
I hereby certify that my business or business entity:
Is registered with the DHS E-Verify system (https://www.e-verify.gov/) to verify the employment eligibility of each new employee hired within three (3) business days after the employee begins working for pay, as required by 8 C.F.R s. 274a for contract\agreement eligibility purposes.
Does not have more than five (5) employees at any given time and does not hire more than five
(5) employees in a calendar year and is not eligible to register to use the DHS E-Verify system.
Does not hire and agrees not to hire employees who are not authorized to be employed in the United States pursuant to 8 U.S.C. s. 1324a(h)(3).
By signing this affidavit, I agree to maintain an active E-Verify registration and that I will notify the Contract Manager within ten (10) calendar days of any change in business entity status as an employer. I further acknowledge that the failure to comply with section 448.095, Florida Statutes, can result in fines of $1,000 per day, prohibition of my business from entering into any contracts with any government entity in the State of Florida for a period of 1-year, suspension or revocation of any business or professional license issued to my business by any agency of the State of Florida and the immediate termination of my contract.
Will certify compliance on the first unemployment tax return submitted to the Department of Commerce, as required by section 448.095(3), Florida Statues.
SCS-E-Verify Registration Affidavit v.8.0 Page | 2 rev 4/16/2024
I HEREBY AFFIRM AND VERIFY THAT THE FOREGOING IS TRUE AND CORRECT.
Sole Proprietor/Authorized Representative
Printed Name
STATE OF _______________________
COUNTY OF _____________________
Sworn to (or Affirmed) and Subscribed Before Me By Means of ☐ Physical Presence or ☐ Online Notarization this ___________ day of __________________, 202__, by ________________________________________, Who ☐ Is Personally Known to Me or ☐ Produced Identification.
Type of Identification Produced: _________________________
Signature of Notary Public
Printed Name of Notary Public Administering Oath Pursuant to §117.03, Florida Statutes
| am the owner or authorized representative of the: |
| Business or Business Entity Legal Name: |
| Business or Business Entity Legal Address: |
| Business or Business Entity Legal Address_2: |
| Business or Business Entity Legal Address_3: |
| Business or Business Entity Taxpayer Identification Number TIN: |
| Printed Name: |
| STATE OF: |
| COUNTY OF: |
| Physical Presence or: Off |
| Online Notarization: Off |
| this: |
| 202: |
| by: Off |
| Produced Identification: Off |
| Is Personally Known to Me or: |
| Type of Identification Produced: |
| Printed Name of Notary Public Administering Oath Pursuant to 11710 Florida Statutes: |
| Check Box8: Off |
| Check Box9: Off |
| Check Box10: Off |
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