WORK_AUTHORIZATION_AFFIDAVIT_FOR_BUSINESS_ENTITIES.pdf

PDF 124 KB Posted

Attached to
Sunset Nature Lodge HVAC Replacement State and local contract opportunity
Solicitation number
25-0260-PR
Issued by
St. Louis County, Missouri

About this file

This is a Work Authorization Affidavit for Business Entities required by the City of Florissant, Missouri for all contracts exceeding $5,000. The affidavit applies to the Sunset Nature Lodge HVAC Replacement project, which solicits sealed bids from qualified HVAC contractors to remove and replace three existing HVAC split systems with Sure Comfort Vantix Line Side-Discharge Universal Heat Pumps, Model RD18AY Series. The project is located at Sunset Nature Lodge, 2300 Sunset Park Drive, Florissant, Missouri 63031, and requires contractors to provide all labor, materials, equipment, permits, supervision, and incidentals necessary for completion. The scope of work includes disconnecting and removing existing systems with proper refrigerant recovery, protecting building finishes, installing new equipment with inverter-driven variable speed compressor technology, inspecting and flushing existing refrigerant line sets, and completing all electrical connections and system testing.

The affidavit mandates that the contractor agent affirm enrollment and participation in a federal work authorization program for all employees and certify that the contractor does not knowingly employ unauthorized aliens in connection with services provided to the City of Florissant. All subcontractors must similarly state in writing that they are not in violation of Missouri Revised Statute 285.530 or submit a sworn affidavit attesting that all employees are lawfully present in the United States. Documentation of participation in a federal work authorization program must be attached to the completed affidavit, which must be subscribed and sworn before a notary public.

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Other files for this state and local contract opportunity

Other files attached to Sunset Nature Lodge HVAC Replacement, newest first.
File Type Posted
Sunset_Nature_Lodge_HVAC_Replacement.pdf PDF
Contract_Template.doc DOC document
Exhibit_A-Sure_Comfort-Vantix_Universal_Heat_Pump.pdf PDF
Special_Conditions.pdf PDF
General_Conditions.pdf PDF
Instructions_to_Bidders.pdf PDF
Missouri_Wage_Order.pdf PDF

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Text version

WORK AUTHORIZATION AFFIDAVIT FOR BUSINESS ENTITIES

PURSUANT TO 285.530 R.S. Mo.

(FOR ALL CONTRACTS IN EXCESS OF $5,000.00)

I, , being duly sworn, attest and state, under penalty of perjury, as follows:

[Contractor Agent]

1. I am employed by and serve as the [Contractor] [Position with Contractor].

2. I hereby affirm enrollment and participation in a federal work authorization [Contractor's] program with respect to all employees working in connection with any goods or services provided to the City of

Florissant. Documentation of participation in a federal work authorization program is attached to this affidavit.

3. does not knowingly employ, hire for employment, or continue to employ an [Contractor] unauthorized alien in connection with the services being provided to the City of Florissant.

4. Furthermore, all subcontractors working on this contract for services to the City of Florissant shall affirmatively state in writing in their contracts with that they are not in violation of Section [Contractor]

285.530 1, R.S. Mo., and shall not thereafter be in violation. Alternatively, the subcontractor shall submit a sworn affidavit under penalty of perjury attesting that all employees are lawfully present in the United States.

Further Affiant Sayeth Not.

[Contractor Agent]

STATE OF MISSOURI

) ss.

COUNTY )

Subscribed and sworn to me, a notary public, this_ _day of _, 20 .

Notary Public

My commission expires:

File details come from the government source that posted it. Updated .