WORK_AUTHORIZATION_AFFIDAVIT_FOR_BUSINESS_ENTITIES.pdf
PDF 124 KB Posted
- Attached to
- Florissant Golf Club Irrigation
- Solicitation number
- 25-0259-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 the Florissant Golf Club Irrigation project, which involves the installation of a new Rain Bird Integrated Control irrigation system throughout the golf course. The affidavit applies to all contracts exceeding $5,000.00 and requires the contractor agent to certify under penalty of perjury that the contractor is enrolled in a federal work authorization program, does not knowingly employ unauthorized aliens, and maintains lawful employment practices for all workers associated with the project. All subcontractors must similarly affirm compliance with Missouri Revised Statute 285.530 either through written contractual statements or sworn affidavits attesting that all employees are lawfully present in the United States.
The affidavit must be executed before a notary public and submitted with documentation of the contractor's participation in a federal work authorization program. This document serves as a mandatory prerequisite for contract award and establishes the contractor's commitment to maintaining a lawful workforce throughout the project term. The requirement applies to the entire scope of work for the irrigation system installation, including materials, labor, equipment, and all associated installation and restoration activities at Florissant Golf Club.
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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 .