WORK_AUTHORIZATION_AFFIDAVIT_FOR_BUSINESS_ENTITIES.pdf
PDF 124 KB Posted
- Attached to
- Crushed Stone/Sand 2026
- Solicitation number
- 25-0257-PW
- 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 $5,000.00. The affidavit applies to the Crushed Stone/Sand 2026 blanket purchase agreement for aggregate materials supply and delivery. The contractor's authorized agent must affirm under penalty of perjury that the contractor maintains enrollment and participation in a federal work authorization program for all employees providing goods or services to the City of Florissant and does not knowingly employ unauthorized aliens in connection with contract services.
All subcontractors performing work on this contract must provide written confirmation of compliance with Missouri Revised Statutes Section 285.530 in their subcontracts or submit sworn affidavits attesting that all employees are lawfully present in the United States. The affidavit requires notarization and must be executed by the contractor agent before a notary public, with documentation of participation in a federal work authorization program attached as supporting evidence.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Crushed_Stone_Sand_2026.pdf | ||
| Crushed_stone_Additional_Specifications.docx | DOCX document | |
| Instructions_to_Bidders.pdf | ||
| Missouri_Wage_Order.pdf | ||
| Special_Conditions.pdf | ||
| General_Conditions.pdf | ||
| STATE_OF_MISSOURI_LABOR_PROVISIONS.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 .