WORK_AUTHORIZATION_AFFIDAVIT_FOR_BUSINESS_ENTITIES.pdf
PDF 124 KB Posted
- Solicitation number
- 25-0253-PD
- 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, applicable to the Ceiling Tile/Grid Rehabilitation Project for the Police Station. The affidavit serves as a compliance document establishing that the contractor and all subcontractors maintain enrollment and participation in a federal work authorization program for all employees assigned to the project. The contractor's authorized agent must attest under penalty of perjury that the contractor does not knowingly employ, hire, or retain unauthorized aliens in connection with services provided to the City of Florissant.
The affidavit requires documentation of federal work authorization program participation to be attached and mandates that all subcontractors provide written attestation within their contracts confirming compliance with Missouri Revised Statutes Section 285.530, or alternatively submit their own sworn affidavits under penalty of perjury verifying that all employees are lawfully present in the United States. The document must be notarized and includes spaces for the affiant's signature, the date of notarization, and the notary public's commission expiration date. This requirement ensures that the contractor meets state employment authorization requirements as a condition of contract award.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Ceiling_Tile_Grid_Rehabilitation_Project_for_Police_Station.pdf | ||
| General_Conditions.pdf | ||
| Instructions_to_Bidders.pdf | ||
| Special_Conditions.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 .