WORK_AUTHORIZATION_AFFIDAVIT_FOR_BUSINESS_ENTITIES.pdf
PDF 124 KB Posted
- Attached to
- Type 1L cement Portland Cement 2026
- Solicitation number
- 25-0256-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 City's procurement of Type 1L cement from qualified manufacturers or distributors for the Department of Public Works.
The affidavit requires the contractor's authorized agent to confirm enrollment and participation in a federal work authorization program for all employees working on the contract. The contractor must attest under penalty of perjury that it does not knowingly employ, hire, or continue to employ unauthorized aliens in connection with goods or services provided to the City of Florissant. All subcontractors must similarly affirm in writing that they comply with Missouri Revised Statutes Section 285.530 or submit a sworn affidavit confirming that all employees are lawfully present in the United States. Documentation of federal work authorization program participation must be attached to the affidavit, which requires notarization and identification of the contractor agent's position with the contractor entity.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Type_1L_cement_Portland_Cement_2026.pdf | ||
| Instructions_to_Bidders.pdf | ||
| Missouri_Wage_Order.pdf | ||
| General_Conditions.pdf | ||
| Special_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 .