WORK_AUTHORIZATION_AFFIDAVIT_FOR_BUSINESS_ENTITIES.pdf
PDF 124 KB Posted
- Attached to
- Janitorial Supplies
- Solicitation number
- 25-0261-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 mandates that the contractor agent, serving as an authorized representative of the contracting entity, attest under penalty of perjury that the contractor maintains enrollment and active participation in a federal work authorization program for all employees providing goods or services to the City. The affidavit further requires that the contractor does not knowingly employ, hire, or retain unauthorized aliens in connection with services provided to the City of Florissant. All subcontractors engaged on the contract must similarly affirm in writing that they comply with Missouri Revised Statutes Section 285.530 and maintain lawful employment practices, either through contractual attestation or sworn affidavit confirming that all employees are lawfully present in the United States.
This affidavit serves as a compliance document for the janitorial supplies contract with the City of Florissant Parks and Recreation Department and must be executed before a notary public. The affidavit requires documentation of federal work authorization program participation to be attached and establishes that both the contractor and all subcontractors must maintain ongoing compliance throughout the contract term. The notarization requirement includes the date, state, county, and notary commission expiration information, ensuring the legal enforceability of the contractor's attestations regarding employment authorization practices.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Janitorial_Supplies.pdf | ||
| Bid_Contract_Template.doc | DOC document | |
| Instructions_to_Bidders.pdf | ||
| General_Conditions.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 .