WORK_AUTHORIZATION_AFFIDAVIT_FOR_BUSINESS_ENTITIES.pdf
PDF 124 KB Posted
- Attached to
- Bulk Rock Salt
- Solicitation number
- 25-0268-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 pertains to a bulk rock salt procurement opportunity for the City of Florissant, where sodium chloride will be supplied as a deicer on an as-needed basis during the contract period of November 15, 2026 through November 14, 2027.
The affidavit requires the contractor agent to affirm under penalty of perjury that the contracting business entity is enrolled and participating in a federal work authorization program for all employees providing goods or services to the City of Florissant. The contractor must certify that it does not knowingly employ, hire, or continue to employ unauthorized aliens in connection with the services provided. Additionally, all subcontractors must be contractually bound to comply with Missouri Revised Statute 285.530 and must either provide written certification of compliance or submit their own sworn affidavits attesting that all employees are lawfully present in the United States. Documentation of participation in a federal work authorization program must be attached to the affidavit and notarized.
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Other files
| File | Type | Posted |
|---|---|---|
| Bulk_Rock_Salt.pdf | ||
| anti-demonstration-against-israel_(1).pdf | ||
| Bid_Contract_Template.doc | DOC document | |
| 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 .