GEORGIA SECURITY AND IMMIGRATION COMPLIANCE ACT AFFIDAVIT AFFIDAVITS

Similar documents
GEORGIA SECURITY AND IMMIGRATION COMPLIANCE and House Bill 87, also known as, The Illegal Immigration Reform and Enforcement Act of 2011

PURCHASING DEPARTMENT

(APPLICATIONS WILL NOT BE ACCEPTED WITHOUT ALL PAPERWORK):

` Coweta County, Georgia Commercial / Special Use Application (Please allow up to two weeks to process applications)

DATE: August 13,

A summary of the vehicle to be purchased: Department Type of Vehicle Quantity Stormwater Department One Ton Dual Rear Wheel Dump Truck w/ Bed 1

Applicant Information All spaces must be filled in. Applications with blank spaces will be rejected.

Taxicab and Vehicle for Hire- New Driver Packet

PROPOSAL FORM 2014 FUEL BID

ALLEGANY COUNTY COMMISSIONERS ALLEGANY COUNTY DEPARTMENT OF PUBLIC WORKS. June 2018 BIDDING SPECIFICATIONS FOR NEW ONE-HALF TON PICKUP TRUCKS

INVITATION TO BID PURCHASING DEPARTMENT P. O. BOX E. CENTRAL AVENUE SECOND FLOOR VALDOSTA, GEORGIA 31601

DATE: February 9,

The attached pre-qualification application should be submitted with your bid, in a separate sealed envelope.

BIBB COUNTY SHERIFF S OFFICE

REGULATIONS OF THE DEPARTMENT OF PROCUREMENT SERVICES FOR CLEAN DIESEL CONTRACTING

CITY OF UNION CITY. County of Hudson State of New Jersey CORPORATION APPLICATION FOR LICENSE FOR BUSINESS OR OCCUPATION TOWING

ONE (1), LPG POWERED SOLID TIRE FORKLIFT For the Boone County Public Works Solid Waste Department

INVITATION TO BID Fort Morgan Golf Course Golf Carts

City of Winter Springs GOLF CART REGISTRATION PACKET. Applicant s Name: Address: City, State Zip. Driver s License No. Additional Drivers

Eligible Renewable Generation (ERG) Application INSTRUCTIONS

CITY OF PORTSMOUTH PURCHASING DEPARTMENT PORTSMOUTH, NEW HAMPSHIRE. Annual Fuel Bid - #01-18 INVITATION TO BID

City of Mobile. Recycling Equipment Rental & Hauling BID NUMBER: 5024

Florida Department of Agriculture and Consumer Services Office of Energy NATURAL GAS FUEL FLEET VEHICLE REBATE PROGRAM

CASE NO. PETITION FOR OCCUPATIONAL DRIVER S LICENSE

[Agreement - TEGSCO, LLC, dba San Francisco AutoReturn - Towing and Storage of Abandoned and Illegally-Parked Vehicles - Not to Exceed $65,400,000]

ADDENDUM NO. 1. April 6, Project: Gas and Diesel Bid for School System Stations

INVITATION TO BID FUEL PRODUCTS

CITY OF SHARON 155 W. CONNELLY BLVD SHARON, PENNSYLVANIA SPECIFICATIONS and FORM OF PROPOSAL

Electric Vehicle Charging Station Incentives PROGRAM HANDBOOK

TOWN OF NORWELL HIGHWAY DEPARTMENT 345 MAIN STREET, NORWELL, MA 02061

VOUCHER INCENTIVE PROGRAM Application Package

Application for Commission Approval to Construct a Generating Station Pursuant to Public Utilities Article Section and

RFQ Fleet Vehicles. The City of Dawson Creek is requesting quotations for the supply and delivery of:

PETROLEUM TRADERS CORPORATION RIGGINS, INC.

THE CORPORATON OF THE TOWN OF MIDLAND VEHICLE TOWING AND POUND SERVICES 2018/2019 TENDER L

Document Title : Effective Date : Author :

Pacific Gas and Electric Company TM

Q10. What are the payment terms? A10. Payment terms vary per participating agency. Refer to Page 16 of bid document.

ARLINGTON COUNTY, VIRGINIA. County Board Agenda Item Meeting of November 18, 2017

TOWING & IMMOBILIZATION CERTIFICATE APPLICATION. Indicate the type of service and the number of vehicle permits to perform this service.

Declaration naming Richard J. Nixon and Dale Brand under section 106 of the Oil and Gas Conservation Act

RFP Agricultural Tractors (AG tractor) SCOPE OF THE PROPOSAL

For Reference Only. Jett Pro Line Maintenance FAA REPAIR STATION NO. YUJR093Y EUROPEAN AVIATION SAFETY AGENCY (EASA) MANUAL SUPPLEMENT

NOTICE INVITING BIDS 2018 DEPARTMENT OF PUBLIC WORKS VEHICLE CITY OF BEAVER DAM, WISCONSIN

CONTRACT DOCUMENTS TOWING SERVICES BOROUGH OF CARLISLE 53 W. SOUTH STREET CARLISLE, PENNSYLVANIA (717)

BEFORE THE GUAM PUBLIC UTILITIES COMMISSION ) ) ) ) ) ) ) ) ORDER INTRODUCTION

Emergency Vehicle Application Package

MEETING: DATE: TYPE OF ACTION: STAFF CONTACT: Recommend to Board. Final Action

SAN ANTONIO WATER SYSTEM PURCHASING DEPARTMENT

STATE IMPLEMENTATION PLAN CREDIT FOR EMISSION REDUCTIONS GENERATED THROUGH INCENTIVE PROGRAMS (Adopted June 20, 2013)

SECTION 1 - APPLICANT INFORMATION. 1) Legal Name: 2) Mailing Address: 3) Physical Address (if different from mailing address):

AMERICAN STRATEGIC MINERALS CORPORATION

DRAFT April 9, STATE IMPLEMENTATION PLAN CREDIT FOR EMISSION REDUCTIONS GENERATED THROUGH INCENTIVE PROGRAMS (Adopted [adoption date])

CITY OF DIXON, CALIFORNIA CITY ENGINEER / PUBLIC WORKS DEPARTMENT, WASTEWATER DIVISION SOLANO COUNTY, CALIFORNIA BID SPECIFICATIONS

Phenix City Schools BID NO. GF Purchase of Three New Vehicles. Bid Opening Date & Time: January 7, 2019 at 9:00 AM EST

ADDENDUM 3. C. Bidders are requested to attach a copy of this Addendum to the Project Manual in their possession.

2018 Clean Diesel Rebate Program

COUNTY OF ROCKLAND Department of General Services Purchasing Division

Regulation of Commercial Waste Originators, Pumpers, Transporters, Processors, and Disposal Facilities

BID SPECIFICATIONS FOR MOTOR VEHICLES: NEW SUV S, INTERCEPTORS, PICKUPS AND WAGONS. Bid Category: Automotive Products, Vehicles, and Services - 04

CHEROKEE NATION TAX COMMISSION MOTOR VEHICLE DIVISION RULES AND REGULATIONS

VOUCHER INCENTIVE PROGRAM. Application Package

HORRY COUNTY SOLID WASTE AUTHORITY, INC.

Summary. disposal for FY and authorize the City Manager to renew the agreement for three 3 additional terms of

OFFICE OF SUPERINTENDENT DELAWARE COMMUNITY SCHOOL CORPORATION 9750 N CR 200 East Muncie, IN Phone: Fax:

SRP BUSINESS SOLUTIONS

Alcohol & Substance Abuse Information. Please complete the following six pages. Sign all forms where highlighted in yellow

SYSTEM SAFETY, SECURITY AND OPERATIONS COMMITTEE JULY 17, 2014 PURCHASE OF HYBRID SEDANS APPROVE CONTRACT AWARD ACTION: RECOMMENDATION

Metro OPERATIONS COMMITTEE JANUARY 20,201 1 SUBJECT: CNG ENGINE OIL AWARD CONTRACT FOR CNG ENGINE OIL RECOMMENDATION

SUBJECT: PARTIAL AWARD INVITATION TO BID NO

2018 Golf Cart Lease Sunset Valley Golf Club

ADDENDUM No. 1. BID No /15 Chevrolet Silverado Work Trucks

COMPRESSED NATURAL GAS (CNG) BUS ENGINES

NATIONAL COUNCIL OF INSURANCE LEGISLATORS (NCOIL)

Page 1 of 6 ADDENDUM NO. 1. January 11, Shuttle Bus Service RFP # H General

CITY OF TACOMA ENVIRONMENTAL SERVICES DEPARTMENT

FIFTH EDITION. Part Three: MANAGEMENT of MUNICIPAL GOVERNMENT. Contracting, Purchasing, and Sale of Municipal Property

Internal Revenue Service

Public Utilities HILLSBOROUGH COUNTY GREASE HAULER PERMIT APPLICATION

General Specifications

Environmental Health Department

Forensic Sciences Chapter ALABAMA DEPARTMENT OF FORENSIC SCIENCES ADMINISTRATIVE CODE CHAPTER IGNITION INTERLOCK RULES

CITY OF SIMI VALLEY MEMORANDUM

MSRC CLEAN TRANSPORTATION FUNDING LOCAL GOVERNMENT PARTNERSHIP

PURCHASING SPECIFICATION

ON-ROAD HEAVY-DUTY TRUCK APPLICATION

1. Do the two Gillig 40 (2401H & 2402H) Hybrid have batteries, if so, what type? IPTC Response: Yes, I believe phosphate.

THE EMPIRE DISTRICT ELECTRIC COMPANY P.S.C. Mo. No. 5 Sec. 4 1st Revised Sheet No. 23

REQUEST FOR QUOTATION (RFQ) REFERENCE: RFQ/KRT/09/004 DATE: 18/01/2009

2018 CLEAN AIR GRANTS ON-ROAD VEHICLE PROGRAM

VOUCHER INCENTIVE PROGRAM Application Package

Mansfield Oil Voyager Fuel Card Program Procedures

INVITATION TO BID 61 ZERO TURN RADIUS MOWER

AWARD CONTRACT FOR LINE BREAKERS

CITY OF DIXON, CALIFORNIA CITY ENGINEER / PUBLIC WORKS DEPARTMENT, WASTEWATER DIVISION SOLANO COUNTY, CALIFORNIA BID SPECIFICATIONS

SUBJECT: CONTRACT C080S, HOIST REPLACEMENT AT BUS MAINTENANCE DIVISIONS 3, 5, 9, 10, AND 18, PETERSON HYDRAULICS AND ROTARY LIFT, A JOINT VENTURE

May 11, 2018 On or before 2:00pm

IC Chapter 5. Motor Vehicle Emission Control

As Introduced. 132nd General Assembly Regular Session S. B. No

Please answer all questions. If the answer to any question is "No" or "None", do not leave blank, but write "No" or "None.

Transcription:

GEORGIA SECURITY AND IMMIGRATION COMPLIANCE ACT AFFIDAVIT AFFIDAVITS O.C.G.A. 13-10-91(b)(1) states, in part, A public employer shall not enter into a contract for the physical performance of services unless the contractor registers and participates in the federal work authorization program. Before a bid for any such service is considered by a public employer, the bid shall include a signed, notarized affidavit from the contractor. O.C.G.A. 13-10-91(b)(6) states, in part, No later than August 1, 2011, the Department of Audits and Accounts shall create and post on its website form affidavits for the federal work authorization program. The Department of Audits and Accounts requested the assistance of the Department of Law to draft the affidavits required by this Code section: Contractor Affidavit under O.C.G.A. 13-10-91(b) (1) Subcontractor Affidavit under O.C.G.A. 13-10-91(b) (3) Sub-subcontractor Affidavit under O.C.G.A. 13-10-91(b) (4) The Contractor Affidavit under O.C.G.A. 13-10-91(b) (1) must be completed, signed and notarized and submitted with your bid response. Effective September 16, 2013 an E-Verify affidavit is required for all transactions when any labor or services ( the physical performance of services ) greater than $2,499.99 are procured or contracted for. The Georgia Security and Immigration Compliance Act (O.C.G.A. 13-10-91) broadly defines the physical performance of services as any performance of labor or services for a public employer using a bidding process or by contract wherein the labor or services exceeds $2,499.99. The affidavit must be obtained prior to the service being contracted for or procured, except in the case of emergency repairs or services. The E-Verify affidavit requirement applies to contractors as well as any subcontractors the contractor may use. It is be the responsibility of the successful contractor to identify subcontractor(s) to the state agency no later than five (5) business days from the date that the vendor enters into an agreement with the subcontractor(s) and to submit completed, signed and notarized affidavit(s) from the subcontractor(s): Subcontractor Affidavit under O.C.G.A. 13-10-91(b) (3) Sub-subcontractor Affidavit under O.C.G.A. 13-10-91(b) (4)

Contractor Affidavit under O.C.G.A. 13-10-91(b)(1) By executing this affidavit, the undersigned contractor verifies its compliance with O.C.G.A. 13-10- 91, stating affirmatively that the individual, firm or corporation which is engaged in the physical performance of services on behalf of Henry County Water Authority has registered with, is authorized to use and uses the federal work authorization program commonly known as E-Verify, or any subsequent replacement program, in accordance with the applicable provisions and deadlines established in O.C.G.A. 13-10-91. Furthermore, the undersigned contractor will continue to use the federal work authorization program throughout the contract period and the undersigned contractor will contract for the physical performance of services in satisfaction of such contract only with subcontractors who present an affidavit to the contractor with the information required by O.C.G.A. 13-10-91(b). Contractor hereby attests that its federal work authorization user identification number and date of authorization are as follows: Name of Contractor I hereby declare under penalty of perjury that the foregoing is true and correct. Executed on, 20 in (city), (state).

Subcontractor Affidavit under O.C.G.A. 13-10-91(b)(3) By executing this affidavit, the undersigned subcontractor verifies its compliance with O.C.G.A. 13-10-91, stating affirmatively that the individual, firm or corporation which is engaged in the physical performance of services under a contract with (name of contractor) on behalf of Henry County Water Authority has registered with, is authorized to use and uses the federal work authorization program commonly known as E-Verify, or any subsequent replacement program, in accordance with the applicable provisions and deadlines established in O.C.G.A. 13-10-91. Furthermore, the undersigned subcontractor will continue to use the federal work authorization program throughout the contract period and the undersigned subcontractor will contract for the physical performance of services in satisfaction of such contract only with sub-subcontractors who present an affidavit to the subcontractor with the information required by O.C.G.A. 13-10-91(b). Additionally, the undersigned subcontractor will forward notice of the receipt of an affidavit from a sub-subcontractor to the contractor within five business days of receipt. If the undersigned subcontractor receives notice that a sub-subcontractor has received an affidavit from any other contracted subsubcontractor, the undersigned subcontractor must forward, within five business days of receipt, a copy of the notice to the contractor. Subcontractor hereby attests that its federal work authorization user identification number and date of authorization are as follows: Name of Subcontractor I hereby declare under penalty of perjury that the foregoing is true and correct. Executed on, 20 in (city), (state).

Sub-subcontractor Affidavit under O.C.G.A. 13-10-91(b) (4) By executing this affidavit, the undersigned sub-subcontractor verifies its compliance with O.C.G.A. 13-10-91, stating affirmatively that the individual, firm or corporation which is engaged in the physical performance of services under a contract for (name of subcontractor or sub-subcontractor with whom such sub-subcontractor has privity of contract) and (name of contractor) on behalf of Henry County Water Authority has registered with, is authorized to use and uses the federal work authorization program commonly known as E-Verify, or any subsequent replacement program, in accordance with the applicable provisions and deadlines established in O.C.G.A. 13-10-91. Furthermore, the undersigned subsubcontractor will continue to use the federal work authorization program throughout the contract period and the undersigned sub-subcontractor will contract for the physical performance of services in satisfaction of such contract only with sub-subcontractors who present an affidavit to the sub-subcontractor with the information required by O.C.G.A. 13-10-91(b). The undersigned sub-subcontractor shall submit, at the time of such contract, this affidavit to (name of subcontractor or sub-subcontractor with whom such subsubcontractor has privity of contract). Additionally, the undersigned sub-subcontractor will forward notice of the receipt of any affidavit from a sub- subcontractor to (name of subcontractor or sub-subcontractor with whom such sub-subcontractor has privity of contract). Sub-subcontractor hereby attests that its federal work authorization user identification number and date of authorization are as follows: Name of Subcontractor I hereby declare under penalty of perjury that the foregoing is true and correct. Executed on, 20 in (city), (state).