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DocuSign Envelope ID:4E43C797-33A3-4C29-9D23-96EA82AC437C <br /> STATE OF NORTH CAROLINA <br /> AFFIDAVIT <br /> ORANGE COUNTY <br /> ************************** <br /> I, (the individual attesting below), being duly authorized by and on behalf of <br /> (the entity bidding on project hereinafter"Employer")after first being duly <br /> sworn hereby swears or affirms as follows: <br /> 1. Employer understands that E-Verify is the federal E-Verify program operated by the United States <br /> Department of Homeland Security and other federal agencies,or any successor or equivalent program used to verify <br /> the work authorization of newly hired employees pursuant to federal law in accordance with NCGS§64-25(5). <br /> 2. Employer understands that Employers Must Use E-Verify. Each employer,after hiring an employee to work <br /> in the United States,shall verify the work authorization of the employee through E-Verify in accordance with <br /> NCGS§64-26(a). <br /> 3. Employer is a person, business entity,or other organization that transacts business in this State and that <br /> employs 25 or more employees in this State. (mark Yes or No) <br /> a. YES or <br /> b. NO <br /> 4. Employer's subcontractors comply with E-Verify,and if Employer is the winning bidder on this project <br /> Employer will ensure compliance with E-Verify by any subcontractors subsequently hired by Employer. <br /> This day of 12013. <br /> Signature of Affiant <br /> Print or Type Name: <br /> State of North Carolina Orange County <br /> D <br /> Signed and sworn to(or affirmed) before me,this the o <br /> day of 12013. v' <br /> Z <br /> My Commission Expires: 0. <br /> C <br /> CD <br /> Notary Public 2L <br />