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DocuSign Envelope ID:489DFD84-DFCE-4E07-BB35-5F6A708DFA3A <br /> I <br /> STATE OF NORTH CAROLINA <br /> AFFIDAVIT <br /> ORANGECOUNTY <br /> i <br /> j I Travis Langley (the individual attesting below), being duly authorized by and on behalf of <br /> I <br /> Lomax Construction, Inc. (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-Verif 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 /> j 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 /> i <br /> In the United States,shall verifythe 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 /> i <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 26 day of June M.2015 <br /> -�2_ <br /> nature of Affiant <br /> Print or Type Name: Travis Langley,VP&Corporate Secretary <br /> State of North Carolina Orange County <br /> 4 <br /> Signed and sworn to(or affirmed) before me,this the 26 th Xo <br /> day of June .,=X 2015 o <br /> z <br /> My Commission Expir W April 14,2016 COUP°a° <br /> otary Public <br /> I <br />