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DocuSign Envelope ID:46276B05-79E0-4089-B879-E62E97F0B2A1 <br /> STATE OF NORTH CAROLINA <br /> AFFIDAVIT <br /> ORANGE COUNTY <br /> ************************** <br /> I, 6 -\A (the individual attesting below),being duly authorized by and on behalf of <br /> — 4 the entity bidding on project hereinafter"Employer")after first being duly <br /> sworn hereby swears or affirms as follows: <br /> L 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-Vertfy in accordance with <br /> NCGS§64-26(a). <br /> 3. Employer 4 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 201S, <br /> ‘41. <br /> .411110 <br /> Sign of Affiant <br /> Print or Type Name: <br /> State of North Carolina Orange County o ow I I <br /> 9„t1/4 JO /4,/d <br /> Signed and sworn to(or affirmed)before me,this the 7- 0 <br /> day of ,2015. A, <br /> • <br /> Z <br /> PUBLIS" <br /> My Commission Expires: <br /> (.1 <br /> (11 <br /> M04.4-\ ac) <br /> do, <br /> 1/6'Z' co <br /> Notary Public 1/11111W‘ <br />