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DocuSign Envelope ID:41 B27956-1 C1 7-475E-9558-D6D38ABE1436 <br /> AFFIDAVIT <br /> ORANGE COUNTY <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 <br /> duly sworn hereby swears or affirms as follows: <br /> I. 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 <br /> verify the work authorization of newly hired employees pursuant to federal law in accordance with NCGS §64- <br /> 25(5). <br /> 2. Employer understands that Employers Must Use E-Verify. Each employer, after hiring an employee to <br /> work in the United States, shall verify the work authorization of the employee through E-Verify in accordance <br /> with 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 12015. <br /> Signature of Affiant <br /> Print or Type Name: <br /> State of North Carolina Orange County <br /> Y <br /> Signed and sworn to (or affirmed)before me, this the <br /> O <br /> day of 1201. <br /> 0 <br /> My Commission Expires: SID <br /> Notary Public <br /> Page 12 of 12 <br />