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DocuSign Envelope ID:7AE8A4FO-DD4C-48AF-9407-33 164957C9A2 <br /> STATE OF NORTH CAROLINA <br /> AFFIDAVIT <br /> ORANGE COUNTY <br /> I, 6fI -rt************************** <br /> I"/LS (the individual attesting below),being duly authorized by and on behalf of <br /> 4701— e-r te c) (the entity bidding on project hereinafter"Employer") after first being <br /> duly 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 <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 9 or <br /> b.NO t4 <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 /> Tit <br /> This rZ.y day of 14- L., 2012. <br /> Si 0 1, A tant <br /> Print or Type Name: .6 4—t p istelinet _31 <br /> State of North Carolina Orange County <br /> -5; <br /> Signed and sworn to(or affirmed)before me, this the I 51 <br /> >4 <br /> mum <br /> oo , <br /> %,..4' '44t41\ <br /> / ç <br /> 5A/ ).. <br /> EP, <br /> My Commission E BOCJ <br /> ttt 04. <br /> N CCP," <br /> Notary Public IA tttttttttttttttt <br /> Orange County Bid Page#4 <br />