Orange County NC Website
Browse       Search
21 <br /> STATE OF NORTH CAROLINA <br /> AFFIDAVIT <br /> ORANGE COUNTY <br /> ************************** <br /> I, -06-r 'u , ! ° (the individual attesting below), being duly authorized by and on behalf of <br /> !\i,/z )5 a`r/�t `-C (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 C,„,c , 201 <br /> Signatur- oa`Affiant <br /> Print or Type Name: , Aja ,,:;i, 1 ��` ....: <br /> State of North Carolina Orange County <br /> D O <br /> Signed and sworn to(or affirmed) before me,this the 0 3 <br /> day of C, 1 e14. or- < <br /> z �e <br /> My Commission Expires: <br /> (/ <br /> co <br /> 1 otary Public °—' � <br />