Browse
Search
2018-012-E County Mgr - Willis of NC Insurance Brokerage
OrangeCountyNC
>
Board of County Commissioners
>
Contracts and Agreements
>
General Contracts and Agreements
>
2010's
>
2018
>
2018-012-E County Mgr - Willis of NC Insurance Brokerage
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
7/31/2018 3:33:39 PM
Creation date
1/30/2018 3:15:21 PM
Metadata
Fields
Template:
Contract
Date
12/1/2017
Contract Starting Date
12/1/2017
Contract Ending Date
12/1/2018
Contract Document Type
Agreement - Services
Amount
$42,500.00
Document Relationships
R 2018-012 Risk Management - Willis of NC Insurance Brokerage
(Attachment)
Path:
\Board of County Commissioners\Contracts and Agreements\Contract Routing Sheets\Routing Sheets\2018
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
21
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
DocuSign Envelope ID: AAB342A1- 84D6- 4FD9- BC12- 585C2F446C71 <br />STATE OF NORTH CAROLINA <br />ORANGE COUNTY <br />AFFIDAVIT <br />he individual attesting below), being duly authorized by and on behalf of <br />(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 <br />Signature of Affiant <br />Print or Type Name: <br />201. <br />State of North Carolina Orange County <br />D <br />Signed and sworn to (or affirmed) before me, this the <br />0 <br />n' <br />day of 2014. v' <br />z <br />0 <br />My Commission Expires: v <br />v' <br />Ln <br />v <br />Notary Public <br />
The URL can be used to link to this page
Your browser does not support the video tag.