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DocuSign Envelope ID: ACF53DOB- DE31- 493C- AC79- 4B38761278A7 <br />STATE OF NORTH CAROLINA <br />AFFIDAVIT <br />ORANGE COUNTY <br />1,ts _(the individual attesting below), being duly authorized by and on behalf of <br />\q gt•i � i'nl�c� i� l @ill. (the entity bidding on project hereinafter "Employer ") after first being <br />duly sworn hereby swears or affirms as follows: <br />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 §64w <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. Emplo 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 'i 0' of�.�L. , 2018. <br />Signature ffiant <br />Print or Type Name:t� <br />State of North Carolina Orange County <br />Signed and sworn to (or affirmed) before me, this the <br />Day of Gor 1 1 , 2011. <br />My Commission E. <br />Z + v <br />Notary Public <br />10 <br />x <br />0 <br />m <br />,CRYSTAL 13AlLEY <br />NOTARY PUBLIC <br />Nolith oM <br />My C4 mnftW n Explre� 2' <br />Orange County Bid 501 W. Franklin St Roof Top Unit Replacement Page ##4 <br />