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DocuSign Envelope ID: CF08811 B -991 E- 4A3C- 87AA- FE61013F9A61 <br />STATE OF NORTH CAROLINA <br />AFFIDAVIT <br />GRANGE COUNTY <br />L #A 4t-Qr—G A4 e4P w KA/ the individual attesting below), being duly authorized by and on behalf of <br />M•k. -RFr ,,, -(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 -Veri 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- "m lover 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 />is f day of NO-V W V 6V 2017. <br />Signat4re of Affiant <br />Print or Type Name: lit &�c,, t <br />State ofN Ah Carolina Orange County <br />,-. <br />R�itrtert►r <br />Signed and sworn to (or affirmed) before me, this the <br />jpz'tRy. <br />day of Nv,wbrn'gey , 201 -7. <br />My Commission Expires. <br />cr-z- / u <br />Notary Public <br />Orange County Bid 1726 Page #8 <br />