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DocuSign Envelope ID: 04E136D1 -507C- 4219- BF16- 446F8D2192F8 <br />STATE OF NORTH CAROLINA <br />ORANGE COUNTY <br />* * * * * * * * * * * * * * * * * * * * * * * * ** <br />AFFIDAVIT <br />the 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 , 201_. <br />Signature of Affiant <br />Print or Type Name: <br />State of North Carolina Orange County <br />D <br />Signed and sworn to (or affirmed) before me, this the o <br />day of , 2014. v' <br />z <br />My Commission Expires: v <br />v' <br />11 -- <br />Notary Public °' <br />