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2017-703-E Health - National Assn of State Mental Health Directors service agreement
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2017-703-E Health - National Assn of State Mental Health Directors service agreement
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Last modified
2/11/2019 12:23:12 PM
Creation date
10/2/2018 4:41:04 PM
Metadata
Fields
Template:
Contract
Date
11/15/2017
Contract Starting Date
11/15/2017
Contract Ending Date
11/30/2018
Contract Document Type
Agreement - Services
Amount
$78,769.00
Document Relationships
R 2017-703-E Health - NRI service agreement
(Attachment)
Path:
\Board of County Commissioners\Contracts and Agreements\Contract Routing Sheets\Routing Sheets\2017
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DocuSign Envelope ID:CAABEAFA-9919-4207-B5CD-58E618EA747E <br /> STATE OF NORTH CAROLINA <br /> AFFIDAVIT <br /> ORANGE COUNTY <br /> ************************** <br /> I, (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 /> -n <br /> Signed and sworn to (or affirmed) before me,this the o <br /> day of 2014. v' <br /> z <br /> My Commission Expires: M. <br /> v <br /> 01 <br /> Ln <br /> rD <br /> °'Notary Public <br />
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