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DocuSign Envelope ID: B94F2D40-3B3C-47A7-86C2-6F1 B4F92C62C <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 , 2013. <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 /> 0 <br /> day of , 2013. v' <br /> z <br /> My Commission Expires: <br /> r+ <br /> v' <br /> ro <br /> Notary Public ;'. <br />