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DocuSign Envelope ID: E53DCC3C-B8E8-410C-BB50-A039C27BD393 <br /> STATE OF NORTH CAROLINA <br /> AFFIDAVIT <br /> ORANGE COUNTY <br /> I _(the i ndividuaI attesting below),being du ly authorized by and on behalf of <br /> (the entity bidding on project hereinafter"Employer")after first being duly <br /> sworn here by swears or affirms as follows: <br /> 1. Employer understands that E-ye ri fy is the federal E-Verify program operated by the United States <br /> De partment of Homeland Security and other federal agencies,or any successor or equivalent program used to verify <br /> the work a uthor i zatio n of newly hired employees pursuantto federal law in accordance with NCGS§54-25(5). <br /> 2. Employer u nde rstands that Employers Must Use E-Verify. Each e m p loye r,afte r h i r i ng a n e m ploye e to work <br /> nthe United States,shall verify the work authorization of the employee through E-Verify in accordance with <br /> N CGS§54r25(a), <br /> 3. Employer is a person,business entity,or other o rga n izat io n that tra nsacts business in this State and that <br /> employs 25 or more employees inthis State, (mark Yes or No) <br /> a. YES__, or <br /> b. NO <br /> 4. Employer's subcontractors comply with E-Verify,and if Employer isthe winning bidder onthis 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 /> n <br /> Signed and swornto(or affirmed) before me,thisthe <br /> day of ---- 2014. W <br /> c <br /> My Commission Expires- ° <br /> i� <br /> Notary Public <br /> 21 <br /> RFP No.xxxx <br />