Orange County NC Website
Browse       Search
DocuSign Envelope ID:90883988-076D-486D-B746-055E86E2D681 <br /> STATE OF NORTH CAROLINA <br /> AFFIDAVIT <br /> ORANGE COUNTY <br /> ssssssssssssssssssssssssss <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 herebyswears or affirms as follows- <br /> 1. Employer u n d e rstan ds that E-Veri is the federal E-Verify program operated by the United States <br /> Department of Homeland Security and other federaI agencies,or a ny s uccess o r or equiva I ent p rag ram used to verify <br /> the work authorization of newly hired employees pursuantto federal law in accordance with NCGS§64-25(5). <br /> 2. Employer understandsthat Emplovers Must Use E-Verify_ Each employer,after hiringan employee to work <br /> in the United States,shall verify the workauthorixation of the employeethrough E-Verify in acrordance with <br /> NCGS§64-26[a]. <br /> 3. Employer is a person,business entity, or other organization th at t ra nsa cts business in this State and that <br /> employs25 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 Fs;the winning bidderon 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 AfFant <br /> Print or Type Name: <br /> State of North Carolina, County <br /> b <br /> Sign edand sworn to(or affirmed) before me,this the " <br /> a <br /> Zt <br /> C- <br /> day of .24= m" <br /> My Commission Expires: m <br /> M <br /> m <br /> Notary Public <br /> P.O. Box 8181 * 131 West Margaret Lane,3`d Floor* Hillsborough, North Carolina 27278 <br /> Telephone:919 245-2625 <br /> Fax:919-644-3001 <br /> E-mail :AMService@orangecountync.gov <br /> Page 3 of 3 <br />