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DocuSign Envelope ID:070B6BC7-CDE2-4AO8-BE62-07FA6BFDO53B <br /> STATE OF NORTH CAROLINA <br /> AFFIDAVIT <br /> ORANGE COUNTY <br /> ************************** <br /> I, St,-/) (the individual attesting below), being duly authorized by and on behalf of <br /> t 1 SS LOS-- n e yrtS4ctALA.a n (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-Verifv 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 ;201 lay of Le _ , 202,$) <br /> 4 <br /> ZorIgnature of Affiant <br /> Print <br /> Type Name: 115e �,J , tSch <br /> State of North Carolina, County <br /> D <br /> Signed and sworn to (or affirmed) before me,thisthe Z•>` �' X \.�`� � Cy ',�, <br /> day of �c 2rnb�r , 20 2- �, ?0 3 o L y <br /> o s0 o 0 6 co_ <br /> My Commission Expires: 1 p <br /> a <br /> LJ- <br /> -f 0 Notary Public ° ��'�+++r+++►tit,������� <br />