Orange County NC Website
Browse       Search
DocuSign Envelope ID:78B556CA-0O28-4315-8EF4-948059C1C6F0 <br /> Contractor Affidavit under O.C.G.A. § 13-10-91(b)(1) <br /> By executing this affidavit,the undersigned contractor verifies its compliance <br /> with O.C.G.A. § 13-10-91, stating affirmatively that the individual, firm or corporation <br /> which is engaged in the physical performance of services on behalf of Orange County,North <br /> Carolina has registered with, is authorized to use and uses the federal work <br /> authorization program commonly known as E-Verify, or any subsequent replacement <br /> program, in accordance with the applicable provisions and deadlines established in <br /> O.C.G.A. § 13-10-91. Furthermore,the undersigned contractor will continue to use the <br /> federal work authorization program throughout the contract period and the undersigned <br /> contractor will contract for the physical performance of services in satisfaction of such <br /> contract only with subcontractors who present an affidavit to the contractor with the <br /> information required by O.C.G.A. § 13-10-91(b). Contractor hereby attests that its <br /> federal work authorization user identification number and date of authorization are as <br /> follows: <br /> 48892 <br /> Federal Work Authorization User Identification Number <br /> March 5. 2008. <br /> Date of Authorization <br /> NetPlanner Systems, Inc. <br /> Name of Contractor <br /> OSP Fiber Optic Infrastructure <br /> Name of Project <br /> Orange County,North Carolina <br /> Name of Public Employer <br /> I hereby declare under penalty of perjury that the foregoing is true and correct. <br /> Executed on 17th of December,2020 in Peachtree Corners,Georgia. <br /> 704& P czed, <br /> Signature of Authorized Officer or Agent <br /> Michael Dycus,Vice President <br /> Printed Name and Title of Authorized Officer or Agent <br /> SUBSCRIB D AND SWOR BFF"QI 6ME <br /> ON THI E Vth D1 ''Q `�ec tuber'_ 2020 <br /> NOTARk PUBL C <br /> %o� <br /> My Commission Expires:, <br /> i � . <br /> 26 <br />