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STATE OF NORTH CAROLINA <br /> AFFIDAVIT <br />ORANGE COUNTY <br /> <br />************************** <br /> <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 _______________, 201_. <br /> <br /> <br /> <br />Signature of Affiant <br />Print or Type Name: _________________________ <br /> <br />State of North Carolina Orange County <br /> <br />Signed and sworn to (or affirmed) before me, this the _____ <br /> <br />day of ________________, 2014. <br /> <br />My Commission Expires: <br /> <br /> <br /> Notary Public <br /> (Affix Official/Notarial Seal) <br />DocuSign Envelope ID: AD43A22F-6754-4919-9754-D100376EF19EDocuSign Envelope ID: C4DE450E-A186-4782-A66E-500EFEA850D3DocuSign Envelope ID: 0571DBE7-0B79-4A80-A5CE-2D7E8B8A9B33DocuSign Envelope ID: 04062D67-2152-494F-87A9-7D0C7854BA09