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Docusign Envelope ID: 1C7ED1D1-5E77-4A65-9197-5DBBABEB67C6 <br /> SUBMIT WITH PROPOSAL. <br /> STATE OF NORTH CAROLINA <br /> AFFIDAVIT <br /> ORANGE COUNTY <br /> ************************** <br /> I� ?&P-4?e (the individual attesting below), being duly authorized by and on behalf of <br /> "SL—it4the entity bidding on project hereinafter"Employer")after first being duly <br /> sworn hereby swears or affirms as follows: <br /> 1. Employer understands that E-Verifyis 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 Emplovers 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 IZ day of_ OTC 20Zy <br /> Signature of Affiant �- <br /> Print or Type Name: ZU/f'1 �rlo V,�� <br /> State of North Carolina. D-Zdn�County <br /> W H <br /> O d <br /> D m` <br /> tNU > X? <br /> Signed and sworn to(or affirmed) before me,this the �- 0 W t ; UJ <br /> C <br /> � ao Z U O2,1 <br /> v <br /> day of �% .202y `_' y U= I H <br /> Q� r- E ; <br /> Z LU 1 0 <br /> My Commission Expires: °v <br /> OI W a > <br /> �. 0 <br /> Notary Public <br /> a� <br />