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SUB*IIT WITH PROPOSAL <br />STATE OF NORTH CAROLINA <br />AFFIDAVIT <br />ORANGE COUNTY <br />,t*** *,S *,fi * * !i t:1.d.* rr,*** * * ** * ** <br />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;,Ve,rifv is the federal E-Verify program operated by the United $tate$ <br />Department of Homeland Security and other federal agencies, or any $uccessor or equivalent program used to verify <br />the work authorization of newly hired employees pursuant to federal law in accordance with NCG$ $64.2${5}. <br />2.EmpIoyerunderstandsthatM.Eachemployer,afterhiringanemployeetowork <br />in the United States, shallverify the work authorizatiorr of the employee through E-Verifu in accordance with <br />NCG5964-?6(a). <br />3. Emqlqyer is a person, business entity, or other organization that transacts business in this State and that <br />employ* 25 or more employees in this State. (mark Yes or No) <br />a. YES <br />b. N0 <br />,or7 <br />4. Employer's subcontractors comply with E-Verifo, 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 />rhis llhdav ot W4^ .zo,af <br />of nt <br />br Type Name:,)enn'.fte ae tdS <br />State of Ngqth Sflrolina, Chrllu;rn County <br />$igned and sworn to (or affirmed) hefore me, this *fi lq <br />day of [\ao 2a!5 <br />My Commission Expires: \Ct "' ,Ae1 <br />+*'o+t <br />P.n) <br />zo <br />o,g <br />IAoq) <br />L <br />I,V ; 1* ch'? <br />lso1r41, L Ss-cl,.z Notary Public <br />t, <br />I <br />NOTARP <br />PuaLtc <br />Docusign Envelope ID: 698F2B7F-27BB-45C9-9CCE-04BCCB3FB4C9