Ga. Comp. R. & Regs. R. 300-10-1-.08 - Subcontractor Affidavit

Contractors shall use the following affidavit form, or an affidavit form that is substantially similar to that provided below, to document a subcontractor's compliance with the requirements of O.C.G.A. 13-10-91:

Subcontractor Affidavit (Example):

SUBCONTRACTOR AFFIDAVIT

By executing this affidavit, the undersigned subcontractor verifies its compliance with O.C.G.A. 13-10-91, stating affirmatively that the individual, firm or corporation which is engaged in the physical performance of services under a contract with (name of contractor) on behalf of (name of public employer) has registered with and is participating in a federal work authorization program* [any of the electronic verification of work authorization programs operated by the United States Department of Homeland Security or any equivalent federal work authorization program operated by the United States Department of Homeland Security to verify information of newly hired employees, pursuant to the Immigration Reform and Control Act of 1986 (IRCA), P.L. 99-603], in accordance with the applicability provisions and deadlines established in O.C.G.A. 13-10-91.

________________________________________

EEV/Basic Pilot Program* User Identification Number

________________________________________ ____________________

BY: Authorized Officer or Agent Date

(Subcontractor Name)

_________________________________________

Title of Authorized Officer or Agent of Subcontractor

_________________________________________

Printed Name of Authorized Officer or Agent

SUBSCRIBED AND SWORN

BEFORE ME ON THIS THE

_____ DAY OF ______________________, 200_

_________________________________________

Notary Public

My Commission Expires:

_________________________________________

* As of the effective date of O.C.G.A. 13-10-91, the applicable federal work authorization program is the "EEV/Basic Pilot Program" operated by the U. S. Citizenship and Immigration Services Bureau of the U.S. Department of Homeland Security, in conjunction with the Social Security Administration (SSA).

(End of Form)

Notes

Ga. Comp. R. & Regs. R. 300-10-1-.08

O.C.G.A. Sec. 13-10-91.

Original Rule entitled "Subcontractor Affidavit" adopted. F. May 25, 2007; eff. June 18, 2007, as specified by the Agency.