Compilation of Rules and Regulations of the State of Georgia › Department 300 - RULES OF GEORGIA DEPARTMENT OF LABOR › Chapter 300-10 - "GEORGIA SECURITY AND IMMIGRATION COMPLIANCE ACT" OF 2006 › Subject 300-10-1 - PUBLIC EMPLOYERS, CONTRACTORS & SUBCONTRACTORS REQD TO VERIFY NEW EMP WORK ELIGIBILITY THROUGH A FEDERAL WORK AUTHORIZATION PROGRAM RULES OF GENERAL APPLICABILITY › Rule 300-10-1-.07 - Contractor Affidavit and Agreement

Current through Rules and Regulations filed through June 27, 2024
Public employers shall use the following affidavit and
				 agreement form, or an affidavit and agreement form that is substantially
				 similar to that provided below, to document a contractor's compliance with the
				 requirements of O.C.G.A.
				  13-10-91:
Contractor Affidavit and Agreement (Example):
CONTRACTOR AFFIDAVIT AND AGREEMENT
By executing this affidavit, the undersigned contractor
				 verifies its compliance with O.C.G.A.
				  13-10-91, stating affirmatively that the individual, firm, or corporation which is
				 contracting with (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.
The undersigned further agrees that, should it employ or
				 contract with any subcontractor(s) in connection with the physical performance
				 of services pursuant to this contract with (name of public employer),
				 contractor will secure from such subcontractor(s) similar verification of
				 compliance with O.C.G.A.
				  13-10-91 on the Subcontractor Affidavit provided in Rule 300-10-01-.08 or a
				 substantially similar form. Contractor further agrees to maintain records of
				 such compliance and provide a copy of each such verification to the (name of
				 the public employer) at the time the subcontractor(s) is retained to perform
				 such service.
________________________________________
EEV/Basic Pilot Program* User Identification Number
________________________________________ __________
BY: Authorized Officer or Agent Date
(Contractor Name)
_________________________________________
Title of Authorized Officer or Agent of Contractor
_________________________________________
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)
O.C.G.A. Sec.
				  13-10-91.