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Project Name <br />Project Number <br />BPW Approval Date <br />VA Clinic - South Bend <br />EMPLOYMENT ELIGIBILITY VERIFICATION <br />STATE OF INDIANA ) <br />) SS: <br />Elkhart COUNTY ) <br />The Contractor affirms under the penalties of perjury that he /she /it does not knowingly employ an <br />unauthorized alien. <br />The Contractor shall enroll in and verify the work eligibility status of all his /her /its newly hired <br />employees through the E- Verify program as defined in IC 22- 5- 1.7 -3. The Contractor is not required to <br />participate should the E- Verify program cease to exist. Additionally, the Contractor is not required to <br />participate if the Contractor is self - employed and does not employ any employees. <br />The Contractor shall not knowingly employ or contract with an unauthorized alien. The Contractor shall <br />not retain an employee or contract with a person that the Contractor subsequently learns is an <br />unauthorized alien. <br />The Contractor shall require his/her /its subcontractors, who perform work under this contract, to certify to <br />the Contractor that the subcontractor does not knowingly employ or contract with an unauthorized alien <br />and that the subcontractor has enrolled and is participating in the E- Verify program. The Contractor <br />agrees to maintain this certification throughout the duration of the term of a contract with a subcontractor. <br />The City may terminate for default if the Contractor fails to cure a breach of this provision no later than <br />thirty (30) days after being notified by the City. <br />Dated this 19th day of March, 2012 <br />Subscribed and sworn to before me this 19th <br />My Commission Expires June 19, 2016 <br />County of Residence <br />DJ Co uction Co., Inc. <br />'o actor (Firm) <br />or Its Agent <br />Printed Name and Title <br />day of March 2012 <br />of <br />Notary Public <br />Cynthia A. Mockler <br />Elkhart <br />F -E -Verify Affidavit July 2011.doc <br />