Opening of Bids - WWTP Belt Filter Press #1 Rehab - Alfa Laval Inc - Financials Submitted, Not Scanned

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Contractor Affidavit under O.C.G.A. § 13-10-91(b)(1) 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 engaged in the physical performance of services on behalf of City of South Bend, Indiana name of public employ ) has registered with, is authorized to use and uses the federal work authorization program commonly known as E-Verify, or any subsequent replacement program, in accordance with the applicable provisions and deadlines established in O.C.G.A. § 13-10-91. Furthermore, the undersigned contractor will continue to use the federal work authorization program throughout the contract period and the undersigned contractor will contract for the physical performance of services in satisfaction of such contract only with subcontractors who present an affidavit to the contractor with the information required by O.C.G.A. § 13-10-91 (b). Contractor hereby attests that its federal work, authorization user identification number and date of authorization are as follows-. 13398 Federal Work Authorization User Identification Number 03-23-2005 Date of Authorization Alfa Laval Inc. Narne of Contractor IFB # 11 8-019: Belt Filter Press #I Rehabilitation Name of Project City of South. Bend, IN. Name of Public Employer I hereby declare under penalty of perjury that the foregoing is true and correct. Execute A r' 19 2 1 1 (city), X 8 in Houston I_(state). Signature of Authorized Officer, or Agent Larry Packard 1 Contracts &Bid Manager Printed Name and Title of Authorized Officer or Agent SUBSCRIBED AND SWORN BEFORE ME ON THIS THE�a�DAY OF 1201ve-- NOTARY PUBLIC My Commission Expires: SHERYLBELLMYER No tary Pub1lo, State of Texas �10$ Comm. Expires 09-03.2020 Notary ID 126648,822