| Agency: | Gwinnett County |
|---|---|
| State: | Georgia |
| Type of Government: | State & Local |
| NAICS Category: |
|
| Posted Date: | May 29, 2026 |
| Due Date: | Jun 15, 2026 |
| Solicitation No: | PA027-26 INV |
| Original Source: | Please Login to View Page |
| Contact information: | Please Login to View Page |
| Bid Documents: | Please Login to View Page |
Preventative Maintenance and Repair of Basketball Goals and Gym Curtains on an Annual Contract
Buyer Contact : Casey.Beauston@GwinnettCounty.com
Opening Date : 06/15/2026 03:00 PM EST
| May 29, 2026 | |
|---|---|
| INFORMAL WRITTEN QUOTE PA027-26 Gwinnett County is soliciting competitive quotes from qualified contractors for Preventative Maintenance and Repair of Basketball Goals and Gym Curtains on an Annual Contract for the Department of Parks and Recreation. Quotes should be typed or submitted in ink and r eturned to the Attention of Casey Beauston, Purchasing Associate III. Quotes should be received by 3:00 P.M. on June 15, 2026 by email casey.beauston@gwinnettcounty.com or sent to the Gwinnett County Financial Services - 2nd Floor - Purchasing Division, 75 Langley Drive, Lawrencevi lle, Georgia 30046. Questions regarding quotes should be directed to Casey Beauston, Purchasing Associate III, at casey.beauston@gwinnettcounty.com or by calling 770-822-7995 no later than 3:00 P.M. on June 5, 2026. Quotes are legal and binding upon the bidder when submitted. The written Quote documents supersede any verbal or written prior communications between the parties. Successful awarded contractor will be required to meet insurance requirements. Insurance Company must be authorized to do business in Georgia by The Ge orgia Insurance Department, listed in the Department of Treasury's Publication of Companies holding Ce rtificates of Authority as Acceptable Surety on Federal Bonds and as acceptable reinsuring companies, and must have an A.M. Best rating of A-7 or higher. Gwinnett County does not discriminate on the basis of disability in the admission or access to its programs or activities. Any requests for reasonable accommodations required by individuals to fully participate in any open meeting, program or activity of Gwinn ett County Government should be directed to the ADA Coordinator, Gwinnett County Justice and Admini stration Center, 770-822-8165. The written quote documents supersede any verbal or written prior communications between the parties. Award will be made to the contractor submitting the lowest responsive and responsible quote. Gwinnett County reserves the right to reject any or all quote s, to waive technicalities, and to make an award deemed in its best interest. Quotes may be split or award ed in entirety. Gwinnett County reserves the option to negotiate terms, conditions and pricing with the lo west responsive, responsible bidder(s) at its discretion. We look forward to your quote and appreciate your interest in Gwinnett County. Casey Beauston, CPPB Purchasing Associate III The following pages should be returned with your quote: Quote Schedule, Pages 5-8 References, Page 9 Contractor Affidavit & Agreement, Page 10 Subcontractor Form, Page 11 | INFORMAL WRITTEN QUOTE PA027-26 Gwinnett County is soliciting competitive quotes from qualified contractors for Preventative Maintenance and Repair of Basketball Goals and Gym Curtains on an Annual Contract for the Department of Parks and Recreation. Quotes should be typed or submitted in ink and r eturned to the Attention of Casey Beauston, Purchasing Associate III. Quotes should be received by 3:00 P.M. on June 15, 2026 by email casey.beauston@gwinnettcounty.com or sent to the Gwinnett County Financial Services - 2nd Floor - Purchasing Division, 75 Langley Drive, Lawrencevi lle, Georgia 30046. Questions regarding quotes should be directed to Casey Beauston, Purchasing Associate III, at casey.beauston@gwinnettcounty.com or by calling 770-822-7995 no later than 3:00 P.M. on June 5, 2026. Quotes are legal and binding upon the bidder when submitted. The written Quote documents supersede any verbal or written prior communications between the parties. Successful awarded contractor will be required to meet insurance requirements. Insurance Company must be authorized to do business in Georgia by The Ge orgia Insurance Department, listed in the Department of Treasury's Publication of Companies holding Ce rtificates of Authority as Acceptable Surety on Federal Bonds and as acceptable reinsuring companies, and must have an A.M. Best rating of A-7 or higher. Gwinnett County does not discriminate on the basis of disability in the admission or access to its programs or activities. Any requests for reasonable accommodations required by individuals to fully participate in any open meeting, program or activity of Gwinn ett County Government should be directed to the ADA Coordinator, Gwinnett County Justice and Admini stration Center, 770-822-8165. The written quote documents supersede any verbal or written prior communications between the parties. Award will be made to the contractor submitting the lowest responsive and responsible quote. Gwinnett County reserves the right to reject any or all quote s, to waive technicalities, and to make an award deemed in its best interest. Quotes may be split or award ed in entirety. Gwinnett County reserves the option to negotiate terms, conditions and pricing with the lo west responsive, responsible bidder(s) at its discretion. We look forward to your quote and appreciate your interest in Gwinnett County. Casey Beauston, CPPB Purchasing Associate III The following pages should be returned with your quote: Quote Schedule, Pages 5-8 References, Page 9 Contractor Affidavit & Agreement, Page 10 Subcontractor Form, Page 11 |
May 29, 2026
INFORMAL WRITTEN QUOTE
PA027-26
Gwinnett County is soliciting competitive quotes from qualified contractors for Preventative Maintenance
and Repair of Basketball Goals and Gym Curtains on an Annual Contract for the Department of Parks and
Recreation.
Quotes should be typed or submitted in ink and r eturned to the Attention of Casey Beauston, Purchasing
Associate III. Quotes should be received by 3:00 P.M. on June 15, 2026 by email
casey.beauston@gwinnettcounty.com or sent to the Gwinnett County Financial Services - 2nd Floor -
Purchasing Division, 75 Langley Drive, Lawrencevi lle, Georgia 30046.
Questions regarding quotes should be directed to Casey Beauston, Purchasing Associate III, at
casey.beauston@gwinnettcounty.com or by calling 770-822-7995 no later than 3:00 P.M. on June 5, 2026.
Quotes are legal and binding upon the bidder when submitted. The written Quote documents supersede
any verbal or written prior communications between the parties.
Successful awarded contractor will be required to meet insurance requirements. Insurance Company must
be authorized to do business in Georgia by The Ge orgia Insurance Department, listed in the Department of
Treasury's Publication of Companies holding Ce rtificates of Authority as Acceptable Surety on Federal
Bonds and as acceptable reinsuring companies, and must have an A.M. Best rating of A-7 or higher.
Gwinnett County does not discriminate on the basis of disability in the admission or access to its programs
or activities. Any requests for reasonable accommodations required by individuals to fully participate in
any open meeting, program or activity of Gwinn ett County Government should be directed to the ADA
Coordinator, Gwinnett County Justice and Admini stration Center, 770-822-8165.
The written quote documents supersede any verbal or written prior communications between the parties.
Award will be made to the contractor submitting the lowest responsive and responsible quote. Gwinnett
County reserves the right to reject any or all quote s, to waive technicalities, and to make an award deemed
in its best interest. Quotes may be split or award ed in entirety. Gwinnett County reserves the option to
negotiate terms, conditions and pricing with the lo west responsive, responsible bidder(s) at its discretion.
We look forward to your quote and appreciate your interest in Gwinnett County.
Casey Beauston, CPPB
Purchasing Associate III
The following pages should be returned with your quote: Quote Schedule, Pages 5-8
References, Page 9
Contractor Affidavit & Agreement, Page 10
Subcontractor Form, Page 11
PA027-26 Page 2
PREVENTATIVE MAINTENANCE AND REPAIR OF BASKETBALL GOALS AND GYM CURTAINS
ON AN ANNUAL CONTRACT
A. SCOPE OF WORK
Gwinnett County Department of Parks and Recreation is seeking a qualified contractor to perform
inspections, preventative maintenance, repairs, and/or replacement of basketball goals and gym curtains
at various County facilities. See Quote Schedule for locations, addresses, and number of goals and
curtains at each location.
B. GENERAL REQUIREMENTS
1. Successful contractor must be experienced with repair and maintenance of basketball goals
and gym curtains. Contractor must adhere to all local, State and Federal laws and regulations.
2. Contractor's references must demonstrate a proven track record of successful service and
repair on basketball goals and gym curtains, within the past five (5) years. A minimum of three
(3) references is required.
3. While no minimum staffing is required for this contract, the contractor shall employ sufficient
labor to manage this contract in its entirety. Response times will be handled in this manner:
a. 2-hour or less response call to call originator on repair calls
b. 24-hour on-site response for emergency calls
c. All repairs shall be completed within 48 hours
4. Should special conditions exist where repairs cannot be completed within 48 hours, the
contractor shall contact the County representative immediately.
5. No subcontractors are to be utilized in this contract without prior permission from the County
representative.
a. There is no mark-up allowed for subcontracted work or rental equipment.
b. The successful contractor is allowed to implement a trip charge for coordinating
subcontracted work or rental equipment as indicated in the Quote Schedule.
6. All work is to be performed within established regular business hours for each facility unless
otherwise approved by the County representative. Contractor must check in with on-site staff
upon arrival at each facility.
7. Gwinnett County reserves the right to add and delete locations at a comparable and agreed-
upon rate, as necessary, during the contract period.
8. Parts supplied by the contractor shall be new, free of defects, and suitable for the intended
service (brand-specific as required). All parts and labor shall carry a minimum one-year
warranty. A copy of any manufacturer's warranty should be provided.
9. Contractor shall adequately protect County property and take necessary precautions during
the work process to protect all persons/property from damage or loss. Reports of any damage
to County property must be submitted by the contractor to the designated County
representative. Damage to public and/or private property shall be the sole responsibility of the
contractor and shall be repaired and/or replaced at no additional cost and to the satisfaction
of the County.
PA027-26 Page 3
10. Contractor shall take necessary precautions for the safety of employees and shall comply with
all applicable provisions of the Federal, State, and local safety laws to prevent accident and
injury to persons on, about, or adjacent to the premises where work is being performed.
11. Contractor shall be responsible for the proper removal and disposal of old parts according to
latest EPA regulations. Contractor shall clean up all refuse, rubbish, scrap materials, and debris
caused by its operations.
C. INVOICING
The successful contractor shall provide the materials below.
1. Section A: Semi-annual inspection invoices must reference the Purchase Order number, list
each service location and price per Quote Schedule, and include an inspection report.
2. Section B: Repair invoices must reference the Purchase Order number and the date(s) and
location where service was performed. Invoices must be itemized with a breakdown by number
of hours of labor (regular); trip charge if applicable; parts/materials at cost plus mark-up as
stated on Quote Schedule.
3. Parts invoice must be submitted with contractor invoice to verify mark-up.
D. INSPECTION AND PREVENTATIVE MAINTENANCE
1. Semi-annual inspections shall be scheduled in March and October. The County will
communicate any rescheduling to the contractor.
2. The semi-annual inspection cost should include all costs associated with completing the
service request, including but not limited to cost of preventative maintenance labor, grease,
and tools.
3. Semi-annual inspection reports shall be submitted to the County within seven (7) business
days of completion.
4. Semi-Annual inspections and preventative maintenance shall be for basketball goals and gym
curtains and shall include but not be limited to the following:
a. Fully inspect backstops for operational safety:
i. Inspect backstop attachment and structure from rim to the ceiling.
ii. Inspect cables.
iii. Inspect backboard attachment hardware.
iv. Inspect goal attachment and rim tension.
v. Inspect Backboard Padding (if applicable).
vi. Inspect Safety Straps (if applicable).
vii. Inspect Height Adjusters and Rods (if applicable).
viii. Inspect Motors and electrical components (if applicable).
ix. Inspect to ensure that backboard and hoops are plumb and square to the court.
b. Perform preventative maintenance on goals to include:
i. Tighten and adjust all loose hardware and moving parts and check torque
specifications.
ii. Lubricate moving parts.
PA027-26 Page 4
c. Gym Curtain Service: Fully inspect curtain for operational safety:
i. Inspect curtain track attachment and structure, torque specifications and curtain
tracking.
ii. Inspect cables.
iii. Inspect motors and electrical components (if applicable).
d. Perform preventative maintenance on gym curtains to include:
i. Tighten and adjust all loose hardware and moving parts.
ii. Lubricate moving parts.
e. Provide a written report on the condition of the backstops and curtains along with any
recommended repairs.
f. Contractor shall immediately inform the County representative of any unsafe
conditions found including any safety hazards, exposed wiring, etc.
g. Contractor shall review basketball goals and gym curtain operations with County
representative at the time of inspections.
E. REPAIR SERVICES ON A TIME & MATERIAL BASIS
1. Contractor shall provide repair services on a time and material basis, to include equipment
replacements and installations of new equipment in response to specific service requests
made by the County representative. Repairs identified during regular preventative maintenance
visits should be made at that time, if possible, per approved phone call to County
representative.
2. Outdoor courts do not require regular maintenance, but are included in repairs for this contract.
3. Compensation to the contractor for service call responses will be based on the hourly labor
rates and the actual cost of parts plus a percentage markup (not to exceed 10%) as indicated
on the Quote Schedule.
4. Only one trip charge per service call request may be added regardless of number of trips to the
site.
| Item # | Location | # of Goals (approx. annual qty) | # of Gym | Unit Price (per service visit) | Total Price | ||
|---|---|---|---|---|---|---|---|
| Curtains | |||||||
| (approx. | |||||||
| annual qty) | |||||||
| Section A: Inspection and Preventative Maintenance | |||||||
| 1a | Goals - Best Friend Park Gym 6224 Jimmy Carter Boulevard Norcross, GA 30071 | 12 (6 goals serviced semi- annually) | $ | $ | |||
| 1b | Gym Curtains - Best Friend Park Gym 6224 Jimmy Carter Boulevard Norcross, GA 30071 | 2 (1 curtain serviced semi- annually) | $ | $ | |||
| 2a | Goals - Bogan Community Center Gym 2723 North Bogan Rd Buford, GA 30519 | 12 (6 goals serviced semi- annually) | $ | $ | |||
| 2b | Gym Curtains - Bogan Community Center Gym 2723 North Bogan Rd Buford, GA 30519 | 2 (1 curtain serviced semi- annually) | $ | $ | |||
| 3a | Goals - George Pierce Park 55 Buford Hwy Suwanee, GA 30024 | 12 (6 goals serviced semi- annually) | $ | $ | |||
| 3b | Gym Curtains - George Pierce Park 55 Buford Hwy Suwanee, GA 30024 | 2 (1 curtain serviced semi- annually) | $ | $ |
| # of Goals |
|---|
| (approx. |
| annual qty) |
| Item |
|---|
| # |
| Unit Price (per |
|---|
| service visit) |
PA027-26 Page 5
FAILURE TO RETURN THIS PAGE AS PART OF YOUR QUOTE DOCUMENT MAY RESULT IN QUOTE BEING DEEMED NON-RESPONSIVE.
QUOTE SCHEDULE
# of Gym
# of Goals
Item Curtains Unit Price (per
Location (approx. Total Price
# (approx. service visit)
annual qty)
annual qty)
Section A: Inspection and Preventative Maintenance
12 (6 goals
Goals - Best Friend Park Gym
serviced
1a 6224 Jimmy Carter Boulevard $ $
semi-
Norcross, GA 30071
annually)
Gym Curtains - Best Friend 2 (1 curtain
Park Gym serviced
1b $ $
6224 Jimmy Carter Boulevard semi-
Norcross, GA 30071 annually)
Goals - Bogan Community 12 (6 goals
Center Gym serviced
2a $ $
2723 North Bogan Rd semi-
Buford, GA 30519 annually)
Gym Curtains - Bogan 2 (1 curtain
Community Center Gym serviced
2b $ $
2723 North Bogan Rd semi-
Buford, GA 30519 annually)
12 (6 goals
Goals - George Pierce Park
serviced
3a 55 Buford Hwy $ $
semi-
Suwanee, GA 30024
annually)
Gym Curtains - George Pierce 2 (1 curtain
Park serviced
3b $ $
55 Buford Hwy semi-
Suwanee, GA 30024 annually)
COMPANY NAME: _________________________________________________________________________
| Item # | Location | # of Goals (approx. annual qty) | # of Gym | Unit Price (per service visit) | Total Price | ||
|---|---|---|---|---|---|---|---|
| Curtains | |||||||
| (approx. | |||||||
| annual qty) | |||||||
| 4a | Goals - Lenora Park Gym 4515 Lenora Church Rd Snellville, GA 30058 | 12 (6 goals serviced semi- annually) | $ | $ | |||
| 4b | Gym Curtains - Lenora Park Gym 4515 Lenora Church Rd Snellville, GA 30058 | 2 (1 curtain serviced semi- annually) | $ | $ | |||
| 5a | Goals - Lucky Shoals Park Gym 4651 Britt Rd Norcross, GA 30093 | 12 (6 goals serviced semi- annually) | $ | $ | |||
| 5b | Gym Curtains - Lucky Shoals Park Gym 4651 Britt Rd Norcross, GA 30093 | 2 (1 curtain serviced semi- annually) | $ | $ | |||
| 6a | Goals - Rhodes Jordan Park Gym 100 E. Crogan St Lawrenceville, GA 30046 | 12 (6 goals serviced semi- annually) | $ | $ | |||
| 6b | Gym Curtains - Rhodes Jordan Park Gym 100 E. Crogan St Lawrenceville, GA 30046 | 2 (1 curtain serviced semi- annually) | $ | $ | |||
| SECTION A TOTAL | $ |
| # of Goals |
|---|
| (approx. |
| annual qty) |
| Item |
|---|
| # |
| Unit Price (per |
|---|
| service visit) |
PA027-26 Page 6
FAILURE TO RETURN THIS PAGE AS PART OF YOUR QUOTE DOCUMENT MAY RESULT IN QUOTE BEING DEEMED NON-RESPONSIVE.
QUOTE SCHEDULE
# of Gym
# of Goals
Item Curtains Unit Price (per
Location (approx. Total Price
# (approx. service visit)
annual qty)
annual qty)
12 (6 goals
Goals - Lenora Park Gym
serviced
4a 4515 Lenora Church Rd $ $
semi-
Snellville, GA 30058
annually)
Gym Curtains - Lenora Park 2 (1 curtain
Gym serviced
4b $ $
4515 Lenora Church Rd semi-
Snellville, GA 30058 annually)
12 (6 goals
Goals - Lucky Shoals Park Gym
serviced
5a 4651 Britt Rd $ $
semi-
Norcross, GA 30093
annually)
Gym Curtains - Lucky Shoals 2 (1 curtain
Park Gym serviced
5b $ $
4651 Britt Rd semi-
Norcross, GA 30093 annually)
Goals - Rhodes Jordan Park 12 (6 goals
Gym serviced
6a $ $
100 E. Crogan St semi-
Lawrenceville, GA 30046 annually)
Gym Curtains - Rhodes Jordan 2 (1 curtain
Park Gym serviced
6b $ $
100 E. Crogan St semi-
Lawrenceville, GA 30046 annually)
SECTION A TOTAL $
COMPANY NAME: _________________________________________________________________________
| Item | Location | Approx. | Unit Price | Total Price | ||||
|---|---|---|---|---|---|---|---|---|
| # | Quantity | |||||||
| Section B: Repair Services | ||||||||
| 7 | Hourly Rate for Repairs During Normal Business Hours Monday - Friday | 100 HR | $ | $ | ||||
| 8 | Hourly Rate for Emergency Repairs, After-hours, Evenings, and Weekends | 25 HR | $ | $ | ||||
| 9 | Trip Charge (one per service request) | 20 EA | $ | $ | ||||
| 10 | State Percentage Mark-Up above Cost for Parts, Materials, and Equipment (Not to Exceed 10%) | $10,000.00 | _____________% | $ | ||||
| SECTION B TOTAL | $ | |||||||
| GRAND TOTAL (SECTION A TOTAL + SECTION TOTAL) | $ |
PA027-26 Page 7
FAILURE TO RETURN THIS PAGE AS PART OF YOUR QUOTE DOCUMENT MAY RESULT IN QUOTE BEING DEEMED NON-RESPONSIVE.
QUOTE SCHEDULE
Item Approx.
Location Unit Price Total Price
# Quantity
Section B: Repair Services
Hourly Rate for Repairs During
7 Normal Business Hours 100 HR $ $
Monday - Friday
Hourly Rate for Emergency
8 Repairs, After-hours, Evenings, 25 HR $ $
and Weekends
Trip Charge (one per service
9 20 EA $ $
request)
State Percentage Mark-Up
above Cost for Parts,
10 $10,000.00 _____________% $
Materials, and Equipment (Not
to Exceed 10%)
SECTION B TOTAL $
GRAND TOTAL (SECTION A TOTAL + SECTION TOTAL) $
COMPANY NAME: _________________________________________________________________________
PA027-26 Page 8
FAILURE TO RETURN THIS PAGE AS PART OF YOUR QUOTE DOCUMENT MAY RESULT IN QUOTE BEING DEEMED NON-RESPONSIVE.
QUOTE SCHEDULE
Certification of Non-Collusion in Quote Preparation
Signature Date
The undersigned acknowledges receipt of the following addenda, listed by number and date appearing on each:
Addendum No. Date Addendum No. Date
In compliance with the attached specifications and the Instructions for Vendors, the undersigned offers and agrees, within ninety (90) days of the date of quote opening,
to furnish any or all of the items upon which prices are quoted, at the price set opposite each item, delivered to the designated point(s) within the time specified in the fee
schedule. By submission of this quote, I understand that Gwinnett County uses Electronic Payments for remittance of goods and services. Vendors should select their
preferred method of electronic payment upon notice of award. For more information on electronic payments, please refer to the Electronic Payment information in the
Instructions for Vendors.
Legal Business Name
Complete Address
Does your company currently have a location within Gwinnett County? Yes No
Representative Signature Printed Name
Telephone Number Fax Number E-mail Address
COMPANY NAME: _________________________________________________________________________
PA027-26 Page 9
FAILURE TO RETURN THIS PAGE AS PART OF YOUR QUOTE DOCUMENT MAY RESULT IN QUOTE BEING
DEEMED NON-RESPONSIVE.
REFERENCES
Gwinnett County requests a minimum of three (3) references where work of a similar size and scope has been
completed.
Note: References should be customized for each project, rather than submitting the same set of references
for every project bid. The references listed should be of similar size and scope of the project being bid on. Do
not submit a project list in lieu of this form.
1. Company Name
Brief Description of Project
Completion Date
Contract Amount $ Start Date
Contact Person Telephone
E-Mail Address
2. Company Name
Brief Description of Project
Completion Date
Contract Amount $ Start Date
Contact Person Telephone
E-Mail Address
3. Company Name
Brief Description of Project
Completion Date
Contract Amount $ Start Date
Contact Person Telephone
E-Mail Address
COMPANY NAME
PA027-26 Page 10
Page 10
PA027-26 Preventative Maintenance and Repair of Basketball Goals and Gym Curtains on an Annual Contract
CONTRACTOR AFFIDAVIT AND AGREEMENT
(THIS FORM SHOULD BE FULLY COMPLETED AND RETURNED WITH YOUR SUBMITTAL)
By executing this affidavit, the undersigned contractor verifies its compliance with The Illegal Immigration Reform
Enhancements for 2013, stating affirmatively that the individual, firm, or corporation which is contracting with the Gwinnett
County Board of Commissioners 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, in accordance with the applicability
provisions and deadlines established therein.
The undersigned further agrees that, should it employ or contract with any subcontractor(s) in connection with the
physical performance of services or the performance of labor pursuant to this contract with the Gwinnett County Board of
Commissioners, contractor will secure from such subcontractor(s) similar verification of compliance with the Illegal Immigration
Reform and Enforcement Act 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 Gwinnett
County Board of Commissioners at the time the subcontractor(s) is retained to perform such service.
_________________________________________ _____________________________________
E-Verify * User Identification Number Date Registered
_________________________________________
Legal Company Name
_________________________________________
Street Address
_________________________________________
City/State/Zip Code
_____________________________________ _____________________________________
BY: Authorized Officer or Agent Date
(Contractor Signature)
For Gwinnett County Use Only:
__________________________________________
Title of Authorized Officer or Agent of Contractor Document ID #____________________
Issue Date: _______________________
___________________________________________
Printed Name of Authorized Officer or Agent
Initials: ___________________________
SUBSCRIBED AND SWORN
BEFORE ME ON THIS THE
_______ DAY OF ______________________, 20_______
________________________________________________
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 "E-Verify" 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).
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