Contract 2020-008A ACity of Casselberry f Procurement and Contract Management Division
95 Triplet Lake Drive, Casselberry, Florida 32707
Phone: 407-262-7700, Ext. 1142 j orocurement(&casselberrv.orq
RFP-2019-0467 — SANITARY SEWER, MANHOLE, AND
LIFT STATION WET WELL REHABILITATION
AMENDMENT #1
THIS Amendment is made by and between the CITY OF CASSELBERRY, a municipal corporation
existing under the laws of the State of Florida, 95 Triplet Lake Drive, Casselberry, Florida 32707, hereinafter
referred to as the "CITY", and GRANITE INLINER, 2531 Jewett Lane, Sanford, Florida 32771 hereinafter referred
to as the "CONTRACTOR".
WITNESSETH:
WHEREAS, the CITY desires to maintain the professional services of the CONTRACTOR to continue to
provide and perform Sanitary Sewer, Manhole and Lift Station Wet Well Rehabilitation, as further described in
Agreement RFP-2019-0467, approved by the CITY COMMISSION, on June 10, 2019, between the CITY and
the CONTRACTOR; and
WHEREAS, pursuant to the original agreement, the covenants, terms, and provisions of the Agreement
may be modified by way of written instrument, mutually accepted by the parties; and
WHEREAS, the purpose of this Amendment is to extend the Term_
NOW, THEREFORE, in consideration of the mutual covenants, terms, and provisions contained herein,
the parties agree as follows:
SECTION 1 TERM
The Agreement is hereby extended one (1) year to June 9, 2023, and may be renewed for an additional one (1)
year period.
SECTION 5 COMPENSATION
No changes to Compensation.
SIGNATURE PAGE TO FOLLOW
PF408A 1 6/2021
City of Casseiberry I Procurement and Contract Management Division
95 Triplet Lake Drive, Casselberry, Florida 32707
Phone: 407-262-7700, Ext. 1142 1 procurementnaasselberrv.orq
RFP-2019-0467 — SANITARY SEWER, MANHOLE, AND
LIFT STATION WET WELL REHABILITATION
IN WITNESS WHEREOF, the parties hereto, by their duly authorized representatives, have executed
this Agreement effective the 1<-,��^day of n ,-,<LL`- , AD 2022.
,,�1111111J�JJ
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SEAL -e n
May 1, 2002
/4'01AN p
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CITY OF CASSELBERRY, FLORIDA
Cheryl L. Olson Digitally signed by Cheryl L. Olson
By:
Date: 2022.03.21 14:06:17-04'00'
Cheryl Olson
Procurement Manager
G TE IN I ER
By:
Print. Daniel Banken
Title: District Manager
For a corporation:
STATE OF FLORIDA
COUNTY OF SEMINOLE �� zt
13� ''L7
The foregoing instrument was acknowledged before me by means of N physical presence or ❑ online notarization, this by
Daniel Banken as District Manager of Granite Inliner, LLC an Indiana corporation, on behalf of the
corporation. He/she is personally known to me or has produced ,)v('Ic as identification.
[Notary Seal]
My Commission Expires: I
N �? 0,—gj,,
ary Public
Jacob Smith
Name typed, printed or stamped
,.+� • JACOB D. SMITH
Notary Public, Stale of Fkxida
* *� Commission No. GG247708
Commission Expires 10103/2022
PF-408A 2 612021
City of Casselberry I Procurement and Contract Management Division
95 Triplet Lake Drive, Casselberry, Florida 32707
Phone: 407-262-7700, Ext. 1142 1 a rocurement6casselberrv.orq
RFP-2019-0467 — SANITARY SEWER, MANHOLE, AND
LIFT STATION WET WELL REHABILITATION
Exhibit "A"
Contractor E-Verify Affidavit
I hereby certify that Granite Inliner, LLC [insert contractor company name] does not employ, contract with,
or subcontract with an unauthorized alien, and is otherwise in full compliance with, section 448.095, Florida
Statutes_
All employees hired on or after January 1, 2021 have had their work authorization status verified through the E-
Verify system.
A true and correct co Granite Inliner`s [insert contractor company name] proof of registration in the
E-Verify st ihs to
7'oAffidavit.
Print Name. Daniel Banken
Date: March 15, 2022
STATE OF FLORIDA
COUNTY OF SEMINOLE
The foregoing instrument was acknowledged before me by means of 0 physical presence or ❑ online
notarization, this 15th day of March by Daniel Banken as District Manager of Granite !miner, LLC , an Indiana
corporation on behalf of the corporation. He/she is personally known to me or has produced
1jt-" (' as identification.
al"
[Notary Sea[] ita- y Public
Jacob Smith
Name typed, printed or stamp
My Commission Expires: c.,l <
4' i �0k� JAC08 D. SMITH
Notary Public, State of Florida
* * Cornmisslnn Na. G
01 Commission Expires 10103/2022
PF-408A 3 512021
City of Casselberry { Procurement and Contract Management Division
95 Triplet Lake Drive, Casselberry, Florida 32707
Phone: 407-262-7700, Ext, 1142 1 procurement an.casselberrv.orq
RFP-2019-0467 — SANITARY SEWER, MANHOLE, AND
LIFT STATION WET WELL. REHABILITATION
Exhibit "A"
Contractor E-Verify Affidavit
I hereby certify that Granite Inliner, LLC [insert contractor company name] does not employ, contract with,
or subcontract with an unauthorized alien, and is otherwise in full compliance with, section 448.095, Florida
Statutes.
All employees hired on or after January 1, 2021 have had their work authorization status verified through the E-
Verify system.
A true and correct copy of Granite Inliner's
E-Verify sys 'v
ail e this Affidavit_
Print Name: Daniel Banken
Date: March 15, 2022
STATE OF FLORIDA
COUNTY OF SEMINOLE
[insert contractor company name] proof of registration in the
The foregoing instrument was acknowledged before me by means of 0 physical presence or ❑ online
notarization, this 15th day of March by Daniel Banken as District Manager of Granite Iniiner, LLC , an Indiana
corporation, on behalf of the corporation. He/she is personally known to me or has produced
tv_j as identification.
[Notary Seal]
o
otary Public
Jacob Smith
Name typed, printed or stamps
My Commission Expires: ci.Tr-r 3 z-&
JAC06 D. SMITH
i— Notary Public, Stale of Fwda
* w
CofnMMion No. GG247708
Commission Expires 10/03/2022
P F-4OBA 1 612021
EmployerWizard
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E-Verif
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Employer Category:
Eedera€ Contraotorwith FAR E-Verify Clause
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Employees being verified:
All new hires and all existing employees -assigned to a Federal contract
NAICS Code: 2373 - HIGHWAY, STREET, AND BRIDGE CONSTRUCTION 1i
Total Hiring Sites: 57
Total Points of Contact: v
U.S. Department of Homelaria Security - www.ors.pov ll.S. Citizenship and Immigration Services - wvror.uscis.pav AP.Cessitsirty Download Viewers
Company 1D Number; 9282
ARTICLE I
PURPOSE AND AUTHORITY
This Memorandum of Understanding (MOU) sets forth the points of agreement between the
Social Security Administration (SSA), the Department of Homeland Security (DHS) and Granite
Construction IncorRorated (Employer) regarding the Employer's participation in the
Employment Eligibility Verification Program (E-Verify). E-Verify is a program in which the
employment eligibility of all newly hired employees will be confirmed after the Employment
Eligibility Verification Form (Form 1-9) has been completed.
Authority for the E-Verify program is found in Title IV, Subtitle A, of the Illegal Immigration
Reform and Immigrant Responsibility Act of 1996 (URIRA), Pub. L. 104-208, 110 Stat. 3009, as
amended (8 U.S.C. § 1324a note).
ARTICLE H
FUNCTIONS TO BE PERFORMED
A. RESPONSIBILITIES OF THE SSA
I. Upon completion of the Form 1-9 by the employee and the Employer, and provided the
Employer complies with the requirements of this MOU, SSA agrees to provide the Employer
with available information that allows the Employer to confirm the accuracy of Social Security
Numbers provided by all newly hired employees and the employment authorization of U.S.
citizens.
2. The SSA agrees to provide to the Employer appropriate assistance with operational
problems that may arise during the Employer's participation in the E-Verify program. The SSA
agrees to provide the Employer with names, titles, addresses, and telephone numbers of SSA
representatives to be contacted during the E-Verify process.
3. The SSA agrees to safeguard the information provided by the Employer through the E-
Verify program procedures, and to limit access to such information, as is appropriate by law, to
individuals responsible for the verification of Social Security Numbers and for evaluation of the
E-Verify program or such other persons or entities who may be authorized by the SSA as
governed by the Privacy Act (5 U.S.C. § 552a), the Social Security Act (42 U.S.C. 1306(a)), and
SSA regulations (20 CFR Part 401).
4. SSA agrees to establish a means of automated verification that is designed (in
conjunction with DHS's automated system if necessary) to provide confirmation or tentative
nogconfirmation of U.S. citizens' employment eligibility and accuracy of SSA records for both
citizens and aliens within 3 Federal Government work days of the initial inquiry.
Company ID Number: 9282
5. SSA agrees to establish a means of secondary verification (including updating SSA
records as may be necessary) for employees who contest SSA tentative nonconfirmations that is
designed to provide final confirmation or nonconfirmation of U.S. citizens' employment
eligibility and accuracy of SSA records for both citizens and aliens within 10 Federal
Government work days of the date of referral to SSA, unless SSA deterrnincs that more than 10
days may be necessary. In such cases, SSA will provide additional verification instructions.
B. RESPONSIBILITIES OF THE DEPARTMENT OF HOMELAND SECURITY
I. Upon completion of the Form 1-9 by the employee and the Employer and after SSA
verifies the accuracy of SSA records for aliens through E-Verify, DHS agrees to provide the
Employer access to selected data from DHS's database to enable the Employer to conduct:
• Automated verification checks on newly hired alien employees by electronic means, and
• Photo verification checks (when available) on newly hired alien employees.
2. DHS agrees to provide to the Employer appropriate assistance with operational problems
that may arise during the Employer's participation in the E-Verify program. DHS agrees to
provide the Employer names, titles, addresses, and telephone numbers of DHS representatives to
be contacted during the E-Verify process.
3. DHS agrees to provide to the Employer a manual (the E-Verify Manual) containing
instructions on E-Verify policies, procedures and requirements for both SSA and DHS, including
restrictions on the use ofE-Verify.. DHS agrees to provide training materials on E-Verify.
4. DHS agrees to provide to the Employer a notice, which indicates the Employer's
participation in the E-Verify program. DHS also agrees to provide to the Employer anti-
discrimination notices issued by the Office of Special Counsel for immigration -Related Unfair
Employment Practices (OSC), Civil Rights Division, and U.S. Department of Justice.
5. DHS agrees to issue the Employer a user identification number and password that permits
the Employer to verify information provided by alien employees with DHS's database.
6. DHS agrees to safeguard the information provided to DHS by the Employer, and to limit
access to such information to individuals responsible for the verification of alien employment
eligibility and for evaluation of the E-Verify program, or to such other persons or entities as may
be authorized by applicable Iaw. Information will be used only to verify the accuracy of Social
Security Numbers and employment eligibility, to enforce the Immigration and Nationality Act
and federal criminal laws, and to ensure accurate wage reports to the SSA.
7. DHS agrees to establish a }Weans of automated verification that is designed (in
conjunction with SSA verification procedures) to provide confirmation or tentative
nonconfi oration of employees' employment eligibility within 3 Federal Government work days
of the initial inquiry.
Company ID Number: 9282
8. DHS agrees to establish a means of secondary verification (including updating DHS
records as may be necessary) for employees who contest DHS tentative nonconfirmations and
photo non -match tentative nonconfrmations that is designed to provide final confirmation or
nonconfirmation of the employees' employment eligibility within 10 Federal Government work
days of the date of referral to DHS, unless DHS determines that more than 10 days may be
necessary. In such cases, DHS will provide additional verification instructions.
C. RESPONSIBILITIES OF THE EMPLOYER
1. The Employer agrees to display the notices supplied by DHS in a prominent place that is
clearly visible to prospective employees.
2. The Employer agrees to provide to the SSA and DHS the names, titles, addresses, and
telephone numbers of the Employer representatives to be contacted regarding E-Verify.
The Employer agrees to become familiar with and comply with the E-Verify Manual.
4. The Employer agrees that any Employer Representative who will perform employment
verification queries will complete the E-Verify Tutorial before that individual initiates any
queries.
A. The employer agrees that all employer representatives will take the refresher
tutorials initiated by the E-Verify program as a condition of continued use of E-
Verify.
B. Failure to complete a refresher tutorial will prevent the employer from continued
use of the program.
5. The Employer agrees to comply with established .Form 1-9 procedures, with two
exceptions:
• If an employee presents a "List B" identity document, the Employer agrees to only accept
"List B" documents that contain a photo. (List B documents identified in S C_F.R. §
274a.2 (b) (1) (B)) can be presented during the Form I-9 process to establish identity).
• If an employee presents a DHS Form I-551 (Permanent Resident Card) or Form I-766
(Employment Authorization Document) to complete the Form I-9, the Employer agrees
to make a photocopy of the document and to retain the photocopy with the employee's
Form I-9. The employer will use the photocopy to verify the photo and to assist the
Department with its review of photo non -matches that are contested by employees. Note
that employees retain the right to present any List A, or List B and List C, documentation
to complete the Form I-9. DHS may in the future designate other documents that activate
the photo screening tool.
6. The Employer understands that participation in E-Verify does not exempt the Employer
from the responsibility to complete, retain, and make available for inspection Forms 1-9 that relate
to its employees, or from other requirements of applicable regulations or laws, except for the
following modified requirements applicable by reason of the Employer's participation in E-
Verify: (1) identity documents must have photos, as described in paragraph 5 above; (2) a
Company ID Number: 9282
rebuttable presumption is established that the Employer has not violated section 274A(a)(1)(A) of
the Immigration and Nationality Act (INA) with respect to the bring of any individual if it
obtains confirmation of the identity and employment eligibility of the individual in compliance
with the terms and conditions of E-Verify ; (3) the Employer must notify DHS if it continues to
employ any employee after receiving a final nonconfirmation, and is subject to a civil money
penalty between $500 and $1,000 for each failure to notify DHS of continued employment
following a final nonconfirmation; (4) the Employer is subject to a rebuttable presumption that it
has knowingly employed an unauthorized alien in violation of section 274A(a)(1)(A) if the
Employer continues to employ any employee after receiving a final nonconfirmation; and (5) no
person or entity participating in E-Verify is civilly or criminally liable under any law for any
action taken in good faith on information provided through the confirmation system. DHS
reserves the right to conduct Form I-9 compliance inspections during the course of E-Verify, as
well as to conduct any other enforcement activity authorized by law.
7. The Employer agrees to initiate E-Verify verification procedures within 3 Employer
business days after each employee has been hired (but after both sections I and 2 of the Form I-9
have been completed), and to complete as many (but only as many) steps of the E-Verify process
as are necessary according to the E-Verify Manual. The Employer is prohibited froin initiating
verification procedures before the employee has been hired and the Form I-9 completed. If the
automated system to be queried is temporarily unavailable, the 3-day time period is extended
until it is again operational in order to accommodate the Employer's attempting, in good faith, to
make inquiries during the period of unavailability. In all cases, the Employer must use the SSA
verification procedures first, and use DHS verification procedures and photo screening tool only
after the the SSA verification response has been given.
8. The Employer agrees not to use E-Verify procedures for pre -employment screening of
job applicants, support for any unlawful employment practice, or any other use not authorized by
this MOU. The Employer must use E-Verify for all new employees and will not verify only
certain employees selectively. The Employer agrees not to use E-Verify procedures for re -
verification, or- for employees hired before the date this MOU is in effect. The Employer
understands that if the Employer uses E-Verify procedures for any purpose other than as
authorized by this MOU, the Employer may be subject to appropriate legal action and the
immediate termination of its access to SSA and DHS information pursuant to this MOU.
9. The Employer agrees to follow appropriate procedures (see Article III.B. below)
regarding tentative nonconfirmations, including notifying employees of the finding, providing
written referral instructions to employees, allowing employees to contest the finding, and not
taking adverse action against employees if they choose to contest the finding. Further, when
employees contest a tentative nonconfirmation based upon a photo non -match, the Employer is
required to take affirmative steps (see Article HI.B. below) to contact DHS with information
necessary to resolve the challenge.
10. The Employer agrees not to take any adverse action against an employee based upon the
employee's employment eligibility status while SSA or DHS is processing the verification request
unless the Employer obtains knowledge (as defined in 8 C.F.R. § 274a.1 (1)) that the employee is
not work authorized. The Employer understands that an initial inability of the SSA or DHS
automated verification to verify work authorization., a tentative nonconfirmation, or the finding of
Company ID Number: 9282
a photo non -snatch, does not mean, and should not be interpreted as, an indication that the
employee is not work authorized. In any of the cases listed above, the employee must be provided
the opportunity to contest the finding, and if he or she does so, may not be terminated or suffer
any adverse employment consequences until and unless secondary verification by SSA or DHS
has been completed and a final nonconfirmation has been issued. if the employee does not choose
to contest a tentative nonconfirmation or a photo non -match, then the Employer can find the
employee is not work authorized and take the appropriate action.
11. The Employer agrees to comply with section 274B of the INA by not discriminating
unlawfully against any individual in hiring, firing, or recruitment or referral practices because of
his or her national origin or, in the case of a protected individual as defined in section 27413(a)(3)
of the INA, because of his or her citizenship status. The Employer understands that such illegal
practices can include selective verification or use of E-Verify, discharging or refusing to hire
eligible employees because they appear or sound "foreign", and premature termination of
employees based upon tentative nonconfirmations, and that any violation of the unfair
immigration -related employment practices provisions of the INA could subject the Employer to
civil penalties pursuant to section 274B of the INA and the termination of its participation in E-
Verify. If the Employer has any questions relating to the anti -discrimination provision, it should
contact OSC at 1-800-255-7688 or I-800-237-2515 (TDD).
12. The Employer agrees to record the case verification number on the employee's Form 1-9
or to print the screen containing the case verification number and attach it to the employee's Norm
1-9.
13_ The Employer agrees that it will use the information it receives from the SSA or DHS
pursuant to E-Verify and this MOU only to confirm the employment eligibility of newly -hired
employees after completion of the Form 1-9. The Employer agrees that it will safeguard this
information, and means of access to it (such as FINS and passwords) to ensure that it is not used
for any other purpose and as necessary to protect its confidentiality, including ensuring that it is
not disseminated to any person other than employees of the Employer who are authorized to
perform the Employer's responsibilities under this MOU.
14. The Employer acknowledges that the information which it receives from SSA is
governed by the Privacy Act (5 U.S.C. § 552a (i) (1) and (3)) and the Social Security Act (42
U.S.C. 1306(a)), and that any person who obtains this information under false pretenses or uses it
for any purpose other than as provided for in this MOU may be subject to criminal penalties.
15. The Employer agrees to allow DHS and SSA, or their authorized agents or designees, to
make periodic visits to the Employer for the purpose of reviewing E-Verify -related records, i.e.,
Forms 1-9, SSA Transaction Records, and DHS verification records, which were created during
the Employer's participation in the E-Verify Program. In addition, for the purpose of evaluating
E-Verify, the Employer agrees to allow DHS and SSA or their authorized agents or designees, to
interview it regarding its experience with E-Verify, to interview employees hired during E-Verify
use concerning their experience with the pilot, and to make employment and E-Verify related
records available to DHS and the SSA, or their designated agents or designees. Failure to comply
with the terms of this paragraph may lead DHS to terminate the Employer's access to E-Verify_
Company ID Number. 9282
ARTICLE III
REFERRAL OF INDIVIDUALS TO THE SSA AND THE DEPARTMENT OF
HOMELAND SECURITY
A. REFERRAL TO THE SSA
1. If the Employer receives a tentative nonconfirmation issued by SSA, the Employer must
print the tentative nonconfirmation notice as directed by the automated system and provide it to
the employee so that the employee may determine whether he or she will contest the tentative
nonconfirmation.
2. The Employer will refer employees to SSA field offices only as directed by the
automated system based on a tentative taonconfirmation, and only after the Employer records the
case verification number, reviews the input to detect any transaction errors, and determines that
the employee contests the tentative nonconfirmation. The Employer will transmit the Social
Security Number to SSA for verification again if this review indicates a need to do so. The
Employer will determine whether the employee contests the tentative nonconfirmation as soon as
possible after the Employer receives it.
3. If the employee contests an SSA tentative nonconfirmation, the Employer will provide
the employee with a referral letter and instruct the employee to visit an SSA office to resolve the
discrepancy within 8 Federal Government work days. The Employer will make a second inquiry
to the SSA database using E-Verify procedures on the date that is 10 Federal Government work
days after the date of the referral in order to obtain confirmation, or final nonconfirmation, unless
otherwise instructed by SSA or unless SSA determines that more than 10 days is necessary to
resolve the tentative nonconfrtnation..
4. The Employer agrees not to ask the employee to obtain a printout from the Social
Security Number database (the Numident) or other written verification of the Social Security
Number from the SSA.
B. REFERRAL TO THE DEPARTMENT OF HOMELAND SECURITY
I _ If the Employer receives a tentative nonconf ination issued by DHS, the Employer trust
print the tentative nonconfirmation notice as directed by the automated system and provide it to
the employee so that the employee may determine whether he or she will contest the tentative
nonconfirmation.
2. If the Employer finds a photo non -match for an alien who provides a document for which
the automated system has transmitted a photo, the employer must print the photo non -match
tentative nonconfirmation notice as directed by the automated system and provide it to the
employee so that the employee may determine whether he or she will contest the finding.
3_ The Employer agrees to refer individuals to DHS only when the employee chooses to
contest a tentative nonconfirmation received from DNS automated verification process or when
Company ID Number-. 9282
the Employer issues a tentative nonconfurnation based upon a photo non -match. The Employer
will determine whether the employee contests the tentative uonconfirmation as soon as possible
after the Employer receives it.
4. If the employee contests a tentative nonconfirmation issued by DHS, the Employer will
provide the employee with a referral letter and instruct the employee to contact the Department
through its toll -free hotline within 8 Federal Government work days.
5. If the employee contests a tentative nonconfirmation based upon a photo non -match, the
Employer will provide the employee with a referral letter to DHS. DHS will electronically
transmit the result of the referral to the Employer within 10 Federal Government work days of the
referral unless it determines that more than 10 days is necessary.
6. The Employer agrees that if an employee contests a tentative nonconfirmation based
upon a photo non -match, the Employer will send a copy of the employee's Form 1-551 or Form I-
766 to DHS for review by:
• Scanning and uploading the document, or
• Sending a photocopy of the document by an express mail account (furnished and paid for
by DHS).
7. The Employer understands that if it cannot determine whether there is a photo
match/non-match, the Employer is required to forward the employee's documentation to DHS by
scanning and uploading, or by sending the document as described in the preceding paragraph, and
resolving the case as specified by the Immigration Services Verifier at DHS who will determine
the photo match or non -match.
ARTICLE IV
SERVICE PROVISIONS
The SSA and DHS will not charge the Employer for verification services performed udder this
MOU. The Employer is responsible for providing equipment needed to make inquiries. To access
the E-Verify System, an Employer will need a personal computer with Internet access.
ARTICLE V
PARTIES
This MOU is effective upon the signature of all parties, and shall continue in effect for as long as
the SSA and DHS conduct the E-Verify program unless modified in writing by the mutual
consent of all parties, or terminated by any party upon 30 days prior written notice to the others.
Any and all system enhancements to the E-Verify program by DHS or SSA, including but not
limited to the E-Verify checking against additional data sources and instituting new verification
procedures, will be covered under this MOU and will not cause the need for a supplemental MOU
that outlines these changes. DHS agrees to train employers on all changes made to E-Verify
through the use of mandatory refresher tutorials and updates to the E-Verify manual. Even.
Company ID Number: 9282
without changes to E-Verify, the Department reserves the right to require employers to take
mandatory refresher tutorials.
Termination by any party shall terminate the MOU as to all parties. The SSA or DHS may
terminate this MOU without prior notice if deemed necessary because of the requirements of law
or policy, or upon a determination by SSA or DHS that there has been a breach of system
integrity or security by the Employer, or a failure on the part of the Employer to comply with
established procedures or legal requirements. Some or all SSA and DHS responsibilities under
this MOU may be performed by contractor(s), and SSA and DHS may adjust verification
responsibilities between each other as they may determine.
Nothing in this MOU is intended, or should be construed, to create any right or benefit,
substantive or procedural, enforceable at law by any third party against the United States, its
agencies, officers, or employees, or against the Employer, its agents, officers, or employees.
Each party shall be solely responsible for defending any claim or action against it arising out of or
related to E-Verify or this MOU, whether civil or criminal, and for any liability wherefrom,
including (but not limited to) any dispute between the Employer and any other person or entity
regarding the applicability of Section 403(d) of IIRIRA to any action taken or allegedly taken by
the Employer.
The employer understands that the fact of its participation in E-Verify is not confidential
information and may be disclosed as authorized or required by law and DHS or SSA policy,
including but not limited to, Congressional oversight, E-Verify publicity and media inquiries,
and responses to inquiries under the Freedom of Information Act (FOIA).
The foregoing constitutes the full agreement on this subject between the SSA, DHS, and the
Employer.
The individuals whose signatures appear below represent that they are authorized to enter into
this MOU on behalf of the Employer and DHS respectively.
To be accepted as a participant in E-Verify, you should only sign the Employer's Section of
the signature page. If you have any questions, contact E-Verify Operations at 888464-
42I8.
Employer Granite Construction Incorporated
Name (Please type or print)
Si
H f� ?. R-,9.
Title
f f(3 A`
Datt i
Department of Homeland Security — Verification Division
Company ID Number: 9282
USC1S Verification Division
Name (Please type or print)
Title
Electronically Signed 09/13/2004
Signature Date
Company ID Number: 9282
INFORMATION REQUIRED
FOR THE E-VERIFY PROGRAM
Information relating to your Company:
Company Name: Granite Construction Incorporated
Company Facility Address: 585 West Beach Street
Watsonville, CA 95076
Company Alternate Address: P-0, Box 50055
Watsonville, CA 95077
County or Parish: SANTA CRUZ
Employer Identification Number: 770239383
North American Industry
Classification Systems Code: 2373
Parent Company:
5,000 to
Number of Employees: 9,999 Number of Sites Verified for: 56
Are you verifying for more than 1 site? If yes, please provide the number of sites verified for in each State
•
ARIZONA
I
site(s)
•
UTAH
I
site(s)
•
MARYLAND
I
site(s)
•
WASHINGTON
6
site(s)
•
NEW MEXICO
I
site($)
•
NEVADA
3
site(s)
•
MINNESOTA
2
site(s)
•
CALYFORNIA
23
site(s)
•
'TEXAS
4
site(s)
FL.OPJDA
4
site($)
♦
MISSOURI
2
site(s)
•
ALASKA
2
site(s)
•
OREGON
2
site(s)
•
PENNSYLVANIA
I
site(s)
•
NEW YORK
I
site(s)
•
NORTH CAROLINA
2
site(s)
Company ID Number: 9282
Information relating to the Program Administrator(s) for your Company on policy questions or operational problems:
Name: Susie Fernandez
Telephone Number: (831) 761 - 4794 Fax Number: (831) 768 - 4491
E-mail Address: Susie.Fernandez@gcinc.com