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The "Exhibit (A) WORKER ELIGIBILITY VERIFICATION AFFIDAVIT FOR" is a formal declaration required for Missouri Department of Transportation (MODOT) contracts exceeding $5,000. It serves to confirm that a business entity is actively enrolled in a federal work authorization program. Furthermore, it affirms that the company will not hire unauthorized aliens. The affidavit must be signed by an authorized representative and notarized to validate the commitment to lawful employment practices.
Gather Required Information: Collect details about your business entity, such as the legal name, address, and federal tax identification number. Additionally, you should be prepared to provide evidence of enrollment in a federal work authorization program.
Complete the Affidavit: Fill out all sections of the form accurately. Ensure that it is signed by an authorized representative of the business. The signature confirms the truthfulness of the affidavit’s content.
Notarization: The affidavit must be notarized. This requires the signature to be authenticated by a notary public who will verify the identity of the signer.
Submit the Form: Submit the completed and notarized affidavit as part of the contract documentation with MODOT to meet the compliance requirements.
This affidavit is used to ensure compliance with legal and contractual obligations tied to MODOT projects. By submitting this affidavit, businesses legally affirm their commitment to hiring policies that exclude unauthorized aliens. This adherence is crucial for participating in state contracts, upholding both state laws and federal compliance standards.
Primarily, this affidavit is utilized by companies entering into contracts with MODOT exceeding $5,000. These include contractors, subcontractors, and any business entities involved in the provision of goods or services for state infrastructure projects. It is essential for ensuring all participants in state-funded projects adhere to employment laws.


Missouri has specific guidelines dictating the use of this affidavit. It is a mandatory document for any business engaging in MODOT contracts above the $5,000 threshold. The affidavit ensures businesses comply with state legislation focused on lawful hiring practices and contributes to maintaining the integrity of public contract implementations.
Failing to submit this affidavit or providing false information can result in severe penalties. These may include contract termination, disqualification from future state contracts, and potential legal action. Non-compliance not only affects business relations with the state but can also lead to reputational damage and financial losses.
The completed affidavit can be submitted through various methods:
While the affidavit is specifically tailored for MODOT contracts, alternative forms may exist for similar purposes in differing contracts or states. However, any equivalent form must equally assure compliance with federal hiring laws, manifest accountability through notarization, and meet any additional state-specific legal requirements.
The "Exhibit (A) WORKER ELIGIBILITY VERIFICATION AFFIDAVIT FOR" is issued by the Missouri Department of Transportation (MODOT). It is an integral part of the contracting package for businesses seeking to engage in projects that are funded by the state, ensuring all parties comply with applicable labor regulations and employment laws.
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