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1`AM 9111 tiu WORKER VERIFICATION CERTIFICATION — SUBCONTRACTOR The term "Subcontractor" applies to any Subcontractor of the General Contractor ('Contractor') AND any Subcontractor of any tier or for any duration thereunder performing work on this Project. This does not include Walmart Contractors. Facility Number: Facility Location: The undersigned, ("Subcontractor"), through its Qualified Employee Veri- fier, certifies, pursuant to that certain Subcontractor Agreement dated , 20 or other Agreement, Scope of Work, or Work Order (collectively referred to as "Subcontract") be- tween ("Contractor/Subcontractor") and Subcontractor pertaining to the Pro- ject identified above, the following is true and correct: 1. Subcontractor has fully complied with all Worker Verification Laws, as defined in the Contract between Contractor and Walmart ("Contract"), with regard to each of Subcon- tractor's employees who shall perform work on the Project pursuant to the Subcontract ("Subcontractor Workers"). 2. As to each Subcontractor Worker described above, Subcontractor has on file a Form I-9 that is free of substantive or uncorrected technical deficiencies (other than timeliness de- ficiencies) and that reflects that the Subcontractor Worker is lawfully eligible to work for Subcontractor. 3. Subcontractor will document those specific Subcontractor Workers in a list exactly in the format below, which shall be affixed to this WV Form and provided to Contractor, supple- mented as necessary to Contractor, maintained and produced according to the requirements of the Subcontract prior to the presentation of such Subcontractor Workers to Contractor for admission to the Project site. Full Le al Name of Individual Name of Employer 4. Legible photocopies of the employment eligibility and identity documentation for Sub- contractor Workers who were hired after the award of the Project to the Contractor have been and will continue to be maintained by Subcontractor for the period required by the Contract. 5. Subcontractor has reported or will report any and all Worker Verification Incidents (as defined in the Subcontract) to Contractor within one (1) hour of such Worker Verification Incident. 6. Subcontractor has not, and its Subcontractors have not been the subject of enforcement or other action by ICE within the two (2) year period prior to the date of this certification. 7. Subcontractor intends, and has procedures in place, to ensure that it and all of its Sub- contractors are in compliance with the Worker Verification Laws and that all Subcon- tractor Workers of any tier on the Project are authorized to work in the United States. 8. None of the Subcontractor Workers is known to Subcontractor to be employed without lawful authorization. 9. Subcontractor shall, and shall cause its Subcontractors to, cooperate with the WV Audi- tor and provide the WV Auditor with access to such documentation and personnel as may be necessary to complete any certification, review or audit. 01351-28 0706 - Zephyrhills, Florida - 16592140 February 16, 2017 1