1-Anti-Human Trafficking Affidavit.docx

DOCX document 40 KB Posted

Attached to
FEMA Emergency Traffic Signal Restoration and Repair
Solicitation number
OPN2131681B1
Issued by
Florida

About this file

This is an Anti-Human Trafficking Affidavit form required by Broward County, Florida for vendors participating in the FEMA Emergency Traffic Signal Restoration and Repair contract opportunity. The affidavit must be completed and submitted with the vendor's initial solicitation response or within three business days of the County's request. Vendors who fail to comply with this requirement within the stated timeframe may be deemed nonresponsive. The form certifies that the vendor does not use coercion for labor or services as defined in Section 787.06, Florida Statutes, and must be signed under penalties of perjury by an authorized representative of the vendor organization.

The affidavit is a mandatory compliance document with no pricing, set-asides, or contractual terms specified within the form itself. The vendor must provide the completed form upon initial submittal, contract award, renewal, or extension. The document requires standard identification information including vendor name, signature, printed name of the signatory, title, and date of execution. Non-compliance with this requirement could result in the vendor being determined nonresponsive and ineligible for contract award.

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Text version

ANTI-HUMAN TRAFFICKING AFFIDAVIT

This completed form should be returned with the Vendor’s submittal. If not provided with the submittal, the Vendor must submit this form within three (3) business days after the County’s request and upon award, renewal, or extension of a contract with Broward County. The Vendor may be deemed nonresponsive for failure to fully comply within the stated timeframe.

The Vendor indicated below does not use coercion for labor or services, as such terms are defined in Section 787.06, Florida Statutes.

Under penalties of perjury, the undersigned declares that they have read the foregoing statement and that the facts stated in it are true.

Vendor Name: Click or tap here to enter text.

Signature:

Printed Name: Click or tap here to enter text.

Title: Click or tap here to enter text.

Date: Click or tap to enter a date.

Form Date 9/9/24

File details come from the government source that posted it. Updated .