1-Anti-Human Trafficking Affidavit.docx

DOCX document 40 KB Posted

Attached to
Air Conditioning and Refrigeration Equipment Maintenance and Replacement Services
Solicitation number
BLD2131493B1
Issued by
Florida

About this file

This is an Anti-Human Trafficking Affidavit form required by Broward County, Florida for vendor participation in state and local contract opportunities. The affidavit applies to the Air Conditioning and Refrigeration Equipment Maintenance and Replacement Services contract, an open-end agreement for furnishing labor, equipment, and materials necessary to perform heating, ventilation, air conditioning, and refrigeration equipment maintenance and replacement services for the Water & Wastewater Services division. Vendors must complete and return the affidavit with their solicitation submittal or within three business days of the County's request. The form must be resubmitted upon contract award, renewal, or extension. Vendors who fail to comply within the stated timeframe may be deemed nonresponsive and ineligible for contract consideration.

The affidavit requires vendors to declare under penalties of perjury that they do not use coercion for labor or services as defined in Section 787.06, Florida Statutes. The vendor must provide their name, signature, printed name, title, and date on the form. All solicitation responses must be submitted electronically through BPRO and vendors must obtain a submission receipt to confirm timely delivery. The form date is September 9, 2024, and vendors are encouraged to provide all documentation, including optional items, to enable comprehensive County review.

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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 .