10-Attachment C-Human Trafficking.pdf
PDF 333 KB Posted
- Attached to
- ROC Security Equipment Addition
- Solicitation number
- PROJ-26-018
- Issued by
- Volusia County, Florida
About this file
This is a Human Trafficking Attestation form required by Halifax Health, a healthcare facility in Florida, for any nongovernmental entity executing, renewing, or extending a contract with the organization. The attestation pertains to a security equipment installation project at the Charles L and Miki N Grant Cancer Center for Hope, which includes installing badge readers, cameras, j-hooks, patch and paint work, ICRA compliance measures, and fire sealant for penetrations in an active healthcare facility. The form must be completed and signed by an authorized officer or representative of the bidding contractor, confirming under penalty of perjury that the entity does not use coercion for labor or services as defined in Florida Statutes Section 787.06.
The attestation requires contractors to acknowledge that any false statements made on the form will result in immediate notification to Halifax Health and will disqualify the entity from entering into any future contracts, renewing existing contracts, or extending current agreements with Halifax Health. This compliance requirement is mandatory pursuant to Florida Statutes Section 787.06(13) and demonstrates Halifax Health's commitment to preventing human trafficking in its procurement processes. The form requires the contractor to provide their entity name, signature, printed name, title, and date of attestation.
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Text version
Human Trafficking Attestation
Pursuant to Florida Statutes Section 787.06(13), this attestation must be completed by an officer or representative of any nongovernmental entity that is executing, renewing, or extending a contract with Halifax Health.
The undersigned, as an authorized representative or officer of, and on behalf of, the “Nongovernmental Entity,” by executing below, attests, under penalty of perjury, to the following:
The Nongovernmental Entity does not use coercion for labor or services as such italicized terms are defined in Florida Statutes Section 787.06, as the same may be amended from time to time.
The undersigned understands that the statements made herein are made for the benefit of Halifax Health, and its compliance with Florida Statutes Section 787.06, and if at any time the attestation made herein is untrue, the Nongovernmental Entity will immediately notify Halifax Health of same and will not, thereafter, enter into any future contracts with Halifax Health, and will not renew or extend any existing contracts.
Nongovernmental Entity Name:__________________________________________________________
Signature: ____________________________________________________________________
Printed Name: ________________________________________________________________________
Title: _______________________________________________________________________
s. 787.06, FS July 2024
Attachment C
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File details come from the government source that posted it. Updated .