11-Affidavit of Compliance with Foreign Entity and Human Trafficking.pdf
PDF 625 KB Posted
- Attached to
- Compacted Garbage Collection and Disposal State and local contract opportunity
- Solicitation number
- ITB No. 2026-021
- Issued by
- Palm Beach County, Florida
About this file
This is an Affidavit of Compliance form required by the Town of Palm Beach, Florida for the Compacted Garbage Collection and Disposal contract opportunity. The affidavit contains two primary compliance certifications that bidders must execute under penalty of perjury: compliance with foreign entity laws and compliance with anti-human trafficking laws. Regarding foreign entity compliance, bidders must attest that their entity is not owned by or controlled by the government of a foreign country of concern as defined under Florida Statutes Sections 287.138 and 692.201, is not organized under foreign laws with a principal place of business in a foreign country of concern, is not a foreign principal, and complies with all applicable requirements of Sections 692.202, 692.203, and 692.204 of the Florida Statutes. For solicitations involving real property purchases, bidders must additionally certify compliance with restrictions on foreign principals purchasing the subject property.
The anti-human trafficking compliance section requires the affiant to certify that they are an adult Florida resident and that the entity does not use coercion for labor or services as defined in Section 787.06 of the Florida Statutes. The affidavit must be signed by an authorized representative of the bidding entity and notarized before a notary public, with the notarization completed either through physical presence or online notarization. The form includes blank fields for the date of execution, entity name and representative title, notary information, and notary commission expiration date. Bidders submitting proposals for the Town of Palm Beach's garbage collection and disposal services must complete and submit this compliance affidavit as part of their bid package.
View the file
Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| 12-ITB revised - Terms and Conditions - Goods and Services.pdf | ||
| 9-E-Verify Form.pdf | ||
| 3-Bidder’s Qualification Form.pdf | ||
| 8-FS 119.0701 and FS 119.071 for Public Records 2024 version.pdf | ||
| 4-Contact Info Form.pdf | ||
| 1-Subcontractors Form.pdf | ||
| 7-Protest Procedure Form.pdf | ||
| 15-ITB No. 2026-021 - Scope of Services.pdf | ||
| 5-Scrutinized Companies Form.pdf | ||
| 13-Town of Palm Beach Insurance Requirements - Risk Type 1 - Standard Contracts and Minor Construction.pdf | ||
| 14-Liquidated Damages Form.pdf | ||
| 10-Reference Form.pdf | ||
| 6-Minimum Qualification Form.pdf | ||
| 2-Drug Free Workplace Form.pdf |
Show all 14
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Text version
Town of Palm Beach Procurement and Contracts Division
Foreign En�ty [Rev. 7/21/2023] and Human Trafficking [Rev. 10/25/2024]
Affidavit of Compliance with Foreign Entity Laws
The undersigned, on behalf of the entity listed below (“Entity”), hereby attests under penalty of perjury as follows:
1. Entity is not owned by the government of a foreign country of concern as defined in Section 287.138, Florida Statutes. (Source: § 287.138(2)(a), Florida Statutes)
2. The government of a foreign country of concern does not have a controlling interest in Entity. (Source: § 287.138(2)(b), Florida Statutes)
3. Entity is not organized under the laws of, and does not have a principal place of business in, a foreign country of concern. (Source: § 287.138(2)(c), Florida Statutes)
4. Entity is not owned or controlled by the government of a foreign country of concern, as defined in Section 692.201, Florida Statutes. (Source: § 288.007(2), Florida Statutes)
5. Entity is not a partnership, association, corporation, organization, or other combination of persons organized under the laws of or having its principal place of business in a foreign country of concern, as defined in Section 692.201, Florida Statutes, or a subsidiary of such entity. (Source:
§ 288.007(2), Florida Statutes)
6. Entity is not a foreign principal, as defined in Section 692.201, Florida Statutes. (Source:
§ 692.202(5)(a)(1), Florida Statutes)
7. Entity is in compliance with all applicable requirements of Sections 692.202, 692.203, and 692.204, Florida Statutes.
8. (Only applicable if purchasing real property) Entity is not a foreign principal prohibited from purchasing the subject real property. Entity is either (a) not a person or entity described in Section 692.204(1)(a), Florida Statutes, or (b) authorized under Section 692.204(2), Florida Statutes, to purchase the subject property. Entity is in compliance with the requirements of Section 692.204, Florida Statutes. (Source: §§ 692.203(6)(a), 692.204(6)(a), Florida Statutes)
Affidavit of Compliance with Anti-Human Trafficking Laws
In accordance with section 787.06(13), Florida Statutes, the undersigned, on behalf of the entity listed below (“Entity”), hereby attests under penalty of perjury that:
1. The Affiant is an adult resident of the State of Florida.
2. The Entity does not use coercion for labor or services as defined in Section 787.06, Florida Statutes, entitled “Human Trafficking”.
3. I understand that I am swearing or affirming under oath to the truthfulness of the claims made in this affidavit and that the punishment for knowingly making a false statement includes fines and/or imprisonment.
Town of Palm Beach Procurement and Contracts Division
Foreign En�ty [Rev. 7/21/2023] and Human Trafficking [Rev. 10/25/2024]
The undersigned is authorized to execute this affidavit on behalf of Entity.
Date: ____________________, 20___ Signed:
Entity: Name:
Title:
STATE OF
COUNTY OF
The foregoing instrument was acknowledged before me, by means of ☐ physical presence or ☐ online notarization, this ____ day of ______________, 20____, by _______________________________, as ____________________________ for _____________________________________________________, who is personally known to me or who has produced ________________________ as identification.
Notary Public Signature: State of Florida at Large (Seal) Print Name: My commission expires:
File details come from the government source that posted it. Updated .