14-14. REQUIRED HUMAN TRAFFICKING AFFIDAVIT.pdf

PDF 198 KB Posted

Attached to
Re-Bid Pump Station 182 Redundant Power
Solicitation number
IFB-043-26-RM
Issued by
Leon County, Florida

About this file

This is a Human Trafficking Affidavit document required for nongovernmental entities bidding on state and local contracts in Florida, specifically related to the Re-Bid Pump Station 182 Redundant Power project for the City of Tallahassee. The affidavit serves as a compliance document pursuant to Section 787.06(13) of the Florida Statutes and must be signed and notarized before submission. The form requires an officer or representative of the bidding entity to attest under penalty of perjury that the entity does not use coercion for labor or services as defined in Florida law. The document must include the entity name, signature, title, and notary verification with identification, and is dated for 2024.

This affidavit is a mandatory submission requirement for any nongovernmental entity seeking to contract with the State of Florida or its local jurisdictions. The notarization requirement ensures the authenticity and legal binding nature of the declaration. Bidders must complete this form as part of their proposal package for the Pump Station 182 project, which involves electrical infrastructure work including conduit installation, transformer coordination, and breaker systems for the City of Tallahassee Electric Department. Failure to provide a properly executed and notarized affidavit may result in proposal rejection or contract disqualification.

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19-APPENDIX D - Pump Station 182 Redundant Power Electrical Specifications.pdf PDF
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5-5. IFB 043-26-RM SUPPLEMENTAL SPECIFICATIONS .pdf PDF
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7-7. IFB 043-26-RM PS-12-182 PLANS Redundant Power - Final Plans SS.pdf PDF
23-APPENDIX H - COT Transformer Specifications.pdf PDF
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25-15. IFB 043-26-RM SUPPLEMENTAL INFORMATION.docx DOCX document
9-9. REQUIRED Responsible Vendor Review Form.docx DOCX document
34-APPENDIX I - WEG TRANSFORMER DATA SHEETS.pdf PDF
22-APPENDIX G - Pump Station 182 Redundant Power - Survey SS.pdf PDF
15-15. IFB 043-26-RM SUPPLEMENTAL INFORMATION.docx DOCX document
28-APPENDIX C - Pump Station182 Redundant Power - FDOT Approved Utility Permit Package.pdf PDF
10-10. REQUIRED Vendor Conflict of Interest.docx DOCX document
27-APPENDIX B - Pump Station 182 Redundant Power - COT Right of Way Permit.pdf PDF
29-APPENDIX D - Pump Station 182 Redundant Power Electrical Specifications.pdf PDF
24-APPENDIX I - WEG TRANSFORMER DATA SHEETS.pdf PDF
3-3.REQUIRED BID SCHEDULE IFB 043-26-RM Pump Station 182 Redundant Power BID SCHEDULE.xlsx XLSX spreadsheet
1-2. REQUIRED Performance and Bid Bond Trench Safety Act Form.docx DOCX document
26-APPENDIX A - COT Environmental Management General Permit (TEM220057).pdf PDF
12-12. REQUIRED IFB Representations Certifications.docx DOCX document
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30-APPENDIX E - COT Gas and Electric General Construction Specifications.pdf PDF
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Text version

IFB No.: ____________________________

NONGOVERNMENTAL ENTITY

HUMAN TRAFFICKING AFFIDAVIT

Section 787.06(13), Florida Statutes

THIS AFFIDAVIT MUST BE SIGNED AND NOTARIZED

I, the undersigned, am an officer or representative of _______________________________ and attest that said entity does not use coercion for labor or services as defined in section 787.06, Florida Statutes. Under penalty of perjury, I hereby declare and affirm, to the best of my knowledge and belief, that the above stated facts are true and correct.

Entity Name: _____________________________

Signature Title

STATE OF __________________________

COUNTY OF ___________________________

SWORN TO AND SUBSCRIBED before me by means of

___physical presence or ___online notarization this ______ day of ________________, 2024.

They are ____personally known to me or has produced _______________________ (Type of Identification) as identification.

(Notary Seal) Notary Public

Print, Type or Stamp Name of Notary

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