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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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 .