14-14. REQUIRED HUMAN TRAFFICKING AFFIDAVIT.pdf

PDF 198 KB Posted

Attached to
Pump Station 92 Replacement
Solicitation number
IFB-044-26-RM
Issued by
Leon County, Florida

About this file

This is a Required Human Trafficking Affidavit form mandated by Section 787.06(13) of Florida Statutes for nongovernmental entities bidding on the Pump Station 92 Replacement project in Florida. The affidavit must be signed and notarized by an officer or representative of the bidding entity, who attests that the entity does not use coercion for labor or services as defined in Florida law. The signatory declares under penalty of perjury that the stated facts are true and correct to the best of their knowledge and belief. The form requires completion of the entity name, signature, and title of the authorized representative, along with notarization by a notary public who must verify the signatory's identity through either physical presence or online notarization.

The affidavit must be notarized before submission and includes standard notarization elements such as the date, county, state, method of notarization, type of identification produced, and the notary's seal and signature. This document serves as a compliance requirement for bidders on the Pump Station 92 Replacement project, ensuring that contractors certify their compliance with Florida's human trafficking statutes prior to contract award. No specific pricing information, set-asides, or funding amounts are addressed in this affidavit form, as it functions solely as a certification and attestation document required during the bid process.

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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 .