15-Affidavit of Compliance with Foreign Entity and Human Trafficking.pdf
PDF 625 KB Posted
- Solicitation number
- ITB No. 2026-024
- Issued by
- Palm Beach County, Florida
About this file
This is an Affidavit of Compliance form required by the Town of Palm Beach, Florida, Procurement and Contracts Division for the A39, A42, A43 Pump Station Ventilation Improvements project. The affidavit contains two primary compliance attestations that prospective contractors must execute under penalty of perjury. The Foreign Entity Laws section requires contractors to certify that the entity is not owned by, controlled by, or organized under the laws of a foreign country of concern as defined in Florida Statutes Sections 287.138 and 692.201, and is not a foreign principal as defined in Section 692.201. The Anti-Human Trafficking Laws section requires the affiant to confirm that the entity does not use coercion for labor or services as defined in Section 787.06, Florida Statutes. The affidavit must be executed by an authorized representative of the bidding entity who is an adult resident of Florida, signed and dated, and notarized before a Florida Notary Public. Contractors submitting bids for this ventilation improvement project at the wastewater pump stations must complete and submit this affidavit as part of their bid package through the Town's eProcurement platform (Bonfire).
The affidavit serves as a mandatory compliance document with no pricing information, set-asides, or contract award terms contained within it. This certification requirement applies uniformly to all prospective bidders regardless of firm size or location and must be included with bids to be considered responsive. The document is formatted to capture entity information, the signature of an authorized representative, and notarization details, ensuring legal enforceability and compliance with Florida state procurement regulations regarding foreign ownership restrictions and human trafficking prohibitions.
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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:
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