15-Anti-Human Trafficking Affidavit.docx

DOCX document 40 KB Posted

Attached to
FEMA Compliant Fabricate and Refurbish Water and Wastewater Control Panels
Solicitation number
OPN2131152B1
Issued by
Broward County, Florida

About this file

This is an Anti-Human Trafficking Affidavit form required by Broward County, Florida for vendors participating in state and local contract opportunities. The affidavit applies to the FEMA Compliant Fabricate and Refurbish Water and Wastewater Control Panels contract, which is an open-end contract to provide fabrication and refurbishment services for water and wastewater control panels to Broward County's Water and Wastewater Services department and other County agencies. Vendors must complete and return the affidavit with their solicitation submittal, or if not provided initially, within three business days of the County's request. The form certifies that the vendor does not use coercion for labor or services as defined under Section 787.06, Florida Statutes. Failure to comply with the submission timeframe may result in the vendor being deemed nonresponsive.

The affidavit requires the vendor to provide their company name, authorized representative signature, printed name, title, and date of execution under penalty of perjury. The form was last updated on September 9, 2024. All solicitation responses, including this completed affidavit, must be submitted electronically through BPRO by the specified closing date and time. The County will not accept submissions through alternative means. Vendors are advised to review the complete solicitation requirements, which include County and State license requirements, FEMA compliance requirements, Florida Department of Transportation certification, and bonding requirements.

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Text version

ANTI-HUMAN TRAFFICKING AFFIDAVIT

This completed form should be returned with the Vendor’s submittal. If not provided with the submittal, the Vendor must submit this form within three (3) business days after the County’s request and upon award, renewal, or extension of a contract with Broward County. The Vendor may be deemed nonresponsive for failure to fully comply within the stated timeframe.

The Vendor indicated below does not use coercion for labor or services, as such terms are defined in Section 787.06, Florida Statutes.

Under penalties of perjury, the undersigned declares that they have read the foregoing statement and that the facts stated in it are true.

Vendor Name: Click or tap here to enter text.

Signature:

Printed Name: Click or tap here to enter text.

Title: Click or tap here to enter text.

Date: Click or tap to enter a date.

Form Date 9/9/24

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