18-18. REQUIRED HUMAN TRAFFICKING AFFIDAVIT.pdf

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Attached to
Dog House Pump Stations Replacements (PS 25, 49, 59, 85)
Solicitation number
IFB-039-26-RM
Issued by
Leon County, Florida

About this file

This is a Required Human Trafficking Affidavit form for a nongovernmental entity related to the Dog House Pump Stations Replacements project (PS 25, 49, 59, 85) in Florida. The affidavit must be signed and notarized by an officer or representative of the bidding entity and certifies that the entity does not use coercion for labor or services as defined in section 787.06, Florida Statutes. The mandatory pre-bid meeting is scheduled for February 18, 2026, at 2:00 PM EST via Microsoft Teams, with dial-in phone options available. The project involves replacement of four existing Smith & Loveless pump stations with new stations, including removal and replacement of gravity inflow sewer mains, bypass pumping assemblies, wet well rehabilitation, installation of new kingpin manholes, generators, electrical site work, fencing modifications, concrete work, landscaping restoration, and material disposal and traffic maintenance services.

All bidders must submit a completed and notarized human trafficking affidavit as part of their proposal. The affidavit requires the bidding entity to declare under penalty of perjury that it does not engage in human trafficking or labor coercion. The form must be sworn to and subscribed before a notary public, with the notary indicating whether the affiant appeared by physical presence or online notarization and providing identification verification. This compliance document is mandatory for all nongovernmental entities bidding on the Dog House Pump Stations Replacements project and must accompany the contractor's bid submission.

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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 .