24-84131503-ITB Business Automobile Attachment M PUR 2024.pdf
PDF 119 KB Posted
- Attached to
- Business Automobile Insurance
- Solicitation number
- ITB-10265
- Issued by
- Duval County, Lee County, Leon County, Fort Lauderdale City, Florida
About this file
This document is a solicitation for Business Automobile Insurance from the State of Florida, solicitation number 24-84131503-ITB. The solicitation requires the completion of two forms: Part A, which certifies that the entity does not use coercion for labor or services as defined in Florida Statutes, and Part B, which certifies that the commodities offered have not been produced, in whole or in part, by forced labor. The solicitation does not provide any additional details about the products or services requested, project overviews, item quantities, response dates, due dates, site visits, bidder's meetings and conferences, award dates, or the term of the contract.
The document does not contain information about pricing terms, set asides, incumbents, the current environment, funding requirements and sources, amounts and sources, or any other salient information. The document appears to be focused solely on the certifications required by the State of Florida regarding the use of coercion for labor or services and the provision of commodities produced by forced labor.
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Text version
Solicitation No. 24-84131503-ITB Business Automobile Insurance
Attachment M
PUR 2024
Part A: Use of Coercion for Labor and Services
Pursuant to section 787.06(13), Florida Statutes, this portion of the form must be completed by an officer or representative of the nongovernmental entity executing, renewing, or extending a contract with a governmental entity.
Name of entity does not use coercion for labor or services as defined in section 787.06, Florida Statutes.
Under penalties of perjury, I declare that I have read the foregoing statement and that the facts stated in it are true.
Entity Name:
Representative/Officer’s Printed Name:
Representative/Officer’s Title:
Signature: Date:
Part B: Provision of Commodities Produced by Forced Labor
Pursuant to section 287.1346(4)(b), Florida Statutes, this portion of the form must be completed by a member of the company’s senior management, as defined in section 287.1346, F.S., when the company submits a response to a solicitation for the provision of commodities and before the company enters into or renews a contract for the provision of commodities.
I certify that to the best of my knowledge, the commodities Name of entity is offering to the Department have not been produced, in whole or in part, by forced labor.
Entity Name:
Senior Management’s Printed Name:
Senior Management member’s Title:
Signature: Date:
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