24-84131514-ITB Government Crime Attachment L PUR 2024.pdf
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- Solicitation number
- ITB-10823
- Issued by
- Leon County, Florida
About this file
This document is Attachment L (PUR 2024) for a Government Crime Insurance solicitation (No. 24-84131514-ITB) from the Florida Department of Management Services. The attachment consists of two certification forms related to labor practices that must be completed by vendors responding to the solicitation. Part A requires an officer or representative of a nongovernmental entity to certify that their organization does not use coercion for labor or services as defined in section 787.06 of Florida Statutes when executing, renewing, or extending a contract with a governmental entity.
Part B of the form requires certification from a member of the company's senior management, per section 287.1346(4)(b) of Florida Statutes, declaring that any commodities being offered to the Department have not been produced using forced labor, in whole or in part. Both sections require entity names, representative names and titles, signatures, and dates. The document includes the official Department of Management Services logo and appears to be an official form requiring completion as part of the bid submission process.
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Text version
Solicitation No. 24-84131514-ITB Government Crime Insurance
Attachment L
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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