25-84131500-ITN DFS BOR Attachment I PUR 2023.pdf
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- Attached to
- Insurance Broker of Record - Reinsurance Broker for Property and Casualty lines, Risk Management and
- Solicitation number
- ITN-13124
- Issued by
- St. Johns County, Florida
About this file
This document is Attachment I, a Provision of Commodities Produced by Forced Labor certification form for Invitation to Negotiate (ITN) No. 25-84131500-ITN issued by the Florida Department of Management Services on behalf of the Department of Financial Services' Division of Risk Management. The form requires a senior management member to certify that the commodities being offered have not been produced, in whole or in part, by forced labor, in compliance with section 287.1346(4)(b) of Florida Statutes. The form provides blank fields for an entity's name, senior management's printed name, title, signature, and date of certification.
The certification is a mandatory requirement when a company submits a response to a solicitation for commodities or before entering into or renewing a contract for commodity provision. It serves as a legal attestation that the company has performed due diligence to ensure its supply chain does not involve forced labor, aligning with Florida's statutory requirements for government procurement processes.
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Text version
ITN No.: 25-84131500-ITN
ITN No.: 25-84131500-ITN
Attachment I
PUR 2023
Provision of Commodities Produced by Forced Labor
Pursuant to section 287.1346(4)(b), Florida Statutes, this written certification 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 offered to the Department by the entity named below 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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