25-84131500-ITN DFS BOR Attachment Q PUR 2024 Coercion Labor Services.pdf
PDF 105 KB Posted
- 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 an affidavit (Attachment Q) 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 attachment requires a nongovernmental entity executing, renewing, or extending a contract with a governmental entity to affirm that they do not use coercion for labor or services as defined in section 787.06 of Florida Statutes. The form provides blank spaces for an entity's name, a representative's printed name and title, signature, and date of execution.
The affidavit is a mandatory compliance document that serves as a legal declaration under penalties of perjury, confirming the entity's commitment to avoiding coercive labor practices. By signing this document, the representative attests to understanding and truthfully stating that their organization does not engage in any form of labor or service coercion as specified in the referenced Florida statute, which is a prerequisite for contracting with a governmental entity in the state of Florida.
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Text version
ITN No.: 25-84131500-ITN
ITN No.: 25-84131500-ITN
Attachment Q
PUR 2024
Use of Coercion for Labor and Services
Pursuant to section 787.06(13), Florida Statutes, this affidavit must be completed by an officer or representative of the nongovernmental entity executing, renewing, or extending a contract with a governmental entity.
The entity named below 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: _____________________
File details come from the government source that posted it. Updated .