3-3. REQUIRED HUMAN TRAFFICKING AFFIDAVIT.pdf

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Attached to
Pavement Preservation Services
Solicitation number
IFB-028-26-RM
Issued by
Leon County, Florida

About this file

This is a Nongovernmental Entity Human Trafficking Affidavit required by the State of Florida for participation in the Pavement Preservation Services contract opportunity. The affidavit serves as a mandatory compliance document for bidders on this pavement preservation project, which involves furnishing and applying bituminous surface treatment, commonly known as chip seal, on paved roadways or prepared road bases within an unspecified Florida county. The affidavit must be completed, signed, and notarized before submission, with the IFB number to be filled in by the bidding entity.

The affidavit requires an officer or representative of the bidding nongovernmental entity to attest under penalty of perjury that the entity does not use coercion for labor or services as defined under Section 787.06 of Florida Statutes. The document must be sworn before a notary public, who will verify the signatory's identity through either physical presence or online notarization. This affidavit is a prerequisite compliance requirement that addresses human trafficking concerns and must be executed in accordance with Florida law as a condition of bid submission for the pavement preservation services contract.

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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 .