3-Attachment C-Human Trafficking.pdf
PDF 333 KB Posted
- Attached to
- Recumbent Cross Trainer
- Solicitation number
- PROJ-26-023
- Issued by
- Volusia County, Florida
About this file
This is a Human Trafficking Attestation document required by Halifax Health, a healthcare organization in Florida, for any nongovernmental entity executing, renewing, or extending a contract with the agency. The attestation form must be completed and signed by an authorized officer or representative of the vendor and confirms that the nongovernmental entity does not use coercion for labor or services as defined under Florida Statutes Section 787.06. The contract opportunity involves providing three NuStep T5XR Recumbent Cross Trainers with full-service delivery to Halifax Health Medical Center in Daytona Beach, Florida.
The attestation requires vendors to acknowledge that any false statements made in the certification may result in immediate notification requirements to Halifax Health and permanent disqualification from future contract execution, renewal, or extension with the organization. The form includes fields for the nongovernmental entity name, authorized representative signature, printed name, and title, and the attestation is executed under penalty of perjury to ensure compliance with applicable Florida statutes governing human trafficking and labor coercion.
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Text version
Human Trafficking Attestation
Pursuant to Florida Statutes Section 787.06(13), this attestation must be completed by an officer or representative of any nongovernmental entity that is executing, renewing, or extending a contract with Halifax Health.
The undersigned, as an authorized representative or officer of, and on behalf of, the “Nongovernmental Entity,” by executing below, attests, under penalty of perjury, to the following:
The Nongovernmental Entity does not use coercion for labor or services as such italicized terms are defined in Florida Statutes Section 787.06, as the same may be amended from time to time.
The undersigned understands that the statements made herein are made for the benefit of Halifax Health, and its compliance with Florida Statutes Section 787.06, and if at any time the attestation made herein is untrue, the Nongovernmental Entity will immediately notify Halifax Health of same and will not, thereafter, enter into any future contracts with Halifax Health, and will not renew or extend any existing contracts.
Nongovernmental Entity Name:__________________________________________________________
Signature: ____________________________________________________________________
Printed Name: ________________________________________________________________________
Title: _______________________________________________________________________
s. 787.06, FS July 2024
Attachment C
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File details come from the government source that posted it. Updated .