3-HUMAN TRAFFICKING AFFIDAVIT.pdf

PDF 243 KB Posted

Attached to
Palm Bay Aquatic Center
Solicitation number
01-RFQ-27
Issued by
Brevard County, Florida

About this file

This is a Human Trafficking Affidavit form required for the Palm Bay Aquatic Center contract opportunity in Florida. The affidavit is a declaration made pursuant to Florida Statute 92.525 in which an authorized representative of a vendor company confirms that the company does not use coercion for labor or services as defined in Florida Statute 787.06. The signatory, who must be over 18 years of age and have personal knowledge of the matters stated, attests under penalties of perjury that the information provided is true and accurate. The form requires completion of the vendor company name, the signatory's role and title, and authorized signature with printed identification.

This affidavit represents a compliance requirement for vendors bidding on the Palm Bay Aquatic Center operational services contract. The City of Palm Bay requires prospective bidders to execute this human trafficking certification as part of the procurement process to ensure vendors comply with Florida state law regarding labor practices. Submission of this completed and signed affidavit is a prerequisite for bid consideration on this opportunity to operate the city's aquatic facility while maintaining recreation services while minimizing financial impact to the municipality.

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HUMAN TRAFFICKING AFFIDAVIT

1. I am over the age of 18 and I have personal knowledge of the matters set forth except as otherwise set forth herein.

2. I currently service ___________________ (Role) of __________________________(Company).

3. ______________________________ (Company) does not use coercion for labor or services, as those terms are defined in Florida Statute 787.06.

4. This declaration is made pursuant to Florida Statute 92.525. I understand that making a false statement in this declaration may subject me to criminal penalties.

Under penalties of perjury, I ___________________________________________ (Signatory Name and

Title), declare that I have read the foregoing Human Trafficking Affidavit and that the facts stated in it are true.

Authorized Signature

Printed Name & Title

Company

File details come from the government source that posted it. Updated .