375-030-31_Affidavit_Regarding_Labor_and_Services.docx
DOCX document 23 KB Posted
- Attached to
- Annual Paving, Drainage and Concrete
- Solicitation number
- ITB 25-086
- Issued by
- Lee County, Fort Lauderdale City, Florida
About this file
The document is an Affidavit Regarding Labor and Services from the Florida Department of Transportation (FDOT), effective July 1, 2024, which requires nongovernmental entities executing contracts with governmental entities to provide a signed affidavit attesting that they do not use coercion for labor or services, as defined under Florida Statutes 787.06(13). The affidavit must be signed by an authorized representative under penalty of perjury, and includes spaces for the nongovernmental entity's name, address, contact information, and requires notarization.
This affidavit is connected to the City of Fort Myers' Invitation to Bid (ITB) 25-086 for Annual Paving, Drainage and Concrete construction services, which seeks qualified contractors to perform site/civil construction repairs and improvements on an as-needed basis. The procurement includes comprehensive requirements such as Disadvantaged Business Enterprise (DBE) participation with a 10.54% goal, E-Verify compliance, and adherence to Build America, Buy America provisions mandating the use of domestically produced iron, steel, manufactured products, and construction materials. The bid allows for multiple awards, potential annual contract pricing adjustments up to 3%, and emphasizes local and minority business enterprise participation, with contractors required to complete a Bidders Opportunity List within three business days of submission.
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Text version
STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION
AFFIDAVIT REGARDING LABOR AND SERVICES
375-030-31
PROCUREMENT
07/24
Effective July 1, 2024, pursuant to §787.06(13), Florida Statutes, when a contract is executed, renewed, or extended between a nongovernmental entity and a governmental entity, the nongovernmental entity must provide the governmental entity with an affidavit signed by an officer or a representative of the nongovernmental entity under penalty of perjury attesting that the nongovernmental entity does not use coercion for labor or services.
| Nongovernmental Entity's Name: |
| Address: |
| Phone Number: |
| Authorized Representative’s Name: |
| Authorized Representative’s Title: |
| Email Address: |
AFFIDAVIT
I, insert nongovernmental entity's authorized representative name, as authorized representative attest that insert nongovernmental entity's namedoes not use coercion for labor or services as defined in §787.06, Florida Statutes.
Under penalty of perjury, I declare that I have read the foregoing Affidavit and that the facts stated in it are true.
| (Signature of authorized representative) |
| Date |
STATE OF FLORIDA
COUNTY OF
Sworn to (or affirmed) and subscribed before me, by means of |_| physical presence or |_|online notarization, this day of , (year), by
Notary Public, not required when digital
Commission Expires
Personally Known |_| OR Produced Identification |_| Type of Identification Produced
File details come from the government source that posted it. Updated .