375-030-31_Affidavit_Regarding_Labor_and_Services.docx
DOCX document 23 KB Posted
- Solicitation number
- 25-057-ITB
- Issued by
- Lee County, Fort Lauderdale City, Florida
About this file
This document is an Affidavit Regarding Labor and Services issued by the Florida Department of Transportation, effective July 1, 2024. The affidavit is a mandatory compliance document required under Florida Statute 787.06(13), which mandates that nongovernmental entities provide a sworn statement to governmental entities upon contract execution, renewal, or extension. The affidavit requires an authorized representative to attest under penalty of perjury that their organization does not use coercion for labor or services.
The affidavit is specifically linked to a City of Fort Myers procurement opportunity for unleaded gasoline and diesel fuel supply and delivery services. While the affidavit itself does not detail the specific contract terms, it represents a critical legal compliance document that vendors must complete as part of the contracting process. The document includes spaces for the nongovernmental entity's name, address, contact information, and requires a notarized signature, emphasizing the serious legal implications of the attestation regarding labor practices and potential coercion.
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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 .