375-030-31_Affidavit_Regarding_Labor_and_Services.docx
DOCX document 23 KB Posted
- Attached to
- Tarpon Street and Riverside Pier Construction
- Solicitation number
- 25-042-ITB
- 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, effective July 1, 2024. The affidavit is a mandatory compliance document that nongovernmental entities must provide when executing, renewing, or extending contracts with governmental entities. The form requires an authorized representative to attest, under penalty of perjury, that their organization does not use coercion for labor or services as defined in Florida Statutes 787.06.
The affidavit is specifically tied to the City of Fort Myers' Tarpon Street and Riverside Pier Construction project (Solicitation No. 25-042-ITB), which involves a comprehensive pier rebuild and restoration. The project includes federal funding components, with FEMA potentially supporting the initiative, and includes specific diversity requirements such as a 15% Minority Business Enterprise (MBE) participation goal and a 10.54% Disadvantaged Business Enterprise (DBE) participation goal. Contractors must meet mandatory qualifications, including holding current Florida business licenses, being in business for at least three consecutive years, and complying with various procurement regulations and affidavit submissions.
View the file
Other files
Show all 23
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
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 .