375-030-31_Affidavit_Regarding_Labor_and_Services.docx
DOCX document 23 KB Posted
- Attached to
- Emergency Bypass Pumps Rental & Delivery (Disaster Contract) State and local contract opportunity
- Solicitation number
- ITB 25-075
- Issued by
- Lee County, Fruitville CDP, Florida
About this file
This document is an Affidavit Regarding Labor and Services from the Florida Department of Transportation, effective July 1, 2024, which mandates that nongovernmental entities executing, renewing, or extending contracts with governmental entities must 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 requires the nongovernmental entity's authorized representative to declare under penalty of perjury that their organization does not engage in coercive labor practices, with the document requiring signature, date, and notarization.
The related state and local contract opportunity involves two separate procurement activities in Florida: Citrus County is seeking qualified contractors for ITB 25-075 to provide on-call maintenance, repair, and replacement services for well pumps and electric motors across 14 water treatment plants, with wells ranging from 2 to 12 inches in diameter and 42 to 340 feet in depth. The county intends to award contracts to two responsive and responsible bidders. Simultaneously, the City of Fort Myers is requesting proposals for emergency bypass pump rentals, specifically 4-inch pumps with specific hose and float requirements, with a preference for silent units.
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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 .