375-030-31_Affidavit_Regarding_Labor_and_Services.docx

23 KB Posted

Attached to
Sanitary Sewer Evaluation Survey Program On-Call Contractors - Lift Station Lining
Solicitation number
RSQ 25-096
Issued by
Lee County, Fruitville CDP, Florida

About this file

Written by GovTribe AI ·

This document is an Affidavit Regarding Labor and Services from the Florida Department of Transportation (FDOT), effective July 1, 2024, which requires nongovernmental entities to provide a signed affidavit when executing, renewing, or extending contracts with governmental entities. The affidavit specifically attests that the nongovernmental entity does not use coercion for labor or services, as defined under Florida Statute 787.06.

The related state and local contract opportunity is for a Sanitary Sewer Evaluation Survey Program seeking multiple Wetwell Lining Contractors licensed in Florida. The selected contractors will provide comprehensive wetwell lining services and on-call urgent repair services within city limits, including supervision/administration, wetwell cleaning, sandblasting, repairs, and coating/lining installation. The contract aims to establish on-call contractors capable of performing these specialized infrastructure maintenance services across various project requirements.

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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 .