375-030-31_Affidavit_Regarding_Labor_and_Services.docx
DOCX document 23 KB Posted
- Solicitation number
- RSQ 25-095
- Issued by
- Lee County, Fort Lauderdale City, Florida
About this file
This document is an Affidavit Regarding Labor and Services from the Florida Department of Transportation (FDOT), effective July 1, 2024, mandated by Florida Statutes 787.06(13). The affidavit requires nongovernmental entities executing, renewing, or extending contracts with governmental entities to provide a signed statement affirming they do not use coercion for labor or services.
The related state and local contract opportunity is for a Sanitary Sewer Evaluation Survey Program seeking multiple Manhole Lining Contractors licensed in Florida. The selected contractors will provide comprehensive manhole lining and on-call urgent repair services, including supervision, manhole cleaning, sandblasting, repairs, and coating/lining installation. The contract aims to secure contractors who can perform these services at various locations as requested by the City, with a focus on complete and flexible service delivery.
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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 .