375-030-31_Affidavit_Regarding_Labor_and_Services.docx
DOCX document 23 KB Posted
- Attached to
- Lake Management Services State and local contract opportunity
- Solicitation number
- ITB 25-090
- 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, effective July 1, 2024, specifically addressing contract requirements for nongovernmental entities engaging with governmental entities. The affidavit mandates that when a contract is executed, renewed, or extended, the nongovernmental entity must provide a signed document attesting that they do not use coercion for labor or services, as defined under Florida Statutes 787.06(13). The form requires the nongovernmental entity to complete detailed contact information and includes a sworn statement to be signed by an authorized representative, with provisions for notarization.
The accompanying state and local contract opportunity is for Lake Management Services issued by the City of Fort Myers, Florida, which seeks a comprehensive maintenance contractor for 16 different sites including lakes, ponds, and preserves. The five-year contract includes monthly aquatic weed control, buffer management, preserve maintenance, shoreline weed control, visual inspections, and quarterly maintenance of aeration systems and fountains. The procurement emphasizes compliance with EPA regulations, NPDES standards, and requires a licensed pesticide applicator. The City has established a Disadvantaged Business Enterprise (DBE) program with a 10.54% DBE goal and will award the contract to the responsive and responsible bidder with the lowest overall cost, with key dates including a pre-submittal meeting on September 16, 2025, and a proposal submission deadline of October 10, 2025.
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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 .