375-030-31_Affidavit_Regarding_Labor_and_Services.docx
DOCX document 23 KB Posted
- Attached to
- Fort Myers Downtown Pedestrian Mall and Micromobility Feasibility Study (FDOT 451523-1-18-01)
- Solicitation number
- 25-036-RSQ
- 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 (FDOT), effective July 1, 2024, which requires nongovernmental entities to provide a signed affidavit attesting that they do not use coercion for labor or services when executing, renewing, or extending contracts with governmental entities. This specific affidavit is associated with the Fort Myers Downtown Pedestrian Mall and Micromobility Feasibility Study (FDOT Project 451523-1-18-01), a two-part feasibility study investigating potential bicycle and pedestrian-only street and micromobility opportunities within the city's Downtown and Midtown districts.
The feasibility study aims to explore Complete Streets transportation forms that can accommodate bicycles and pedestrians while reducing greenhouse gas emissions, aligning with the City's Comprehensive Plan, Element 2, Transportation, Objective 3. The affidavit form requires the nongovernmental entity's authorized representative to declare under penalty of perjury that they do not engage in labor coercion, as defined in Florida Statutes 787.06, and must be notarized to validate the commitment. While specific contract pricing, funding sources, and detailed project costs are not explicitly outlined in this document, the affidavit serves as a critical compliance mechanism ensuring ethical labor practices for governmental contract partnerships.
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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 .