375-030-31_Affidavit_Regarding_Labor_and_Services.docx

DOCX document 23 KB Posted

Attached to
Electrical Vehicle Charging Station
Solicitation number
25-072-RFP
Issued by
Lee County, Fort Lauderdale City, Florida

About this file

This is an Affidavit Regarding Labor and Services form issued by the Florida Department of Transportation for procurement 375-030-31, effective July 1, 2024, related to the City of Fort Myers' Electrical Vehicle Charging Station (EVCS) project. The City of Fort Myers solicited proposals through a Request for Proposal released on July 2, 2025, with proposals due by August 5, 2025. The procurement seeks a qualified contractor to provide a comprehensive turnkey solution for fully funding, designing, installing, operating, maintaining, marketing, and potentially removing EVCS on publicly owned properties. The ideal solution must include all equipment, software, networking, accessories, and warranties, with preference for units capable of servicing multiple vehicles simultaneously. Key project deliverables include identifying optimal city-owned installation locations, providing proper parking signage, reconfiguring parking stalls, and ensuring compliance with permitting, ADA, and parking requirements. A pre-submittal meeting was scheduled for July 11, 2025, with anticipated City Council contract approval on September 2, 2025. The contract will have an initial seven-year term with three one-year renewal options.

This affidavit form requires authorized representatives of nongovernmental entities to attest under penalty of perjury that their organization does not use coercion for labor or services, as defined in Florida Statutes 787.06. The document must be signed by an authorized representative and notarized before execution of the contract. Contractors must demonstrate at least five years of experience with turnkey EVCS installations in the U.S. market and provide a detailed business model outlining pricing structures, billing practices, service fees, revenue distribution, and electricity cost recovery. The procurement emphasizes participation from Disadvantaged Business Enterprises (DBE) and Minority Business Enterprises (MBE), with the Florida Department of Transportation maintaining a race-neutral DBE program with an overall 10.54% DBE goal. Additional compliance requirements include E-Verify employment eligibility verification, Build America Buy America (BABA) provisions mandating domestic iron and steel products, anti-lobbying certifications, and certifications regarding debarment, human trafficking prevention, and foreign entity restrictions. Evaluation will be points-based, with 50% focused on firm experience and qualifications, 40% on project approach, and 10% on pricing.

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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 .