4-E. HUMAN TRAFFICKING AFFIDAVIT.pdf

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Attached to
Magnesium Hydroxide-Rebid
Solicitation number
IFB-067-26-CPW
Issued by
Leon County, Florida

About this file

This is a Nongovernmental Entity Human Trafficking Affidavit required by the City of Tallahassee for its Magnesium Hydroxide-Rebid solicitation in Florida. The affidavit serves as a compliance document pursuant to Section 787.06(13) of the Florida Statutes and must be signed and notarized by an officer or representative of the bidding entity. The document requires the signatory to attest that the entity does not use coercion for labor or services as defined in Florida law. The affidavit must be executed under penalty of perjury and sworn before a notary public, with the notary certifying the identity of the signatory through either physical presence or online notarization. The form includes designated spaces for the entity name, signature, title, state and county information, date, notary seal, and notary identification details.

This affidavit is a mandatory compliance requirement for vendors bidding on the City of Tallahassee's Magnesium Hydroxide slurry supply contract, which addresses the City's wastewater system needs for hydrogen sulfide control, odor control, and corrosion control across approximately 1,000 miles of sewer main and 114 pump stations. All prospective bidders must submit a completed and notarized Human Trafficking Affidavit as part of their bid package to demonstrate compliance with Florida's human trafficking statutes and establish their eligibility to contract with the City.

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Text version

IFB No.: ____________________________

NONGOVERNMENTAL ENTITY

HUMAN TRAFFICKING AFFIDAVIT

Section 787.06(13), Florida Statutes

THIS AFFIDAVIT MUST BE SIGNED AND NOTARIZED

I, the undersigned, am an officer or representative of _______________________________ and attest that said entity does not use coercion for labor or services as defined in section 787.06, Florida Statutes. Under penalty of perjury, I hereby declare and affirm, to the best of my knowledge and belief, that the above stated facts are true and correct.

Entity Name: _____________________________

Signature Title

STATE OF __________________________

COUNTY OF ___________________________

SWORN TO AND SUBSCRIBED before me by means of

___physical presence or ___online notarization this ______ day of ________________, 2024.

They are ____personally known to me or has produced _______________________ (Type of Identification) as identification.

(Notary Seal) Notary Public

Print, Type or Stamp Name of Notary

File details come from the government source that posted it. Updated .