4-HUMAN TRAFFICKING AFFIDAVIT.pdf

PDF 243 KB Posted

Attached to
North Regional Wastewater Treatment Plan (NWWTP) Mechanical Integrity Testing
Solicitation number
47-ITB-26
Issued by
Brevard County, Florida

About this file

This is a Human Trafficking Affidavit required for the North Regional Wastewater Treatment Plant (NRWWTP) Mechanical Integrity Testing project in Florida. The affidavit serves as a declaration by an authorized company representative confirming that the company does not use coercion for labor or services as defined under Florida Statute 787.06. The signatory must be over 18 years of age and have personal knowledge of the statements made. The declaration is executed pursuant to Florida Statute 92.525, and the signatory acknowledges that providing false information may result in criminal penalties under perjury laws.

The affidavit requires completion of company name, signatory role, signatory name and title, and authorized signature. This document appears to be a mandatory compliance requirement for contractors bidding on or performing work related to the mechanical integrity testing project at the NRWWTP, which involves testing of the facility's Class I Deep Injection Well (IW-1) in accordance with applicable regulatory requirements. No pricing, funding, or contract term information is specified in this affidavit document.

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Other files

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5-STANDARD TERMS CONDITIONS.pdf PDF
2-DRUG FREE WORKPLACE.pdf PDF
1-NON-COLLUSION AFFIDAVIT.pdf PDF
3-REFERENCES.pdf PDF
7-DIW IW-1 MIT Specifications Draft rev2 with Figures.pdf PDF
6-DRAFT AGREEMENT.docx DOCX document

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HUMAN TRAFFICKING AFFIDAVIT

1. I am over the age of 18 and I have personal knowledge of the matters set forth except as otherwise set forth herein.

2. I currently service ___________________ (Role) of __________________________(Company).

3. ______________________________ (Company) does not use coercion for labor or services, as those terms are defined in Florida Statute 787.06.

4. This declaration is made pursuant to Florida Statute 92.525. I understand that making a false statement in this declaration may subject me to criminal penalties.

Under penalties of perjury, I ___________________________________________ (Signatory Name and

Title), declare that I have read the foregoing Human Trafficking Affidavit and that the facts stated in it are true.

Authorized Signature

Printed Name & Title

Company

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