4-HUMAN TRAFFICKING AFFIDAVIT.pdf
PDF 243 KB Posted
- Solicitation number
- 52-ITB-26
- Issued by
- Brevard County, Florida
About this file
This is a Human Trafficking Affidavit document required by the City of Palm Bay, Florida in connection with an automatic gate and power-assisted door repair services contract opportunity. The affidavit requires an authorized signatory from the bidding company to certify under penalty of perjury that they are over 18 years of age, hold a specified role within the company, and have personal knowledge of the company's labor practices. The declarant must affirm that the company does not use coercion for labor or services as defined in Florida Statute 787.06.
The affidavit is executed pursuant to Florida Statute 92.525 and carries serious legal consequences, as false statements may subject the signatory to criminal penalties. Bidders seeking to contract with the City of Palm Bay for automatic gate and power-assisted door repair services must complete this document with the authorized representative's signature, printed name, title, and company name. This certification serves as the city's compliance mechanism to ensure contractors meet anti-human trafficking requirements under Florida law.
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Other files
| File | Type | Posted |
|---|---|---|
| 3-REFERENCES.pdf | ||
| 5-STANDARD TERMS CONDITIONS.pdf | ||
| 6-DRAFT AGREEMENT.docx | DOCX document | |
| 2-DRUG FREE WORKPLACE.pdf | ||
| 1-NON-COLLUSION AFFIDAVIT.pdf | ||
| 7-52-ITB-26 Bid Form.xlsx | XLSX spreadsheet |
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Text version
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 .