6-Attachment C-Human Trafficking.pdf
PDF 333 KB Posted
- Attached to
- Twin Lakes SSPD Equipment Replacement
- Solicitation number
- PROJ-25-134
- Issued by
- Volusia County, Florida
About this file
This document is a Human Trafficking Attestation form required by Halifax Health, a healthcare organization, as mandated by Florida Statutes Section 787.06(13). The attestation must be completed by an officer or representative of any nongovernmental entity that is executing, renewing, or extending a contract with Halifax Health. The form serves as a compliance requirement rather than a solicitation for specific products or services, and does not contain information about response dates, quantities, site visits, bidder meetings, or contract terms.
The attestation requires the nongovernmental entity to affirm under penalty of perjury that it does not use coercion for labor or services as defined in Florida Statutes Section 787.06. The signing party must also acknowledge that if the attestation becomes untrue at any time, they will immediately notify Halifax Health and will not enter into future contracts or renew existing contracts with the organization. The document includes signature fields for the nongovernmental entity name, authorized representative signature, printed name, and title, and is dated July 2024 as Attachment C to a larger contract document.
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Text version
Human Trafficking Attestation
Pursuant to Florida Statutes Section 787.06(13), this attestation must be completed by an officer or representative of any nongovernmental entity that is executing, renewing, or extending a contract with Halifax Health.
The undersigned, as an authorized representative or officer of, and on behalf of, the “Nongovernmental Entity,” by executing below, attests, under penalty of perjury, to the following:
The Nongovernmental Entity does not use coercion for labor or services as such italicized terms are defined in Florida Statutes Section 787.06, as the same may be amended from time to time.
The undersigned understands that the statements made herein are made for the benefit of Halifax Health, and its compliance with Florida Statutes Section 787.06, and if at any time the attestation made herein is untrue, the Nongovernmental Entity will immediately notify Halifax Health of same and will not, thereafter, enter into any future contracts with Halifax Health, and will not renew or extend any existing contracts.
Nongovernmental Entity Name:__________________________________________________________
Signature: ____________________________________________________________________
Printed Name: ________________________________________________________________________
Title: _______________________________________________________________________
s. 787.06, FS July 2024
Attachment C
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File details come from the government source that posted it. Updated .