6-Attachment C-Human Trafficking.pdf
PDF 333 KB Posted
- Attached to
- SEVCC CU3&CU6 Replacements
- Solicitation number
- PROJ-26-027
- Issued by
- Volusia County, Florida
About this file
This is a Human Trafficking Attestation form required by Halifax Health for nongovernmental entities executing, renewing, or extending contracts related to the SEVCC CU3&CU6 Replacements project in Florida. The attestation must be completed and signed by an authorized representative or officer of the contracting entity. The form serves as a compliance document pursuant to Florida Statutes Section 787.06(13) and requires the nongovernmental entity to attest under penalty of perjury that it does not use coercion for labor or services as defined in the referenced statute.
The attestation carries significant obligations for the signing party. By executing the form, the nongovernmental entity acknowledges that the statements are made for the benefit of Halifax Health and its compliance with Florida law. The entity commits to immediately notify Halifax Health if any statement becomes untrue at any time and agrees to refrain from entering into any future contracts with Halifax Health and from renewing or extending existing contracts upon discovery of any false attestations. The form requires completion of the nongovernmental entity name, authorized signature, printed name, and title of the signatory.
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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 .