6-TOH-240 - Anti Human Trafficking Affidavit.pdf
PDF 116 KB Posted
- Attached to
- Capital Improvement Funding
- Solicitation number
- RFLC-26-001
- Issued by
- Osceola County, Florida
About this file
This is an Anti-Human Trafficking Affidavit form required by the Tohopekaliga Water Authority in Florida for any nongovernmental entity seeking to engage in business with the Authority. The form mandates that all entities executing contracts with Toho must complete and submit a notarized affidavit attesting that they do not use coercion for labor or services as defined under Section 787.06 of the Florida Statutes. The affidavit requires the authorized representative of the entity to declare under penalty of perjury that they understand the prohibition against human trafficking and forced labor, are personally knowledgeable about the entity's compliance, and are authorized to bind the entity to this attestation.
The form requires notarization and must include the signature and printed name of an authorized representative with their title and date. The affidavit further obligates entities to immediately notify Toho if they ever engage in coercion for labor or services in the future, with the understanding that any such violation would prevent contract execution, renewal, or extension with the Authority. This form applies to the Capital Improvement Funding solicitation, which seeks a sealed term sheet for a direct placement loan from financial institutions in accordance with the Authority's proposed terms.
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Text version
FORM
TOH-240
v: 5/2025
Anti-Human Trafficking Affidavit
Form Page
Instructions: “Nongovernmental Entity”, defined as any person or entity seeking to engage in business with the Tohopekaliga Water Authority (“Toho”), must complete the following form. The terms “Contract” and “Agreement” may be used interchangeably.
Nongovernmental Entity Name
Solicitation/Contract Number(s):
The undersigned, on behalf of the Nongovernmental Entity, hereby attests as follows:
A. The Nongovernmental Entity understands and affirms that Section 787.06(13), Florida Statutes, prohibits Toho from executing, renewing, or extending a contract with entities that use coercion for labor or services, as such terms are defined in Section 787.06, Florida Statutes.
B. The Nongovernmental Entity hereby attests, under penalty of perjury, that the Nongovernmental Entity does not use coercion for labor or services as defined in Section 787.06(2), Florida Statutes.
C. The Nongovernmental Entity understands and affirms that if at any time in the future, the
Nongovernmental Entity does use coercion for labor or services, the Nongovernmental Entity will immediately notify Toho and no contracts may be executed, renewed, or extended with Toho.
The undersigned hereby represents that they: make the above attestation based upon personal knowledge; are over the age of 18 years and otherwise competent to make the above attestation; and are authorized to legally bind and make the above attestation on behalf of the Nongovernmental Entity.
Under penalties of perjury, the undersigned declares that they have read and understand the contents of the foregoing document and that the facts stated in it are true.
Authorized Signature:
Printed Name:
Title:
Date:
STATE OF _________________
COUNTY OF _______________
The foregoing instrument was acknowledged before me by means of ☐ physical presence or ☐ online notarization, this ____ day of ________________, 20____, by ____________________________, as __________________ on behalf of the Nongovernmental Entity. They ☐ are personally known to me or ☐ have produced ___________________ as identification.
Signature of Notary Public Name of Notary Typed, Printed or Stamped My Commission Expires: _______________
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