7-Affidavit Regarding Labor & Services.docx

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Attached to
DISTRICTWIDE DATA NETWORK STRUCTURED CABLING SYSTEM FOR FLORIDA DEPARTMENT OF TRANSPORTATION DISTRIC
Solicitation number
ITB-10100
Issued by
Broward County, Fruitville CDP, Florida

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The document is an Affidavit Regarding Labor and Services required by the Florida Department of Transportation (FDOT) for a DISTRICTWIDE DATA NETWORK STRUCTURED CABLING SYSTEM contract opportunity. The contract is for the procurement of a districtwide data network structured cabling system for FDOT District 4. The affidavit must be signed by an authorized representative of the nongovernmental entity, attesting that the entity does not use coercion for labor or services. The contract opportunity is open to registered vendors in the State of Florida's MyFloridaMarketplace system, and out-of-state vendors must be authorized to do business in Florida. The solicitation includes public meeting notices and agendas, and the resulting contract will be subject to the MFMP Transaction Fee. Vendors on the Scrutinized Companies lists are prohibited from bidding on or entering into contracts over $1 million.

The solicitation includes compliance requirements related to nondiscrimination statutes and authorities, such as Title VI of the Civil Rights Act of 1964, the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970, and the Americans with Disabilities Act. Vendors must also comply with the Inspector General requirements outlined in Florida Statutes.

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STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION

AFFIDAVIT REGARDING LABOR AND SERVICES

375-030-31

PROCUREMENT

07/24

Effective July 1, 2024, pursuant to §787.06(13), Florida Statutes, when a contract is executed, renewed, or extended between a nongovernmental entity and a governmental entity, the nongovernmental entity must provide the governmental entity with an affidavit signed by an officer or a representative of the nongovernmental entity under penalty of perjury attesting that the nongovernmental entity does not use coercion for labor or services.

Nongovernmental Entity's Name:
Address:
Phone Number:
Authorized Representative’s Name:
Authorized Representative’s Title:
Email Address:

AFFIDAVIT

I, insert nongovernmental entity's authorized representative name, as authorized representative attest that insert nongovernmental entity's namedoes not use coercion for labor or services as defined in §787.06, Florida Statutes.

Under penalty of perjury, I declare that I have read the foregoing Affidavit and that the facts stated in it are true.

(Signature of authorized representative)
Date

STATE OF FLORIDA

COUNTY OF

Sworn to (or affirmed) and subscribed before me, by means of |_| physical presence or |_|online notarization, this day of , (year), by

Notary Public, not required when digital

Commission Expires

Personally Known |_| OR Produced Identification |_| Type of Identification Produced

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