7-Affidavit Regarding Labor & Services.pdf

PDF 8 KB Posted

Attached to
DISTRICTWIDE IMPLEMENTATION AND MAINTENANCE OF NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDE
Solicitation number
RFP-12807
Issued by
Broward County, Graceville City, Florida

About this file

This document is an Affidavit Regarding Labor and Services form issued by the Florida Department of Transportation (FDOT), effective July 1, 2024. The form is designed to comply with §787.06(13), Florida Statutes, requiring nongovernmental entities to provide a signed affidavit to governmental entities when executing, renewing, or extending a contract. The affidavit mandates that the nongovernmental entity's authorized representative attest under penalty of perjury that the organization does not use coercion for labor or services as defined in the referenced statute.

The form provides a template for nongovernmental entities to complete, including fields for the entity's name, address, contact information, and the authorized representative's details. The document includes a notarization section to verify the authenticity of the affidavit, with options for physical presence or online notarization. While the form is primarily a legal compliance document, it serves as a critical mechanism for ensuring ethical labor practices in contracts between nongovernmental and governmental entities in the state of Florida.

View the file

Other files

Show all 16

On GovTribe

Work with this file

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file

Text version

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 .