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 .