7-Attachment C-Human Trafficking.pdf
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- Attached to
- France Tower Lobby Area Window Tint
- Solicitation number
- PROJ-25-132
- 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 with the healthcare organization, pursuant to Florida Statutes Section 787.06(13). The document serves as Attachment C and requires completion by an authorized officer or representative of any contracting entity. The attestation must be signed under penalty of perjury and includes fields for the nongovernmental entity name, authorized signature, printed name, and title of the signatory.
The form requires the contracting entity to attest that it does not use coercion for labor or services as defined in Florida Statutes Section 787.06 and commits to immediately notify Halifax Health if this attestation becomes untrue at any time during the contract period. The entity must also agree that if the attestation becomes false, it will not enter into future contracts with Halifax Health or renew or extend existing contracts. This compliance document is dated July 2024 and represents a mandatory requirement for all nongovernmental contractors working with Halifax Health to ensure adherence to Florida's anti-human trafficking statutes.
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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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