7-Attachment C-Human Trafficking.pdf
PDF 333 KB Posted
- Attached to
- PORT ORANGE FSED IRRIGATION
- Solicitation number
- PROJ-26-043
- Issued by
- Volusia County, Florida
About this file
This is a Human Trafficking Attestation form required by Halifax Health for any nongovernmental entity executing, renewing, or extending a contract with the organization in Florida. The attestation requires an authorized representative or officer of the contractor to confirm under penalty of perjury that the entity does not use coercion for labor or services as defined in Florida Statutes Section 787.06. The form must be completed and signed by the contractor's representative, including printed name and title. The attestation applies to all contract phases, including new contract execution, renewals, and extensions.
The contractor must understand that if the attestation becomes untrue at any time during the contract term, the entity must immediately notify Halifax Health and will be prohibited from entering into future contracts or renewing existing contracts with Halifax Health. This requirement is part of Halifax Health's compliance with Florida Statutes Section 787.06 regarding human trafficking prevention. The form provides designated spaces for the nongovernmental entity name, authorized signature, printed name, and title of the signatory.
View the file
Other files
Show all 11
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
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
| Text1: |
| Text2: |
| Text3: |
File details come from the government source that posted it. Updated .