8-Attachment C-Human Trafficking.pdf

PDF 333 KB Posted

Attached to
Port Orange SPD Equipment Replacement
Solicitation number
PROJ-25-136
Issued by
Volusia County, Florida

About this file

This document is a Human Trafficking Attestation form from Halifax Health, requiring completion by nongovernmental entities executing, renewing, or extending contracts with the organization. The form is based on Florida Statutes Section 787.06(13) and requires an authorized representative to attest, under penalty of perjury, that their organization does not use coercion for labor or services as defined in the referenced statute.

The attestation includes a critical compliance commitment, wherein the nongovernmental entity agrees to immediately notify Halifax Health if the attestation becomes untrue and agrees to forfeit the ability to enter into future contracts or renew existing contracts with Halifax Health. The document is structured as a standard legal form with spaces for the nongovernmental entity's name, signature, printed name, and title, and is dated for July 2024. The form serves as a legal safeguard to ensure contractors do not engage in human trafficking practices.

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