9-Attachment C-Human Trafficking.pdf
PDF 333 KB Posted
- Attached to
- 200 TON ROOM BOOSTER PUMP
- Solicitation number
- PROJ-26-067
- Issued by
- Volusia County, Florida
About this file
This is a Human Trafficking Attestation form required by Halifax Health in Florida for any nongovernmental entity executing, renewing, or extending a contract with the organization. The attestation pertains to a contract opportunity for the removal and replacement of existing booster pumps in the 200-ton room. An authorized representative or officer of the bidding entity must complete and sign the form, attesting under penalty of perjury that the nongovernmental entity does not use coercion for labor or services as defined in Florida Statutes Section 787.06.
The nongovernmental entity acknowledges that the statements made in the attestation are for Halifax Health's compliance with Florida Statutes Section 787.06 and agrees that if the attestation becomes untrue at any time, the entity will immediately notify Halifax Health and will not enter into any future contracts with Halifax Health or renew or extend any existing contracts. The form requires the nongovernmental entity name, signature, printed name, and title of the authorized representative or officer completing the attestation.
View the file
Other files
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 .