Affidavit.docx
DOCX document 19 KB Posted
- Solicitation number
- 25-0770-ITB-C
- Issued by
- Pinellas County, Florida
About this file
The document is a Human Trafficking Affidavit for Pinellas County, Florida, related to a contract for drawbridge services with the Pinellas County Public Works Department. The affidavit requires the contractor to attest that they do not use coercion for labor or services, as defined by Florida Statutes Section 787.06. The associated contract opportunity involves providing preventative maintenance and emergency response and repair services for three bascule bridges, encompassing all necessary labor, materials, equipment, and traffic control to assess bridge conditions and perform immediate repairs.
The affidavit requires an authorized representative to sign under penalties of perjury, confirming the truthfulness of the statements, and must be notarized. While specific pricing, funding sources, and contract term details are not explicitly provided in this document, the affidavit appears to be a standard compliance requirement for contractors bidding on the drawbridge services contract. The document includes fields for the contractor's federal work authorization identification, contract number, and notary validation, indicating a formal procurement process consistent with state and local government contracting protocols.
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Text version
HUMAN TRAFFICKING AFFIDAVIT
In accordance with section 787.06 (13), Florida Statutes, the undersigned, on behalf of ____________________________ (the “Contractor”), hereby attests that the Contractor does not use coercion for labor or services as defined in Section 787.06, Florida Statutes.
The undersigned must be an authorized representative of the Contractor who can execute this affidavit on the Contractor’s behalf.
Under penalties of perjury, I______________________, declare that I have read the foregoing affidavit and that the facts stated in it are true.
Signature:______________________________ Print Name:______________________________ Date:______________________________ Federal Work Authorization User Identification No.:_____________________________ Name of Pinellas County Contract and Contract No.:____________________________
STATE OF FLORIDA COUNTY OF ________________
The foregoing instrument was acknowledged before me by means of 1) physical presence __ or 2) online notarization___, this __________________________ (date) by ____________________________ of _____________________________________, a __________________________________ corporation, on behalf of the corporation.
He/she is personally known to me or has produced __________________________________ as identification.
[Notary Seal]
Notary Public:_________________________________________ Name typed, printed, or stamped:_________________________________________ My Commission Expires:_________________________________________
File details come from the government source that posted it. Updated .