Affidavit Regarding Labor and Services.docx

This is an Affidavit Regarding Labor and Services form issued by the State of Florida Department of Transportation, effective July 1, 2024, pursuant to Florida Statutes 787.06(14). The affidavit is required when a contract is executed, renewed, or extended between a nongovernmental entity and a governmental entity. The form requires the nongovernmental entity to provide basic identifying information including the entity's name, address, phone number, and the authorized representative's name, title, and email address. The authorized representative must attest under penalty of perjury that the nongovernmental entity does not use coercion for labor or services as defined in Florida Statutes 787.06.

The affidavit must be signed by an authorized officer or representative of the nongovernmental entity and notarized by a notary public. The notary must verify the signatory's identity through either physical presence or online notarization and document whether the individual was personally known or produced identification. The notarized affidavit becomes a required submission document for any state and local contract opportunity with the Florida Department of Transportation, with no specific pricing terms, set-asides, or funding amounts addressed in this particular form, as it serves solely as a compliance and attestation document.