Affidavit Regarding Labor & Services.docx
DOCX document 23 KB Posted
- Attached to
- DISTRICT WIDE TITLE SEARCH AND EXAMINATION SERVICES FOR FLORIDA DEPARTMENT OF TRANSPORTATION - DISTR
- Solicitation number
- RFP-15845
- Issued by
- Broward County, Fruitville CDP, Florida
About this file
This is an Affidavit Regarding Labor and Services document required by the Florida Department of Transportation (FDOT) for the District Wide Title Search and Examination Services procurement (DOT-RFP-27-4001-CO). Effective July 1, 2024, pursuant to Florida Statutes 787.06(13), all nongovernmental entities executing, renewing, or extending contracts with governmental entities must provide a signed affidavit attesting that they do not use coercion for labor or services. The affidavit requires completion by an authorized representative of the nongovernmental entity and must be notarized before submission. The form requests the nongovernmental entity's name, address, phone number, authorized representative's name, title, and email address. The affidavit must be sworn to or affirmed before a notary public, with options for either physical presence or online notarization. The notary must verify the signatory through personal knowledge or produced identification and document the commission expiration date.
This document serves as a compliance requirement for the title search and examination services contract valued at a maximum of $1,050,000 and running through August 13, 2031, with potential renewal options. All respondents to the FDOT solicitation must complete and submit this affidavit along with other required documentation, including the Foreign Country of Concern Attestation. The form's completion and notarization are mandatory elements of the proposal submission process, with failure to provide the executed affidavit potentially affecting a bidder's responsiveness and eligibility for contract award. This labor compliance attestation aligns with Florida's statutory requirements to prevent human trafficking and coercive labor practices in state contracting.
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Text version
STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION
AFFIDAVIT REGARDING LABOR AND SERVICES
375-030-31
PROCUREMENT
07/24
Effective July 1, 2024, pursuant to §787.06(13), Florida Statutes, when a contract is executed, renewed, or extended between a nongovernmental entity and a governmental entity, the nongovernmental entity must provide the governmental entity with an affidavit signed by an officer or a representative of the nongovernmental entity under penalty of perjury attesting that the nongovernmental entity does not use coercion for labor or services.
| Nongovernmental Entity's Name: |
| Address: |
| Phone Number: |
| Authorized Representative’s Name: |
| Authorized Representative’s Title: |
| Email Address: |
AFFIDAVIT
I, insert nongovernmental entity's authorized representative name, as authorized representative attest that insert nongovernmental entity's namedoes not use coercion for labor or services as defined in §787.06, Florida Statutes.
Under penalty of perjury, I declare that I have read the foregoing Affidavit and that the facts stated in it are true.
| (Signature of authorized representative) |
| Date |
STATE OF FLORIDA
COUNTY OF
Sworn to (or affirmed) and subscribed before me, by means of |_| physical presence or |_|online notarization, this day of , (year), by
Notary Public, not required when digital
Commission Expires
Personally Known |_| OR Produced Identification |_| Type of Identification Produced
File details come from the government source that posted it. Updated .