Coercion_affidavit_10.16.25.pdf
PDF 100 KB Posted
- Attached to
- ERCES Inspections State and local contract opportunity
- Solicitation number
- 033-TD-0426
- Issued by
- Florida
About this file
This is an affidavit form required by the State of Florida for all nongovernmental entities executing, renewing, or extending contracts with governmental entities, effective July 1, 2024. The document applies to the ERCES Inspections contract opportunity in Florida, which involves the provision of required semi-annual inspections, annual inspections and testing, and 5-year grid re-tests of all Emergency Responder Communication Enhancement Systems. The affidavit must be completed and notarized by an authorized representative of the vendor and submitted as part of the contract execution requirements.
The affidavit serves as a compliance certification wherein vendors attest under penalty of perjury that they do not engage in coercion for labor or services, including prohibited practices such as use of physical force, unlawful restraint or confinement, exploitative debt practices, document confiscation, threats of financial harm, fraudulent inducement, or provision of controlled substances for exploitation purposes. The document must be signed by an authorized representative and acknowledged before a notary public, with the notary verifying the signatory's identity through personal knowledge or government-issued identification.
View the file
Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| 033-TD-0426_ERCES_Inspections_final.pdf | ||
| Conflict_of_Interest_Statement.pdf | ||
| PCSB_Form_Contract_Addendum_7.17.25.pdf | ||
| Addendum_Acknowledgment_Form.pdf | ||
| Reference_Request.docx | DOCX document | |
| Drug_Free_Workplace_Certification_Form.pdf | ||
| Contact_Information_Form.pdf | ||
| Foreign_Countries_affidavit_9.23.25.pdf |
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Text version
Affidavit Regarding the Use of Coercion for Labor and Services
State of Florida County of __________________
Name of Vendor: _____________________________________________________________________
Address: ____________________________________________________________________________
Phone Number: ______________________________________________________________________
Authorized Representative’s Name: _____________________________________________________
Authorized Representative’s Title: _______________________________________________________
Effective July 1, 2024, Section 787.06(14), Florida Statutes, requires all nongovernmental entities executing, renewing, or extending a contract with a governmental entity to provide an affidavit signed by an officer or representative under penalty of perjury attesting that the nongovernmental entity does not use coercion for labor or services.
As the person authorized to sign on behalf of the vendor, I certify that the vendor identified above does not:
• Use or threaten to use physical force against any person;
• Restrain, isolate, or confine or threaten to restrain, isolate, or confine any person without lawful authority and against her or his will;
• Use lending or other credit methods to establish a debt by any person when labor or services are pledged as a security for the debt, if the value of the labor or services as reasonably assessed is not applied toward the liquidation of the debt, the length and nature of the labor or services are not respectively limited and defined;
• Destroy, conceal, remove, confiscate, withhold, or possess any actual or purported passport, visa, or other immigration document, or any other actual or purported government identification document, of any person;
• Cause or threaten to cause financial harm to any person;
• Entice or lure any person by fraud or deceit; or
• Provide a controlled substance as outlined in Schedule I or Schedule II of Florida Statute 893.03 to any person for the purpose of exploitation of that person.
Under penalty of perjury, I declare that I have read the foregoing document and that the facts stated in it are true.
Signature of Authorized Representative: ______________________________________________
The foregoing instrument was acknowledged before me this _____ day of _____, 20____, by ________________________, as Authorized Representative of the above-named Vendor who is (___) personally known to me or (____) produced a _______ driver’s license as identification.
Notary Public, State of _____________________ Commission no.: __________________________ My commission expires:____________________
File details come from the government source that posted it. Updated .