Common_Carrier_Attestation_02.05.2025.pdf
PDF 112 KB Posted
- Attached to
- Indigent Burial and Cremation Services
- Solicitation number
- 26-0292-RFP
- Issued by
- Pinellas County, Clewiston City, Florida
About this file
Common Carrier Attestation for Pinellas County Indigent Burial and Cremation Services
This document is a Common Carrier Attestation form required by Pinellas County, Florida for contractors bidding on indigent burial and cremation services (RFP 26-0292-RFP). The attestation requires authorized contractor representatives to certify compliance with Florida Statute 908.111 and 92.525, confirming that the contractor will not knowingly transport unauthorized aliens into Florida during the contract term, except to facilitate their detention, removal, or departure. The form requires completion of standard identification information including the contractor's name, Federal Work Authorization User Identification Number, the Pinellas County contract name and number, signature, printed name, and date of execution. The attestation must be executed under penalties of perjury by an authorized representative with authority to bind the contractor. The contract term is five years from the date of award for the indigent burial and cremation services.
Pinellas County reserves the right to terminate the associated agreement for cause if the contractor is found in violation of the Common Carrier Attestation. This requirement is one of multiple compliance documents bidders must submit, including a Foreign Countries of Concern Affidavit, Human Trafficking Affidavit, HIPAA Business Associate Agreement, and proof of required insurance coverage (commercial general liability of $1,000,000, professional liability of $1,000,000, and workers' compensation insurance). Proposals are due April 14, 2026, at 3:00 PM via the OpenGov procurement website, with questions due by March 31, 2026, at 12:00 PM. The annual funding estimate does not exceed $550,000.
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Text version
COMMON CARRIER ATTESTATION
In accordance with section 908.111, Florida Statutes, the undersigned, on behalf of ___________________________ (the “Contractor”), attests and agrees they are in conformity with Florida Statute § 92.525 and is not willfully providing and will not willfully provide any service during the contract term in furtherance of transporting a person into this state knowing that the person is an unauthorized alien, except to facilitate the detention, removal, or departure of the person from this state or the United States.
For purposes of this Attestation, the Contractor is a “Common carrier” if it is a person, firm, or corporation that undertakes for hire, as a regular business, to transport persons or commodities from place to place, offering his or her services to all such as may choose to employ the common carrier and pay his or her charges.
The undersigned must be an authorized representative of the Contractor who can execute this Attestation on the Contractor’s behalf.
Under penalties of perjury, I _________________, declare that I have read the foregoing Common Carrier Attestation 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.:____________________________
COMMON CARRIER TERMINATION
The County reserves the right to terminate the associated agreement, for cause, if the Contractor is found in violation of its attestation above.
https://www.lawinsider.com/clause/attestation https://www.lawinsider.com/clause/attestation
| Print Name: |
| Date: |
| Federal Work Authorization User Identification No: |
| Name of Pinellas County Contract and Contract No: |
| Contractor: |
| Name: |
| Contractor Signature_es_:signer:signature: |
File details come from the government source that posted it. Updated .