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
This is a Common Carrier Attestation form required by Pinellas County, Florida, for contractors bidding on the Indigent Burial and Cremation Services contract (RFP 26-0292-RFP). The attestation requires the contractor's authorized representative to certify compliance with Florida Statute 908.111 and 92.525, affirming that the contractor will not knowingly transport unauthorized aliens into Florida during the contract term, except to facilitate their detention, removal, or departure from the state or United States. The form defines "common carrier" as any person, firm, or corporation that transports persons or commodities for hire as a regular business. The signatory must provide their printed name, signature, date, and Federal Work Authorization User Identification Number. The attestation must identify the name of the Pinellas County contract and its associated contract number.
Pinellas County reserves the right to terminate the contract for cause if the contractor is found in violation of the Common Carrier Attestation. This compliance requirement is a mandatory submission element for all bidders responding to the indigent burial and cremation services solicitation and represents one of several attestations and certifications required alongside the Foreign Countries of Concern Affidavit, Human Trafficking Affidavit, and HIPAA Business Associate Agreement to qualify for contract award consideration.
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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 .