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 Common Carrier Attestation form is required by Pinellas County, Florida for the Indigent Burial and Cremation Services contract opportunity (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 detention, removal, or departure. The form requires the contractor's authorized representative to provide their printed name, signature, date, Federal Work Authorization User Identification Number, and the specific name and contract number of the Pinellas County contract. The attestation must be executed under penalties of perjury, with the county reserving the right to terminate the contract for cause if any violation of this attestation is discovered during the contract performance period.

The Common Carrier Attestation is a compliance document that applies to contractors providing services that may involve transportation of persons, including funeral service providers handling body removal and transport operations. Contractors must certify their status as either a common carrier or non-carrier entity and acknowledge the specific immigration-related compliance requirements under Florida law. This attestation form serves as a legally binding declaration and represents one of several required compliance documents for the indigent burial and cremation services solicitation, alongside Foreign Countries of Concern Affidavits, Human Trafficking Affidavits, and HIPAA Business Associate Agreements. Failure to comply with the terms stated in this attestation constitutes grounds for immediate contract termination.

View the file

Other files

File Type Posted
Indigent_Burial_and_Cremation_Services_(Addendum_#1_Revision).pdf PDF
Indigent_Burial_and_Cremation_Services_(Addendum_#1_Revision).pdf PDF
Indigent_Burial_and_Cremation_Services.pdf PDF
Indigent_Burial_and_Cremation_Services.pdf PDF
Policies_and_Procedures.pdf PDF
Policies_and_Procedures.pdf PDF
Policies_and_Procedures.pdf PDF
Pinellas_County_Application_for_Indigent_Cremation_Watermarked.pdf PDF
Pinellas_County_Application_for_Indigent_Cremation_Watermarked.pdf PDF
Indigent_Funeral_Referral_(Pinellas_County)_watermarked_.pdf PDF
Indigent_Funeral_Referral_(Pinellas_County)_watermarked_.pdf PDF
Attachment_C.pdf PDF
Attachment_C.pdf PDF
Attachment_C.pdf PDF
HIPAA_Business_Associate_Agreement.pdf PDF
HIPAA_Business_Associate_Agreement.pdf PDF
HIPAA_Business_Associate_Agreement.pdf PDF
HIPAA_Business_Associate_Agreement.pdf PDF
Human_Trafficking_Affidavit_11.20.25.pdf PDF
Non-Competitive_Oversight_Committee_Justification_Form.docx DOCX document
Notice_of_Intent_to_Sole_Source_07-25-2023.pdf PDF
Bid_Submittal_Sheet_without_lost_calls_stipulation.xlsx XLSX spreadsheet
Common_Carrier_Attestation_02.05.2025.pdf PDF
Foreign_Countries_of_Concern_Affidavit_12.11.2025.pdf PDF
HIPAA_Business_Associate_Agreement.docx DOCX document
FY25_LM_Blank_Template.docx DOCX document
Logic_Model_Guidance.docx DOCX document
FY25_LM_Blank_Template.docx DOCX document
Foreign_Countries_of_Concern_Affidavit_12.11.2025.pdf PDF
HIPAA_Business_Associate_Agreement.docx DOCX document
Bid_Submittal_Sheet_without_lost_calls_stipulation.xlsx XLSX spreadsheet
Common_Carrier_Attestation_02.05.2025.pdf PDF
Foreign_Countries_of_Concern_Affidavit_12.11.2025.pdf PDF
Foreign_Countries_of_Concern_Affidavit_12.11.2025.pdf PDF
FY25_LM_Blank_Template.docx DOCX document
Bid_Submittal_Sheet_without_lost_calls_stipulation.xlsx XLSX spreadsheet
HIPAA_Business_Associate_Agreement.docx DOCX document
Notice_of_Intent_to_Sole_Source_07-25-2023.pdf PDF
Policies_and_Procedures_for_RFP_watermarked.pdf PDF
Logic_Model_Guidance.docx DOCX document
Policies_and_Procedures_for_RFP_watermarked.pdf PDF
HIPAA_Business_Associate_Agreement.docx DOCX document
Human_Trafficking_Affidavit_11.20.25.pdf PDF
Bid_Submittal_Sheet_without_lost_calls_stipulation.xlsx XLSX spreadsheet
Common_Carrier_Attestation_02.05.2025.pdf PDF
HIPAA_Business_Associate_Agreement.docx DOCX document
Logic_Model_Guidance.docx DOCX document
Non-Competitive_Oversight_Committee_Justification_Form.docx DOCX document
Notice_of_Intent_to_Sole_Source_07-25-2023.pdf PDF
Policies_and_Procedures_for_RFP_watermarked.pdf PDF
Show 40 more

50 files listed here. See the rest on GovTribe.

On GovTribe

Work with this file

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file

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 .