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.
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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 .