Common_Carrier_Attestation_02.05.2025.pdf

PDF 112 KB Posted

Attached to
Pinellas County Health Program Evaluation Services State and local contract opportunity
Solicitation number
25-0913-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 Health Program Evaluation Services contract. The attestation requires contractors to declare compliance with Florida Statute 908.111 and 92.525, affirming that they will not knowingly transport unauthorized aliens into Florida during the contract term, except to facilitate detention, removal, or departure. The form must be executed by an authorized representative of the contractor under penalties of perjury and includes fields for the contractor's printed name, signature, date, Federal Work Authorization User Identification Number, and the specific Pinellas County contract name and number. The attestation is one of several mandatory compliance documents that potential vendors must submit, along with a Human Trafficking Affidavit, HIPAA Business Associate Agreement, and Foreign Countries of Concern Affidavit.

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 applies to all contractors regardless of whether they are designated as set-asides or hold incumbent status. The attestation serves as a condition precedent to contract award and must be properly completed and submitted with the proposal due by October 2, 2025, at 3:00 pm. No pricing or financial terms are addressed in this attestation form; it is purely a legal compliance and regulatory requirement specific to Florida state law regarding transportation services and immigration enforcement.

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Non-Competitive_Oversight_Committee_Justification_Form.docx DOCX document
Notice_of_Intent_to_Sole_Source_07-25-2023.pdf PDF
Common_Carrier_Attestation_02.05.2025.pdf PDF
Foreign_Countries_of_Concern_Affidavit_02.05.2025.pdf PDF
Human_Trafficking_Affidavit_02.05.2025.pdf PDF
Common_Carrier_Attestation_02.05.2025.pdf PDF
Foreign_Countries_of_Concern_Affidavit_02.05.2025.pdf PDF
Common_Carrier_Attestation_02.05.2025.pdf PDF
Foreign_Countries_of_Concern_Affidavit_02.05.2025.pdf PDF
Human_Trafficking_Affidavit_02.05.2025.pdf PDF
Common_Carrier_Attestation_02.05.2025.pdf PDF
Non-Competitive_Oversight_Committee_Justification_Form.docx DOCX document
Notice_of_Intent_to_Sole_Source_07-25-2023.pdf PDF
Foreign_Countries_of_Concern_Affidavit_02.05.2025.pdf PDF
Non-Competitive_Oversight_Committee_Justification_Form.docx DOCX document
Foreign_Countries_of_Concern_Affidavit_02.05.2025.pdf PDF
Human_Trafficking_Affidavit_02.05.2025.pdf PDF
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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 .