Common_Carrier_Attestation_02.05.2025.pdf
PDF 112 KB Posted
- Attached to
- 26-0408-RFP Pharmacy Benefit Manager Services
- Solicitation number
- 26-0408-REQ
- Issued by
- Pinellas County, Florida
About this file
This Common Carrier Attestation is a compliance document required by Pinellas County, Florida for RFP 26-0408 regarding Pharmacy Benefit Manager Services. The attestation requires contractor representatives to certify under penalties of perjury that they comply with Florida Statute 92.525 and will not knowingly provide transportation services to unauthorized aliens during the contract term, except to facilitate detention, removal, or departure from the state or United States. A "common carrier" under this definition includes any person, firm, or corporation that undertakes transportation of persons or commodities for hire as a regular business, offering services to all who pay applicable charges. The authorized contractor representative must sign the attestation and provide their printed name, signature date, Federal Work Authorization User Identification Number, and contract details. Pinellas County reserves the right to terminate the associated agreement for cause if the contractor is found in violation of the attestation.
This document serves as a mandatory compliance requirement within the broader RFP 26-0408 procurement process. All proposing firms seeking the Pharmacy Benefit Manager Services contract must complete and submit this notarized affidavit along with other compliance documents addressing human trafficking laws, foreign country of concern ownership restrictions, and common carrier obligations. The attestation applies to the five-year contract term with two optional one-year renewal periods, with services commencing January 1, 2027. Failure to comply with the common carrier attestation constitutes grounds for immediate contract termination and represents a material breach of the procurement requirements established by Pinellas County.
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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: |
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