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 is a Common Carrier Attestation form required by Pinellas County, Florida for the RFP 26-0408 Pharmacy Benefit Manager Services procurement. The attestation document serves as a mandatory compliance certification that contractors must complete and submit as part of their proposal response. The form requires an authorized representative of the contracting firm to attest, under penalties of perjury, that the contractor complies with Florida Statute 92.525 and will not knowingly transport unauthorized aliens into Florida during the contract term, except to facilitate their detention, removal, or departure. The document defines "common carrier" as any person, firm, or corporation that undertakes transportation services for hire as a regular business. The attestation must include the contractor's name, authorized representative's signature and printed name, date of execution, Federal Work Authorization User Identification Number, and the specific Pinellas County contract name and number. Proposals for pharmacy benefit management services must be submitted electronically through the OpenGov procurement platform by March 31, 2026 at 3:00 p.m., with the contract term commencing January 1, 2027 and spanning five years with two optional one-year renewal periods.
Pinellas County reserves the right to terminate the associated pharmacy benefit manager agreement for cause if the contractor is found in violation of the common carrier attestation. This compliance requirement is one of several mandatory certifications that all proposing firms must complete and submit as part of the RFP response, alongside notarized affidavits addressing compliance with human trafficking laws under Florida Statute Section 787.06(14) and foreign country of concern ownership restrictions. The common carrier attestation requirement applies uniformly to all vendors regardless of set-aside status or disadvantaged enterprise designation, ensuring that all firms competing for the Pinellas County pharmacy benefit management contract meet this statutory obligation prior to contract award and execution.
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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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