CONSOLIDATED STATE LAW AFFIDAVIT

AFFIDAVIT OF COMPLIANCE WITH CONVICTED VENDOR LIST (PUBLIC ENTITY CRIME) PURSUANT TO SECTION 287.133, FLORIDA STATUTES, PROHIBITION AGAINST CONTRACTING WITH SCRUTINIZED COMPANIES PURSUANT TO SECTION 287.135, FLORIDA STATUTES, PROHIBITION AGAINST HUMAN TRAFFICKING PURSUANT TO SECTION 787.06, FLORIDA STATUTES, COMPLIANCE WITH E-VERIFY PURSUANT TO SECTION 448.095, FLORIDA STATUTES, PROHIBITION AGAINST ECONOMIC INCENTIVES TO FOREIGN COUNTRIES OF CONCERN PURSUANT TO SECTION 288.0071, FLORIDA STATUTES, AND COMPLIANCE WITH FOREIGN COUNTRIES OF CONCERN PURSUANT TO SECTION 287.138, FLORIDA STATUTES.

The undersigned Affiant, on behalf of the Entity listed below (“Entity”), hereby attests under penalty of perjury as follows:

1. Public Entity Crimes

a. Affiant understands that a “person” or “affiliate” who has been placed on the “convicted vendor list” following a “conviction” for a “public entity crime” (as those terms are defined in Section 287.133, Florida Statutes) for a period of 36 months following the date of being placed on the convicted vendor list, is ineligible to contract with or submit a bid, proposal or reply to contract with the City of Gainesville. Entities placed on either the “discriminatory vendor list” or “antitrust vendor list” are ineligible to transact business with the City of Gainesville.

b. Affiant understands and attests that neither Affiant, nor any person or affiliate of the Entity, nor the Entity have been placed on any of the above referenced vendor lists that would render the Entity ineligible to contract with or submit a bid, proposal or reply to contract with the City of Gainesville.

2. Scrutinized Companies

a. Affiant understands that pursuant to Section 287.135(2)(a), Florida Statutes, the Entity would be ineligible to contract with or submit a bid, proposal or reply to contract with the City of Gainesville if the Entity is on the “Scrutinized Companies that Boycott Israel List” (created pursuant to Section 215.4725, Florida Statutes) or is engaged in a boycott of Israel.

b. Affiant understand that if the value of the contract is one million dollars or more if, at the time of bidding on, submitting a proposal or reply for, or entering into or renewing a contract, the Entity:

1. Is on the Scrutinized Companies with Activities in Sudan List or the Scrutinized Companies with Activities in Iran Terrorism Sectors List, created pursuant to Section 215.473, Florida Statutes; or

2. Is engaged in business operations in Cuba or Syria.

c. Affiant attests that neither Affiant nor the Entity are on the Scrutinized Companies that Boycott Israel List, Scrutinized Companies with Activities in Sudan List or the Scrutinized Companies with Activities in Iran Terrorism Sectors List, nor are we engaged in a boycott of Israel, and understand that any resulting contract may be terminated for a falsification of this Affidavit.

3. E-Verify Affiant understand and attests that:

a. Pursuant to Section 448.095(5), Florida Statutes, the Entity must comply with Florida’s E-Verify law to enter into a contract with the City of Gainesville.

b. The undersigned Entity is registered with and uses the United States Department of Homeland Security’s E-Verify system to verify the work authorization status of all new employees.

c. If the Entity has subcontractors, that the Entity requires subcontractors to provide affidavits stating the subcontractor does not employ, contract with, or subcontract with an unauthorized alien.

d. No public employer has terminated a contract with the Entity pursuant to Section 448.095(5), Florida Statutes, within the year immediately preceding the date of termination of the contract.

e. Entity is currently in compliance and will remain in compliance, for the duration of any contract with the City of Gainesville, with all requirements of Section 448.095(5), Florida Statutes.

f. If there is a good faith belief that the Entity has knowingly violated Section 448.09(1), Florida Statutes, there is an obligation on the part of the City of Gainesville to terminate a contract pursuant to Section 448.095(5), Florida Statutes.

g. If there is a good faith belief that one of Entity’s subcontractor(s) has knowingly violated the Section 448.09(1), Florida Statutes, but the Entity has otherwise complied with its obligations thereunder, then the Entity will be required to immediately terminate the contract with the subcontractor in order to continue providing services to the City of Gainesville.

4. Anti-Human Trafficking Affiant hereby certifies that the undersigned Entity does not use coercion of labor or services as those terms are defined in section 787.06(13), Florida Statutes.

5. Compliance with Prohibition Against Economic Incentives to Foreign Countries of Concern.

Affiant, on behalf of the Entity attest to the following:

That pursuant to Section 288.0071, F.S, as a condition of this Agreement, the Entity attests to the following: that it is not a foreign entity or a foreign country of concern such as the People’s Republic of China, the Russian Federation, the Islamic Republic of Iran, the Democratic People’s Republic of Korea, the Republic of Cuba, the Venezuelan regime of Nicolás Maduro or the Syrian Arab Republic with whom the City is prohibited from contracting with under Florida law.

6. Compliance with Foreign Countries of Concern Affiant, on behalf of the Entity attest to the following:

1. Entity is not owned by the government of a foreign country of concern as defined in Section 287.138, Florida Statutes. (Source: § 287.138(2)(a), Florida Statutes.)

1. The government of a foreign country of concern does not have a controlling interest in Entity. (Source: § 287.138(2)(b), Florida Statutes.)

1. Entity is not organized under the laws of and does not have a principal place of business in a foreign country of concern. (Source: § 287.138(2)(c), Florida Statutes.)

THE AFFIANT IS AUTHORIZED TO EXECUTE THIS AFFIDAVIT ON BEHALF OF THE ENTITY.

AFFIANT HEREBY CERTIFIES UNDER PENALTY OF PERJURY THAT THE STATEMENTS AND FACTS IN THIS AFFIDAVIT AND IN ANY ATTACHMENTS ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE.

Date: ________________________ (Affiant) Signed: ______________________________

Entity: _______________________ Name: _______________________________

Title: _________________________________

STATE OF _____________________

COUNTY OF ___________________

SWORN to (or affirmed) and subscribed before me, by means of physical presence or online notarization, this ______ day of ________________, 20__, by _____________________, as ________________________, who is personally known to me or who has produced _________________ as identification.

[AFFIX NOTARY SEAL/STAMP] ____________________________

Signature of Notary Name: ______________________ (Print or Type Name) Notary Public: State of Florida My Commission Expires_______