Foreign Countries of Concern and Human Trafficking Affidavit.pdf
PDF 228 KB Posted
- Attached to
- 2027 Milling and Resurfacing Project
- Solicitation number
- 146156
- Issued by
- Polk County, Florida
About this file
This is a compliance affidavit form required by the Central Florida Tourism Oversight District for the 2027 Milling and Resurfacing Project in Florida. The affidavit must be completed and submitted with all bid responses and is mandated by Florida Statutes 287.138 and 787.06. The form establishes that respondent entities must certify compliance with prohibitions against contracting with foreign countries of concern and human trafficking violations prior to bid submission or contract execution.
The affidavit requires entities to affirm under penalty of perjury that they are not owned by or controlled by governments of foreign countries of concern (defined as China, Russia, Iran, North Korea, Cuba, the Venezuelan regime of Nicolas Maduro, or Syria), are not organized under the laws of such countries, and do not maintain principal places of business in those jurisdictions. Additionally, entities must certify they do not utilize coercion for labor or services, which encompasses physical force, unlawful restraint, debt bondage, document confiscation, financial harm threats, fraud, or provision of controlled substances for exploitation purposes. False statements on the affidavit may result in bid rejection, vendor debarment, and contract termination. The form requires the entity name, bid or contract identification, date, and signature of an authorized officer or representative.
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Text version
Completed form must be submitted with bid response or to contract writer.
Procurement & Contracting Department
PO Box 690519, Orlando, FL 32869
COMPLIANCE WITH: §FS 287.138 (CONTRACTING WITH ENTITIES OF FOREIGN
COUNTRIES OF CONCERN PROHIBITED) and §FS 787.06 (HUMAN TRAFFICKING)
DEFINITIONS
“Foreign country of concern” means 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, including any agency of or any other entity of significant control of such foreign country of concern.
“Controlling interest” means possession of the power to direct or cause the direction of the management or policies of a company, whether through ownership of securities, by contract, or otherwise. A person or entity that directly or indirectly has the right to vote 25 percent or more of the voting interests of the company or is entitled to 25 percent or more of its profits is presumed to possess a controlling interest.
“Coercion” means:
(1) Using or threatening to use physical force against any person; (2) Restraining, isolating, or confining or threatening to restrain, isolate, or confine any person without lawful authority and against her or his will; (3) Using lending or other credit methods to establish a debt by any person when labor or services are pledged as a security for the debt, if the value of the labor or services as reasonably assessed is not applied toward the liquidation of the debt, the length and nature of the labor or services are not respectively limited and defined; (4) Destroying, concealing, removing, confiscating, withholding, or possessing any actual or purported passport, visa, or other immigration document, or any other actual or purported government identification document, of any person; (5) Causing or threatening to cause financial harm to any person; (6) Enticing or luring any person by fraud or deceit; or (7) Providing a controlled substance as outlined in Schedule I or Schedule II of §FS 893.03 to any person for the purpose of exploitation of that person.
“Labor” means work of economic or financial value.
“Services” means any act committed at the behest of, under the supervision of, or for the benefit of another. The term includes, but is not limited to, forced marriage, servitude, or the removal of organs.
ENTITY INFORMATION
(References to “entity” refer to the corporation, Limited Liability Company, sole proprietor or individual submitting a bid/proposal or executed contract/amendment/renewal/extension to the Central Florida Tourism Oversight District.)
The entity does not meet any of the criteria below:
(a) The entity is owned by the government of a foreign country of concern;
(b) The government of a foreign country of concern has a controlling interest in the entity; or
(c) The entity is organized under the laws of or has its principal place of business in a foreign country of concern.
(d) The entity uses coercion for labor or services as defined in §FS 787.06.
RESPONDENT/COMPANY (“ENTITY”) AFFIDAVIT
I affirm the entity is not owned by the government of a foreign country of concern; the government of a foreign country of concern does not have a controlling interest in the entity; the entity is not organized under the laws of or has its principal place of business in a foreign country of concern; and the entity does not use coercion for labor or services.
I attest under the penalty of perjury that the entity does not meet any of the criteria in paragraphs (a)-(d) above and understand that a false statement may result in bid rejection, debarment and contract termination.
ENTITY NAME: _____________________________________________________________________________________________________________
Bid/Contract: ____________________________________________________________________________ Date: ___________________________
Officer/Authorized Representative Signature: ____________________________________________________________________________ http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=0200-0299/0287/Sections/0287.138.html http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=0200-0299/0287/Sections/0287.138.html http://www.leg.state.fl.us/Statutes/index.cfm?App_mode=Display_Statute&URL=0700-0799/0787/Sections/0787.06.html#:%7E:text=(c)1.-,For%20labor%20or%20services%20of%20any%20child%20younger%20than%2018,775.084.
http://www.leg.state.fl.us/Statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=0800-0899/0893/Sections/0893.03.html http://www.leg.state.fl.us/Statutes/index.cfm?App_mode=Display_Statute&URL=0700-0799/0787/Sections/0787.06.html#:%7E:text=(c)1.-,For%20labor%20or%20services%20of%20any%20child%20younger%20than%2018,775.084.
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