Foreign Countries of Concern and Human Trafficking Affidavit.pdf

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Attached to
Traffic Management System Maintenance
Solicitation number
147288
Issued by
Polk County, Florida

About this file

This is a Foreign Countries of Concern and Human Trafficking Affidavit required by the Central Florida Tourism Oversight District for the Traffic Management System Maintenance contract opportunity in Florida, mandated under Florida Statutes 287.138 and 787.06. The affidavit must be completed and submitted with the bid response to the Procurement & Contracting Department at PO Box 690519, Orlando, FL 32869. The document establishes compliance requirements for all bidding entities and includes definitions of "foreign country of concern" (the People's Republic of China, Russian Federation, Islamic Republic of Iran, Democratic People's Republic of Korea, Republic of Cuba, Venezuelan regime of Nicolas Maduro, and Syrian Arab Republic), "controlling interest" (direct or indirect voting rights or profit entitlement of 25 percent or more), "coercion" (seven specified methods of labor exploitation), "labor," and "services."

The affidavit requires the entity's authorized representative to certify under penalty of perjury that the entity is not owned by or subject to controlling interest of a foreign country of concern government, is not organized under the laws of or principally located in a foreign country of concern, and does not use coercion for labor or services. False statements may result in bid rejection, debarment, and contract termination. Bidders must provide their entity name, bid or contract number, date, and authorized signature on the completed form.

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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.

Check Box1: Off
ENTITY NAME:
Date:
Bid/Contract:

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