FORM 09-PUR 2024_USE OF COERCION FOR LABOR AND SERVICES.pdf

PDF 133 KB Posted

Attached to
MyFloridaNet-3 ITN
Solicitation number
ITN-16760
Issued by
Florida

About this file

This is an affidavit form issued by the Florida Department of Management Services (DMS) for the MyFloridaNetwork-3 contract opportunity (ITN No. DMS-26/27-025). The form serves as a compliance document that must be completed and submitted by any nongovernmental entity bidding on or executing a contract with a Florida governmental entity. The primary purpose of the affidavit is to certify that the bidding entity does not engage in coercion for labor or services as defined under Florida Statutes Section 787.06(13). The form requires completion by an authorized officer or representative of the nongovernmental entity and must be signed under penalty of perjury.

The form contains designated fields for the entity name, representative's printed name and title, signature, and date of execution. No pricing terms, set-asides, incumbent information, or other financial details are specified within this document, as it functions solely as a certification requirement for bid submission eligibility. Completion and submission of this affidavit is a mandatory prerequisite for contract consideration under the MyFloridaNetwork-3 procurement opportunity.

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Text version

ITN No.: DMS-26/27-025 Page 1 of 2

PUR 2024

4050 Esplanade Way Tallahassee, FL 32399-0950

850-488-2786

Ron DeSantis, Governor Tom Berger, Secretary

FORM 9 – PUR 2024 USE OF COERCION FOR LABOR AND SERVICES

FOR

MyFloridaNetwork-3

ITN NO: DMS-26/27-025

THE STATE OF FLORIDA

DEPARTMENT OF MANAGEMENT SERVICES

ITN No.: DMS-26/27-025 Page 2 of 2

Use of Coercion for Labor and Services

Pursuant to section 787.06(13), Florida Statutes, this affidavit must be completed by an officer or representative of the nongovernmental entity executing, renewing, or extending a contract with a governmental entity.

The entity named below does not use coercion for labor or services as defined in section 787.06, Florida Statutes.

Under penalties of perjury, I declare that I have read the foregoing statement and that the facts stated in it are true.

Entity Name: ____________________________________

Representative/Officer’s Printed Name: _________________________________

Representative/Officer’s Title: ___________________________________

Signature: ___________________________________ Date: _____________________

File details come from the government source that posted it. Updated .