FORM 10 - pur 2024 use of coercion forced labor combined final.docx

DOCX document 31 KB Posted

Attached to
Operation and Management of Contractor-Operated Correctional Facilities – Blackwater CF
Solicitation number
ITN-17259
Issued by
Santa Rosa County, Florida

About this file

This is a compliance certification form (Form 10) issued by the Florida Department of Corrections in connection with an Invitation to Negotiate (ITN) for the operation and management of the Blackwater River Correctional Facility. The form consists of two parts that must be completed by vendors submitting responses to the solicitation. Part A requires an officer or representative of the nongovernmental entity to certify under penalties of perjury that the entity does not use coercion for labor or services as defined in Florida Statutes section 787.06(13). Part B requires a member of the company's senior management to certify that any commodities being offered to the Department have not been produced, in whole or in part, by forced labor, as required under Florida Statutes section 287.1346(4)(b). Responses must be submitted through the MyFloridaMarketPlace Sourcing Event via the SAP Business Network, with inquiries directed to Sharita Newman, Procurement Officer, at Purchasing@FDC.MyFlorida.com.

The form itself does not contain pricing information, set-asides, incumbent contractor details, funding amounts, or contract term specifications. These details would be contained in the primary ITN solicitation documents. The form serves exclusively as a mandatory attestation requirement for vendor eligibility and compliance with Florida state labor and forced labor prohibitions prior to contract execution or renewal.

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Text version

PUR 2024

Part A: Use of Coercion for Labor and Services

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

Name of entity 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:

Part B: Provision of Commodities Produced by Forced Labor

Pursuant to section 287.1346(4)(b), Florida Statutes, this portion of the form must be completed by a member of the company’s senior management, as defined in section 287.1346, F.S., when the company submits a response to a solicitation for the provision of commodities and before the company enters into or renews a contract for the provision of commodities.

I certify that to the best of my knowledge, the commodities Name of entity is offering to the Department have not been produced, in whole or in part, by forced labor.

Entity Name:

Senior Management’s Printed Name:

Senior Management member’s Title:

Signature: Date:

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