FORM 13-PUR 1808 COMMON CARRIER OR CONTRACTED CARRIER ATTESTATION.pdf

ITN No.: DMS-24/25-260 Page 1 of 2 MyFloridaNet-3 Core Services

FORM 13 – PUR 1808 COMMON CARRIER OR CONTRACTED CARRIER ATTESTATION

4050 Esplanade Way Tallahassee, FL 32399-0950

850-488-2786

Ron DeSantis, Governor Pedro Allende, Secretary

FORM 13 – PUR 1808 COMMON CARRIER OR CONTRACTED CARRIER

ATTESTATION FORM

FOR

MyFloridaNetwork-3

ITN NO: DMS-24/25-260

THE STATE OF FLORIDA

DEPARTMENT OF MANAGEMENT SERVICES

ITN No.: DMS-24/25-260 Page 2 of 2 MyFloridaNet-3 Core Services

FORM 13 – PUR 1808 COMMON CARRIER OR CONTRACTED CARRIER ATTESTATION

COMMON CARRIER OR CONTRACTED CARRIER ATTESTATION FORM

(PUR 1808)

This form must be completed by a Common Carrier or contracted carrier and submitted to the Governmental Entity with which a Contract being is executed, amended, or renewed. Capitalized terms used herein have the definitions ascribed in section 908.111, F.S.

[Name of Common Carrier or contracted carrier] is not willfully providing and will not willfully provide any service during the Contract term in furtherance of transporting a person into this state knowing that the person is an Unauthorized Alien, except to facilitate the detention, removal, or departure of the person from this state or the United States.

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

Printed Name:

Title:

Signature: Date: