Form 4 - Use of Coercion Forced Labor.docx
DOCX document 32 KB Posted
- Attached to
- Emergency Fuels State and local contract opportunity
- Solicitation number
- RFP-12351
- Issued by
- Leon County, Florida
About this file
Form 4 is a Florida state government compliance document related to labor and commodity procurement regulations under sections 787.06 and 287.1346 of Florida Statutes. The form requires non-governmental entities to declare, under penalties of perjury, that they do not use coercion for labor or services and that their commodities are not produced through forced labor when submitting responses to government solicitations or entering/renewing government contracts.
The document is divided into two parts: Part A addresses the entity's commitment to avoiding labor coercion, and Part B requires certification that commodities are not produced by forced labor. Both sections require an authorized representative or senior management member to complete key information including entity name, printed name, title, signature, and date. The form serves as a legal attestation to ethical labor practices and is a mandatory component of the procurement process for entities seeking to do business with Florida governmental entities.
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Text version
Form 4
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 .