Form 5 - PUR 2024 Use of Coercion.pdf
PDF 401 KB Posted
- Attached to
- American Sign Language Interpretation
- Solicitation number
- ITB-12692
- Issued by
- Leon County, Florida
About this file
This document is Form 5 (PUR 2024) from the Florida Division of Emergency Management (FDEM) related to an Invitation to Bid (ITB-DEM-24-25-019) for American Sign Language Interpretation Services. The form is a mandatory certification document requiring vendors to affirm they do not use coercion for labor or services and have not produced commodities through forced labor. Specifically, Part A requires an officer of the nongovernmental entity to declare they do not use coercion for labor as defined in section 787.06 of Florida Statutes, while Part B requires a senior management member to certify that commodities offered have not been produced by forced labor.
The certification form is part of the procurement process for statewide ASL interpretation services, which will require vendors to complete mandatory compliance documentation. By signing, representatives attest under penalties of perjury that the statements are true, demonstrating the state's commitment to ethical labor practices and vendor accountability. This form is a prerequisite for potential contractors seeking to provide ASL interpretation services for gubernatorial press briefings during emergency-related states of emergency, ensuring that vendors meet specific legal and ethical standards before contract consideration.
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Text version
ITB-DEM-24-25-019
Form 5
PUR 2024
ITB-DEM-24-25-019 American Sign Language Interpretation Services
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.
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 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:
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| Senior Managements Printed Name: |
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| Name of entity: |
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