Human_Trafficking_Affidavit_02.05.2025_(3).pdf
PDF 89 KB Posted
- Solicitation number
- 26-0394-ITB-C
- Issued by
- Pinellas County, Clewiston City, Florida
About this file
Human Trafficking Affidavit for Pinellas County HVAC Renovation Project
This is a notarized Human Trafficking Affidavit required for the Pinellas County, Florida Solid Waste Administration Building HVAC Renovation project (ITB-C #26-0394-ITB-C). The affidavit serves as a mandatory compliance document in accordance with Florida Statute Section 787.06(13), requiring an authorized contractor representative to attest under penalties of perjury that the contractor does not use coercion for labor or services as defined in state law. The document must be executed by an authorized representative, include the contractor's name and Federal Work Authorization User Identification Number, reference the specific Pinellas County contract name and number, and be notarized with the notary's seal, commission expiration date, and identification of the person executing the affidavit. Step One qualification submissions incorporating this compliance document are due April 21, 2026 at 3:00 p.m., with Step Two sealed bids due May 5, 2026 at 3:00 p.m. All project work must be completed within 365 consecutive calendar days from the Notice to Proceed.
The affidavit is one of several mandatory compliance requirements for bidders on this project, along with E-Verify affidavits, Foreign Country of Concern affidavits, and Common Carrier attestations, all requiring notarization. Contractors and all subcontractors must register with and use the E-Verify system in accordance with Florida Statute 448.095 to verify non-employment of unauthorized aliens. The project budget is estimated at $686,580.00, with no incumbent contractor identified. Bidders must possess a Certified General Contractor license with electrical and demolition classifications, EPA Section 608 Technician Certification, general liability insurance of $1,000,000 per occurrence, and performance and payment bonds equal to 100% of the contract amount. No set-asides or disadvantaged enterprise restrictions apply to this procurement.
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Text version
HUMAN TRAFFICKING AFFIDAVIT
In accordance with section 787.06 (13), Florida Statutes, the undersigned, on behalf of ____________________________ (the “Contractor”), hereby attests that the Contractor does not use coercion for labor or services as defined in Section 787.06, Florida Statutes.
The undersigned must be an authorized representative of the Contractor who can execute this affidavit on the Contractor’s behalf.
Under penalties of perjury, I______________________, declare that I have read the foregoing affidavit and that the facts stated in it are true.
Signature: ______________________________ Print Name: ______________________________
Date: ______________________________ Federal Work Authorization User Identification No.: _____________________________ Name of Pinellas County Contract and Contract No.: ____________________________
STATE OF FLORIDA COUNTY OF ________________
The foregoing instrument was acknowledged before me by means of 1) physical presence __ or
2) online notarization___, this __________________________ (date) by ____________________________ of _____________________________________, a __________________________________ corporation, on behalf of the corporation.
He/she is personally known to me or has produced __________________________________ as identification.
[Notary Seal]
Notary Public: _________________________________________ Name typed, printed, or stamped: _________________________________________
My Commission Expires: _________________________________________
| Print Name: |
| Federal Work Authorization User Identification No: |
| Name of Pinellas County Contract and Contract No: |
| Notary Public: |
| Name typed printed or stamped: |
| My Commission Expires: |
| Contractor Name: |
| Contractor Name 1: |
| Pinellas County: |
| Date: |
| Check Box1: Yes |
| Notary Name: |
| 1: |
| 2: |
| Type of Identification: |
| Check Box2: Off |
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