Human_Trafficking_Affidavit_02.05.2025_(3).pdf

This is a Human Trafficking Affidavit form required by Pinellas County, Florida, in accordance with Section 787.06(13) of the Florida Statutes, related to an Infrastructure Repair Work Order Contract. The affidavit serves as a certification document that must be executed by an authorized representative of the contractor. The form requires the contractor to attest under penalties of perjury that it does not use coercion for labor or services as defined in Florida Statutes Section 787.06. The document must include the contractor's name, the authorized representative's signature and printed name, the date of execution, the Federal Work Authorization User Identification Number, and the specific name and contract number of the Pinellas County contract. The affidavit requires notarization before a Notary Public, who must document whether the acknowledgment occurred through physical presence or online notarization, identify the signatory, verify identification, and affix their notary seal along with commission expiration date.

The affidavit serves as a compliance requirement for contractors bidding on or executing infrastructure repair work orders with Pinellas County. No pricing terms, funding amounts, or contract award information are contained within this attestation document. The form is a standard compliance and certification instrument designed to ensure contractors meet Florida's human trafficking prevention requirements prior to contract award or execution. Completion and proper notarization of this affidavit are mandatory conditions for contractor participation in Pinellas County contracting opportunities.