Human_Trafficking_Affidavit_02.05.2025_(3).pdf
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- Solicitation number
- 26-0370-RFQ-CCNAC
- Issued by
- Pinellas County, Florida
About this file
This is a Human Trafficking Affidavit required by Pinellas County, Florida for the Unmanned Aerial Services and Professional Engineering Services procurement (RFQ #26-0370-CCNAC). The affidavit serves as a mandatory compliance document in which contractors attest under penalties of perjury that they do not use coercion for labor or services as defined in Section 787.06 of the Florida Statutes. The document must be executed by an authorized representative of the contractor and notarized before a notary public. The affidavit requires the contractor to provide their Federal Work Authorization User Identification Number, the name and number of the Pinellas County contract, and includes sections for the notary public to acknowledge the execution through either physical presence or online notarization. Written questions regarding the procurement are due by March 27, 2026, at 3:00 PM Eastern Time, with all submittals due by April 7, 2026, at 3:00 PM Eastern Time via the OpenGov Procurement platform. The contract term is five years from the award date with two optional 12-month extensions, subject to performance evaluation and rate renegotiation.
This affidavit is one of multiple mandatory compliance documents required from all proposers, alongside a Foreign Countries of Concern Affidavit certifying that the firm and its controlling interests are not owned or controlled by specified foreign governments including China, Russia, Iran, North Korea, Cuba, Venezuela, or Syria. Proposers must also comply with Pinellas County's Small Business Enterprise set-aside requirement, which mandates that each work assignment valued at $50,000 or greater incorporate a minimum 10 percent financial commitment to a certified Pinellas County SBE subconsultant, unless the prime firm itself qualifies as an SBE. Evaluation will be based on 1,000 points, with SBE certification carrying significant weight at 100 points. Compensation will be negotiated on a per-work-assignment basis using an agreed-upon fee schedule with all compensation fully loaded to include profit, markup, and local travel expenses within the Tampa Bay metropolitan area.
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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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