Human_Trafficking_Affidavit_02.05.2025_(3).pdf
PDF 89 KB Posted
- Attached to
- STAR Center AHU -104, -161, -162 Replacement
- Solicitation number
- 26-0306-ITB-C
- Issued by
- Pinellas County, Clewiston City, Florida
About this file
This is a Human Trafficking Affidavit form required by Pinellas County, Florida for the STAR Center AHU -104, -161, -162 Replacement project (ITB-C #26-0306). The affidavit requires an authorized contractor representative to attest under penalties of perjury that the contractor does not use coercion for labor or services as defined in Section 787.06 of the Florida Statutes. The form must be notarized and include the contractor's name, Federal Work Authorization User Identification Number, the Pinellas County contract name and number, the notary's seal and commission expiration date, and the signature of the authorized representative. The two-step procurement process includes a mandatory Step 1 Qualification Submittal deadline of March 10, 2026 at 3:00 PM and a Step 2 Bid Submission deadline of March 26, 2026 at 3:00 PM, with mandatory pre-bid conferences scheduled for March 4, 2026 at 10:00 AM on-site and March 10, 2026 at 3:30 PM via Microsoft Teams.
This affidavit is one of several mandatory compliance certifications required from bidders for the project, alongside E-Verify registration, Common Carrier Attestation, and Foreign Country of Concern Affidavit submissions. Contractors must furnish a 5 percent bid bond with their proposal, with performance and payment bonds each equal to 100 percent of the contract amount required upon award. Partial payments will be made as work progresses with 5 percent retainage until final completion. The project includes a Small Business Enterprise participation goal of 3 percent, with subcontractors required to be selected from Pinellas, Hillsborough, Pasco, or Manatee Counties. All contractor personnel requiring facility access must comply with St. Petersburg-Clearwater International Airport security requirements, including TSA criminal history record checks and SIDA training. The contractor must commence work within 15 consecutive calendar days of receiving a Notice to Proceed and complete all work within 365 consecutive calendar days.
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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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