Human_Trafficking_Affidavit_02.05.2025.pdf
PDF 89 KB Posted
- Attached to
- Derelict Vessel Removal
- Solicitation number
- 25-0554-ITB
- Issued by
- Pinellas County, Florida
About this file
This document is a Human Trafficking Affidavit for a Pinellas County contract related to the Derelict Vessel Removal project. The affidavit is designed to ensure that contractors participating in the project do not use coercion for labor or services, in accordance with Section 787.06(13) of Florida Statutes. The document requires an authorized representative of the contractor to attest that they do not engage in human trafficking practices, signing under penalties of perjury.
The affidavit is part of the procurement process for a five-year contract with the Public Works Department to remove and dispose of derelict vessels from Pinellas County waterways. The contract requires the contractor to comply with Local, State, and Federal requirements, providing all necessary labor, materials, and equipment for marine vessel removal, transport, and disposal. The form includes spaces for the contractor's signature, federal work authorization identification, contract details, and notarization, emphasizing the legal and ethical standards required for participation in this government contract.
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Other files
| File | Type | Posted |
|---|---|---|
| Derelict_Vessel_Removal_(Addendum_#3_Revision).pdf | ||
| FEMA_Grant_Provisions.pdf | ||
| Attachment_D.pdf | ||
| Attachment_A.pdf | ||
| Attachment_B.pdf | ||
| Attachment_C.pdf | ||
| Common_Carrier_Attestation_02.05.2025.pdf | ||
| Specifications_.pdf | ||
| Budget_Estimate_(For_Review_Only).xlsx | XLSX spreadsheet | |
| Non-Competitive_Oversight_Committee_Justification_Form.docx | DOCX document | |
| Foreign_Countries_of_Concern_Affidavit_02.05.2025.pdf |
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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 |
File details come from the government source that posted it. Updated .