Human_Trafficking_Affidavit_02.05.2025.pdf
PDF 89 KB Posted
- Solicitation number
- 25-0406-ITB
- Issued by
- Pinellas County, Florida
About this file
This document is a Human Trafficking Affidavit for a Pinellas County contract related to a non-native plant removal project at Lealman Neighborhood Park. The affidavit requires an authorized contractor representative to attest that they do not use coercion for labor or services, in compliance with Section 787.06(13) of Florida Statutes. The document provides a template for the contractor to declare under penalties of perjury that they have read and understand the affidavit, with spaces for signature, printed name, date, Federal Work Authorization User Identification Number, and contract details.
The affidavit is specifically associated with a project to remove non-native vegetation from a 0.36-acre wetland out-parcel in a residential neighborhood. The contractor will be responsible for completely removing all non-native trees, stems, limbs, brush, and leaves daily, transporting them to a legal disposal site. Special environmental constraints include prohibiting equipment within the project footprint and no digging allowed. The contractor must also manage traffic control throughout the work duration, indicating the project's sensitivity to the surrounding residential 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 |
File details come from the government source that posted it. Updated .