Human_Trafficking_Affidavit_02.05.2025.pdf
PDF 89 KB Posted
- Attached to
- Disaster Debris Collection and Removal 2025-2030
- Solicitation number
- 25-0644-RFP
- Issued by
- Pinellas County, Florida
About this file
This document is a Human Trafficking Affidavit for a Pinellas County contract related to Disaster Debris Collection and Removal services for 2025-2030. The affidavit is executed in accordance with section 787.06(13) of Florida Statutes, requiring contractors to attest that they do not use coercion for labor or services. The contract aims to establish services for comprehensive disaster debris collection and removal across municipalities within Pinellas County, with the intent of awarding to five firms to ensure adequate service coverage for potential disaster events of varying sizes.
The affidavit requires an authorized representative of the contractor to declare under penalties of perjury that they have read and affirm the document's contents, including providing their signature, printed name, date, and Federal Work Authorization User Identification Number. The document must be notarized, with options for physical presence or online notarization, and includes spaces for county information, identification verification, and notary details. While specific pricing terms are not detailed in this document, the broader contract opportunity suggests a multi-year service arrangement designed to provide flexible emergency response capabilities for debris management across Pinellas County.
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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 .