Human_Trafficking_Affidavit_02.05.2025.pdf
PDF 89 KB Posted
- Attached to
- Litter & Debris Services
- Solicitation number
- 25-0641-ITB
- Issued by
- Pinellas County, Florida
About this file
This document is a Human Trafficking Affidavit for a Pinellas County contract related to litter and debris services. The affidavit is required under section 787.06(13) of Florida Statutes, wherein the contractor must attest that they do not use coercion for labor or services. The form requires an authorized representative to sign and declare under penalties of perjury that the statements are true, and includes spaces for notarization, signature, date, and contract identification details.
The affidavit is specifically connected to a Pinellas County Public Works Department contract for urban landscape maintenance services. The associated contract involves comprehensive grounds maintenance, including litter pickup in roadway medians, rights-of-way, stormwater mitigation ponds, and County-owned outparcels. The service area encompasses 41 locations across four regional zones, covering 71.22 miles of roadway, with services to be performed on a cyclical basis (currently defined as 12 cycles annually). This document represents a standard compliance requirement to ensure ethical labor practices for contractors bidding on the county's litter and debris services contract.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Litter_&_Debris_Services.pdf | ||
| Exhibit_B-_Contractor_Equipment_List.xlsx | XLSX spreadsheet | |
| Exhibit_A_Litter_Locations_(6).xlsx | XLSX spreadsheet | |
| Non-Competitive_Oversight_Committee_Justification_Form.docx | DOCX document | |
| Common_Carrier_Attestation_02.05.2025.pdf | ||
| Exhibit_B-_Contractor_Equipment_List_.xlsx | XLSX spreadsheet | |
| 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 .