Human_Trafficking_Affidavit_02.05.2025.pdf
PDF 89 KB Posted
- Solicitation number
- 26-0056-RFP
- Issued by
- Pinellas County, Florida
About this file
This is a Human Trafficking Affidavit form required by Pinellas County, Florida for the Concession Services – Luggage Cart Rental contract opportunity at St. Pete-Clearwater International Airport. The affidavit requires an authorized contractor representative to attest under penalties of perjury that the contracting entity 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, the authorized representative's signature and printed name, the Federal Work Authorization User Identification Number, and the specific Pinellas County contract name and number. The notary public must acknowledge the affidavit through either physical presence or online notarization and provide their commission expiration date.
The affidavit is a mandatory compliance document that all proposers responding to the luggage cart concession RFP must complete and submit as part of their proposal package. This requirement applies to all vendors regardless of business structure or size and represents standard attestation requirements for Pinellas County contract opportunities. The affidavit serves as a certification mechanism to ensure contractor compliance with Florida's human trafficking statutes and demonstrates the county's commitment to ethical labor practices throughout the contract term, which runs for 60 months beginning February 27, 2026, with options for two additional 12-month renewal periods.
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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 .