Human_Trafficking_Affidavit_02.05.2025.pdf
PDF 89 KB Posted
- Attached to
- SES Learning Management State and local contract opportunity
- Solicitation number
- 25-0653-RFP
- Issued by
- Pinellas County, Clewiston City, Florida
About this file
This is a Human Trafficking Affidavit required by Pinellas County, Florida for the SES Learning Management System procurement (RFP No. 25-0653-RFP). The affidavit is a mandatory compliance document through which authorized contractor representatives attest, under penalties of perjury, that their organization does not use coercion for labor or services as defined in Section 787.06 of the Florida Statutes. The document requires the contractor's authorized representative to sign and print their name, provide the date of execution, include their Federal Work Authorization User Identification Number, and reference the name and contract number of the Pinellas County contract. The affidavit must be notarized, with the notary public providing their name, commission expiration date, and identifying the type of identification presented by the contractor representative. This affidavit is one of several legal requirements accompanying the LMS procurement, which involves proposals due by October 9, 2025, at 3:00 pm, with an initial contract term of 60 months plus two optional 12-month renewal periods.
The Human Trafficking Affidavit serves as a statutory compliance certification rather than a pricing or service delivery document. All prospective vendors responding to RFP No. 25-0653-RFP must complete and submit this affidavit as a condition of proposal eligibility. The document contains no pricing information, set-asides, or financial terms, as it functions solely as a legal attestation of compliance with Florida human trafficking prevention statutes. Vendors must ensure that their authorized representatives execute the affidavit before a notary public and include all required information, including Federal Work Authorization identification, to meet Pinellas County's mandatory affidavit requirements for this enterprise-level LMS procurement.
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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 |
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