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 solicitation at St. Pete-Clearwater International Airport. The affidavit requires an authorized contractor representative to attest under penalty of perjury that the contractor does not use coercion for labor or services as defined in Section 787.06 of the Florida Statutes. The document must be notarized and include the signatory's printed name, signature, date, Federal Work Authorization User Identification Number, and the name and number of the Pinellas County contract. The notary public must also complete corresponding certification fields, including the date of acknowledgment, method of notarization (physical presence or online), the notary's name, commission expiration date, and notary seal.
This mandatory affidavit is a standard compliance requirement for all Pinellas County contract opportunities and must be executed as part of the proposal submission process. Contractors responding to the luggage cart concession RFP, with proposals due by December 9, 2025, must complete and submit this affidavit along with other required documentation including Common Carrier Attestations and Foreign Countries of Concern Affidavits. The form serves as a contractual commitment ensuring the contractor complies with Florida human trafficking statutes and demonstrates good faith compliance with state and local legal requirements throughout the 60-month contract term, which commences February 27, 2026, with potential extension options for up to two additional 12-month 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 |
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