Human_Trafficking_Affidavit_02.05.2025.pdf

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Attached to
Boiler Maintenance and Repair
Solicitation number
26-0107-ITB
Issued by
Pinellas County, Clewiston City, Florida

About this file

This is a Human Trafficking Affidavit required by Pinellas County, Florida for contractors bidding on the Boiler Maintenance and Repair contract. The affidavit certifies that the contractor does not use coercion for labor or services as defined in Section 787.06 of the Florida Statutes. The document requires an authorized representative of the bidding contractor to execute the affidavit under penalty of perjury, stating that the contractor complies with anti-trafficking labor standards. The affidavit must be notarized, with the notary public certifying the contractor's representative's identity through either physical presence or online notarization. Contractors must submit this completed and notarized affidavit along with their proposals for the boiler maintenance and repair services, which include four scheduled inspections per boiler annually at five county facilities (Detention Campus, Medical Examiner, Animal Services, Gulf Coast Museum of Art, and Vet Tech facility). Proposals are due electronically via OpenGov by January 15, 2026 at 3:00 p.m.

The affidavit serves as a mandatory compliance document and does not contain pricing information, set-asides, or funding details. Rather, it functions as a certification requirement that all bidders must complete and submit to demonstrate their commitment to legal labor practices and compliance with Florida statutory requirements regarding human trafficking prevention. The affidavit includes fields for the contractor's name, the authorized representative's signature and printed name, the notary's information and commission expiration date, and the Federal Work Authorization User Identification Number. This document is a prerequisite for bid submission and does not address contract pricing, insurance requirements, or other substantive contract terms separately detailed in the solicitation.

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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 .