Human_Trafficking_Affidavit_11.20.25.pdf
PDF 115 KB Posted
- Solicitation number
- 26-0234-RFP
- Issued by
- Pinellas County, Clewiston City, Florida
About this file
This is a Human Trafficking Affidavit document required by Pinellas County, Florida for the Janitorial Services for Construction and Property Management Facilities contract (RFP 26-0234-RFP). The affidavit, executed in accordance with Section 787.06(14) of the Florida Statutes, requires contractors to attest under penalties of perjury that they do not use coercion for labor or services. The document must be completed by an authorized representative of the contractor and notarized before contract award. All bidders responding to this janitorial services solicitation are required to submit this mandatory attestation along with other required affidavits, including the Common Carrier Attestation and Foreign Countries of Concern Affidavit.
The affidavit form contains fields for the contractor name, authorized representative signature and printed name, date of execution, Federal Work Authorization User Identification Number, contract name and number, and notary acknowledgment details including the notary's seal, commission expiration date, and method of notarization (physical presence or online). This compliance document is a prerequisite for all responsive bidders and must be completed and submitted prior to final contract award to ensure contractors meet Florida's statutory requirements regarding labor practices and human trafficking prevention.
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Text version
HUMAN TRAFFICKING AFFIDAVIT
In accordance with section 787.06 (14), 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 .