Human_Trafficking_Affidavit_11.20.25.pdf

This is a Human Trafficking Affidavit form required by Pinellas County, Florida, in conjunction with its Request for Proposal (RFP 26-0292-RFP) for indigent burial and cremation services. The affidavit mandates that an authorized contractor representative attest under penalties of perjury that the contractor does not use coercion for labor or services as defined in Section 787.06 of the Florida Statutes. The form requires completion of contractor identification information, Federal Work Authorization User Identification Number, the name and number of the Pinellas County contract, and signature and notarization by an authorized representative. The document must be acknowledged before a notary public either through physical presence or online notarization, with the notary providing their seal, commission expiration date, and identification of the signatory. Proposals are due on April 14, 2026, at 3:00 PM, with the contract term extending five years from the date of award.

This affidavit is one of four mandatory compliance documents required from all bidders responding to the indigent burial and cremation services RFP. All qualified providers meeting minimum qualifications—including current Florida funeral director licensure, FDEP-certified incinerator facility, and minimum five years of governmental service experience—must execute this human trafficking attestation along with a Foreign Countries of Concern Affidavit, a Common Carrier Attestation, and a HIPAA Business Associate Agreement. No set-asides for disadvantaged enterprises are noted, and no incumbent vendor information is referenced. The annual funding estimate does not exceed $550,000, with pricing capped at $30,000 total annual bid amount.