Human_Trafficking_Affidavit_11.20.25.pdf
PDF 115 KB Posted
- Attached to
- Executive Search Services
- Solicitation number
- 26-0276-RFP
- Issued by
- Pinellas County, Florida
About this file
This is a Human Trafficking Affidavit document required by Pinellas County, Florida for contractors pursuing the Executive Search Services contract opportunity. The affidavit requires an authorized representative of the contractor to attest under penalties of perjury that the contractor does not use coercion for labor or services as defined in Florida Statutes Section 787.06. The form must be notarized and includes fields for the contractor's name, the authorized representative's signature and printed name, date of execution, Federal Work Authorization User Identification Number, the specific Pinellas County contract name and number, and notary information including the notary's seal, commission expiration date, and type of identification presented. The document serves as a compliance mechanism for Pinellas County's mandatory requirement that all contractors executing a Human Trafficking Affidavit pursuant to Florida Statutes Section 787.06(14), with completion and submission required as part of the proposal process for executive search services.
This affidavit represents one of several mandatory compliance documents that bidders for the Executive Search Services contract must execute, alongside a Common Carrier Attestation, E-Verify compliance certification, and a Foreign Country of Concern Affidavit. The human trafficking affidavit requirement reflects Florida statutory obligations and Pinellas County's commitment to preventing labor exploitation in its contracting processes. No financial implications or pricing considerations are associated with this particular document; it functions purely as a legal certification and attestation requirement for contract eligibility.
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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 |
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