Human_Trafficking_Affidavit_11.20.25.pdf

PDF 115 KB Posted

Attached to
HVAC-Systems and Related Services
Solicitation number
26-0009-RFP
Issued by
Pinellas County, Florida

About this file

This is a Human Trafficking Affidavit required by Pinellas County, Florida for contractors bidding on the HVAC Systems and Related Services contract. The affidavit is a mandatory compliance document in which an authorized contractor representative attests, 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 document must be notarized and includes fields for the contractor's name, the authorized representative's signature and printed name, the date of execution, Federal Work Authorization User Identification Number, the Pinellas County contract name and number, notary information including the date of notarization and type of identification presented, and the notary's commission expiration date. The affidavit serves as a certification of compliance with Florida's human trafficking laws and is part of the broader mandatory compliance affidavits required for all bidders on this procurement.

This affidavit is a standard compliance requirement for state and local contracts in Florida and does not establish pricing, set-asides, incumbents, or funding terms. Rather, it represents a legal prerequisite that all interested contractors must complete and submit as part of their proposal package for the Pinellas County HVAC contract. The affidavit demonstrates the county's commitment to ethical procurement practices and ensures that contractors certify their adherence to applicable labor laws and anti-trafficking statutes prior to contract award.

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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 .