Human_Trafficking_Affidavit_11.20.25.pdf
PDF 115 KB Posted
- Attached to
- Groundskeeping - Mowing, Landscape & Irrigation Services State and local contract opportunity
- Solicitation number
- 26-0255-RFP
- Issued by
- Pinellas County, Florida
About this file
This is a Human Trafficking Affidavit required by Pinellas County, Florida, in accordance with Section 787.06(14) of the Florida Statutes, for the Groundskeeping – Mowing, Landscape & Irrigation Services contract opportunity. The affidavit serves as a certification that the contractor does not use coercion for labor or services as defined in Florida law. The document requires completion and notarization by an authorized representative of the contractor, including the contractor's name, Federal Work Authorization User Identification Number, and the specific Pinellas County contract name and number. The affidavit must be executed under penalty of perjury and acknowledged before a notary public, either through physical presence or online notarization.
No pricing terms, set-asides, incumbent information, funding amounts, or other financial details are specified within this affidavit document. The form is a compliance and certification instrument designed to ensure that all contractors performing services for Pinellas County adhere to anti-human trafficking statutes. Contractors are required to submit this notarized affidavit as part of their contract execution process prior to commencing work on the countywide mowing, landscaping, and irrigation services project.
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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 .