Human_Trafficking_Affidavit_.pdf
PDF 134 KB Posted
- Attached to
- Public Art Consultant
- Solicitation number
- RFP 0070-24
- Issued by
- Lee County, Fruitville CDP, Florida
About this file
This is a Human Trafficking Affidavit form required by Section 787.06(13) of Florida Statutes, to be completed by an officer or representative of a nongovernmental entity when executing, renewing, or extending a contract with a city government (the specific city is left blank in this template). The document is specifically linked to a Public Art Consultant opportunity with the City of Fort Myers, where the consultant will develop, plan, and implement public art projects under the direction of the Public Art Committee and assigned Department Director.
The affidavit requires the nongovernmental entity to attest under penalty of perjury that they do not use coercion for labor or services as defined in Florida Statutes, and that they will immediately notify the governmental entity if such practices ever occur in the future. The form must be signed by an authorized representative, dated, and notarized, with spaces for company information, signature, and notary details. This document serves as a legal commitment to ethical labor practices and is a mandatory component of the contract process for the Public Art Consultant opportunity in Fort Myers, Florida.
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| Public_Art_Consultant_(Addendum_#1_Revision).pdf | ||
| Contract-Service,_non-CCNA.pdf | ||
| Local_MBE_Form.pdf | ||
| Contract-CMAR.pdf | ||
| Contract-Design_Build.pdf | ||
| BABA_Form.pdf | ||
| Contract-Services,_CCNA.pdf | ||
| Contract_(draft),_Construction.pdf | ||
| Federal_MBE_Form.pdf | ||
| Local_Preference_Affidavit.pdf | ||
| RFP-Checklist.docx | DOCX document | |
| DOT_Forms-Professional_Services.pdf | ||
| ITB_-_Notice_of_Award.docx | DOCX document |
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Text version
H U M A N T R A F F I C K I N G A F F I D A V I T
In compliance with Section 787.06(13), Florida Statutes, this affidavit must be completed by an officer or representative of a nongovernmental entity that is executing, renewing, or extending a contract with the City of _______________ (the “Governmental Entity”).
The undersigned, on behalf of the entity listed below (the “Nongovernmental Entity”), hereby attests under penalty of perjury as follows:
1. I am over the age of 18 and I have personal knowledge of the matters set forth herein.
2. I am an officer or representative of_________________________, a non-governmental entity and I am authorized to provide this affidavit on behalf of Nongovernmental Entity)
3. Nongovernmental Entity, and any of its subsidiaries or affiliates, do not use coercion for labor or services, as those terms are defined in Section 787.06, Florida Statutes, as may be amended from time to time.
4. If, at any time in the future, Nongovernmental Entity does use coercion for labor or services, Nongovernmental Entity will immediately notify Governmental Entity and no contracts may be executed, renewed, or extended between the parties.
5. I have read the foregoing affidavit and confirm that the facts stated in it are true, and are made for the benefit of, and reliance by Governmental Entity.
Company: ___________________________________________
Authorized Signature: Date: _____________
Printed Name:
Title: _________________________________________________
STATE OF _________________
COUNTY OF _______________
The foregoing instrument was acknowledged before me by means of ☐ physical presence or ☐ online notarization, this ____ day of ________________, 20____, by _________________________________, as _________________________ on behalf of the company/corporation. They ☐ are personally known to me or ☐ have produced _________________ as identification.
Notary Public Signature
(Affix Notary Stamp or Seal) Print, Type or Stamp Name of Notary:__________ My commission expires:______________________
| contract with the City of: |
| I am an officer or representative of: |
| Company: |
| Date: |
| Printed Name: |
| Title: |
| STATE OF: |
| COUNTY OF: |
| The foregoing instrument was acknowledged before me by means of: Off |
| physical presence or: Off |
| online notarization this 1: |
| online notarization this 2: |
| day of: |
| 20: |
| as: |
| companycorporation They: Off |
| are personally known to me or: Off |
| as identification: |
| Print Type or Stamp Name of Notary: |
| My commission expires: |
File details come from the government source that posted it. Updated .