Human_Trafficking_Affidavit_.pdf
PDF 575 KB Posted
- Attached to
- Wastewater Pump Station R & R
- Solicitation number
- CC-7100-26/HSM (A)
- Issued by
- Seminole County, Florida
About this file
This is a Human Trafficking Affidavit form required by the Seminole County Board of County Commissioners in Florida for the Wastewater Pump Station R & R project (CC-7100-26/HSM (A)). The affidavit serves as a compliance document under Florida Statutes Section 787.06 and must be executed by an authorized officer or representative of any nongovernmental entity bidding on or contracting with Seminole County. The document requires the signatory to declare under penalty of perjury that neither the entity nor any of its subsidiaries or affiliates use coercion for labor or services as defined in Florida law. The form must be notarized and includes spaces for the signatory's name, title, date, and notary acknowledgment with commission expiration information.
This affidavit is a mandatory submission requirement for contractors responding to Seminole County's invitation to bid for wastewater pump station maintenance, repair, refurbishment, and equipment renewal projects. Prospective bidders must demonstrate experience with a minimum of eight municipal pump station construction and rehabilitation projects completed within the past five years, including five rehabilitation projects and three new construction projects, and must have been in business for at least three years. All qualified bids must address all 18 scopes of work items identified in the project specifications. Bid documents are available through the Seminole County website at https://secure.procurenew.com/portal/seminolefl, with M/WBEs encouraged to participate.
View the file
Other files
Show all 13
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
2. I am an officer or representative of (“Nongovernmental
Entity”) and authorized to provide this affidavit on its behalf.
3. Neither Nongovernmental Entity, nor any of its subsidiaries or affiliates, use coercion for labor or services, as those terms are defined in section 787.06, Florida Statutes, as may be amended.
4. This declaration is made pursuant to section 92.525, Florida Statutes. I acknowledge and understand that making a false statement in this declaration may subject me to criminal penalties.
Signature Date
Print 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 Nongovernmental Entity. 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:
EXHIBIT H
H UM AN T RAF F I CK I N G AF F I DA VI T
CONTRACT # ____________________________
In compliance with section 787.06, Florida Statutes, the undersigned, on behalf of the
Nongovernmental Entity identified herein, hereby declares, under penalty of perjury, that the following facts stated herein are true:
1. I am over the age of 18 and I have personal knowledge of the matters set forth herein.
| Entity and authorized to provide this affidavit on its behalf: |
| Date: |
| Print Name Title: |
| COUNTY OF: |
| undefined: |
| The foregoing instrument was acknowledged before me by means of: Off |
| physical presence or: Off |
| day of: |
| 20: |
| undefined_2: |
| on behalf of the Nongovernmental Entity They: Off |
| are personally: |
| have produced as identification: |
| known to me or: Off |
| Print Type or Stamp Name of Notary: |
| My commission expires: |
| Text1: |
File details come from the government source that posted it. Updated .