Human_Trafficking_Affidavit.pdf
PDF 89 KB Posted
- Attached to
- Hydrogeologic Consulting Services 2026-2031 (GEC) - Professional Engineering Consulting Services
- Solicitation number
- 26-0616-RFQ-CCNAC
- 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(13) of the Florida Statutes. The affidavit applies to the Hydrogeologic Consulting Services 2026-2031 contract for professional engineering consulting services sought by Pinellas County Utilities. The affidavit requires an authorized contractor representative to declare under penalties of perjury that the contractor does not use coercion for labor or services as defined in Section 787.06, Florida Statutes. The document must include the affiant's signature, printed name, date, Federal Work Authorization User Identification Number, the name of the Pinellas County contract and its corresponding contract number, and notarization by a Florida notary public confirming the affiant's identity through either physical presence or online notarization.
The affidavit contains fields for the contractor's name, the notary public's information including commission expiration date, and identification type produced by the affiant. This document serves as a compliance requirement for contract execution and must be completed and notarized prior to contract award. No pricing, set-asides, or other financial terms are specified in this affidavit, as it functions solely as a certification of the contractor's compliance with Florida's human trafficking statutes.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 26-0616-RFQ-CCNAC.pdf | ||
| Foreign_Countries_of_Concern_Affidavit.pdf | ||
| Sample_Agreement.pdf | ||
| Preliminary_Staff_Report_-_Hydrogeo_Consulting_Svcs.pdf | ||
| Hydrogeo_Scope_2026.docx | DOCX document | |
| Non-Competitive_Oversight_Committee_Justification_Form.docx | DOCX document |
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
HUMAN TRAFFICKING AFFIDAVIT
In accordance with section 787.06 (13), 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 .