Human_Trafficking_Affidavit_.pdf
PDF 138 KB Posted
- Attached to
- COMPREHENSIVE FEE STUDIES
- Solicitation number
- RFP2026-3
- Issued by
- Broward County, Florida
About this file
This is a Human Trafficking Affidavit form required by the City of Cooper City, Florida, in compliance with Section 787.06(13) of the Florida Statutes. The affidavit must be completed and signed by an authorized officer or representative of any nongovernmental entity executing, renewing, or extending a contract with the City. The form requires the signing official to attest under penalty of perjury that they are over 18 years of age, authorized to represent the entity, and possess personal knowledge of the matters contained in the affidavit. The document serves as a contractual requirement for the City's Comprehensive Fee Studies solicitation, which seeks qualified consulting firms to conduct multi-department fee and rate studies across multiple service areas including water utility rates, wastewater utility rates, community development fees, parks and recreation fees, and fire rescue fees and cost allocation.
The affidavit mandates that the nongovernmental entity and any of its subsidiaries or affiliates certify they do not use coercion for labor or services as defined in Florida Statutes Section 787.06. The entity must further commit to immediately notify the City should any future use of coercion for labor or services occur, with the understanding that such violation would prevent execution, renewal, or extension of any contracts between the parties. The form requires notarization by a notary public and includes spaces for the company name, authorized signature, printed name, title, date, state and county information, and notary commission expiration date. This affidavit serves as a prerequisite compliance document for all proposers responding to the City of Cooper City's fee study contract opportunity.
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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:______________________
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