This information is required for all vendors providing goods or services to the State College of Florida. Please complete each section accurately. The College uses this form to ensure compliance with applicable state and federal guidelines and to identify any potential risks.
RED FLAG SELF DISCLOSURE STATEMENT. I certify that the information provided in this Red Flag Self Disclosure Form is true and correct to the best of my knowledge. I understand that providing false or misleading information may result in disqualification from doing business with the College.
Section 787.06(13), Florida Statutes requires all nongovernmental entities executing, renewing, or extending a contract with a governmental entity to provide an affidavit signed by an officer or representative of the nongovernmental entity under penalty of perjury that the nongovernmental entity does not use coercion for labor or services as defined in Section 787.06. Failure to execute this form may impact your company’s eligibility to do business with State College of Florida, Manatee – Sarasota.As the person authorized to sign on behalf of the Contractor, I certify that the Contractor identified on this form DOES NOT engage in the following:• Using or threatening to use physical force against any person• Restraining, isolating, or confining or threatening to restrain, isolate, or confine any person without lawful authority and against her or his will• Using lending or other credit methods to establish a debt by any person when labor or services are pledged as a security for the debt, if the value of the labor or services as reasonably assessed is not applied toward the liquidation of the debt, the length and nature of the labor or services are not respectively limited and defined• Destroying, concealing, removing, confiscating, withholding, or possessing any actual or purported passport, visa, or other immigration document, or any other actual or purported government identification document, of any person• Causing or threatening to cause financial harm to any person• Enticing or luring any person by fraud or deceit• Providing a controlled substance as outlined in Schedule I or Schedule II of s. 893.03 to any person for the purpose of exploitation of that person
AFFIDAVIT REGARDING USE OF COERCION FOR LABOR/SERVICES STATEMENT. Under penalties of perjury, I declare that I have read the foregoing document and the facts stated are true.
Please upload the following documents-1. Executed copies of any quotes or contracts related to the services/goods your company is providing. 2. W9 signed within the past 12 months. 3. ACH documentation information including a letter from the company bank and/or a voided check.***To upload multiple documents, press and hold the Ctrl button your keyboard and select your documents.