Human_Trafficking_Affidavit.docx
DOCX document 15 KB Posted
- Solicitation number
- 2026-RFP-067
- Issued by
- Polk County, Florida
About this file
This is a Human Trafficking Affidavit document related to Lakeland Electric's MGT1 Water Mist Fire Protection System Replacement project in Florida. The affidavit serves as a compliance and certification document for the contract opportunity. The project involves replacing the existing MGT1 fire suppression system with a self-contained high-pressure water mist fire protection system that operates using stored-pressure nitrogen/water cylinders and electrically supervised solenoid-operated valves rather than electric motor-driven pumps. The work is scheduled to be completed during a planned outage period from September 13-19, during which MGT1 will be unavailable. Bidders are required to submit Attachment L as part of their pricing proposal.
The affidavit functions as a declarative certification document that bidders must complete and submit as part of their proposal requirements. This document typically requires authorized representatives to attest to their organization's compliance with human trafficking laws and regulations, including verification that the organization and its subcontractors have not engaged in human trafficking activities and will comply with applicable anti-trafficking requirements throughout contract performance. Such affidavits are standard compliance documentation for Florida state and local contracts and serve to ensure that only qualified, compliant organizations participate in public procurements.
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Other files
| File | Type | Posted |
|---|---|---|
| MGT1_Water_Mist_Fire_Protection_system_replacement.pdf | ||
| Pricing_Proposal.xlsx | XLSX spreadsheet | |
| MGT1_Fire_System_upgrade_scoring_.docx | DOCX document | |
| MGT1_CO2_System_Management_Justification_Memo_(1).docx | DOCX document | |
| MGT1_Water_Mist_Fire_Protection_System_Replacement.docx | DOCX document | |
| PSM_-_Contractor_Annual_Audit_Form.pdf | ||
| Indemnification_2026_Contractor_-_FDOT.docx | DOCX document | |
| Indemnification_2026_Consultant.doc | DOC document | |
| Indemnification_2026_Vendor.doc | DOC document | |
| Contractor_Safety_Evaluation_Form.pdf | ||
| Indemnification_2026_Consultant_-_FDOT.docx | DOCX document | |
| Indemnification_2026_Contractor.doc | DOC document |
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Text version
HUMAN TRAFFICKING AFFIDAVIT
In compliance with Section 787.06(14), 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 Lakeland, Florida (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 Nongovernmental 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: _____________________________________ Printed Name:____________________________________________ Date:______________________ 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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