Human_Trafficking_Affidavit.docx
DOCX document 15 KB Posted
- Solicitation number
- 2026-RFP-080
- Issued by
- Polk County, Florida
About this file
This is a Human Trafficking Affidavit required by the City of Lakeland, Florida for nongovernmental entities executing, renewing, or extending contracts. The affidavit applies to the Scaffolding and Insulation Services contract opportunity at Lakeland Electric Power Generation Facilities, which seeks qualified contractors to provide scaffolding, mechanical insulation installation, repair, maintenance, and removal services on an as-needed basis. Services will support routine maintenance, forced outages, planned outages, capital projects, inspections, and emergency response activities at designated facilities including McIntosh Power Plant, Larsen Power Plant, Winston Peaking Station, and other Lakeland Electric facilities. The contract term is one year with four optional one-year renewals available upon mutual consent.
The affidavit requires an authorized officer or representative of the contractor to attest under penalty of perjury that the entity and its subsidiaries or affiliates do not use coercion for labor or services as defined in Section 787.06, Florida Statutes. Contractors must immediately notify the City of Lakeland if any future use of coercion occurs, as such violation would prevent contract execution, renewal, or extension. The affidavit must be notarized and includes fields for company name, authorized signature, printed name, date, title, and notary acknowledgment with identification verification requirements.
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
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:______________________
File details come from the government source that posted it. Updated .