Human_Trafficking_Affidavit.docx
DOCX document 15 KB Posted
- Solicitation number
- 2026-RFQ-094
- 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 with the city in connection with the Planning, Urban Design, Economic Analysis and Implementation Services (CCNA) solicitation. The affidavit must be completed and notarized by an authorized officer or representative of the contractor prior to contract execution. The document serves as a compliance measure under Section 787.06(14), Florida Statutes, and requires the executing entity to attest under penalty of perjury that it and any of its subsidiaries or affiliates do not use coercion for labor or services as defined in Florida law. The affiant must confirm personal knowledge of the matters stated and authorize the submission on behalf of the nongovernmental entity.
The affidavit mandates that contractors immediately notify the City of Lakeland if they engage in coercion for labor or services at any point during the contract term, with such violation prohibiting future contract execution, renewal, or extension between the parties. The document requires completion of company identification, authorized signature, printed name, date, and title fields, along with notarization by a notary public who verifies the signatory's identity through physical presence or online notarization. This affidavit is a standard compliance requirement for all contractors bidding on City of Lakeland contracts and must be submitted as part of the overall proposal package.
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Other files
| File | Type | Posted |
|---|---|---|
| Continuing_Contract-Planning_Services_OCT_2021_-_Sample_Document.docx | DOCX document | |
| Planning,_Urban_Design,_Economic_Analysis_and_Implementation_Services_(CCNA).pdf | ||
| Indemnification_2026_Contractor.doc | DOC document | |
| Indemnification_2026_Vendor.doc | DOC document | |
| Indemnification_2026_Consultant.doc | DOC document | |
| Indemnification_2026_Contractor_-_FDOT.docx | DOCX document | |
| PSM_-_Contractor_Audit_Form.pdf | ||
| Indemnification_2026_Consultant_-_FDOT.docx | DOCX 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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