Human_Trafficking_Affidavit.docx
DOCX document 15 KB Posted
- Solicitation number
- 2026-RFP-116
- 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 municipality. The affidavit applies to the Annual Maintenance, Repair, and Inspection Services contract for mobile medium-heavy equipment at Lakeland Electric's power plants. The form must be completed and signed by an authorized officer or representative of the contracting entity and notarized before a notary public. The affidavit confirms that the nongovernmental entity and its subsidiaries or affiliates do not use coercion for labor or services as defined under Florida Statutes Section 787.06, and commits the entity to immediately notify the City if any such coercion occurs in the future, which would prohibit execution, renewal, or extension of any contracts between the parties.
The affidavit requires the signatory to attest under penalty of perjury to the truthfulness of the statements and to have personal knowledge of the matters contained therein. The notarization must indicate whether the acknowledgment occurred through physical presence or online notarization and identify the type of identification produced by the signatory. This compliance document is mandatory for contract eligibility and serves as the City of Lakeland's mechanism to enforce anti-human trafficking standards in accordance with Florida law.
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Other files
| File | Type | Posted |
|---|---|---|
| Annual_Maintenance,_Repair,_and_Inspection_Services_for_Mobile_Medium-Heavy_Equipment.pdf | ||
| Final_2026_City_of_Lakeland_Standard_Contract_Form.pdf | ||
| COL_Purchase_Order_Ts&Cs.pdf | ||
| Lakeland_Electric_Mobile_Heavy_Equipment_Inventory.xlsx | XLSX spreadsheet | |
| PSM_-_Contractor_Audit_Form.pdf | ||
| Indemnification_2026_Contractor_-_FDOT.docx | DOCX document | |
| Indemnification_2026_Contractor.doc | DOC document | |
| Indemnification_2026_Consultant.doc | DOC document | |
| Indemnification_2026_Vendor.doc | DOC document | |
| 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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