Human_Trafficking_Affidavit.docx
DOCX document 15 KB Posted
- Attached to
- CONSULTING SERVICES FOR THE PREPARATION OF A DATA CENTER AND LARGE-LOAD DEVELOPMENT REGULATORY FRAMEWORK
- Solicitation number
- 2026-RFP-109
- 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 must be completed and notarized by an authorized officer or representative of the contracting entity. The form requires attestation under penalty of perjury that the nongovernmental entity and its subsidiaries or affiliates do not use coercion for labor or services as defined in Section 787.06, Florida Statutes. The affidavit further requires the entity to commit to immediately notifying the City if it engages in coercion for labor or services in the future, which would preclude any further contract execution, renewal, or extension between the parties.
The affidavit must be notarized by a notary public who certifies that the authorized representative appeared in person or through online notarization and provided appropriate identification. The form includes standard notarization elements including the date, county, notary signature, notary stamp or seal, notary name, and commission expiration date. This affidavit requirement applies to the City of Lakeland's consulting services solicitation for the development of a comprehensive regulatory framework governing data centers and large-load developments. Completion and submission of this affidavit is a mandatory compliance requirement for any nongovernmental entity seeking to enter into or modify a contract with the City.
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Other files
| File | Type | Posted |
|---|---|---|
| CONSULTING_SERVICES_FOR_THE_PREPARATION_OF_A_DATA_CENTER_AND_LARGE-LOAD_DEVELOPMENT_REGULATORY_FRAMEWORK_(Addendum_#2_Revision).pdf | ||
| Sample_Standard_Contract_Form.pdf | ||
| PSM_-_Contractor_Audit_Form.pdf | ||
| Indemnification_2026_Contractor_-_FDOT.docx | DOCX document | |
| Indemnification_2026_Contractor.doc | DOC document | |
| Indemnification_2026_Vendor.doc | DOC document | |
| Indemnification_2026_Consultant_-_FDOT.docx | DOCX document | |
| Indemnification_2026_Consultant.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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