Human_Trafficking_Affidavit.docx
DOCX document 15 KB Posted
- Attached to
- Annual Substation Herbicide Treatment
- Solicitation number
- 2026-RFP-104
- Issued by
- Polk County, Florida
About this file
This is a Human Trafficking Affidavit form required by the City of Lakeland, Florida in compliance with Section 787.06(14) of the Florida Statutes for the Annual Substation Herbicide Treatment contract opportunity. The affidavit must be completed and notarized by an authorized officer or representative of any nongovernmental entity executing, renewing, or extending a contract with the City of Lakeland. The contract solicitation seeks a Vegetation Management Contractor to provide semi-annual bare-earth herbicide treatments at Lakeland Electric substations and related areas. The services must be performed safely with aesthetically pleasing results. The contract term is one year with four optional one-year renewals available upon mutual consent.
The affidavit requires the signing party to attest under penalty of perjury that the nongovernmental entity and its subsidiaries or affiliates do not use coercion for labor or services as defined in Florida Statutes Section 787.06. The entity must commit to immediately notifying the City of Lakeland if any coercion for labor or services occurs in the future, with the understanding that such violation would prevent execution, renewal, or extension of any contracts between the parties. The form must be notarized before a notary public who confirms the signatory's identity through physical presence or online notarization and affixes their official seal or stamp to the document.
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Other files
| File | Type | Posted |
|---|---|---|
| Annual_Substation_Herbicide_Treatment_(Addendum_#2_Revision).pdf | ||
| Annual_Substation_Herbicide_Treatment_24Sept2026.pdf | ||
| Annual_Substation_Herbicide_Treatment_(Addendum_#1_Revision).pdf | ||
| 2023-ITB-080_Bid_Tab.pdf | ||
| Annual_Substation_Herbicide_Treatment.pdf | ||
| Indemnification_2026_Contractor.doc | DOC document | |
| PSM_-_Contractor_Audit_Form.pdf | ||
| Indemnification_2026_Consultant.doc | DOC document | |
| Indemnification_2026_Contractor_-_FDOT.docx | DOCX document | |
| Indemnification_2026_Consultant_-_FDOT.docx | DOCX document | |
| Indemnification_2026_Vendor.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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