Human_Trafficking_Affidavit.docx
DOCX document 15 KB Posted
- Attached to
- ANNUAL ROTATING EQUIPMENT INSPECTION, TESTING, REPAIR, RECONDITIONING AND STORAGE SERVICES
- Solicitation number
- 2026-RFP-130
- 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 Rotating Equipment Inspection, Testing, Repair, Reconditioning and Storage Services contract, which involves inspection, testing, repair, rebuilding, refurbishment, and storage services for rotating equipment at the McIntosh and Larsen Power Plants. Services encompass industrial electric motors and pumps across various manufacturers, sizes, horsepower ratings, voltages, and configurations. The scope includes cleaning, inspection and testing, motor rewinding, pump and motor repair and reconditioning, machining, balancing and alignment, vibration analysis, predictive motor diagnostic analysis, field services, painting and preservation, transportation, emergency services, and indoor storage. The City may award to one or more qualified contractors based on demonstrated capabilities and equipment servicing needs.
An authorized officer or representative of the nongovernmental entity must complete and notarize the affidavit, attesting 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. The affidavit requires confirmation that facts stated are true and made for the benefit and reliance of the City of Lakeland. Should the nongovernmental entity engage in coercion for labor or services at any future time, immediate notification to the City is required, and no contracts may be executed, renewed, or extended between the parties.
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Other files
| File | Type | Posted |
|---|---|---|
| ANNUAL_ROTATING_EQUIPMENT_INSPECTION,_TESTING,_REPAIR,_RECONDITIONING_AND_STORAGE_SERVICES.pdf | ||
| Representative_Rotating_Equipment_Inventory_v3_(7).docx | DOCX document | |
| PSM_-_Contractor_Audit_Form.pdf | ||
| Indemnification_2026_Consultant.doc | DOC document | |
| Indemnification_2026_Contractor_-_FDOT.docx | DOCX document | |
| Indemnification_2026_Vendor.doc | DOC document | |
| Indemnification_2026_Consultant_-_FDOT.docx | DOCX document | |
| Indemnification_2026_Contractor.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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