Human_Trafficking_Affidavit.docx
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- Solicitation number
- 2026-RFP-100
- Issued by
- Polk County, Florida
About this file
This is a Human Trafficking Affidavit required by the City of Lakeland, Florida, in compliance with Section 787.06(14), Florida Statutes, for execution by any nongovernmental entity entering into, renewing, or extending a contract with the municipality. The affidavit must be completed by an authorized officer or representative of the contracting entity and notarized before a notary public. The document requires the executing entity to attest that it and its subsidiaries or affiliates do not use coercion for labor or services as defined under Florida Statutes Section 787.06. Bidders must affirm that if any coercion for labor or services occurs in the future, the entity will immediately notify the City of Lakeland, and no further contracts may be executed, renewed, or extended between the parties.
The affidavit is a mandatory compliance document for the Municipal Fire Protection Non-Ad Valorem Assessment Program and Rate Study contract opportunity, with proposals due September 21, 2026. This one-year contract includes two one-year renewal options and requires the selected consultant to serve as the principal advisor in developing a comprehensive funding strategy for municipal fire protection services, potentially including implementation of a non-ad valorem assessment beginning with the City's FY 2028 budget. The affidavit itself contains no pricing information, set-asides, or financial terms; rather, it functions as a prerequisite compliance certification accompanying other required documentation including indemnification forms, contractor audit forms, and a sample standard contract form. All prospective contractors must complete and submit the notarized affidavit as part of their proposal package.
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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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