Human_Trafficking_Affidavit.docx
DOCX document 15 KB Posted
- Solicitation number
- 2025-RFP-077
- Issued by
- Polk County, Illinois
About this file
This document is a Human Trafficking Affidavit required by the City of Lakeland, Florida for nongovernmental entities executing, renewing, or extending contracts with the city. The affidavit is specifically related to an Annual Fireworks Display Services contract for shows scheduled on Thursday, December 4th, 2025, and Friday, July 3rd, 2026, with potential renewal options for three consecutive years upon mutual consent.
The affidavit mandates that the nongovernmental entity attest under penalty of perjury that they do not use coercion for labor or services as defined in Section 787.06 of Florida Statutes. The document requires an authorized representative to sign and have the affidavit notarized, confirming the entity's commitment to ethical labor practices. If the entity were to engage in coercive labor practices at any point, they would be obligated to immediately notify the governmental entity, which would prevent future contract execution, renewal, or extension.
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Other files
| File | Type | Posted |
|---|---|---|
| Annual_Fireworks_Display_Services_(Addendum_#2_Revision).pdf | ||
| Annual_Fireworks_Display_Services.pdf | ||
| Contractor_Safety_Evaluation_Form.pdf | ||
| Indemnification_2025_Consultant_-_FDOT.docx | DOCX document | |
| Contractor_Safety_Evaluation_Form.pdf | ||
| Human_Trafficking_Affidavit.docx | DOCX document | |
| Indemnification_2025_Consultant.doc | DOC document | |
| Indemnification_2025_Contractor.doc | DOC document | |
| Indemnification_2025_Consultant.doc | DOC document | |
| Indemnification_2025_Contractor.doc | DOC document | |
| Indemnification_2025_Vendor.doc | DOC document | |
| Indemnification_2025_Contractor_-_FDOT.docx | DOCX document | |
| Indemnification_2025_Vendor.doc | DOC document | |
| PSM_-_Contractor_Annual_Audit_Form.pdf | ||
| Indemnification_2025_Contractor_-_FDOT.docx | DOCX document | |
| PSM_-_Contractor_Annual_Audit_Form.pdf | ||
| Indemnification_2025_Consultant_-_FDOT.docx | DOCX document |
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Text version
HUMAN TRAFFICKING AFFIDAVIT
In compliance with Section 787.06(13), 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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