Human_Trafficking_Affidavit.docx
DOCX document 15 KB Posted
- Attached to
- Public Safety Scheduling and Timekeeping Software State and local contract opportunity
- Solicitation number
- 2026-RFP-030
- 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 with a nongovernmental entity seeking to execute, renew, or extend a contract with the municipality. The affidavit applies to the City of Lakeland's procurement for Public Safety Scheduling and Timekeeping Software, a cloud-based system intended to serve the Police and Fire departments. The document requires an authorized officer or representative of the contracting nongovernmental entity to attest under penalty of perjury that the entity and its subsidiaries or affiliates do not use coercion for labor or services as defined by Florida law. The affidavit must be notarized by a notary public who verifies the signer's identity through physical presence or online notarization.
The affidavit establishes an ongoing compliance obligation whereby the nongovernmental entity must immediately notify the City of Lakeland if it engages in coercion for labor or services at any point during contract performance, with such violation preventing further contract execution, renewal, or extension. This certification is a prerequisite to contract award for the Public Safety Scheduling and Timekeeping Software project, which carries a budgetary estimate of $150,000 for year-one licensing and setup costs and $75,000 for annual recurring license renewals. No specific response deadline, award date, or contract term is referenced in the affidavit itself; these details would be established in the underlying solicitation documents.
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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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