Human_Trafficking_Affidavit.docx
DOCX document 15 KB Posted
- Solicitation number
- 2026-RFQ-032
- Issued by
- Polk County, Florida
About this file
This is a Human Trafficking Affidavit document required by the City of Lakeland, Florida for nongovernmental entities executing, renewing, or extending contracts with the municipality, in compliance with Section 787.06(14), Florida Statutes. The affidavit applies to the Construction Manager at Risk (CMAR) Services contract for replacement of control structure gates at Se7en Wetlands in Polk County. The affidavit must be completed and signed by an authorized officer or representative of the contracting entity and notarized. The document requires the signatory 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. The signatory must also commit that if coercion for labor or services occurs at any future time, the entity will immediately notify the City of Lakeland, and no contracts may be executed, renewed, or extended between the parties. A notarized signature page is required, completed before a notary public with identification verification and notary seal or stamp affixed.
This affidavit is one of multiple required certifications and compliance documents that all respondents to the Se7en Wetlands CMAR procurement must submit with their qualifications by the May 6, 2026 deadline at 2:00 p.m. The human trafficking affidavit requirement reflects Florida's statutory commitment to preventing human trafficking and forced labor in state and local government contracting. Submission of this affidavit is mandatory for contract award consideration and contract execution, renewals, or extensions with the City of Lakeland.
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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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