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) of the Florida Statutes. The affidavit must be completed and executed by an authorized officer or representative of any nongovernmental entity executing, renewing, or extending a contract with the City of Lakeland. The document serves as a formal attestation, made under penalty of perjury, that the nongovernmental entity and its subsidiaries or affiliates do not engage in coercion for labor or services as defined under Florida law. The affidavit requires the authorized signatory to confirm personal knowledge of the matters presented and authorizes the submission on behalf of the nongovernmental entity. The document must be notarized by a notary public, with the notarization conducted either through physical presence or online notarization. The affidavit includes provisions requiring immediate notification to the City should the entity ever engage in coercive labor practices in the future, with such violation potentially preventing execution, renewal, or extension of any contracts between the parties.
The affidavit is a standard compliance document with no associated pricing, funding, or procurement terms. As a prerequisite contractual document, it applies to the Public Safety Scheduling and Timekeeping Software procurement issued by the City of Lakeland with proposals due April 23, 2026, at 3:30 p.m. Prospective vendors responding to this Request for Proposal must submit a completed Human Trafficking Affidavit along with other required certifications and documentation, including drug-free workplace certification, suspension and debarment certifications, and a Hold Harmless Indemnification Agreement. The affidavit contains no renewal options, set-asides, or pricing components; it functions solely as a mandatory compliance and attestation requirement established under Florida state law.
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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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