Human_Trafficking_Affidavit_.pdf
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- Attached to
- Fort Myers Downtown Pedestrian Mall and Micromobility Feasibility Study (FDOT 451523-1-18-01)
- Solicitation number
- 25-036-RSQ
- Issued by
- Lee County, Fort Lauderdale City, Florida
About this file
This is a Human Trafficking Affidavit required by the City of Fort Myers in compliance with Section 787.06(13) of the Florida Statutes for nongovernmental entities executing, renewing, or extending contracts with the municipality. The affidavit must be completed and notarized by an authorized officer or representative of the contractor and submitted as part of the procurement process for the Downtown Pedestrian Mall and Micromobility Feasibility Study. The document serves as a sworn certification 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 law, with an obligation to immediately notify the City should any such practices occur in the future. The affidavit requires completion of company information, authorized signature, printed name, and title, followed by notarization with the notary's signature, seal, and commission expiration date.
The affidavit contains no pricing information, set-asides, or funding details, as it is solely a compliance and attestation document. This form is a mandatory requirement for all nongovernmental entities bidding on the Fort Myers contract opportunity and must be properly executed and notarized before contract execution, renewal, or extension. The affidavit demonstrates the City's commitment to combating human trafficking and ensuring ethical labor practices among its contractors, consistent with Florida state law requirements for public procurement activities.
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Text version
H U M A N T R A F F I C K I N G A F F I D A V I T
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 _______________ (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 non-governmental 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: Date: _____________
Printed Name:
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:______________________
| contract with the City of: |
| I am an officer or representative of: |
| Company: |
| Date: |
| Printed Name: |
| Title: |
| STATE OF: |
| COUNTY OF: |
| The foregoing instrument was acknowledged before me by means of: Off |
| physical presence or: Off |
| online notarization this 1: |
| online notarization this 2: |
| day of: |
| 20: |
| as: |
| companycorporation They: Off |
| are personally known to me or: Off |
| as identification: |
| Print Type or Stamp Name of Notary: |
| My commission expires: |
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