Human_Trafficking_Affidavit_.pdf
PDF 134 KB Posted
- Attached to
- Electrical Vehicle Charging Station
- Solicitation number
- 25-072-RFP
- 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 Florida Statutes Section 787.06(13) for any nongovernmental entity executing, renewing, or extending a contract with the municipality. The affidavit mandates that an authorized officer or representative of the contracting entity attest under penalty of perjury that the organization and its subsidiaries or affiliates do not use coercion for labor or services as defined by Florida law. The document requires the authorized signatory to confirm the truthfulness of the affidavit, provide their printed name and title, and commit to immediately notifying the City should any future violations occur. The affidavit must be notarized by a qualified notary public who verifies the signatory's identity through physical presence or online notarization, with the notary's signature, seal or stamp, name, and commission expiration date required on the document.
This form is a mandatory compliance document applicable to the City of Fort Myers' Electrical Vehicle Charging Station project procurement, which involves a comprehensive turnkey solution including design, installation, operation, maintenance, and potential removal of charging stations on publicly owned properties. Prospective contractors must complete and submit this affidavit as part of their proposal response to the RFP released July 2, 2025, with proposals due August 5, 2025. The affidavit serves as a prerequisite certification that bidders meet the City's human trafficking prevention standards and demonstrates commitment to ethical labor practices throughout the contract term, which extends for an initial seven years with three one-year renewal options.
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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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