FORM_10_-_CERTIFICATION_OF_RESPONDENT_REGARDING_TAX_DELINQUENCY_AND_FELONY_CONVICTIONS.pdf
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- Solicitation number
- 2026-072-MC
- Issued by
- Lee County, Fruitville CDP, Florida
About this file
This is a Certification of Respondent form related to RFQ 2026-072-MC issued by the Lee County Port Authority in Florida for a progressive design-build project involving a parking garage, Quick Turnaround Area (QTA), and demolition/remediation of existing facilities at Southwest Florida International Airport. The form requires respondents to certify their current status regarding tax delinquency and felony convictions through checkmark responses to two mandatory certification statements. Respondents must declare whether they are a corporation with any unpaid Federal tax liability that has been assessed and for which all judicial and administrative remedies have been exhausted or lapsed, and whether they were convicted of a criminal violation under Federal law within the preceding twenty-four months.
Respondents who answer affirmatively to either certification question are ineligible to receive an award unless the agency suspension and debarment official (SDO) has considered suspension or debarment and determined that further action is not required to protect the Government's interests. In such cases, respondents must provide detailed information about their tax liability or conviction to the Owner, who will notify the FAA Airports District Office and the agency's SDO to facilitate the required considerations before award decisions are made. The form includes specific term definitions for felony conviction and tax delinquency as they apply to Federal law, and requires respondent signature, date, company name, and title before submission. All lower-tier subcontracts must incorporate this certification provision.
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Text version
RFQ 2026-072-MC: PROGRESSIVE DESIGN-BUILD FOR PARKING GARAGE, QUICK TURNAROUND AREA (QTA), AND DEMOLITION/REMEDIATION OF EXISTING FACILITIES
FORM 10: CERTIFICATION OF RESPONDENT REGARDING TAX DELINQUENCY AND FELONY
CONVICTIONS
The Respondent must complete the following two (2) certification statements. The Respondent must indicate its current status as it relates to tax delinquency and felony conviction by inserting a checkmark (✔) or the letter “X” in the space following the applicable response. The Respondent agrees that, if awarded a contract resulting from this solicitation, it will incorporate this provision for certification in all lower tier subcontracts.
Certifications
1) The Respondent represents that it ☐ is or ☐ is not a corporation that has any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability.
2) The Respondent represents that it ☐ is or ☐ is not a corporation that was convicted of a criminal violation under any Federal law within the preceding twenty-four (24) months.
Note If a Respondent responds in the affirmative to either of the above representations, the Respondent is ineligible to receive an award unless the Sponsor has received notification from the agency suspension and debarment official (SDO) that the SDO has considered suspension or debarment and determined that further action is not required to protect the Government’s interests. The Respondent therefore must provide information to the owner about its tax liability or conviction to the Owner, who will then notify the FAA Airports District Office, which will then notify the agency’s SDO to facilitate completion of the required considerations before award decisions are made.
Term Definitions Felony Conviction: Felony conviction means a conviction within the preceding twenty-four (24) months of a felony criminal violation under any Federal law and includes conviction of an offense defined in a section of the U.S. Code that specifically classifies the offense as a felony and conviction of an offense that is classified as a felony under 18 USC § 3559.
Tax Delinquency: A tax delinquency is any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted, or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability.
Date Signature
Company Name Title
Rev: 6.29.2026 Page 52 of 58
| Date: |
| Company Name: |
| Title: |
| Check Box11: Off |
| Check Box12: Off |
| Check Box13: Off |
| Check Box14: Off |
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