FORM_5_LOBBYING_AFFIDAVIT.pdf
PDF 98 KB Posted
- Solicitation number
- 26-0068BW
- Issued by
- Lee County, Fruitville CDP, Florida
About this file
This is a Lobbying Affidavit form (Form 5) required for the Request for Qualifications (RFQ) 26-0068BW submitted to the Lee County Port Authority in Florida. The form serves as a sworn statement in which respondents must certify that neither they nor their agents have engaged in lobbying activities to obtain the award of the General Planning and Environmental Services contract from the Lee County Board of Port Commissioners, members of the Airports Special Management Committee, or employees of the Lee County Port Authority. All respondents are required to complete and submit this form, and in cases involving joint ventures, each joint venture partner must provide their own affidavit.
The affidavit requires the respondent or authorized representative to swear under oath that they have complied with federal regulations concerning lobbying activities as outlined in 31 U.S.C. Section 1352, 49 CFR Part 20, and Lee County Ordinance No. 03-14. The form must be notarized, with the notary public providing identification verification and commission expiration details. Submission of this form is mandatory for all respondents seeking consideration for the contract award.
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Text version
RFQ 26-0068BW: GENERAL PLANNING AND ENVIRONMENTAL SERVICES FOR THE LEE COUNTY PORT AUTHORITY
FORM 5: LOBBYING AFFIDAVIT
STATE OF ______________
COUNTY OF ____________
______________________________________________being first duly sworn, deposes and says that he or she is the (sole owner) (general partner) (joint venture partner) (president) (secretary) or (authorized representative) (circle one) of ______________________________________________ (Respondent), maker of the attached RFQ and that neither the Respondent nor its agents have lobbied to obtain an award of the Agreement required by this Request for Qualifications from Lee County Board of Port Commissioners, members of the Airports Special Management Committee or employees of Lee County Port Authority, individually or collectively, regarding this Request for Qualifications.
The Respondent further states that it has complied with the federal regulations concerning lobbying activities contained in 31 U.S.C., section 1352, 49 CFR Part 20 and Lee County Ordinance No. 03-14 relating to lobbying activities.
AFFIANT
Notary Public
STATE OF ______________
COUNTY OF ____________
The foregoing instrument was signed and acknowledged before me this _______ day of _____________________, 20_____, by ____________________________________________ by means of physical presence or online notarization who produced the following as identification _________________________________ (type of identification) or is personally known to me.
My Commission Expires ________________ [stamp or seal]
[Signature of Notary Public]
[Typed or printed name]
NOTE - THIS FORM MUST BE COMPLETED AND SUBMITTED BY ALL RESPONDENTS
AND, IN THE CASE OF A JOINT VENTURE, FROM EACH JOINT VENTURE PARTNER
Rev: 3.4.2026 Page 44 of 48
| COUNTY OF: |
| undefined: |
| or she is the sole owner general partner joint venture partner president secretary or authorized: |
| maker of the attached RFQ and that neither the Respondent nor its agents have lobbied to obtain an award: |
| The foregoing instrument was signed and acknowledged before me this 2: |
| physical presence or: |
| online notarization who produced the following as identification: |
| type of identification or is personally known to me: |
| My Commission Expires: |
| Typed or printed name: |
| State of: |
| County of: |
| This day: |
File details come from the government source that posted it. Updated .