Form_6_Scrutinized_Companies_Certification.pdf
PDF 103 KB Posted
- Attached to
- Landscaping Services at Page Field
- Solicitation number
- 26-0080LB
- Issued by
- Lee County, Fort Lauderdale City, Florida
About this file
This is a Scrutinized Companies Certification form (Form 6) required for RFB 26-0080LB: Landscaping Services at Page Field, issued by the Lee County Port Authority in Florida. The form is a mandatory certification document that bidders must complete and submit as part of their bid package for the landscaping services contract at Page Field Airport. The certification requires bidders to attest under penalties of perjury that their company has not been placed on specified government scrutiny lists, does not conduct business operations in restricted countries, and will not engage in prohibited boycott activities during the contract term.
Bidders must acknowledge understanding the serious consequences of submitting false certifications, which include contract termination, debarment from bidding for three years, civil penalties, and assessment of attorney's fees and costs. The form requires notarization and must be signed by an authorized company representative. Bidders are also required to inform the Lee County Port Authority of any changes to the certified information prior to contract execution. The certification addresses compliance with Florida Statutes sections 287.135 and 215.4725, ensuring that selected contractors meet the state's financial and ethical standards for public procurement.
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Text version
RFB 26-0080LB: LANDSCAPING SERVICES AT PAGE FIELD
FORM 6: SCRUTINIZED COMPANIES CERTIFICATION
Bidder hereby certifies under penalties of perjury as of the date of submission of its RFB to provide goods and services to Lee County Port Authority that it has not been placed on the Scrutinized Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List as defined in section 287.135, Florida Statutes, is not engaged in business operations in Cuba and Syria; and will not engage in “Boycott Israel” activities, as defined in section 215.4725 (1)(a), Florida Statutes, that result in Bidder being placed on the Scrutinized Companies that Boycott Israel List created after October 1, 2016 and during the term of any contract awarded pursuant to this Request for Bids.
I further certify that I am duly authorized to submit this certification on behalf of the company as its agent and that the company is ready, willing and able to perform if awarded a contract.
I UNDERSTAND THAT THE SUBMISSION OF THIS FORM TO THE PROCUREMENT OFFICE FOR LEE
COUNTY PORT AUTHORITY IS FOR THAT PUBLIC ENTITY ONLY AND, THAT FALSIFICATION OF
THIS CERTIFICATION MAY RESULT IN TERMINATION OF THE CONTRACT, DEBARMENT OF THE
COMPANY FROM SUBMITTING A BID OR PROPOSAL FOR A PERIOD OF THREE (3) YEARS FROM
THE DATE THE CERTIFICATION IS DETERMINED TO BE FALSE, CIVIL PENALTIES, AND THE
ASSESSMENT OF ATTORNEY’S FEES AND COSTS AGAINST THE COMPANY. I ALSO UNDERSTAND
THAT I AM REQUIRED TO INFORM LEE COUNTY PORT AUTHORITY PRIOR TO ENTERING INTO A
CONTRACT OF ANY CHANGE IN THE INFORMATION CONTAINED IN THIS FORM.
[Signature]
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]
Rev: 3.24.2026 Page 54 of 61
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| online notarization who produced the following as identification: |
| type of identification or is personally known to me: |
| My Commission Expires: |
| Typed or printed name: |
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| Check Box15: Off |
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