RFP_26-0073LB_FORM_5_-_AFFIDAVIT_OF_COMPLIANCE_WITH_FLORIDA_STATUTES.pdf
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- Solicitation number
- 26-0073-LB
- Issued by
- Lee County, Fruitville CDP, Florida
About this file
This is an Affidavit of Compliance form for RFP 26-0073LB issued by the Lee County Port Authority for Operation, Management, and Maintenance Services of the Baggage Handling System (BHS) at Southwest Florida International Airport (RSW). The RFP solicits proposals from qualified firms to provide comprehensive BHS services, including industry-skilled labor, materials, equipment, tools, training, parts management, and warranty administration for two outbound common-use automated in-line baggage handling systems and inbound carousel bag claim devices at the airport. The Authority seeks properly certified and experienced providers to perform these services according to specifications outlined in the procurement documents.
Form 5 serves as a mandatory compliance affidavit requiring proposers to certify compliance with Florida Statutes Sections 287.138 and 787.06. Affiant must attest under oath that the proposing firm is not owned by, does not have controlling interest from, and is not organized under the law of or principally located in designated foreign countries of concern, specifically the People's Republic of China, Russian Federation, Islamic Republic of Iran, Democratic People's Republic of Korea, Republic of Cuba, Venezuelan regime of Nicolas Maduro, or Syrian Arab Republic. Additionally, proposers must certify they do not use coercion for labor or services as defined in statute. The affidavit must be executed before a notary public and submitted as part of the proposal response to prevent the Port Authority from contracting with entities that could provide improper access to personal identifying information.
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Text version
RFP 26-0073LB: OPERATION, MANAGEMENT, AND MAINTENANCE SERVICES OF THE BAGGAGE HANDLING SYSTEM (BHS)
FORM 5: AFFIDAVIT OF COMPLIANCE WITH SECTIONS 287.138 (FOREIGN ENTITIES OF
CONCERN) and 787.06 (HUMAN TRAFFICKING), FLORIDA STATUTES
Before me, the undersigned authority, personally appeared _______________________ (Name of Affiant) after being first duly sworn, deposes and says of his/her personal knowledge the following:
1. Affiant is the (Title) of (Business Name) ____________________________________________ which does business in the State of Florida, hereinafter called the “Proposer.”
2. Proposer, pursuant to Section 287.138, Florida Statutes, certifies that (1) Proposer is not owned by a government of a foreign country of concern; (2) a government of a foreign country of concern does not have a “controlling interest” in Proposer, as defined by Section 287.138(1)(a), Florida Statutes;
and (3) Proposer is not organized under the law of nor has its principal place of business in a foreign country of concern. For the purposes of this affidavit, foreign country of concern means the People’s Republic of China, the Russian Federation, the Islamic Republic of Iran, the Democratic People’s Republic of Korea, the Republic of Cuba, the Venezuelan regime of Nicolás Maduro, or the Syrian Arab Republic, including any agency of or any other entity of significant control of such foreign country of concern, as defined in Section 287.138(1)(c), Florida Statutes, as amended from time to time.
3. Proposer, pursuant to Section 787.06, Florida Statutes, certifies that Proposer does not use coercion for labor or services as defined in Section 787.06, Florida Statutes, as amended from time to time.
4. This Affidavit is executed by the Proposer in accordance with Section 287.138, Florida Statutes, for the purposes of preventing the Port Authority from entering contracts with foreign entities of concern which would provide proper access to an individual’s personal identifying information.
5. This Affidavit is executed by the Proposer in accordance with Section 787.06, Florida Statutes.
Signed and Delivered on this day of , 20__.
Signature of Affiant
Printed Name
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: 5.28.2026 Page 55 of 58
| BAGGAGE HANDLING SYSTEMS (BHS) BACKGROUND AND INFORMATION |
| Evaluation Criteria Summary |
File details come from the government source that posted it. Updated .