10-Foreign Country of Concern Attestation (PII).docx
DOCX document 36 KB Posted
- Attached to
- Master Banking Services
- Solicitation number
- GEN2131264P1
- Issued by
- Broward County, Florida
About this file
This file is a Foreign Country of Concern Attestation form required by Broward County, Florida for vendors seeking to provide Master Banking Services. The attestation is mandatory for any contract that provides access to personal identifying information and must be completed and submitted with the vendor's proposal. If not included in the initial submittal, vendors must provide the form within three business days of the County's request and no later than contract execution. Failure to comply within the specified timeframe may result in the vendor being deemed nonresponsive. The Master Banking Services solicitation encompasses five service groups: Lockbox Services, Merchant Card Services, Purchasing Card Services, Third-Party Custodian/Safekeeping Services, and Treasury Services. Vendors may submit proposals for one or multiple banking services but must perform all work directly without subcontracting or outsourcing. Each banking service proposal requires separate submissions of evaluation criteria responses, pricing, and all other required documentation.
The Foreign Country of Concern Attestation requires the vendor to declare, under penalties of perjury, that it is not owned by the government of a Foreign Country of Concern, not organized under the laws of a Foreign Country of Concern, does not have its Principal Place of Business in a Foreign Country of Concern, and that no Foreign Country of Concern government holds a Controlling Interest in the entity. The attestation form, dated September 9, 2024, must be signed and notarized by an authorized representative. Additional solicitation requirements include compliance with License/Certification Requirements, completion of an Enterprise Technology Services Vendor Security Questionnaire, and adherence to Payment Card Industry Data Security Standards. The County also applies Office of Economic and Small Business Development procurement preferences for Small Business Enterprises and County Business Enterprises. Vendors are encouraged to submit all available documentation, including optional items listed in BPRO, to facilitate timely and comprehensive evaluation.
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Text version
FOREIGN COUNTRY OF CONCERN ATTESTATION
(for Contracts giving access to an individual’s personal identifying information)
The completed form should be returned with the Vendor’s submittal. If not provided with the submittal, Vendor must submit the form(s) within three business days after County’s request and no later than entering, renewing, or extending, a contract with Broward County. Vendor may be deemed nonresponsive for failure to fully comply within the stated timeframe.
Capitalized terms used herein have the definitions ascribed in Rule 60A-1.020, F.A.C.
Vendor is not owned by the government of a Foreign Country of Concern, is not organized under the laws of nor has its Principal Place of Business in a Foreign Country of Concern, and the government of a Foreign Country of Concern does not have a Controlling Interest in the entity.
Under penalties of perjury, I declare that I have read the foregoing statement and that the facts stated in it are true.
Vendor Name: Click or tap here to enter text.
Signature: ______________________________ Printed Name: Click or tap here to enter text.
Title: Click or tap here to enter text.
Date: Click or tap to enter a date.
Form Date 9/9/24
File details come from the government source that posted it. Updated .