10834_Attachment L.pdf
PDF 106 KB Posted
- Attached to
- 10834 - PREV - Mentoring Services
- Solicitation number
- RFP-10478
- Issued by
- Leon County, Florida
About this file
This document is a Foreign Country of Concern Attestation form (PUR 1355) required for entities submitting bids, proposals, or replies to, or entering into, renewing, or extending contracts with a Governmental Entity that would grant the entity access to an individual's Personal Identifying Information. The form requires the entity to attest that it is not owned by, organized under the laws of, or have its principal place of business in a Foreign Country of Concern, and that the government of a Foreign Country of Concern does not have a Controlling Interest in the entity. The entity must provide the printed name, title, and signature of an authorized officer or representative attesting to these facts under penalties of perjury.
The document provides the specific legal citation to the applicable Florida Administrative Code rule (Rule 60A-1.020, F.A.C.) governing this attestation requirement. No other details regarding a specific contract opportunity are included in this document.
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Text version
PUR 1355 (10/23) Page 1 of 1 Rule 60A-1.020, F.A.C.
FOREIGN COUNTRY OF CONCERN ATTESTATION
(PUR 1355)
This form must be completed by an officer or representative of an entity submitting a bid, proposal, or reply to, or entering into, renewing, or extending, a contract with a Governmental Entity which would grant the entity access to an individual’s Personal Identifying Information.
Capitalized terms used herein have the definitions ascribed in Rule 60A-1.020, F.A.C.
Name of entity 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.
Printed Name:
Title:
Signature: Date:
https://www.flrules.org/gateway/RuleNo.asp?title=GENERAL%20REGULATIONS&ID=60A-1.020
File details come from the government source that posted it. Updated .