10913_RFP_Attachment L.pdf
PDF 87 KB Posted
- Attached to
- Department of Juvenile Justice (Department or DJJ) Solicitation # 10913 – RES-Males- 78 beds
- Solicitation number
- RFP-13971
- Issued by
- Palm Beach County, Florida
About this file
This document is a Foreign Country of Concern Attestation form (PUR 1355) issued under Rule 60A-1.020, F.A.C., applicable to government contract procurement processes. The form is designed to be completed by an officer or representative of an entity when submitting a bid, proposal, or entering into a contract with a Governmental Entity that would grant access to an individual's Personal Identifying Information.
The attestation requires the entity to declare that it is not owned by the government of a Foreign Country of Concern, not organized under the laws of or having 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 form must be signed under penalties of perjury, with the signatory affirming the truthfulness of the statement. Blank fields are provided for the printed name, title, signature, and date of the attesting representative.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| RFP_10913_Addendum.pdf | ||
| 10913_RFP_Attachment_N.pdf | ||
| 10913_RFP_Notice_of_Agency_Decision.pdf | ||
| RFP_10913_Final.pdf | ||
| 10913_Exhibit 8.pdf | ||
| 10913_Exhibit 9.pdf | ||
| 10913_RFP_Attachment_S.pdf | ||
| RFP_10913_Informational_Notice_1.pdf | ||
| 10913_RFP_Attachment_Q.pdf |
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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 .