10913_RFP_Attachment L.pdf

This document is the Foreign Country of Concern Attestation form (PUR 1355) required by the State of Florida under Rule 60A-1.020, F.A.C. The form must be completed by an officer or representative of any entity submitting a bid, proposal, or reply to, or entering into, renewing, or extending a contract with a Governmental Entity that would grant the entity access to an individual's Personal Identifying Information. The attestation certifies that the entity is not owned by the government of a Foreign Country of Concern, is 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 the government of a Foreign Country of Concern does not have a Controlling Interest in the entity. The signatory must declare under penalties of perjury that the facts stated in the attestation are true.

The form requires completion of four fields: Printed Name, Title, Signature, and Date. The document references Rule 60A-1.020, F.A.C. for the definitions of capitalized terms used in the attestation. This form is a standard compliance requirement for entities seeking to contract with Florida governmental entities that will handle sensitive personal information, serving as a security and eligibility screening mechanism.