10991 Attachment L_PUR_1355.pdf
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- Solicitation number
- RFP-14195
- Issued by
- Miami-Dade County, Florida
About this file
This document is a Foreign Country of Concern Attestation form (PUR 1355) for a governmental entity, specifically referencing Rule 60A-1.020, F.A.C. The form requires an officer or representative of an entity submitting a bid, proposal, or contract with a Governmental Entity to attest that their organization is not owned, organized, or controlled by the government of a Foreign Country of Concern, and does not have its Principal Place of Business in such a country.
The attestation is a legal declaration made under penalties of perjury, where the representative confirms the truthfulness of the statement regarding the entity's ownership, business location, and governance. The form provides spaces for the printed name, title, signature, and date of the authorized representative, and is designed to ensure transparency and compliance with specific governmental regulations concerning international business relationships and potential security concerns related to personal identifying information.
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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 .