11-Foreign Country of Concern Attestation (PII).docx

This is a Foreign Country of Concern Attestation form required by Broward County, Florida for vendors seeking to provide an Artificial Intelligence-Enabled System for Employee Screening X-Ray Machines at Fort Lauderdale-Hollywood International Airport. The attestation applies specifically to contracts that grant access to personal identifying information (PII). Vendors must complete and return the form with their solicitation submittal, or if not initially provided, within three business days of the County's request and prior to entering, renewing, or extending any contract with Broward County. Failure to comply within the specified timeframe may result in the vendor being deemed nonresponsive.

Under the attestation, the vendor certifies under penalties of perjury that it 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 form requires the vendor to provide its name, signature of an authorized representative with printed name and title, and the date of execution. The form was dated September 9, 2024.