2-AFFIDAVIT OF COMPLIANCE - Denying Doing Business with a Foreign Country of Concern 10.docx.docx
DOCX document 17 KB Posted
- Attached to
- State Lobbying Services
- Solicitation number
- RFP-25-00318
- Issued by
- Hillsborough County, Florida
About this file
This is a mandatory compliance affidavit document required for submission with bids or proposals to Hillsborough County, Florida, related to their State Lobbying Services procurement opportunity. The affidavit, mandated by Florida Statute 287.138, must accompany all bids for the County's competitive sealed proposal process seeking qualified lobbying firms to represent the Board of County Commissioners and County Administrator before Florida's legislative and executive branches over a three-year contract period with an estimated budget of $175,000 per contract.
The affidavit requires bidders to provide notarized sworn statements denying any involvement with designated "Foreign Countries of Concern," specifically China, Russia, Iran, North Korea, South Korea, Cuba, Venezuela under Nicolas Maduro, or Syria, including any agencies or entities under their significant control. Compliance requirements became effective January 1, 2024, and mandate that companies affirm they are not owned by, controlled by, or organized under the laws of these foreign countries, nor do they have their principal place of business in such countries. The document must be completed by an authorized company representative with sufficient knowledge and authority, properly notarized, and submitted as part of the proposal package to maintain bid eligibility.
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| 5-Direct Deposit Authorization Form 5.15.2025.pdf.pdf | ||
| 9-RFP-25-00318 Preliminary Tabulation.pdf | ||
| 1-Drug Free Workplace Form.doc.doc | DOC document | |
| 4-Substitute W9 Form.pdf.pdf | ||
| 6-RFP-25-00318 State Lobbying Services.pdf | ||
| 8-RFP-25-00318 Addendum No. 2.pdf | ||
| 3-Insurance Certificate.doc.doc | DOC document | |
| 7-RFP-25-00318 Addendum No. 1.pdf |
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Text version
AFFIDAVIT OF COMPLIANCE
DENYING BIDDER’S/OFFEROR’S INVOLVEMENT WITH A FOREIGN COUNTRY OF CONCERN
(Pursuant to Florida Statutes 287.138)
*** THIS AFFIDAVIT MUST BE SUBMITTED WITH BIDDER’S BID/OFFER
(Per Florida Statutes, Section 287.138(4)(a), beginning January 1, 2024, Hillsborough County cannot accept a bid on, a proposal for, or reply to, or enter into a contract with a company/entity which would grant such company/entity access to an individual’s personal identifying information unless the company/entity provides the County with an Affidavit denying the company’s/entity’s involvement with a Foreign Country of Concern.)
______________________________________, being duly sworn deposes and states as follows under penalties of perjury:
(Name of person signing Affidavit)
1. My name is __________________________________________________ (Full Name)
2. I am the ____________________________ of ______________________________________________________ (Job Title – Officer/Authorized Representative) (Company Name)
3. The Company was formed in __________________________________________and is a ____________________ (Country and State) (Type of Entity (e.g., Inc., LLC, etc.)
4. I affirm that I am duly authorized and empowered and have sufficient knowledge to execute and deliver this Affidavit on behalf of the Company stated above.
5. I affirm that I have duly read and understand Florida Statutes Section 287.138 in its entirety and affirm as follows:
** For the purposes of this Affidavit a “Foreign Country of Concern” shall mean the People’s Republic of China, the Russian Federation, the Islamic Republic of Iran, the Democratic People’s Republic of Korea, the Republic of Korea, the Republic of Cuba, the Venezuelan regime of Nicolas Maduro, or the Syrian Arab Republic, including any agency of or any other entity of significant control of such foreign country.
(a) The Company is not owned by the government of a Foreign Country of Concern;
(b) The government of a Foreign Country of Concern has no controlling interest in the Company; and
(c) The Company is not organized under the laws of or does not have its principal place of business in a Foreign Country of Concern.
Under penalties of perjury, I declare that I have read this Affidavit and that the facts stated herein are true:
| __________________________________________ | ||||
| (Signature of Affiant) | ||||
| STATE OF | ) | |||
| COUNTY OF | ) | |||
| The foregoing instrument was acknowledged before me by means of physical presence | ||||
| or online notarization this _____ day of | , 20 | , by_________________________________________. |
(Name of Affiant)
(Signature of Notary Public)
(Print, Type, or Stamp Name of Notary Public) Personally Known OR Produced Identification Type of Identification Produced: ___________________________
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