2-Attachment E-Foreign Country of Concern.pdf

This is a Foreign Country of Concern Attestation form (PUR 1355) required by the State of Florida for a cooling tower power train replacement project located at a facility in Daytona Beach, Florida. The attestation must be completed by an authorized officer or representative of any entity submitting a bid or proposal for this contract opportunity, which involves removing and replacing an existing virology hood in the Microbiology and Tissue Processor laboratory area. The scope of work includes modifications to existing ductwork, fans, and utilities, painting of the work area, and demolition and replacement of vinyl flooring at the main campus located at 303 North Clyde Morris Boulevard, Daytona Beach, Florida 32114.

The attestation requires the bidding entity to declare under penalties of perjury 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 maintain a controlling interest in the entity. The form must include the printed name, title, signature, and date of the authorized representative completing the attestation. This compliance requirement is established under Rule 60A-1.020, Florida Administrative Code, and applies to all contractors seeking access to personal identifying information through their contract with the governmental entity.