287.138-Foreign_Entities_Affidavit.pdf

PDF 182 KB Posted

Attached to
Fleishman Park Improvements State and local contract opportunity
Solicitation number
25-020-ITB
Issued by
Lee County, Fort Lauderdale City, Florida

About this file

The document is an Affidavit of Compliance with Section 287.138, Florida Statutes, for the City of Fort Myers, specifically related to contracting with foreign entities. This affidavit requires vendors to certify that they are not owned by, controlled by, or principally located in certain foreign countries of concern, including China, Russia, Iran, North Korea, Cuba, Venezuela, and Syria. The purpose is to prevent the county from entering contracts with foreign entities that could potentially access an individual's personal identifying information.

The affidavit is a standard compliance document that must be completed and notarized by a vendor's authorized representative, affirming their company's independence from specified foreign governments or entities. For the Fleishman Park Improvements project, this document serves as a legal safeguard to ensure that contractors meet specific state-level restrictions on foreign business involvement, protecting local governmental interests and individual privacy.

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Text version

AFFIDAVIT OF COMPLIANCE WITH SECTION 287.138, FLORIDA STATUTES,

CONTRACTING WITH FOREIGN ENTITIES OF CONCERN

Before me, the undersigned authority, personally appeared (Name of affiant)

______________________________________________, who, after being first duly sworn, deposes and says of his or her personal knowledge the following:

1. Affiant is the (Title) ________________________________________________ of (Business Name)

_____________________________________________________________________________ which does business in the State of Florida, hereinafter called the “Vendor.”

2. Vendor, pursuant to Section 287.138, Florida Statues, certifies that (1) Vendor is not owned by a government of a foreign country of concern; (2) a government of a foreign country of concern does not have a “controlling interest” in Vendor, as defined by Section 287.138(1)(a), Florida Statutes; and (3) Vendor is not organized under the law of nor has its principal place of business in a foreign country of concern. For the purposes of this affidavit, foreign country of concern means the People’s Republic of China, the Russian Federation, the

Islamic Republic of Iran, the Democratic People’s Republic of Korea, the Republic of Cuba, the Venezuelan regime of Nicolás Maduro, or the Syrian Arab Republic, including any agency of or any other entity of significant control of such foreign country of concern, as defined in Section 287.138(1)(c), Florida Statutes.

3. This Affidavit is executed by the Vendor accordance with Section 287.138, Florida Statutes, for the purposes of preventing the County from entering contracts with foreign entities of concern which would provide

Vendor access to an individual’s personal identifying information.

Signed and Delivered on this day of _______________, 202__.

BY: ___________________________________

Signature of Affiant

Printed Name

STATE OF FLORIDA

COUNTY OF __________

Sworn to (or affirmed) and subscribed before me by means of physical presence or online notarization, this ____ day of ___________________, 20____, by ______________________________.

Personally Known OR Produced Identification Type of Identification Produced ____________ ______________________________

(Notary Signature)

(SEAL)

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