3-Attachment E-Foreign Country of Concern.pdf

809 KB Posted

Attached to
Twin Lakes SSPD Equipment Replacement
Solicitation number
PROJ-25-134
Issued by
Volusia County, Florida

About this file

Written by GovTribe AI ·

This is a Foreign Country of Concern Attestation form (PUR 1355) required by a Governmental Entity in Florida for contractors that will have access to Personal Identifying Information. The form must be completed by an officer or representative of any entity submitting a bid, proposal, or reply to, or entering into, renewing, or extending a contract with the Governmental Entity. The attestation requires entities to declare under penalties of perjury that they are not owned by, organized under the laws of, do not have their principal place of business in, and are not controlled by the government of a Foreign Country of Concern.

The form references Rule 60A-1.020, F.A.C. for definitions of capitalized terms and was issued in October 2023. The attestation includes fields for the printed name, title, signature, and date of the officer or representative completing the form. This appears to be a standard compliance requirement for entities seeking to contract with Florida governmental entities when such contracts involve access to personal identifying information of individuals.

View the file

Other files

File Type Posted
12-EXHIBIT 1 - STERIS Higlighted Tech Data and Equipment Drawing.pdf PDF
2-Attachment D-Scrutinized Companies.pdf PDF
1-Attachment A - Public Entity Crimes.pdf PDF
4-Exhibit A- Bonfire FAQs.pdf PDF
6-Attachment C-Human Trafficking.pdf PDF
8-Attachment B-Bidders Cert.pdf PDF
10-EXHIBIT 3 - 2400 GPD Core SPD Water Purification.pdf PDF
11-EXHIBIT 2 - 2510-SPD-TL-PE Combined.pdf PDF
7-Attachment F-Subcontractors List.pdf PDF
13-ITB PROJ-25-134 Twin Lakes SPD Equipment Replacement.pdf PDF
5-Exhibit B - IRS Form W9.pdf PDF
9-Attachment G-Total Project Cost.pdf PDF
Show all 12

On GovTribe

Work with this file

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file
Try for free Login

Text version

The file's text, extracted by GovTribe without its formatting.

Attachment E

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: __________

PUR 1355 (10/23) Rule 60A-1.020, F.A.C.

PUR 1355 1023:
Rule 60A1020 FAC:
Text1:
Text3:
Text4:

File details come from the government source that posted it. Updated .