3-Form - Scrutinized.pdf
PDF 77 KB Posted
- Attached to
- RFP for Disaster Debris Management
- Solicitation number
- 2026011
- Issued by
- Indian River County, Florida
About this file
This is a Certification Regarding Prohibition Against Contracting with Scrutinized Companies form required for submission with bids and proposals to Florida state and local government entities. The form applies to a Request for Proposal for Disaster Debris Management issued by a Florida county. The RFP seeks contractor(s) to manage debris resulting from catastrophic events such as tornadoes and hurricanes in accordance with requirements established by the Federal Emergency Management Agency (FEMA), the Florida Department of Environmental Protection (FDEP), the Florida Department of Emergency Management (FDEM), and local county ordinances. The contractor must demonstrate capacity to rapidly mobilize and respond to wide-scale debris volumes and possess specialized experience in disaster response and debris removal services across preparation, response, recovery, and mitigation phases. The scope also includes beach cleaning due to Red Tide or other marine-related events.
The certification requires that respondents certify neither they nor their wholly owned subsidiaries, majority-owned subsidiaries, parent companies, or affiliates have been placed on the Scrutinized Companies that Boycott Israel List or are engaged in a boycott of Israel. For contracts valued at one million dollars or more, respondents must additionally certify they are not on the Scrutinized Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List, and are not engaged in business operations in Cuba or Syria as defined by Florida Statutes section 215.473. The county reserves the right to immediately terminate any resulting contract upon written notice if the respondent submits a false certification or is subsequently found to be in violation of these restrictions.
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| 2-Form - Foreign Entity Ownership.pdf | ||
| 10-2026011 RFP for Disaster Debris Management.pdf | ||
| 1-Form - Anti-Human Traffic.pdf | ||
| 8-Proposal Pricing Forms.xlsx | XLSX spreadsheet | |
| 4-Form - Disclosure Form.pdf | ||
| 9-2026011 Disaster Debris Management Sample Agreement.docx | DOCX document | |
| 5-Form - Debarment.pdf |
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Text version
CERTIFICATION REGARDING PROHIBITION AGAINST
CONTRACTING WITH SCRUTINIZED COMPANIES
(This form MUST be submitted with your bid/proposal/SOQ)
I hereby certify that neither the undersigned entity, nor any of its wholly owned subsidiaries, majority-owned subsidiaries, parent companies, or affiliates of such entities or business associations, that exists for the purpose of making profit have been placed on the Scrutinized Companies that Boycott Israel List created pursuant to s. 215.4725 of the Florida Statutes, or are engaged in a boycott of Israel.
In addition, if this solicitation is for a contract for goods or services of one million dollars or more, I hereby certify that neither the undersigned entity, nor any of its wholly owned subsidiaries, majority-owned subsidiaries, parent companies, or affiliates of such entities or business associations, that exists for the purpose of making profit are on the Scrutinized Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List, created pursuant to s. 215.473 of the Florida Statutes, or are engaged in business operations in Cuba or Syria as defined in said statute.
I understand and agree that the County may immediately terminate any contract resulting from this solicitation upon written notice if the undersigned entity (or any of those related entities of respondent as defined above by Florida law) are found to have submitted a false certification or any of the following occur with respect to the company or a related entity: (i) it has been placed on the Scrutinized Companies that Boycott Israel List, or is engaged in a boycott of Israel, or (ii) for any contract for goods or services of one million dollars or more, it has been placed on the Scrutinized Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List, or it is found to have been engaged in business operations in Cuba or Syria.
Name of Respondent: ___________________________________
By: ________________________________________________ (Authorized Signature)
Name:
Title: ______________________________________________
Date:_____________________________
| Name: |
| Title: |
| Date: |
| Firm/Entity: |
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