4-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 the Digital Building Sign contract opportunity with Halifax Health. The attestation requires the bidding entity to confirm under penalties of perjury that it is not owned by, organized under the laws of, or located in a Foreign Country of Concern, and that no Foreign Country of Concern government maintains a controlling interest in the entity. An authorized officer or representative of the bidding entity must complete the form by providing their printed name, title, signature, and date. This form is mandatory for any entity seeking to submit a bid, proposal, or reply to, or enter into, renew, or extend a contract with the governmental entity that would grant access to an individual's Personal Identifying Information.

The attestation is based on definitions established in Rule 60A-1.020, Florida Administrative Code, and serves as a compliance mechanism to protect against foreign government influence in state contracts. Capitalized terms referenced in the form are defined in the Florida Administrative Code rule cited. Bidders should note that completion of this attestation is a prerequisite to contract award consideration for opportunities involving access to personal identifying information.