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 entities bidding on or entering into contracts with governmental entities that would grant access to Personal Identifying Information. The form applies to Halifax Health's solicitation for artwork at the Medical Center of Deltona. The attestation requires that an officer or representative of the bidding entity certify under penalties of perjury that the entity is not owned by, organized under the laws of, or has its Principal Place of Business in a Foreign Country of Concern, and that the government of a Foreign Country of Concern does not have a Controlling Interest in the entity. The form must be completed and signed by an authorized representative of the bidding organization and submitted as part of the bid response.

This attestation is governed by Rule 60A-1.020, F.A.C., and serves as a compliance requirement for contractors seeking access to sensitive personal identifying information through state and local government contracts. The form does not contain pricing information, set-asides, or other commercial terms, as it functions solely as a certification document to ensure contractor eligibility and compliance with Florida's foreign ownership restrictions for sensitive data access contracts.