4-SCRUTINIZED COMPANIES FORM.pdf
PDF 600 KB Posted
- Attached to
- Sea Turtle Nesting Monitoring
- Solicitation number
- RFP No. 2026-007
- Issued by
- Palm Beach County, Florida
About this file
This is a Scrutinized Companies Certification form required by the Town of Palm Beach, Florida, Purchasing Division for vendors participating in state and local contract opportunities. The form applies to the Sea Turtle Nesting Monitoring contract, which requires the Town of Palm Beach to solicit proposals from qualified firms to conduct daily monitoring of marine turtle nests from March 1st through October 31st in compliance with Florida Department of Environmental Protection requirements. The scope of work includes daily monitoring and documentation of nesting activity, identification and categorization of false crawls, reporting of nesting and hatching success, monitoring of lighting sources visible from the beach, escarpment formations, nesting seabird and shorebird activity, nest marking for equipment avoidance, management of marine turtle survey zones, and submission of required Florida Fish and Wildlife Conservation Commission spreadsheets and reports. Proposals must be submitted online through Bonfire, the Town's eProcurement platform, and proposers may not withdraw proposals for 120 days from the opening date. A non-mandatory pre-proposal conference will be held virtually via Microsoft Teams.
The certification form requires vendors to affirm under oath that their company is not listed on any Scrutinized Companies lists created pursuant to Florida Statutes 215.4725, 215.473, or 287.135. Vendors must certify four specific conditions: that the company is not participating in a boycott of Israel; that the company does not appear on the Scrutinized Companies with Activities in Sudan List; that the company does not appear on the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List; and that the company is not engaged in business operations in Cuba or Syria. The form must be signed and dated by an authorized representative of the vendor company and submitted with the proposal to the Town of Palm Beach Purchasing Division located at 951 Okeechobee Road, Suite D, West Palm Beach, Florida 33401.
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Text version
11/16/18
Scrutinized Company Certification
1. This company is not participating in a boycott of Israel such that it is not refusing to deal, terminating business activities, or taking other actions to limit commercial relations with Israel, or persons or entities doing business in Israel or in Israeli-controlled territories, in a discriminatory manner.
2. This Company does not appear on the Scrutinized Companies with Activities in Sudan List where the
State Board of Administration has established the following criteria:
a. Have a material business relationship with the government of Sudan or a government-created project involving oil related, mineral extraction, or power generation activities, or
b. Have a material business relationship involving the supply of military equipment, or
c. Impart minimal benefit to disadvantaged citizens that are typically located in the geographic periphery of Sudan, or
d. Have been complicit in the genocidal campaign in Darfur.
3. This Company does not appear on the Scrutinized Companies with Activities in the Iran Petroleum
Energy Sector List where the State Board of Administration has established the following criteria:
a. Have a material business relationship with the government of Iran or a government-created project involving oil related or mineral extraction activities, or
b. Have made material investments with the effect of significantly enhancing Iran‘s petroleum sector.
4. This Company is not engaged in business operations in Cuba or Syria.
VENDOR/COMPANY NAME:
NAME:
TITLE:
SIGNATURE:
DATE:
TOWN OF PALM BEACH
PURCHASING DIVISION
951 Okeechobee Road Suite D West Palm Beach, Florida 33401
Telephone: (561) 838-5406
PURCHASING DIVISION
951 Okeechobee Road Suite D West Palm Beach, Florida 33401
Telephone: (561) 838-5406 Facsimile (561) 835-4688 Website: www.townofpalmbeach.com
I hereby swear or affirm that as of the date below this company is not listed on a Scrutinized Companies list created pursuant to 215.4725, 215.473, or 287.135, Florida Statutes. Pursuant to 287.135, Florida Statutes I further affirm that:
http://www.leg.state.fl.us/Statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=0200-0299/0215/Sections/0215.4725.html http://www.leg.state.fl.us/Statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=0200-0299/0215/Sections/0215.4725.html http://www.leg.state.fl.us/Statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=0200-0299/0287/Sections/0287.135.html
| VENDORCOMPANY NAME: |
| Name: |
| Title: |
| Signiture: |
| Date: |
File details come from the government source that posted it. Updated .