4-SCRUTINIZED COMPANIES FORM.pdf
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- Attached to
- RFP 2026-014 Emergency Food Services
- Solicitation number
- RFP No. 2026-014
- Issued by
- Palm Beach County, Florida
About this file
This is a Scrutinized Company Certification form required by the Town of Palm Beach, Florida for vendors participating in RFP 2026-014 for Emergency Food Services. The certification requires vendors to attest that their company is not participating in boycotts of Israel, does not appear on state scrutinized companies lists related to Sudan, Iran's petroleum sector, or business operations in Cuba or Syria. The form references Florida Statutes 215.4725, 215.473, and 287.135 as the legal basis for these certifications and must be signed and dated by an authorized company representative prior to proposal submission.
Vendors must complete this certification as a compliance requirement for the emergency food services contract, which involves providing meals for approximately 250 employees per day following hurricanes or other disasters, potentially for one to two weeks. The Town of Palm Beach will award the contract based on best value and may select one or more vendors. The initial contract term is one year with four one-year renewal options for a potential five-year total, and other municipalities may be permitted to utilize the awarded contract under the same pricing terms. FEMA terms and conditions apply to this solicitation as the Town anticipates requesting reimbursement from FEMA for disaster-related food services.
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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 .