6-AFFIDAVIT OF COMPLIANCE - Denying Doing Business with a Foreign Country of Concern 02.26.2026.docx
DOCX document 17 KB Posted
- Solicitation number
- RPS-26-00274
- Issued by
- Hillsborough County, Florida
About this file
This is an Affidavit of Compliance form required by Hillsborough County, Florida, in connection with a professional services contract opportunity for Waste-to-Energy and Solid Waste Systems valued at approximately $6 million. The affidavit must be submitted with all bids and proposals and certifies that the bidding company has no involvement with designated foreign countries of concern. The five-year term contract requires proposals by July 24, 2026, at 2:00 p.m. Eastern Time, submitted electronically through Euna Procurement. The scope encompasses independent consulting engineer services including annual inspections of the Resource Recovery Facility and two transfer stations, quarterly facility reviews, environmental testing and monitoring, monthly facility meetings, bond compliance reporting, service agreement development, project development and permitting support, technical training, and optimization services for the County's waste-to-energy operations.
The affidavit requires the signatory to affirm under penalties of perjury that the company is not owned by or under the controlling interest of the governments of China, the Russian Federation, Iran, North Korea, Cuba, Venezuela, or Syria, and that the company is not organized under the laws of or based in any of these foreign countries of concern. A notary public must acknowledge and authenticate the affidavit. Compensation is structured as negotiated work orders based on direct salary rates by personnel classification, audited and certified overhead and profit multipliers, and reimbursable costs, with individual study work orders not to exceed $500,000. The contractor must provide comprehensive liability insurance including $1 million professional liability coverage with Hillsborough County named as additional insured and comply with E-Verify, IMAGE Best Practices, and local business tax requirements.
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Text version
AFFIDAVIT OF COMPLIANCE
DENYING BIDDER’S/OFFEROR’S INVOLVEMENT WITH A FOREIGN COUNTRY OF CONCERN
(Pursuant to Florida Statutes 287.138)
*** THIS AFFIDAVIT MUST BE SUBMITTED WITH BIDDER’S BID/OFFER
(Per Florida Statutes, Section 287.138(4)(a), beginning January 1, 2024, Hillsborough County cannot accept a bid on, a proposal for, or reply to, or enter into a contract with a company/entity which would grant such company/entity access to an individual’s personal identifying information unless the company/entity provides the County with an Affidavit denying the company’s/entity’s involvement with a Foreign Country of Concern.)
______________________________________, being duly sworn deposes and states as follows under penalties of perjury:
(Name of person signing Affidavit)
1. My name is __________________________________________________ (Full Name)
2. I am the ____________________________ of ______________________________________________________ (Job Title – Officer/Authorized Representative) (Company Name)
3. The Company was formed in __________________________________________and is a ____________________ (Country and State) (Type of Entity (e.g., Inc., LLC, etc.)
4. I affirm that I am duly authorized and empowered and have sufficient knowledge to execute and deliver this Affidavit on behalf of the Company stated above.
5. I affirm that I have duly read and understand Florida Statutes Section 287.138 in its entirety and affirm as follows:
** For the purposes of this Affidavit a “Foreign Country of Concern” shall mean the People’s Republic of China, the Russian Federation, the Islamic Republic of Iran, the Democratic People’s Republic of Korea, the Republic of Cuba, the Venezuelan regime of Nicolas Maduro, or the Syrian Arab Republic, including any agency of or any other entity of significant control of such foreign country. “Controlling interest” shall have the meaning set forth in Florida Statutes Section 287.138(1)(a).
(a) The Company is not owned by the government of a Foreign Country of Concern;
(b) The government of a Foreign Country of Concern has no controlling interest in the Company; and
(c) The Company is not organized under the laws of or does not have its principal place of business in a Foreign Country of Concern.
Under penalties of perjury, I declare that I have read this Affidavit and that the facts stated herein are true:
| __________________________________________ | ||||
| (Signature of Affiant) | ||||
| STATE OF | ) | |||
| COUNTY OF | ) | |||
| The foregoing instrument was acknowledged before me by means of physical presence | ||||
| or online notarization this _____ day of | , 20 | , by_________________________________________. |
(Name of Affiant)
(Signature of Notary Public)
(Print, Type, or Stamp Name of Notary Public) Personally Known OR Produced Identification Type of Identification Produced: ___________________________
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