6-AFFIDAVIT OF COMPLIANCE - Denying Doing Business with a Foreign Country of Concern 02.26.2026.docx
DOCX document 17 KB Posted
- Attached to
- Miscellaneous Subsurface Investigation & Testing
- Solicitation number
- RPS-26-00367
- Issued by
- Hillsborough County, Florida
About this file
This is an Affidavit of Compliance document related to Hillsborough County Capital Programs Department's procurement for Miscellaneous Subsurface Investigation & Testing services in Florida. The affidavit establishes compliance requirements for bidders participating in this $6,000,000 estimated value contract opportunity. The scope of work encompasses geotechnical services, construction materials testing, roofing and waterproofing assessments, materials engineering, and asbestos-related services, with qualified personnel required to provide tests, furnish necessary accredited equipment, and deliver written reports, evaluations, and recommendations related to work order deliverables.
The affidavit specifically addresses the denial of doing business with foreign countries of concern as a compliance certification requirement for potential contractors. Bidders submitting proposals for this subsurface investigation and testing contract must execute this affidavit to attest to their compliance with restrictions on conducting business with designated foreign countries of concern. This compliance certification is a mandatory prerequisite for bid consideration and contract award eligibility under Hillsborough County's procurement policies and applicable Florida state 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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