6-Foreign Country of Concern Attestation (PII).docx
DOCX document 36 KB Posted
- Attached to
- Actuarial Services for Self-Insurance Programs
- Solicitation number
- GEN2131030Q1
- Issued by
- Broward County, Florida
About this file
This document is a Foreign Country of Concern Attestation form from Broward County, Florida, specifically related to a solicitation for Actuarial Services for Self-Insurance Programs. The contract is an open-end procurement for actuarial services to support the Accounting Division and other Broward County agencies, with vendors required to submit a completed attestation form confirming they are not owned, organized, or controlled by governments of foreign countries of concern. Vendors must submit their responses electronically through BPRO by the specified closing date and time, with a strong recommendation to provide all requested documents, including optional files, to facilitate a comprehensive review.
The solicitation includes specific requirements related to the Office of Economic and Small Business Development (OESBD), with procurement preferences for Small Business Enterprises (SBE) and County Business Enterprises (CBE). Vendors are expected to submit questions and clarification requests through BPRO by a designated due date, with the County responding in the platform's Messages section. Technical support is available through support@gobonfire.com for submission difficulties, and vendors are cautioned to carefully review the full solicitation document beyond the summary provided. The attestation form requires vendors to declare under penalties of perjury that they meet the specified foreign ownership and control criteria.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 5-OESBD - Procurement Preferences SBE-CBE.docx | DOCX document | |
| 8-Special Instructions to Vendors - GEN2131030Q1.pdf | ||
| 2-Vendor Questionnaire - Quotes and Bids.docx | DOCX document | |
| 1-Insurance Requirements - Quotes Bids.docx | DOCX document | |
| 3-Insurance Requirement, GEN2131030Q1, Actuarial Services.pdf | ||
| 4-General Conditions - Quotes and Bids.pdf | ||
| 7-Scope of Work - GEN2131030Q1.pdf |
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Text version
FOREIGN COUNTRY OF CONCERN ATTESTATION
(for Contracts giving access to an individual’s personal identifying information)
The completed form should be returned with the Vendor’s submittal. If not provided with the submittal, Vendor must submit the form(s) within three business days after County’s request and no later than entering, renewing, or extending, a contract with Broward County. Vendor may be deemed nonresponsive for failure to fully comply within the stated timeframe.
Capitalized terms used herein have the definitions ascribed in Rule 60A-1.020, F.A.C.
Vendor is not owned by the government of a Foreign Country of Concern, is not organized under the laws of nor has its Principal Place of Business in a Foreign Country of Concern, and the government of a Foreign Country of Concern does not have a Controlling Interest in the entity.
Under penalties of perjury, I declare that I have read the foregoing statement and that the facts stated in it are true.
Vendor Name: Click or tap here to enter text.
Signature: ______________________________ Printed Name: Click or tap here to enter text.
Title: Click or tap here to enter text.
Date: Click or tap to enter a date.
Form Date 9/9/24
File details come from the government source that posted it. Updated .