6-Scrutinized Companies Form.pdf
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- Solicitation number
- ITB No. 2026-044
- Issued by
- Palm Beach County, Florida
About this file
This is a Scrutinized Companies Certification Form required by the Town of Palm Beach, Florida for vendors bidding on the Mandel Recreation Center Fitness Room Flooring Project. The Town is soliciting competitive bids for construction services to remove existing flooring, prepare the subfloor/surface, and install new rubber flooring at the recreation center located at 340 Seaview Avenue, Palm Beach, Florida. Work must be scheduled between August 1-10, with specific start and completion dates to be confirmed. A non-mandatory pre-bid meeting and site visit will be held on Tuesday, May 26, 2026, at 2:00 PM EST at the Mandel Recreation Center, with attendance strongly encouraged as the only direct forum for clarification with project management and Town staff. All bids must be submitted online through Euna Procurement (Bonfire), the Town's eProcurement platform. The contract will be awarded to the lowest responsive and responsible bidder whose bid meets all requirements and criteria, with the Town reserving the right to award on an all-or-none or line-by-line basis. Quoted prices must remain valid for ninety days from the bid closing date.
As a condition of bidding, all vendors must certify compliance with Florida Statutes 215.4725, 215.473, and 287.135 by confirming they do not appear on any state Scrutinized Companies lists and are not engaged in boycotts of Israel or have material business relationships with the governments of Sudan, Iran, Cuba, or Syria. Vendors must also swear or affirm under oath that their company meets these requirements as of the submission date. The certification form must be signed and dated by an authorized company representative and submitted with the bid proposal.
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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: |
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