7. PUR_1355.docx
DOCX document 31 KB Posted
- Attached to
- District Five Right-of-Way Appraisal, Cost Estimates, Design Support and Valuation Support Services
- Solicitation number
- ITN-13285
- Issued by
- Volusia County, Florida
About this file
This document is a Foreign Country of Concern Attestation form (PUR 1355) designed for governmental entities to verify a bidder's ownership and business origins. The form requires an officer or representative of an entity submitting a bid, proposal, or contract to certify that their organization is not owned by, organized under the laws of, or principally located in a Foreign Country of Concern, and that no such government has a controlling interest in the entity.
The attestation is a standard compliance document for state and local government contracting, requiring a signed declaration under penalties of perjury. The form includes spaces for the entity's printed name, the signatory's title, signature, and date, and is structured to ensure transparency and security in government procurement processes by screening potential contractors based on their international ownership and organizational structure.
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Other files
| File | Type | Posted |
|---|---|---|
| DOT-ITN-26-5001-ROW COMPLETE 07-08-2025.pdf | ||
| Q&A #2.pdf | ||
| Q&A #3.pdf | ||
| Q&A #5.pdf | ||
| Q&A #1.pdf | ||
| Q&A #4.pdf |
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Text version
FOREIGN COUNTRY OF CONCERN ATTESTATION
(PUR 1355)
This form must be completed by an officer or representative of an entity submitting a bid, proposal, or reply to, or entering into, renewing, or extending, a contract with a Governmental Entity which would grant the entity access to an individual’s Personal Identifying Information. Capitalized terms used herein have the definitions ascribed in Rule 60A-1.020, F.A.C.
Name of entity 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.
Printed Name:
Title:
Signature: Date:
PUR 1355 (10/23) Page 1 of 1 Rule 60A-1.020, F.A.C.
File details come from the government source that posted it. Updated .