7-Scrutinized Companies.pdf
PDF 198 KB Posted
- Attached to
- Automated External Defibrillators (AED)
- Solicitation number
- ITB No. 2026-007
- Issued by
- Palm Beach County, Florida
About this file
This document is a Scrutinized Company Certification form from the Town of Palm Beach Procurement and Contract Management Division located in West Palm Beach, Florida. The form requires vendors or companies to certify their compliance with specific state statutes related to business activities in certain countries, including Israel, Sudan, Iran, Cuba, Venezuela, China, North Korea, and Syria. The certification requires companies to affirm they are not participating in boycotts, have no material business relationships with governments of these countries, and are not engaged in discriminatory or restricted business operations.
The certification includes detailed criteria for companies to attest that they do not have significant business connections with governments or projects involving oil, mineral extraction, military equipment, or other sensitive sectors in the listed countries. The form also includes a section asking whether the company requires access to Town of Palm Beach employees' personal identification information, with a note that the awarded firm will need to provide a notarized affidavit. The document provides space for the vendor/company name, representative's name, title, signature, and date, but these fields are left blank in the provided image.
View the file
Other files
Show all 11
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
Town of Palm Beach
PROCUREMENT AND CONTRACT MANAGEMENT DIVISION
951 Okeechobee Road Suite D West Palm Beach, Florida 33401
Telephone: (561) 838-5406
Scrutinized Company Certification 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:
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, Venezuela, China, North Korea, Iran and Syria.
Please select YES or NO if your company needs access to a Town of Palm Beach employee or other Town representatives’ personal identification information?
*The awarded firm will be require to have a notarize affidavit, which will be provided by the Town.
YES: ---------------- NO: -------------------
VENDOR/COMPANY NAME: ---------------------------------------------
NAME: --------------------------------------------
TITLE: --------------------------------------------
Signature: ---------------------------------------------
DATE: ---------------------------------------------
| YES: |
| NO: |
| VENDORCOMPANY NAME: |
| 1: |
| 2: |
| 3: |
| 4: |
File details come from the government source that posted it. Updated .