8-Form - Scrutinized.pdf
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- Attached to
- Indian River County West Regional / Glendale Wastewater Treatment Facility Metal Roof Panel Replacement
- Solicitation number
- 2027004
- Issued by
- Indian River County, Florida
About this file
This is a certification form for the Indian River County, Florida metal roof panel replacement project at the West Regional/Glendale Wastewater Treatment Facility. The form must be submitted with all bids or proposals and requires the respondent to certify compliance with Florida's scrutinized companies laws. Bidders must confirm that neither they nor their subsidiaries, parent companies, or affiliates are placed on the Scrutinized Companies that Boycott Israel List or engaged in a boycott of Israel. For contracts valued at one million dollars or more, respondents must additionally certify that they are not on the Scrutinized Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List, and are not engaged in business operations in Cuba or Syria.
The certification must be signed by an authorized representative of the respondent entity and submitted with the bid package. Indian River County reserves the right to immediately terminate any resulting contract upon written notice if the respondent or any related entity is found to have submitted a false certification or subsequently placed on any of the specified scrutinized companies lists, engaged in a boycott of Israel, or found conducting business operations in the prohibited countries. This requirement applies to all contractors and subcontractors involved in the project.
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Text version
CERTIFICATION REGARDING PROHIBITION AGAINST
CONTRACTING WITH SCRUTINIZED COMPANIES
(This form MUST be submitted with your bid/proposal/SOQ)
I hereby certify that neither the undersigned entity, nor any of its wholly owned subsidiaries, majority-owned subsidiaries, parent companies, or affiliates of such entities or business associations, that exists for the purpose of making profit have been placed on the Scrutinized Companies that Boycott Israel List created pursuant to s. 215.4725 of the Florida Statutes, or are engaged in a boycott of Israel.
In addition, if this solicitation is for a contract for goods or services of one million dollars or more, I hereby certify that neither the undersigned entity, nor any of its wholly owned subsidiaries, majority-owned subsidiaries, parent companies, or affiliates of such entities or business associations, that exists for the purpose of making profit are on the Scrutinized Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List, created pursuant to s. 215.473 of the Florida Statutes, or are engaged in business operations in Cuba or Syria as defined in said statute.
I understand and agree that the County may immediately terminate any contract resulting from this solicitation upon written notice if the undersigned entity (or any of those related entities of respondent as defined above by Florida law) are found to have submitted a false certification or any of the following occur with respect to the company or a related entity: (i) it has been placed on the Scrutinized Companies that Boycott Israel List, or is engaged in a boycott of Israel, or (ii) for any contract for goods or services of one million dollars or more, it has been placed on the Scrutinized Companies with Activities in Sudan List or the Scrutinized Companies with Activities in the Iran Petroleum Energy Sector List, or it is found to have been engaged in business operations in Cuba or Syria.
Name of Respondent: ___________________________________
By: ________________________________________________ (Authorized Signature)
Name:
Title: ______________________________________________
Date:_____________________________
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