Affidavit_Regarding_Foreign_Countries_of_Concern.pdf
PDF 99 KB Posted
- Attached to
- School Operational Supplies - Stock
- Solicitation number
- 047-RW-0626
- Issued by
- Polk County, Florida
About this file
This is an Affidavit Regarding Foreign Countries of Concern submitted in connection with The School Board of Polk County's procurement of school operational supplies for a one-year contract. The affidavit serves as a compliance document requiring bidders to certify their status regarding business relationships and operations in countries identified as foreign countries of concern by the State of Florida. The document establishes the legal framework under which bidders must attest to their adherence to Florida's restrictions on contracting with entities that have prohibited business dealings in designated foreign jurisdictions. This certification is a mandatory prerequisite for bid submission and contract award consideration in this school operational supplies procurement.
The affidavit requires bidders to disclose whether they, their affiliates, subsidiaries, or agents conduct business in foreign countries of concern as defined by Florida law. Bidders must certify under penalty of perjury that they are either in compliance with Florida's foreign countries of concern restrictions or provide detailed explanations of any non-compliance situations. This requirement reflects Florida's policy to ensure state and local government contracts, including those for school operational supplies, do not support business operations in countries deemed contrary to the state's interests. The affidavit is a standard compliance document integrated into the bidding process for school procurement contracts in Florida and must be completed and submitted with all bid proposals.
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Text version
Affidavit Regarding Foreign Countries of Concern
State of Florida County of __________________
Name of Vendor: _____________________________________________________________________
Address: ____________________________________________________________________________
Phone Number: ______________________________________________________________________
Authorized Representative’s Name: _____________________________________________________
Authorized Representative’s Title: _______________________________________________________
Effective January 1, 2024, Section 287.138, Florida Statutes, prohibits a Florida governmental entity from entering into a contract that may grant or allow access to any individual’s personal identifying information unless the contracting entity furnishes an affidavit signed by an officer or representative under penalty of perjury concerning foreign countries of concern.
As the person authorized to sign on behalf of the vendor, I certify that:
• The vendor is not owned by the People’s Republic of China, the Russian Federation, the Islamic Republic of Iran, the Democratic People’s Republic of Korea, the Republic of Cuba, the Venezuelan regime of Nicolás Maduro, or the Syrian Arab Republic, or by any agency of or any other entity of significant control of any of such foreign country of concern.
• The government of the People’s Republic of China, the Russian Federation, the Islamic Republic of Iran, the Democratic People’s Republic of Korea, the Republic of Cuba, the Venezuelan regime of Nicolás Maduro, or the Syrian Arab Republic does not have a controlling interest in the vendor.
• The vendor is not organized under the laws of and does not have its principal place of business in the People’s Republic of China, the Russian Federation, the Islamic Republic of Iran, the Democratic People’s Republic of Korea, the Republic of Cuba, the Venezuelan regime of Nicolás Maduro, or the Syrian Arab Republic.
Under penalty of perjury, I declare that I have read the foregoing document and that the facts stated in it are true.
Signature of Authorized Representative: _______________________________________________
The foregoing instrument was acknowledged before me this _____ day of _____, 20____, by _________________________, as Authorized Representative of the above-named Vendor who is (___) personally known to me or (____) produced a _______ driver’s license as identification.
Notary Public, State of _____________________ Commission no.: __________________________ My commission expires:____________________
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