Appendix_B_Foreign_Country_of_Concern_Attestation.pdf

PDF 678 KB Posted

Attached to
Advanced Traffic Management System Design Continuing Services State and local contract opportunity
Solicitation number
26-18SS
Issued by
Sarasota County, Siesta Key CDP, Florida

About this file

This is a Foreign Country of Concern Attestation form (PUR 1355) required by the City of Sarasota, Florida for the Advanced Traffic Management System Design Continuing Services procurement. The attestation must be completed by an officer or representative of any entity submitting a bid or proposal for a contract that would grant access to personal identifying information. The form requires the signing official to declare under penalties of perjury that the entity is not owned by a Foreign Country of Concern, is not organized under the laws of a Foreign Country of Concern, does not have its Principal Place of Business in a Foreign Country of Concern, and that the government of a Foreign Country of Concern does not have a Controlling Interest in the entity. The form includes fields for the entity name, printed name of the signatory, title, signature, and date of execution, and references Rule 60A-1.020, F.A.C. for applicable definitions of capitalized terms.

This attestation is a mandatory compliance document tied to the City of Sarasota's CCNA procurement for regional ATMS engineering services. All proposers seeking to be included in the qualified engineer consultant pool must complete and submit this form as part of their proposal package. The requirement applies uniformly to all bidders regardless of company size or background and serves as a federal compliance measure given the project's FEMA funding source. Failure to complete this attestation or providing false information constitutes grounds for proposal rejection or contract termination and potential legal consequences under perjury statutes.

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Text version

PUR 1355 (10/23) Page 1 of 1 Rule 60A-1.020, F.A.C.

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.

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:

APPENDIX B

https://www.flrules.org/gateway/RuleNo.asp?title=GENERAL%20REGULATIONS&ID=60A-1.020

Name of Entity:
Print Name:
Title:
Date:
Signature5_es_:signer:signature:

File details come from the government source that posted it. Updated .