Attachment I, PUR 1355 Foreign Country of Concern Attestation.pdf
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- Attached to
- Management Consulting Services RFP V2 State and local contract opportunity
- Solicitation number
- RFP-12253
- Issued by
- Orange County, Orlando City, Florida
About this file
This document is a Foreign Country of Concern Attestation form (PUR 1355) for the Florida Department of Management Services, designed to be completed by an entity submitting a bid, proposal, or contract for a governmental opportunity that would grant access to Personal Identifying Information. The form requires an authorized representative to declare 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 must be signed under penalties of perjury, with the signatory providing their printed name, title, and the date of execution. This form is part of the mandatory documentation for the Management Consulting Services RFP (No. 25-80101500-RFP-V2), which aims to establish a new State Term Contract for consulting services across nine service categories. The form helps ensure that potential contractors do not have significant ties to countries deemed to be of concern, thereby protecting the state's interests and sensitive information.
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Text version
ATTACHMENT I
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.
______________(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: ___________________ https://www.flrules.org/gateway/RuleNo.asp?title=GENERAL%20REGULATIONS&ID=60A-1.020
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