Attachment J, PUR 1355 Foreign Country of Concern Attestation.pdf

This is an attestation form (PUR 1355) required by the State of Florida, Department of Management Services for the Telematic Asset Tracking Services and Related Equipment RFP. The form must be completed by an officer or representative of any entity submitting a bid, proposal, or response to, or entering into, renewing, or extending a contract with a Florida governmental entity that would grant access to an individual's Personal Identifying Information. The attestation certifies that the submitting entity is not owned by the government of 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 requires the signatory to declare under penalties of perjury that the statements are true and must include the printed name, title, signature, and date of an authorized officer or representative.

The attestation is governed by Rule 60A-1.020, F.A.C., and terms used within the form derive their definitions from that administrative rule. This form is a mandatory compliance document for participation in the solicitation and must be submitted with the proposal response via MyFloridaMarketPlace Sourcing Event and the SAP Business Network. Failure to properly complete and submit this attestation may result in proposal disqualification. The procurement officer for this opportunity is Nicole Walker, located in the Florida Department of Management Services, Division of State Purchasing, and can be contacted at Nicole.Walker@dms.fl.gov or 850-488-7804.