Attachment J - PUR 1355 Foreign Country of Concern Attestation.pdf
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- Attached to
- Contact Center Services RFP
- Solicitation number
- RFP-14821
- Issued by
- Florida
About this file
This is an attestation form (PUR 1355) required by the State of Florida, Department of Management Services, for entities submitting bids, proposals, or replies to state contracts that would grant access to personal identifying information. The form must be completed by an officer or representative of the responding entity and submitted as part of the Contact Center Services RFP. The attestation certifies that the entity is not owned by, organized under the laws of, does not have its principal place of business in, and is not controlled by the government of a Foreign Country of Concern, as defined in Rule 60A-1.020, F.A.C. The declaration is made under penalties of perjury and requires the signatory to provide printed name, title, signature, and date.
This form is a mandatory compliance document for all respondents to the Contact Center Services RFP issued by the State of Florida. Failure to complete and submit the attestation as required may result in bid rejection. The form applies to any contract award under this procurement that would involve access to personal identifying information. The attestation requirement reflects state policy regarding foreign ownership and control restrictions for vendors handling sensitive personal data in state contracts.
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PUR 1355 (10/23) Page 1 of 1 Rule 60A-1.020, F.A.C.
ATTACHMENT J
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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