Attachment K, Form PUR 1355 Foreign Country of Concern Attestation Form.pdf

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Attached to
Firearms and Related Accessories ITB
Solicitation number
ITB-13527
Issued by
Florida

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This document is a Foreign Country of Concern Attestation form (PUR 1355) related to a governmental entity's procurement process, specifically designed to verify an entity's ownership and business connections. The form requires an officer or representative of an entity submitting a bid, proposal, or entering a contract with a governmental entity to attest that their organization is not owned by, organized under the laws of, or having a principal place of business in a "Foreign Country of Concern," and that such a foreign government does not have a controlling interest in the entity.

The attestation is linked to Rule 60A-1.020, F.A.C. and is particularly focused on contracts that would grant access to an individual's Personal Identifying Information. By signing the document, the representative declares under penalties of perjury that the statements made are true, and must provide their printed name, title, signature, and date of execution. The form serves as a protective measure to ensure that sensitive government contracts are not awarded to entities with potentially compromising international connections.

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

Attachment K

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

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