Attachment K, PUR 1355 Foreign Country of Concern Attestation.docx

33 KB Posted

Attached to
Mail Services
Solicitation number
RFP-10992
Issued by
Florida

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Attachment K is a Foreign Country of Concern Attestation form (PUR 1355) required by the Florida Department of Management Services for entities submitting bids, proposals, or replies to government contracts that would grant access to personal identifying information. The form requires entities to declare under penalty of perjury that they are not owned by, organized under the laws of, or have their principal place of business in a Foreign Country of Concern, and that such foreign countries do not have a controlling interest in the entity.

The form requires the entity's representative to provide their printed name, title, signature, and date of attestation. This document appears to be a mandatory submission requirement related to a Mail Services contract opportunity, though the specific relationship between the form and the contract is not detailed in the document itself.

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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: ___________________

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

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