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

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

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This is an attestation form (Attachment K, PUR 1355) required by the Florida Department of Management Services for entities submitting bids, proposals, or replies for a Mail Services contract opportunity. The form requires bidding entities to certify that they are not owned by, organized under the laws of, or principally located in a Foreign Country of Concern, and that no Foreign Country of Concern has a controlling interest in their entity.

The form must be completed by an officer or representative of the bidding entity and includes fields for the entity name, printed name of the signatory, title, signature, and date. The document is governed by Rule 60A-1.020, F.A.C. and requires the signatory to declare under penalty of perjury that the statements made are true.

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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 .