Attachment L.pdf
PDF 107 KB Posted
- Attached to
- RES-Males-24 beds-Moderate Risk-SAOS-MHOS- South
- Solicitation number
- RFP-12286
- Issued by
- Broward County, Florida
About this file
The document is a Foreign Country of Concern Attestation form (PUR 1355) issued under Rule 60A-1.020, F.A.C., designed for entities submitting bids, proposals, or entering contracts with governmental entities that would provide access to personal identifying information. The form requires an officer or representative of the entity to attest that their organization is not owned by, organized under the laws of, or principally located in a Foreign Country of Concern, and that no such government has a controlling interest in the entity.
The attestation form is a standardized declaration requiring the signatory to affirm under penalties of perjury that the statements made are true. It includes blank fields for the printed name, title, signature, and date of the attesting individual, and is part of a regulatory process to ensure transparency and security in government contracting by screening out potential foreign-controlled entities from accessing sensitive information.
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Text version
PUR 1355 (10/23) Page 1 of 1 Rule 60A-1.020, F.A.C.
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 .