Attachment L_PUR_1355.pdf
PDF 106 KB Posted
- Attached to
- PROB – RFP 10872 - Comprehensive Evaluations and Specialized Add-On Evaluations - - Statewide
- Solicitation number
- RFP-10161
- Issued by
- Leon County, Florida
About this file
This 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 governmental contracts that would grant access to personal identifying information. The form is specifically associated with RFP 10872 for Comprehensive Evaluations and Specialized Add-On Evaluations issued by the Florida Department of Juvenile Justice's Office of Probation and Community Intervention.
The form requires an officer or representative of the bidding entity to attest under penalty of perjury that their organization is not owned by, organized under the laws of, or principally located in a Foreign Country of Concern. Additionally, they must certify that no Foreign Country of Concern has a controlling interest in their entity. The form includes fields for the representative's printed name, title, signature, and date, and references Rule 60A-1.020, F.A.C. for definitions of capitalized terms.
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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 .