Attachment M, PUR 1355 Foreign Country of Concern Attestation.pdf

This is an attestation form (PUR 1355) required by the Florida Department of Management Services for vendors bidding on the Medium and Heavy Trucks Invitation to Bid (ITB). The form must be completed by an officer or representative of any entity submitting a bid, proposal, or reply to, or entering into, renewing, or extending a contract with a Florida governmental entity that would grant access to an individual's Personal Identifying Information. The Department of Management Services intends to establish a State Term Contract for Medium and Heavy Trucks with potential multiple statewide awards, though it reserves the right to award to one or multiple bidders statewide or by region, or to make no award based on the State's best interest. Vendors must submit responses through MyFloridaMarketPlace Sourcing Event via the SAP Business Network and monitor the Vendor Information Portal (VIP) throughout the procurement process. The procurement officer is Alyssa Wallace, Purchasing Analyst, who can be contacted at (850) 410-2426 or Alyssa.Wallace@dms.fl.gov.

The attestation form requires the bidding entity to declare under penalties of perjury that it is not owned by the government of a Foreign Country of Concern, is not organized under the laws of or does not have its Principal Place of Business in a Foreign Country of Concern, and that the government of a Foreign Country of Concern does not have a Controlling Interest in the entity. The form must be signed by an officer or representative of the bidding entity and includes fields for printed name, title, signature, and date. This requirement applies to all vendors seeking to access Personal Identifying Information through their contract with the State, and is governed by Rule 60A-1.020, Florida Administrative Code.