CONTRACTING_WITH_ENTITIES_OF_FOREIGN_COUNTRIES_OF_CONCERN_PROHIBITED_AFFIDAVIT.pdf

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Attached to
Electrical Services
Solicitation number
26356-RFP-MST
Issued by
Hillsborough County, Florida

About this file

This is a required affidavit form for contract submission with Hillsborough County Public Schools (HCPS) in Florida, mandated by Florida Statutes 287.138. The affidavit must be completed and executed by an authorized representative of any proposer or contractor submitting a bid, proposal, or quote for work with HCPS, and the associated submission will not be accepted without this completed form. The contract opportunity involves providing electrical services to HCPS, including commercial electrical services for high voltage systems, new installations, maintenance, repairs, electrical upgrades, modernizations, rewiring, circuit breaker installations, panel upgrades, troubleshooting, and diagnostics. The contractor must provide all necessary labor, materials, supervision, equipment, and related items to complete work requests, and must have experience servicing large school districts with high voltage systems, switchgear, and coordination with TECO energy services. The electrical services are identified as critical to campus security.

The affidavit requires the proposer to certify that the legal company name does not meet any of the criteria prohibiting contracting with foreign entities of concern, specifically that the company is not owned by, does not have a controlling interest held by, and is not organized under the laws of or principally based in the People's Republic of China, Russian Federation, Islamic Republic of Iran, Democratic People's Republic of Korea, Republic of Cuba, the Venezuelan regime of Nicolas Maduro, or the Syrian Arab Republic. The affidavit is executed under penalties of perjury pursuant to Florida Statutes 95.525.

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CONTRACTING WITH ENTITIES OF FOREIGN COUNTRIES OF CONCERN PROHIBITED AFFIDAVIT

The Contracting with Entities of Foreign Countries of Concern Prohibited Affidavit Form (“Form”) is required by § 287.138, Florida Statutes, which is deemed as being expressly incorporated into this Form. This Affidavit must be completed by a person authorized to make this attestation on behalf of the Proposer/Contractor for the purpose of submitting a bid, proposal, quote, or other response, or otherwise entering into a contract with the HCPS. The associated bid, proposal, quote, or other response will not be accepted unless and until this completed and executed Affidavit is submitted to HCPS.

“Controlling interest” means possession of the power to direct or cause the direction of the management or policies of a company, whether through ownership of securities, by contract, or otherwise. A person or entity that directly or indirectly has the right to vote 25 percent or more of the voting interests of the company or is entitled to 25 percent or more of its profits is presumed to possess a controlling interest.

“Foreign country of concern” means the People’s Republic of China, the Russian Federation, the Islamic Republic of Iran, the Democratic People’s Republic of Korea, the Republic of Cuba, the Venezuelan regime of Nicolás Maduro, or the Syrian Arab Republic, including any agency of or any other entity of significant control of such foreign country of concern.

“Governmental entity” means any state, county, district, authority, or municipal officer, department, division, board, bureau, commission, or other separate unit of government created or established by law including, but not limited to, the Commission on Ethics, the Public Service Commission, the Office of Public Counsel, and any other public or private agency, person, partnership, corporation, or business entity acting on behalf of any public agency.

A governmental entity may not knowingly enter into a contract with an entity which would give access to an individual’s personal identifying information if:

(a) The entity is owned by the government of a foreign country of concern;

(b) The government of a foreign country of concern has a controlling interest in the entity; or

(c) The entity is organized under the laws of or has its principal place of business in a foreign country of concern.

Legal Company Name ( ____________ _____) does not meet any of the criteria set forth in paragraphs 2(a) – (c) of § 287.138, Florida Statutes.

Pursuant to § 95.525, Florida Statutes, under penalties of perjury, I declare that I have read the foregoing statement and that the facts stated in it are true.

Print Name of Proposer/Contractor’s Authorized Representative

Title of Proposer/Contractor's Authorized

Signature of Proposer/Contractor’s Authorized

Date

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