CONTRACTING_WITH_ENTITIES_OF_FOREIGN_COUNTRIES_OF_CONCERN_PROHIBITED_AFFIDAVIT.pdf
PDF 93 KB Posted
- Attached to
- Payment Program Services State and local contract opportunity
- Solicitation number
- 25434-RFP-DST
- Issued by
- Florida
About this file
This is a required affidavit form for contracting with Hillsborough County Public Schools (HCPS) in Florida, mandated by Florida Statute 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 HCPS contracts, specifically in response to an RFP for Payment Program Services seeking financial institutions to provide Procurement Card Services and payment programs. The affidavit is a mandatory submission requirement and must accompany all bid responses; contracts will not be accepted without this completed form.
The affidavit requires the proposer to certify under penalties of perjury that their legal entity does not meet any of three prohibited criteria: (1) being owned by a government of a foreign country of concern, (2) having a foreign country of concern government maintain a controlling interest in the entity, or (3) being organized under the laws of or having its principal place of business in a foreign country of concern. Foreign countries of concern are defined as the People's Republic of China, Russian Federation, Islamic Republic of Iran, Democratic People's Republic of Korea, Republic of Cuba, Venezuelan regime of Nicolas Maduro, or Syrian Arab Republic. "Controlling interest" is defined as possessing the power to direct management or policies through ownership of 25 percent or more of voting interests or entitlement to 25 percent or more of profits. This compliance certification is required for all state and local contract opportunities in Florida.
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| 25434_Notice_of_Short_List_.pdf | ||
| 25434-RFP-DST__Payment_Program_Services_Notice_of_Short_List_.pdf | ||
| 25434-RFP-DST__Payment_Program_Services_Addendum_3_Questions.docx | DOCX document | |
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| 25434-RFP-DST_Payment_Program_Services_Addendum_2.pdf | ||
| 25434-RFP-DST_Payment_Program_Services_Addendum_1_SBEP.pdf | ||
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| 25434-RFP-DST_Payment_Program_Services.pdf | ||
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Text version
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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