Exhibit G - PII Certification - Organization.pdf
PDF 83 KB Posted
- Attached to
- ACP Client Data Removal Services
- Solicitation number
- RFP AADA 2027000046 1
- Issued by
- Denver County, Denver City, Colorado
About this file
This document is a Personal Identifying Information (PII) Certification form issued by the State of Colorado pursuant to C.R.S. 24-74-105, required for third-party entities and organizations seeking access to PII through a database or automated network in connection with the ACP Client Data Removal Services contract opportunity. The certification requires the signing authorized representative to affirm under penalty of perjury that the Organization has not and will not use or disclose any Personal Identifying Information, as defined by C.R.S. 24-74-102(1), for the purpose of investigating, participating in, cooperating with, or assisting Federal Immigration Enforcement, including the enforcement of civil immigration laws and the Illegal Immigration and Immigrant Responsibility Act (8 U.S.C. § 1325 and 1326), unless compelled by Federal or State law, court-issued subpoena, warrant, or order.
The certification form requires the authorized signatory to provide their printed name, title, date, and signature, and includes a representation that the individual executing the certification possesses full legal authority to bind the Organization. This PII certification is a compliance requirement for any entity bidding on or performing work related to the ACP Client Data Removal Services contract and serves as documentation of the Organization's commitment to protecting personally identifying information and complying with Colorado state law regarding immigration enforcement restrictions.
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Text version
Exhibit G 1
Exhibit G - PII Certification
State of Colorado
Third Party Entity / Organization Certification For Access to PII Through a Database or
Automated Network
Pursuant to § 24-74-105, C.R.S., I, _________________, on behalf of __________________________ (legal name of entity / organization) (the “Organization”), hereby certify under the penalty of perjury that the
Organization has not and will not use or disclose any Personal Identifying Information, as defined by § 24-74-
102(1), C.R.S., for the purpose of investigating for, participating in, cooperating with, or assisting Federal
Immigration Enforcement, including the enforcement of civil immigration laws, and the Illegal Immigration and Immigrant Responsibility Act, which is codified at 8 U.S.C. §§ 1325 and 1326, unless required to do so to comply with Federal or State law, or to comply with a court-issued subpoena, warrant or order.
I hereby represent and certify that I have full legal authority to execute this certification on behalf of the
Organization.
Signature:
Printed Name:
Title:
Date:
File details come from the government source that posted it. Updated .