F._Use_of_Companies_owned_or_Controlled_by_a__Foreign_Country_of_Concern_Affidavit_for_Nongovernmental_Entities.pdf
PDF 1 MB Posted
- Attached to
- HVAC Filter Replacement Service Bid
- Solicitation number
- 26-0130
- Issued by
- Sarasota County, Florida
About this file
This is an affidavit form required by the School Board of Sarasota County, Florida, for the HVAC Filter Replacement Service Bid #26-0130. The affidavit is mandated under Section 287.138 of the Florida Statutes and must be completed and signed by all nongovernmental entities (vendors) responding to this one-year contract opportunity. The contract covers ongoing replacement of HVAC filters and frames for all facilities owned and operated by the School Board of Sarasota County, including all required service and materials. The School Board is pursuing a green initiative and has established minimum filter specifications for disposable or recycled filter materials.
The affidavit requires the authorized representative of the responding vendor to certify under penalty of perjury that the company is not owned or controlled by a foreign country of concern, specifically 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 Nicolas Maduro, or the Syrian Arab Republic. The vendor must also confirm that the government of a foreign country of concern does not hold a controlling interest in the company and that the company is not organized under the laws of or principally based in any such foreign country. The completed affidavit must be signed by an officer or authorized representative of the nongovernmental entity and submitted as Attachment F to the bid proposal.
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Text version
#30889369v1
State of Florida Affidavit Regarding the Use of Companies Owned or Controlled by a Foreign Country of Concern
Respondent Vendor Name:
Vendor FEIN:
Vendor's Authorized Representative Name and Title: ___________________________________
Address: ______________________________________________________________________
City: ____________________________ State: ______________ ZIP: _____________________
Phone Number: _____________________________________________
Email Address:
Section 287.138, Florida Statutes prohibits governmental entities from entering into contracts with companies owned or controlled by a foreign country of concern, meaning 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. It requires all nongovernmental entities executing, renewing, or extending a contract with a governmental entity to provide an affidavit signed by an officer or representative of the nongovernmental entity under penalty of perjury that the nongovernmental entity is not owned or controlled by a foreign country of concern. The School Board of Sarasota County is a governmental entity for purposes of this statute.
As the person authorized to sign on behalf of Respondent, I certify that the company identified:
• Is not owned by the government of a foreign country of concern.
• The government of a foreign country of concern does not have controlling interest in the company.
• The company is not organized under the laws of or has its principal place of business in a foreign country of concern.
Under penalties of perjury, I declare that I have read the foregoing document and that the facts stated in it are true.
By: __________________________________________________________________________
AUTHORIZED SIGNATURE
Print Name and Title: ____________________________________ Date: ___________________
THE SCHOOL BOARD OF SARASOTA COUNTY, FLORIDA
HVAC FILTER REPLACEMENT SERVICE – BID #26-0130
ATTACHMENT F
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