F._Use_of_Companies_owned_or_Controlled_by_a__Foreign_Country_of_Concern_Affidavit_for_Nongovernmental_Entities.pdf
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- Solicitation number
- 26-0119
- Issued by
- Sarasota County, Florida
About this file
This is an affidavit document required by the School Board of Sarasota County, Florida for vendors responding to Bid #26-0119 for Tank Pumping and Hydro-Jetting Service. The affidavit mandates that all nongovernmental entities executing, renewing, or extending contracts with the School Board must certify under penalty of perjury that they are not owned or controlled by specified foreign countries of concern. The contract pertains to the provision of comprehensive tank pumping and hydro-jetting services for all School Board facilities, including labor, supervision, fuel, travel, disposal fees, equipment, materials, and transportation necessary to pump grease traps, septic tanks, and transfer stations. Regular service visits for grease traps are scheduled twice annually on a predetermined basis as agreed upon between the School Board's authorized representative and the selected contractor.
The affidavit requires the vendor's authorized representative to certify that the company is not owned by the government of a foreign country of concern, that no such government holds controlling interest in the company, and that the company is not organized under the laws of or based in a foreign country of concern. The prohibited foreign countries of concern are identified as 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, and the Syrian Arab Republic. The affidavit must be signed by an authorized company officer or representative and notarized before submission to the School Board of Sarasota County as Attachment F of the bid package.
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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: ___________________
STATE OF ________________
COUNTY OF ______________
The foregoing instrument was acknowledged before me by means of ☐ physical presence or ☐ online notarization this ______ day of ______________, 202_, by ____________________________________, who is personally known ___ or produced ___________________________ as Identification.
Notary Public Print Name:
My Commission Expires: ___________
THE SCHOOL BOARD OF SARASOTA COUNTY, FLORIDA
TANK PUMPING & HYDRO-JETTING SERVICE - BID #26-0119
ATTACHMENT F
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