Foreign_Countries_of_Concern_Affidavit_12.11.2025.pdf
PDF 128 KB Posted
- Attached to
- Groundskeeping - Mowing, Landscape & Irrigation Services State and local contract opportunity
- Solicitation number
- 26-0255-RFP
- Issued by
- Pinellas County, Florida
About this file
This is a Foreign Country of Concern Affidavit required by Pinellas County, Florida for contractors bidding on or entering into contracts that would grant access to an individual's Personal Identifying Information. The affidavit requires contractors to certify that they are not owned by, do not have a controlling interest held by, and are not organized under the laws of or principally located in specified foreign countries of concern, which include 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 document must be completed and signed by an authorized representative of the contractor, notarized, and submitted as part of the bid or proposal process. A "Controlling Interest" is defined as direct or indirect possession of the power to direct management or policies through ownership of securities or contract, with a presumption of controlling interest at 25 percent or more of voting interests or profits.
The affidavit serves as a compliance certification mechanism for the Groundskeeping, Mowing, Landscaping, and Irrigation Services solicitation issued by Pinellas County for comprehensive countywide maintenance across 37 facilities in five geographic zones. The contractor must provide notarized certification under penalties of perjury, with the notary public completing their portion of the document including seal, commission expiration date, and method of acknowledgment. This affidavit is one of multiple required compliance certifications, alongside attestations regarding common carrier status and human trafficking, that bidders must submit to demonstrate eligibility and compliance with Florida Statutes Section 287.138 prior to contract award and execution.
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Text version
Foreign Country of Concern Affidavit
I hereby certify that ____________________________________( the “Contractor”) is not an entity owned by the government of a Foreign Country of Concern; the government of a Foreign Country of Concern does not have a Controlling Interest in the entity; nor is the entity organized under the laws of or has its principal place of business in a Foreign Country of Concern, and is otherwise in full compliance with Section §287.138, Florida Statutes.
This Affidavit must be completed by an authorized representative of the Contractor submitting a bid, proposal, reply to, or entering into, renewing, or extending, a contract with the County, which would grant the entity access to an individual’s Personal Identifying Information.
For purposes of this Affidavit:
“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.
“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.
Under penalties of perjury, I declare that I have read the foregoing affidavit and that the facts stated in it are true.
Signature: ______________________________
Print Name: ______________________________
Date: ______________________________
Federal Work Authorization User Identification No.: _____________________________
Name of Pinellas County Contract and Contract No.: ____________________________
STATE OF FLORIDA COUNTY OF ________________
The foregoing instrument was acknowledged before me by means of 1) physical presence __ or 2) online notarization___, this __________________________ (date) by ____________________________ of _____________________________________, a __________________________________ corporation, on behalf of the corporation.
He/she is personally known to me or has produced __________________________________ as identification.
[Notary Seal]
Notary Public: _________________________________________
Name typed, printed, or stamped: _________________________________________
My Commission Expires: _________________________________________
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