Foreign_Countries_of_Concern_Affidavit_12.11.2025.pdf

PDF 128 KB Posted

Attached to
Microsoft Entra Identity Services – Advisory, Design, and Implementation Support State and local contract opportunity
Solicitation number
26-0259-RFI
Issued by
Pinellas County, Clewiston City, Florida

About this file

This is a Foreign Country of Concern Affidavit required by Pinellas County, Florida for contractors seeking to enter into contracts that would grant access to personal identifying information. The affidavit applies to this Request for Information (RFI) issued by Pinellas County Business Technology Services regarding Microsoft Entra Identity Services advisory, design, and implementation support. The RFI seeks information from qualified vendors with demonstrated expertise in supporting large, complex, multi-agency identity environments. This RFI is for informational purposes only and does not constitute a solicitation or commitment to purchase services.

The affidavit certifies that the contractor is not owned by or subject to controlling interest from 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 affidavit must be completed and notarized by an authorized representative of any contractor submitting a bid, proposal, or entering into a contract with Pinellas County. Controlling interest is defined as 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. The affidavit includes standard notarization requirements and compliance certification under penalties of perjury.

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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: _________________________________________

Print Name:
Date:
Federal Work Authorization User Identification No:
Name of Pinellas County Contract and Contract No:
Notary Public:
Contractor Name:
County Name:
Notarization Date:
Name:
Type of Identification:
1:
2:
Notary Name:
Expiration Date:
Check Box3: Off
Check Box4: Off

File details come from the government source that posted it. Updated .