Form 3 - Foreign Countries of Concern.docx
DOCX document 31 KB Posted
- Attached to
- Emergency Fuels State and local contract opportunity
- Solicitation number
- RFP-12351
- Issued by
- Leon County, Florida
About this file
The document is Form 3 - Foreign Countries of Concern, an attestation form from the Florida Division of Emergency Management (FDEM) for vendors participating in the Emergency Fueling Contracts solicitation (RFP-DEM-24-25-018). The form requires bidders to certify that their organization is not owned, organized, or controlled by a foreign government of concern. The related solicitation seeks qualified vendors to provide comprehensive emergency fueling resources for Leon County and statewide emergency response capabilities, with vendors required to mobilize a minimum of 20 vehicles within 24 hours and 100 vehicles within 7 days. The contract will support multiple fuel types, including gasoline, diesel, aviation, marine, and propane. Key dates include a question submission deadline of April 24, 2025, proposal due date of May 13, 2025, a public opening on May 14, 2025, and an anticipated Notice of Intent to Award by June 24, 2025.
The solicitation includes multiple compliance requirements, with vendors needing to provide a $5 million performance bond and maintain extensive insurance coverage. The evaluation process allocates 150 points to technical proposals, 80 points for vendor resources, and 70 points for price proposals. The contract will have an initial three-year term with the possibility of three additional one-year renewals, and no guaranteed minimum purchase quantity is specified. Vendors must be prepared to support the State Emergency Response Team (SERT) during various emergency activations, with contract usage dependent on agency needs. While no specific set-aside designations are explicitly mentioned, the Form 6 Subcontractors document suggests potential preferences for Certified Minority Business Enterprises. Contractors will be required to complete multiple compliance forms, including attestations regarding labor practices, foreign country connections, and subcontractor relationships.
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Text version
FORM 3
FOREIGN COUNTRY OF CONCERN ATTESTATION
(PUR 1355)
This form must be completed by an officer or representative of an entity submitting a bid, proposal, or reply to, or entering into, renewing, or extending, a contract with a Governmental Entity which would grant the entity access to an individual’s Personal Identifying Information. Capitalized terms used herein have the definitions ascribed in Rule 60A-1.020, F.A.C.
Name of entity is not owned by the government of a Foreign Country of Concern, is not organized under the laws of nor has its Principal Place of Business in a Foreign Country of Concern, and the government of a Foreign Country of Concern does not have a Controlling Interest in the entity.
Under penalties of perjury, I declare that I have read the foregoing statement and that the facts stated in it are true.
Printed Name:
Title:
Signature: Date:
PUR 1355 (10/23) Page 1 of 1 Rule 60A-1.020, F.A.C.
File details come from the government source that posted it. Updated .