Form 3 - PUR1355 Foreign Countries of Concern.pdf

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Attached to
American Sign Language Interpretation
Solicitation number
ITB-12692
Issued by
Leon County, Florida

About this file

This document is Form 3 PUR 1355, a Foreign Country of Concern Attestation form for the Florida Division of Emergency Management's Invitation to Bid (ITB-DEM-24-25-019) for American Sign Language (ASL) Interpretation Services. The form requires an officer or representative of a bidding entity to certify that their organization is not owned by, organized under the laws of, or controlled by the government of a Foreign Country of Concern when seeking a contract that would provide access to personal identifying information.

The attestation form is a mandatory component of the bid submission process for the statewide ASL interpretation services contract. By signing the document, the bidder affirms under penalties of perjury that they meet the specified criteria regarding foreign ownership and control, which is a prerequisite for participating in this state procurement opportunity. The form must be completed and submitted along with other required documentation as part of the bid package for the ASL interpretation services solicitation.

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ITB-DEM-24-25-019

Form 3 PUR 1355 Foreign Country of Concern Attestation

ITB-DEM-24-25-019 American Sign Language Interpretation Services

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.

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:

https://www.flrules.org/gateway/RuleNo.asp?title=GENERAL%20REGULATIONS&ID=60A-1.020

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