Form 5 - PUR1355 Foreign Countries.pdf

Form 5 is a Foreign Country of Concern Attestation form (PUR 1355) required by a governmental entity for contract submissions involving access to personal identifying information. The form mandates that an officer or representative of an entity certify that their organization is not owned by, organized under the laws of, or principally located in a Foreign Country of Concern, and that no such government has a controlling interest in the entity. By signing the document, the representative declares under penalties of perjury that the statements made are true.

The form is a standard compliance document designed to protect government interests by ensuring that entities entering into contracts do not have significant foreign government ties that could potentially compromise data security or present national security risks. While the form itself does not contain specific contract details, it is part of the procurement process for the Florida Division of Emergency Management's Elevate Florida residential mitigation grant program, which requires vendors to complete this attestation as part of their proposal submission.