Form_7.14_-_Affidavit_of_Compliance_with_F.S._287.138.pdf
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- Solicitation number
- ITB-26-18-CW
- Issued by
- Volusia County, Florida
About this file
This is an Affidavit of Compliance with Section 287.138, Florida Statutes, required by the City of Port Orange for a Mitigation Reconstruction of a Flood Prone Home Project involving the installation of a new elevated manufactured home. The affidavit serves as a certification document that must be completed and submitted with all bids for the project. The form requires the contractor or authorized representative to attest under penalty of perjury that the entity is not owned by, controlled by, or organized under the laws of any foreign country of concern, including 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 notarized and include the affiant's signature, title, and business name, along with the notary public's acknowledgment, commission number, and expiration date. All bidders are required to complete this document in its entirety and return it with their submittal to demonstrate compliance with Florida law regarding foreign entity restrictions on public contracts. The form contains specific fields for date completion, entity identification, and official notarization to ensure authenticity and legal validity of the compliance certification.
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Text version
FORM 7.14 – AFFIDAVIT OF COMPLIANCE WITH SECTION 287.138, FLORIDA STATUTES
AFFIDAVIT OF COMPLIANCE WITH SECTION 287.138, FLORIDA STATUTES CONTRACTING WITH
FOREIGN ENTITIES OF CONCERN
The undersigned (“Affiant”), on behalf of the entity listed below (“Entity”), hereby attests under penalty of perjury as follows:
1. Affiant is the ________________________________ of _____________________________________________________________________ (Title) (Business Name) which does business in the State of Florida, hereinafter called the “Entity”.
2. Entity is not owned by the government of a foreign country of concern, as defined in Section 287.138 (1)
(c), Florida Statutes.
3. The government of a foreign country of concern does not have a controlling interest in Entity, as defined in Section 287.138 (1)(a), Florida Statutes.
4. Entity is not organized under the laws of, and does not have a principal place of business in, a foreign country of concern.
5. Entity is not owned or controlled by the government of a foreign country of concern.
6. For purposes of this affidavit, a 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 Nicolas Maduro, or the Syrian Arab Republic, including any agency of or any other entity of significant control of such foreign country of concern, as defined in Section 287.138(1)(c), Florida Statutes.
The undersigned is authorized to execute this affidavit on behalf of the Entity.
Date: ______________________, 20____ Signed: ____________________________________________________
Entity: ______________________________________________ Name: _____________________________________________
Title: _______________________________________________________________________
STATE OF: ___________________________ COUNTY OF: ___________________________
The foregoing instrument was acknowledged before me by means of ☐physical presence or ☐online notarization, this _________ day of _______________________, 2026, by____________________________________________________________ and who:
☐Is personally known to me; or ☐ has produced ________________________________________ as identification.
Notary Public, State of Florida at Large: (seal) Printed Name/Seal of Notary, Commission and Expiration Date:
My commission expires: _________________________________________
This document must be completed and returned with your Submittal
File details come from the government source that posted it. Updated .