Form 8 PUR_1355_Attestation.docx
DOCX document 31 KB Posted
- Attached to
- District Five Vehicle Detection System-Lake County State and local contract opportunity
- Solicitation number
- ITB-12280
- Issued by
- Lake County, Florida
About this file
This document is a Form 8 PUR_1355 Foreign Country of Concern Attestation form used by governmental entities in Florida, specifically governed by Rule 60A-1.020, F.A.C. The form requires an officer or representative of an entity submitting a bid, proposal, or entering into a contract to attest that their organization is not owned, organized, or controlled by a government of a Foreign Country of Concern, and does not have its principal place of business in such a country.
The attestation form is a legal declaration designed to protect sensitive information and ensure that entities doing business with governmental organizations do not have significant foreign governmental ties that could compromise security or data privacy. By signing the document under penalties of perjury, the representative affirms the truthfulness of their statements regarding the entity's ownership, organizational structure, and controlling interests. The form is specifically focused on protecting access to Personal Identifying Information and must be completed as part of the contract submission, renewal, or extension process.
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Other files for this state and local contract opportunity
| File | Type | Posted |
|---|---|---|
| DOT-ITB-25-5013-IDE2 Complete.pdf |
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Text version
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 .