FORM 8 - PUR1355 Foreign Country of Concern Attestation.docx
DOCX document 33 KB Posted
- Solicitation number
- ITN-17169
- Issued by
- Palm Beach County, Florida
About this file
This is a Foreign Country of Concern Attestation form (PUR 1355) required by the Florida Department of Corrections for the Operation and Management of the South Bay Correctional Facility. The form must be completed by an officer or representative of any entity submitting a bid, proposal, or reply to, or entering into, renewing, or extending a contract with a Governmental Entity that would grant access to Personal Identifying Information. The attestation requires the submitting entity to declare under penalties of perjury that it is not owned by the government of a Foreign Country of Concern, is not organized under the laws of or has its Principal Place of Business in a Foreign Country of Concern, and that the government of a Foreign Country of Concern does not have a Controlling Interest in the entity.
The form requires the signature, printed name, title, and date from an authorized representative of the bidding entity. The attestation is based on definitions provided in Rule 60A-1.020, F.A.C., and reflects Florida's compliance requirements for contractors seeking access to sensitive information within the state's correctional system.
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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 .