FORM 8 - PUR1355 Foreign Country of Concern Attestation.docx
DOCX document 33 KB Posted
- Solicitation number
- ITN-12052
- Issued by
- Bay County, Florida
About this file
This document is a standard Form 8 (PUR1355) 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 authorized officer or representative of an entity submitting a bid, proposal, or entering into a contract to affirm that their organization is not owned, controlled, or principally located in a Foreign Country of Concern, particularly when the contract would provide access to personal identifying information.
The attestation serves as a legal declaration under penalties of perjury, requiring the entity's representative to complete and sign the document, confirming their organization's independence from foreign government control or significant influence. The form includes fields for the printed name, title, signature, and date of the authorized representative, and is designed to ensure transparency and security in government contracting processes by screening out potential entities with substantial foreign government connections.
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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 .