FORM 8 - PUR1355 Foreign Country of Concern Attestation.docx
DOCX document 33 KB Posted
- Solicitation number
- ITN-12132
- Issued by
- Clay County, Florida
About this file
This document is a Foreign Country of Concern Attestation form (PUR 1355) designed for use in Florida government procurement processes. The form is required to be completed by an entity submitting a bid, proposal, or entering into a contract with a governmental entity where the entity would potentially gain access to personal identifying information. The attestation requires the entity to confirm it is not owned, organized, or controlled by a government from a specified "Foreign Country of Concern" as defined in Rule 60A-1.020, Florida Administrative Code.
The form is a sworn declaration where an authorized representative must verify under penalties of perjury that their organization meets specific geographic and ownership criteria related to foreign government involvement. The document provides space for the representative to print their name, title, provide a signature, and date the attestation, which serves as a legal certification of the entity's compliance with state procurement regulations regarding foreign ownership and control.
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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 .