ITN_10848_Attachment L.docx
DOCX document 31 KB Posted
- Attached to
- CINS/FINS & Statewide Respite Care Services
- Solicitation number
- ITN-09961
- Issued by
- Leon County, Florida
About this file
This document is a Foreign Country of Concern Attestation form (PUR 1355) required for a solicitation (ITN #10848) issued by the Florida Department of Juvenile Justice (DJJ) to select a lead agency to provide statewide Children in Need of Services/Families in Need of Services (CINS/FINS), Statewide Respite Care Services, and evidence-based or promising practices delinquency programming. The selected lead agency will be responsible for designing, implementing, and managing a network of local service providers to deliver these residential and non-residential services to youth ages 6-18 across Florida's 20 judicial circuits. The solicitation seeks proposals from community, faith-based, and not-for-profit organizations, LLCs, and/or local government divisions.
The attestation form requires the entity submitting a bid, proposal, or reply to confirm that it is not owned by, organized under the laws of, or have its principal place of business in a Foreign Country of Concern, and that a Foreign Country of Concern does not have a controlling interest in the entity. Pricing, set-asides, incumbents, and funding details are not provided in this document, which focuses on the administrative requirements for responding to the solicitation.
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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 .