RFP_10875_Att L PUR_1355.pdf

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Attached to
PROB-Juvenile Sexual Offender Evaluation and Treatment Services-Statewide
Solicitation number
RFP-10225
Issued by
Leon County, Florida

About this file

This document is a Foreign Country of Concern Attestation (PUR 1355) form that must be completed by 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. The entity must attest 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 the government of a Foreign Country of Concern does not have a Controlling Interest in the entity.

The related state and local contract opportunity is for Juvenile Sexual Offender Evaluation and Treatment Services to be provided statewide in Florida on behalf of the Department of Juvenile Justice (DJJ) and the Office of Probation and Community Intervention. The services sought include psychosexual evaluations and individual, family, and group juvenile sexual offender counseling/therapy for youth who have been charged with a sexual offense or have a history of sexually inappropriate behavior and are assigned to probation or Department residential facilities. The services are to be available in circuits throughout the state of Florida as identified in any resulting Rate Agreement.

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Text version

PUR 1355 (10/23) Page 1 of 1 Rule 60A-1.020, F.A.C.

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:

https://www.flrules.org/gateway/RuleNo.asp?title=GENERAL%20REGULATIONS&ID=60A-1.020

File details come from the government source that posted it. Updated .