RFP_10925_Attachment_L.pdf
PDF 109 KB Posted
- Solicitation number
- RFP-13398
- Issued by
- Leon County, Florida
About this file
This document is a Foreign Country of Concern Attestation form (PUR 1355) issued under Rule 60A-1.020, F.A.C., intended for entities submitting bids, proposals, or entering contracts with a Governmental Entity where the entity would gain access to Personal Identifying Information. The form requires an officer or representative of the entity to certify that the organization is not owned by, organized under the laws of, or principally located in a Foreign Country of Concern, and that no such government has a controlling interest in the entity.
The attestation must be signed under penalties of perjury, with the signer declaring the truthfulness of the statements. Specific details such as the entity's name, the signer's printed name, title, signature, and date are to be filled in on the form. The document is designed to ensure transparency and protect sensitive information by requiring entities to disclose their ownership and organizational structure in relation to countries of concern.
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Other files
| File | Type | Posted |
|---|---|---|
| RFP_10925_Attachment_Q.pdf | ||
| RFP_10925_Attachment N.pdf | ||
| RFP_10925 Addendum 2.pdf | ||
| RFP_10925_AttachmentS.pdf | ||
| RFP_10925_Notice_of_Agency_Decision.pdf | ||
| RFP_10925_Informational_Notice 3.pdf | ||
| RFP_10925_Addendum_1.pdf | ||
| RFP_10925.pdf | ||
| RFP_10925_Informational_Notice_1.pdf | ||
| RFP_10925_Informational_Notice_2.pdf | ||
| RFP_10925_Attachment_L.pdf | ||
| 10925_Attachment_I_Treatment Modality.docx | DOCX document | |
| 10925_AttachmentJ_Price Sheet.docx | DOCX document |
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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 .