RFP_10956_Attachment_L.pdf

The document is a Foreign Country of Concern Attestation form (PUR 1355) issued under Rule 60A-1.020, F.A.C., requiring completion by an officer or representative of an entity submitting a bid, proposal, or contract with a Governmental Entity that would grant access to Personal Identifying Information. The form requires the entity to attest that it is not owned by the government of a Foreign Country of Concern, not organized under the laws of a Foreign Country of Concern, does not have 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.

The attestation must be signed under penalties of perjury, with the signatory declaring that they have read the statement and that the facts stated are true. The form provides spaces for the printed name, title, signature, and date of the authorized representative making the declaration. This document appears to be a standard compliance form designed to ensure that entities doing business with governmental bodies do not have significant foreign government connections that could potentially compromise sensitive information or pose national security risks.