RFP 10982 _ForeignCountryofConcernAttestation.pdf
PDF 107 KB Posted
- Solicitation number
- RFP-13521
- Issued by
- Okaloosa County, Florida
About this file
This document is a Foreign Country of Concern Attestation form (PUR 1355) related to a governmental procurement process in Florida, specifically referencing Rule 60A-1.020 of the Florida Administrative Code. The form is required to be completed by an officer or representative of an entity submitting a bid, proposal, or reply to a Governmental Entity, or when entering into, renewing, or extending a contract that would grant the entity access to an individual's Personal Identifying Information.
The attestation requires the entity to confirm that it is not owned by the government of a Foreign Country of Concern, not organized under the laws of or having its Principal Place of Business in a Foreign Country of Concern, and that no government of a Foreign Country of Concern has a Controlling Interest in the entity. The form must be signed under penalties of perjury, with the signatory declaring that the statements made are true. Blank spaces are provided for the printed name, title, signature, and date of the authorized representative completing the form.
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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 .